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  • 1
    Electronic Resource
    Electronic Resource
    Hyperthyroidism Influences Ultrasound Bone Measurement on the Os Calcis (1998)
    Springer
    Osteoporosis international 8 (1998), S. 455-459 
    Details
    ISSN: 1433-2965
    Keywords: Key words:BMD – Bone loss – Hyperthyroidism – Ultrasound parameters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The objective of our study was to compare bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters in women with hyperthyroidism and controls. In this cross-sectional study, QUS parameters and BMD values observed in untreated hyperthyroid patients were compared with data obtained from age-matched controls. Twenty-four women with Graves' disease were studied. Eight patients were postmenopausal. All patients had evidence of thyrotoxicosis as indicated by a raised total serum thyroxine and a suppressed serum thyroid stimulating hormone. BMD of the hip, lumbar spine and whole body, and body composition, were measured by DXA. Ultrasound evaluation on the os calcis was performed with an Achilles device. All measurements were performed before antithyroid therapy. The QUS parameters of BUA, SOS and Stiffness were significantly lower in hyperthyroid patients than in controls. Similar results were observed for the BMD of lumbar spine, femoral neck and total skeleton. Lean tissue and fat mass were also significantly decreased in hyperthyroid patients. In conclusion, these findings suggest that hyperthyroidism affects cortical and trabecular bone equally, as well as bone quality. QUS measurements may be helpful for assessing, using a simple and non-irradiating method, the bone effects of thyrotoxicosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050091
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  • 2
    Electronic Resource
    Electronic Resource
    Do Markers of Bone Resorption Add to Bone Mineral Density and Ultrasonographic Heel Measurement for the Prediction of Hip Fracture in Elderly Women? The EPIDOS Prospective Study (1998)
    Springer
    Osteoporosis international 8 (1998), S. 563-569 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bone markers – DXA – Hip fracture – Osteoporosis – Risk factors – Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We have previously shown that hip bone mineral density (BMD), heel broadband ultrasound attenuation (BUA) and bone resorption markers are independent predictors of hip fracture in elderly women. We investigated whether a combination of these three parameters could improve the predictive value of a single test in a nested case–control analysis (75 hip fractures and 228 age-matched controls) of the EPIDOS prospective study comprising 7598 healthy women 75 years of age and older followed prospectively for a mean 22 months. At baseline, prior fracture, femoral neck BMD by dual-energy X-ray absorptiometry (DXA), heel BUA and urinary type I collagen C-telopeptide breakdown products (CTX) were assessed. The area under the receiver operating characteristic curve was significant for the three diagnostic tests, heel BUA being the best single predictor. The added value of urinary CTX to either BMD or BUA depends on the cutoff point chosen to define patients at risk and on the therapeutic strategy that is considered. Defining patients at risk as those with low BMD (or low BUA) or high CTX resulted in a significant increase in the sensitivity compared with BMD or BUA alone – a strategy that could be applied when a broad treatment is considered. However, this increased sensitivity was also obtained simply by increasing the BMD and BUA cutoffs, suggesting that a combination of CTX with BMD/BUA is not useful for that type of treatment strategy. Conversely, defining patients at risk as those with both low BMD and high CTX increases the specificity (88% vs 78%) with a similar number of hip fracture patients being identified (30% vs 32%) – a combination that could be useful when the strategy is to target treatment to a subset of high-risk patients. This strategy appears to be more cost-effective than bone mass measurement alone as indicated by the 37% fewer patients who need to be treated to avoid one fracture per year. If DXA or ultrasound is not available, the combination of a bone resorption marker with a history of any type of fracture after the age of 50 years gave a predictive value similar to that obtained with femoral neck BMD or heel BUA alone, for both types of treatment strategy. We conclude that the combination of urinary CTX with hip BMD could be useful for the identification of elderly women at high risk for hip fracture, resulting in higher specificity for a given sensitivity threshold than BMD measurement alone. If DXA is not available, the combination of history of fracture and urinary CTX performs as well as hip BMD to assess hip fracture risk in elderly women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050100
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  • 3
    Electronic Resource
    Electronic Resource
    How Hip and Whole-Body Bone Mineral Density Predict Hip Fracture in Elderly Women: The EPIDOS Prospective Study (1998)
    Springer
    Osteoporosis international 8 (1998), S. 247-254 
    Details
    ISSN: 1433-2965
