Measurement of bone mineral content (BMC) of the lumbar spine, II. Correlation between forearm BMC and lumbar spine BMC

Krølner, B.; Nielsen, Signe Tellerup; Lund, B.; Sørensen, Ole; Uhrenholdt, A

doi:10.3109/00365518009091979

Cited by 34 publications

(11 citation statements)

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“…Although the radial density was moderately correlated with spinal density in both patients and normal subjects, the prediction error was too large (>25% at the 95% confidence interval) to allow even gross quantitative assessment of the spine. Previous studies have reported similar findings (6)(7)(8)(9)22,23). Conceivably, appendicular sites containing more trabecular bone could be expected to give better prediction, but this is not the case.…”

Section: Discussionmentioning

confidence: 55%

Radial and spinal bone mineral density in a patient population

Mazess

Barden

Ettinger

1988

Arthritis & Rheumatism

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Density of the radius (by single-photon absorptiometry) and the spine (by dual-photon absorptiometry) was measured in 281 normal young women and in a large heterogenous group of 1,622 consecutive female patients. Both spinal and radial density were useful measurements when performed on patients with medical indications; spine and radius densities in these patients averaged 1620% below those of age-matched controls. However, patients younger than 60 years of age had deficits of spine density that were twice as large as those in the radius, and twice as many of these patients had spinal osteopenia, compared with those with radial osteopenia. After age 70, loss of density in the radius approximated that in the spine and the prevalence of osteopenia was similar at both sites. The poorer sensitivity of the radius measurement reflected the fact that it did not predict spine density. The standard error of the estimate was 0.12 gm/cm2 in normal subjects and 0.15 gm/cm2 in patients. At any given radial density, the spinal density of patients averaged 0.18 gm/cm2 (15-20 % ) below that in normal subjects. Predictions of spinal density from body weight were as accurate as predictions from radial density. Preferential spinal osteopenia occurring without radial osteopenia precluded radial densitometry as a screening method for individuals with osteoporosis before age 60. However, measurement of the radius was more effective than body weight for defining groups at risk, even though the radius did not reliably predict individual spine density. A radius shaft density <0.55 gm/cm2 occurring with a body weight 6 5 kg was associated with a high prevalence of spinal osteopenia.Osteoporosis, or accentuated loss of bone in the axial skeleton, is a common disorder among the elderly that is manifested by fractures of the spine, proximal femur, and proximal humerus (1). Bone mineral content (BMC) is directly proportional to bone strength in these fracture regions (2,3). Bone loss at fracture sites, measured by dual-photon absorptiometry, is associated closely with increased fracture rates at these sites (43). A 10% decrease in bone mineral density (BMD) increases the risk of fracture 2-3-fold. Therefore, the 30-35% decrease in spine density and 45% decrease in femoral density, usually found in patients with fractures, implies a fracture risk that is 20-50 times greater than that in young normal women, and 10-20 times greater than that of age-matched controls.There is relatively poor diagnostic sensitivity for crush fracture using peripheral densitometry compared with axial densitometry (4,6). Pocock et a1 (7) showed that spinal or femoral osteopenia (>20% loss of BMD) could be detected with a sensitivity of 85% (1 5% undetected) from forearm densitometry only when the false-positive rate was higher than 60% (~4 0 % specificity). Presumably, this was due to the poor correlation between axial and appendicular bone

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Section: Discussionmentioning

confidence: 55%

Radial and spinal bone mineral density in a patient population

Mazess

Barden

Ettinger

1988

Arthritis & Rheumatism

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“…walking, as well as the axial skeleton may. Further, there is data to suggest that the upper limb sites, which are largely cortical bone, do not accurately reflect the skeletal axial sites such as the lumbar spine and femoral neck, which have higher percentages of trabecular bone (35)(36)(37). Hence, those studies where only forearm measurements have been made may not reliably reflect any benefit, or lack thereof, of exercise on the more clinically important axial bone sites of the femoral neck and spine.…”

Section: Discussionmentioning

confidence: 90%

Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density.

Pocock¹,

Eisman²,

Yeates³

et al. 1986

J. Clin. Invest.

251

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The relationship between physical fitness and bone mass in the femoral neck, lumbar spine, and forearm was studied in 84 normal women. Femoral neck and lumbar spine bone mineral density and forearm bone mineral content were estimated by absorptiometry. Fitness was quantitated from predicted maximal oxygen uptake. Femoral neck and lumbar bone mineral density were significantly correlated with fitness as well as age and weight.in the 46 postmenopausal'subjects, fitness was the only significant predictor of femoral neck bone mineral density, and both weight and fitness predicted the lumbar bone mineral density. These data represent the first demonstration of a correlation between physical fitness, and, by implication, habitual physical activity, and bone mass in the femoral neck; they also support the previous reported correlation between lumbar bone mass and physical activity. The data suggest that increased physical fitness may increase bone mass at the sites of clinically important fractures in osteoporosis.

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“…It is perhaps a little surprising that the trabecular component of the forearm BD is only weakly correlated to that of the spine (20,(24)(25)(26). However, studies ofpatients with various metabolic bone diseases have suggested that appendicular trabecular bone is relatively inactive compared with that in the axial skeleton (30)(31)(32)(33). By far the most important metabolic bone disease is postmenopausal osteoporosis in terms of frequency, morbidity, mortality, and cost (27).…”

Section: Discussionmentioning

confidence: 99%

Regional and total skeletal measurements in the early postmenopause.

Stevenson¹,

Banks²,

Spinks³

et al. 1987

J. Clin. Invest.

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In a cross-sectional study of 70 early postmenopausil women, regional bone measurements were compared with total body calcium (TBC*). Spinal and forearm trabecular bone were mainly related to age and time since menopause. In contrast, TBCa and forearm integral (cortical and trabecular) and cortical bone were unrelated to age, although the time since menopause also had some influence. Forearm integral and cortical bone measurements were quite well correlated with TBCa (r = 0.84 and 0.73, respectively, P < 0.001). The correlation between spinal bone measurements and any of the forearm measurements, even purely trabecular bone,' was weak (r < 0.52, P < 0.001). Our results show quite clearly that forearm bone measurements cannot be used to predict bone density in the vertebrae. Loss of ovarian function affects bone in general, and trabecular bone in particular. Bone measurements at specific anatomical sites are clearly necessary for studies of metabolic bone diseases and their response to treatment.

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Measurement of bone mineral content (BMC) of the lumbar spine, II. Correlation between forearm BMC and lumbar spine BMC

Cited by 34 publications

References 0 publications

Radial and spinal bone mineral density in a patient population

Radial and spinal bone mineral density in a patient population

Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density.

Regional and total skeletal measurements in the early postmenopause.

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