The utility of dual-energy X-ray absorptiometry, calcaneal quantitative ultrasound, and fracture risk indices (FRAX® and Osteoporosis Risk Assessment Instrument) for the identification of women with distal forearm or hip fractures: A pilot study

Esmaeilzadeh, Sina; Cesme, Fatih; Oral, Aydan; Yalıman, Ayşe; Sindel, Dilşad

doi:10.3109/07435800.2015.1120744

Cited by 12 publications

(17 citation statements)

References 46 publications

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“…Early and accurate fracture risk assessment remains an important topic in the management of PMOP . Although the World Health Organization developed a tool of Fracture Risk Assessment (FRAX) to generally predict the fracture probability during 10 years, it is still necessary to establish an individualized risk estimation aiming at the specific PMOP patients in a specific institution. In this study, we investigated multiple blood routine biomarkers in relation to the risk of fracture.…”

Section: Discussionmentioning

confidence: 99%

Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

Fang

Zhang

Wang

et al. 2019

Clinical Laboratory Analysis

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Abbreviations: BMD, bone mineral density; BMI, body mass index; CI, confidence interval; DEXA, dual-energy X-ray absorptiometry; HR, hazard ratio; LMR, lymphocyte-to-monocyte ratio; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; NLR, neutrophil-to-lymphocyte ratio; OR, odds ratio; PDW, platelet distribution width; PLR, platelet-to-lymphocyte ratio; PMOP, postmenopausal osteoporosis; RDW, red blood cell distribution width; SII, systemic immune-inflammation index. AbstractBackground: Postmenopausal osteoporosis (PMOP) is a bone metabolism disorder involving systematic inflammation activation. Blood routine examination is easily available in clinical practice and contains abundant information reflecting the systematic inflammation level. Thus, it is attractive to achieve early diagnosis of PMOP and predict osteoporotic fracture risk just based on the biomarkers in blood routine examination.Methods: A multi-centric prospective cohort study was designed and enrolled postmenopausal women from two independent institutions. All participants underwent the dual-energy X-ray absorptiometry (DEXA) scanning for diagnosing PMOP. Blood routine examination was conducted, and the key inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) were calculated. PMOP patients were followed up to observe osteoporotic fracture and identify the related risk predictors.Results: A total of 92 participants out of 238 enrolled postmenopausal women were diagnosed with PMOP, with a prevalence of 38.66%. The main risk factors identified for PMOP included older age (OR = 2.06, 95% CI = 1.14-3.72), longer menopause duration (OR = 3.14, 95% CI = 2.06-4.79), higher NLR (OR = 2.11, 95% CI = 1.37-3.25), and higher SII (OR = 3.02, 95% CI = 1.98-4.61). Besides age and menopause duration, SII ≥834.89 was newly identified as a prominent risk factor for discriminating osteoporotic fracture risk in PMOP patients (HR = 3.66, 95% CI = 1.249-10.71). Conclusion:As an easy and economical biomarker calculated from blood routine examination, SII not only acts as a good risk predictor for PMOP diagnosis but also well discriminates the osteoporotic fracture risk, which deserves further investigation and application in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

Fang

Zhang

Wang

et al. 2019

Clinical Laboratory Analysis

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“…Finally, in the UK Biobank, quantitative ultrasound was used to assess BMD of the heel in nearly the total sample, whereas DXA measurements in the hip/spine were performed only in a subset of participants. Nevertheless, associations between calcaneal quantitative ultrasound, well-established risk factors for osteoporosisand increased fracture risk have been previously shown 45,46.…”

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confidence: 99%

Hyperthyroidism and bone mineral density: Dissecting the causal association with Mendelian randomization analysis

