Prevalence and associated factors of T-score discordance between different sites in Iranian patients with spinal cord injury

Abstract

Objectives: The present study was conducted to determine the prevalence of T-score discordance and its risk factors in a group of patients with spinal cord injury in a university teaching hospital in the Iranian capital of Tehran. Methods: This cross-sectional study was conducted on paraplegic men undergoing bone density testing in an outpatient clinic at a hospital in the Iranian capital, Tehran, between March 2011 and 2012. A questionnaire on demographic and anthropometric characteristics, including age, height, weight, engagement in physical activity and personal smoking habits, was filled out for each subject. All the subjects underwent bone mineral density measurement and blood samples were sent for laboratory testing. Results: Major T-score discordance between two sites was noted in 54 (41.22%) patients. Multivariate logistic regression revealed that every unit increase in serum calcium levels, as the only factor influencing T-score discordance, was associated with a 2.49-fold increased risk in T-score discordance in the area. As for the spine and radius, BMI was the only influencing factor as every unit increase in BMI was associated with a 14% lower risk for T-score discordance in these regions. Body mass index was the only factor, based on the multivariate model, affecting the risk of developing T-score discordance between two sites. Conclusion: Our study revealed the high prevalence of T-score discordance in patients with spinal cord injury. Physicians should therefore be encouraged to perform BMD at three sites when visiting patients with such injuries.

Risk factors for the development of osteoporosis after spinal cord injury. A 12-month follow-up study

“…However, it should be pointed out that most subjects included in our study were young males, with nearly 50 % being under 30 years of age, thereby making it difficult to apply these specific criteria (Tscore) and explaining why we have proposed risk BMD thresholds in absolute values. Previous studies have also indicated a marked bone loss and increased incidence of osteoporosis ranging from 21 to 81 % after SCI [2][3][4][5][6][7]. Nevertheless, in these studies, risk factors for osteoporosis development were analyzed long-term after SCI, and consequently, no early cutoff risk values for BMD have been previously proposed.…”

“…Thus, depending on the characteristics of the patients and the diagnostic criteria, 21 to 81 % of subjects will develop osteoporosis after SCI [2][3][4][5][6][7], with age, gender, timesince-injury, and severity of SCI being risk factors related to osteoporosis development long-term after injury [3,4]. However, in spite of this common complication, the clinical evaluation and therapeutic approach to these patients is clearly insufficient, with several authors describing the frequent absence of preventive antiosteoporotic treatment in this condition [8,9].…”