    Keywords: Key words: Aging – Bone mineral density – Hip fracture – Osteoporosis – Prospective study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We conducted a population-based cohort study in 7598 white healthy women, aged 75 years and over, recruited from the voting lists. We measured at baseline bone mineral density (BMD g/cm2) of the proximal femur (neck, trochanter and Ward's triangle) and the whole body, as well as fat and lean body mass, by dual-energy X-ray absorptiometry (DXA). One hundred and fifty-four women underwent a hip fracture during an average 2 years follow-up. Each standard deviation decrease in BMD increased the risk of hip fracture adjusted for age, weight and centre by 1.9 (95% CL 1.5, 2.3) for the femoral neck, 2.6 times (2.0, 3.3) for the trochanter, 1.8 times (1.4, 2.2) for Ward's triangle, 1.6 times (1.2, 2.0) for the whole body, and 1.3 times (1.0, 1.5) for the fat mass. The areas under the receiver operating characteristic (ROC) curves were not significantly different between trochanter and femoral neck BMD, whereas ROC curves of femoral neck and trochanter BMD were significantly better than those for Ward's triangle and whole-body BMD. emsp;Women who sustained an intertrochanteric fracture were older (84 ± 4.5 years) than women who had a cervical fracture (81 ± 4.5 years) and trochanter BMD seemed to be a stronger predictor of intertrochanteric ([RR = 4.5 (3.1, 6.5)] than cervical fractures ([RR = 1.8 (1.5, 2.3]). emsp;In very elderly women aged 80 years and more, hip BMD was still a significant predictor of hip fracture but the relative risk was significantly lower than in women younger than 80 years. emsp;In the 48% of women who had a femoral neck BMD T-score less than –2.5, the relative risk of hip fracture was increased by 3, and the unadjusted incidence of hip fracture was 16.4 per 1000 woman-years compared with 1.1 in the population with a femoral neck BMD T-score 5–1.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050061
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  • 4
    Electronic Resource
    Electronic Resource
    Measurement of Bone Mineral Density in Mother–Daughter Pairs for Evaluating the Family Influence on Bone Mass Acquisition: A GRIO Survey (1998)
    Springer
    Osteoporosis international 8 (1998), S. 379-384 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bone mineral density – Dual-energy X-ray absorptiometry – Genetics – Heredity – Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The relative influence of genetic and environmental determinants on bone mass is still unclear. Using an original multicentric mode of recruitment, based on absorptiometry current practice, the hypothesis of a familial predisposition to low bone mineral content was assessed. The study was based on dual-energy X-ray absorptiometry (DXA) measurements of lumbar and femoral neck bone mineral density (BMD), using daughters of women with a low BMD (case mothers). These BMD values were compared with those of control daughters of women with a normal BMD. Case mothers (n= 72) aged 54.3 ± 4.8 years were recruited on the basis of a questionnaire and a vertebral Z-score 〈 – 2 SD. Their healthy daughters of more than 20 years (n= 77) aged 28.2 ± 4.9 years had their vertebral and femoral BMD Z-score determined. The control groups were composed of mothers aged 54.1 ± 4.7 years, paired by age ± 2 years to the case mothers, and of their daughters of more than 20 years old, aged 27.7 ± 5.8 years. For daughters, a significant difference was found between the mean vertebral Z-scores (–0.82 ± 1.08 for cases and 0.01 ± 1.14 for controls, p 〈 0.0001). The difference was in the same direction but was not statistically significant for mean femoral Z-scores (–0.58 ± 1.15 for cases and –0.22 ± 1.33 for controls, p 〈0.073). These findings confirm the hypothesis of a familial predisposition to low BMD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050078
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Fractal Analysis of Bone Texture on Os Calcis Radiographs Compared with Trabecular Microarchitecture Analyzed by Histomorphometry (1998)
    Springer
    Calcified tissue international 63 (1998), S. 121-125 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Fractal analysis—Os calcis—Radiographs—Histomorphometry—Microarchitecture.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Microarchitecture of trabecular bone is an important determinant of bone fragility; to date, its evaluation requires bone biopsy with histomorphometry analysis. Methods of noninvasive characterization of trabecular bone microarchitecture are in development and we have developed and validated a bone texture analysis applied to bone radiographs and based on fractal geometry. The aim of our study was to compare this fractal analysis of trabecular bone texture on radiographs to the trabecular microarchitecture analyzed by bone histomorphometry on os calcis biopsies. Thirty eight ossa calcis from 19 human cadavers were studied. Fractal analysis of the trabecular bone of os calcis radiographs was performed by the maximum likelihood estimator following the fractional brownian motion model. The ossa calcis were dissected, then transcortical biopsy cores focused on the fractal analysis region of interest were obtained. Structural and connectivity parameters were measured with both automatic and semiautomatic analyzers. We have found a significant relationship between the fractal Hmean parameter and structural histomorphometric indices; the best correlation was found with trabecular separation (r =−0.55; P= 0.0004). Based on a stepwise regression analysis, trabecular spacing and trabeculae number together would explain 38% of the variance of the fractal parameter. Although the relationship with connectivity indices was poor, our fractal analysis of os calcis trabecular bone texture on radiographs seemed to partially reflect the trabecular bone microarchitecture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900501
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    Paper (German National Licenses)
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