Deshmukh

Papageorgiou

Aye

et al. 2020

Clinical Endocrinology

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Introduction: Untreated hyperthyroidism is associated with accelerated bone turnover, low bone mineral density (BMD) and increased susceptibility to fragility fractures. Although treatment appears to improve or even reverse some of these adverse skeletal effects, there is limited guidance on routine BMD assessment in hyperthyroid patients following treatment. By using Mendelian randomization (MR) analysis, we aimed to assess the causal association of hyperthyroid thyroid states with BMD and fractures using the UK Biobank. Methods: This MR analysis included data from 473 818 participants (women: 54% of the total sample, the median age of 58.0 years (IQR = 50-63 years), median body mass index (BMI) of 26.70 (IQR + 24.11-29.82 kg/m 2) as part of the UK Biobank study. The study outcomes were heel BMD assessed by quantitative ultrasound of the heel and self-reported fractures. Beta-weighted genetic risk score analysis was performed using 19 single nucleotide polymorphisms (SNPs) for Graves' disease, 9 SNPs for hyperthyroidism and 11 SNPs for autoimmune thyroiditis. Since the unadjusted risk score MR is equivalent to the inverse-variance weighted method, the genetic risk score analysis was adjusted for age, gender and BMI. Sensitivity analyses were conducted using the Mendelian randomization-Egger (MR-Egger) and the inversevariance weighted estimate methods. Replication analysis was performed using the GEnetic Factors for Osteoporosis (GEFOS) consortium data. Results: MR analysis using beta-weighted genetic risk score showed no association of genetic risk for Graves' disease (Beta = −0.01, P-value = .10), autoimmune thyroiditis (Beta = −0.006 P-value = .25) and hyperthyroidism (Beta = −0.009, Pvalue = .18) with heel ultrasound BMD. MR-Egger and inverse-variance MR methods in UK Biobank and GEFOS consortium confirmed these findings. The genetic risk for these hyperthyroid conditions was not associated with an increased risk of fractures. Conclusion: Our study shows that excess genetic risk for Graves' autoimmune thyroiditis and hyperthyroidism does not increase the risk for low BMD and is not associated fractures in the Caucasian population. Our findings do not support routine screening for osteoporosis following definitive treatment of hyperthyroid states.

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“…Bone density determination plays the biggest role in the study of bone health. Besides the clinical gold standard dual energy X-ray absorptiometry (DXA), quantitative ultrasound (QUS) is an established alternative to estimate bone density and predict osteoporotic fractures ( Bauer et al, 1997 ; Khaw et al, 2004 ; Chan et al, 2013 ; Hollaender et al, 2009 ; Olszynski et al, 2013 ; Esmaeilzadeh et al, 2016 ) in specific study settings ( Krieg et al, 2003 ; Gluer, 2008 ). Systematic reviews and meta-analyses as well as the International Society for Clinical Densitometry (ISCD) validated QUS as being a good predictor for hip and other non-vertebral fractures and as reliable as DXA ( Marín et al, 2006 ; Moayyeri et al, 2012 ; Krieg et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Short-termed changes in quantitative ultrasound estimated bone density among young men in an 18-weeks follow-up during their basic training for the Swiss Armed Forces

Strässle

Grossmann

Eppenberger

et al. 2023

PeerJ

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Background Quantitative Ultrasound (QUS) methods have been widely used to assess estimated bone density. This study aimed to assess changes in estimated bone density in association with changes in body composition, physical activity, and anthropometry. Methods We examined changes in anthropometry, body composition, and physical activity associated with changes in estimated bone mineral density (measured using quantitative ultrasound with a heel ultrasound device indicating broadband ultrasound attenuation BUA and speed of sound SOS) in a follow-up sample of n = 73 young men at the beginning and again 18 weeks later at the end of basic military training. Results At the end of the basic training, the subjects were on average significantly heavier (+1.0%), slightly taller (+0.5%) and had a higher fat mass (+6.6%) and grip strength (+8.6%). A significant decrease in mean physical activity (−49.5%) and mean estimated bone density calculated with BUA (−7.5%) was observed in the paired t-test. The results of the multivariable linear regressions (backward selection) show that changes in skeletal muscle mass (delta = 2nd measurement minus 1st measurement) have negative and body weight (delta) have positive association with the speed of sound SOS (delta), while fat mass (delta) and physical activity (delta) had the strongest negative associations with estimated bone mineral density (delta). In particular, we found a negative association between fat mass (delta) and estimated bone mineral density (delta, estimated with BUA). Conclusion Our study suggests that estimated bone density from the calcaneus can change within a few months even in young and mostly healthy individuals, depending upon physical activity levels and other co-factors. Further studies including other troop types as control groups as well as on women should follow in order to investigate this public health relevant topic in more depth. To what extent the estimated bone density measurement with quantitative ultrasound is clinically relevant needs to be investigated in further studies.

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The utility of dual-energy X-ray absorptiometry, calcaneal quantitative ultrasound, and fracture risk indices (FRAX® and Osteoporosis Risk Assessment Instrument) for the identification of women with distal forearm or hip fractures: A pilot study

Abstract: It can be concluded that QUS variables, particularly BUA, and FRAX® major osteoporotic fracture probability without BMD are good candidates for the identification of both hip and distal forearm fractures.

Cited by 12 publications

References 46 publications

Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

Hyperthyroidism and bone mineral density: Dissecting the causal association with Mendelian randomization analysis

Short-termed changes in quantitative ultrasound estimated bone density among young men in an 18-weeks follow-up during their basic training for the Swiss Armed Forces

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