Journal of Clinical Densitometry RSS feed: Articles in Press. The official journal of the International Society for Clinical Densitometry (ISCD) , the Journal of Clinical Densitometry: Assessment of Skeletal Health publishes the latest clinical research on the uses of bone mass and density measurements in medical practice, as well as state-of-the-art review articles on critical topics. The Journal is committed to serving ISCD's mission—the education of heterogenous physician specialties and technologists who are involved in the clinical assessment of skeletal health. The focus of JCD is bone mass measurement, including epidemiology of bone mass, how drugs and diseases alter bone mass, new techniques and quality assurance in bone mass imaging technologies, and bone mass health/economics. Combining high quality research and review articles with sound, practice-oriented advice, JCD meets the diverse diagnostic and management needs of radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, family physicians, internists, and technologists whose patients require diagnostic clinical densitometry for therapeutic management. http://www.clinicaldensitometry.com//inpress?rss=yesElsevier Inc.en © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved. Journal of Clinical Densitometry1094-69502011-12-19 © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.clinicaldensitometry.com/article/PIIS1094695011001788/abstract?rss=yesAbstract: Clothing styles that conceal skin from ultraviolet sun radiation contribute to vitamin D deficiency, especially in veiled female minorities in high latitudes. This is the first research into possible effects of ethnic dress on the os calcis and the first study outside North Africa and the Middle East to investigate whether discernible differences in bone quality exist between veiled and unveiled women. The limited previous research into clothing habits and bone health has been inconclusive. One hundred eight women aged 18–45yr living in the United Kingdom (around 51° north) were analyzed. Forty-three consistently covered arms, hair, and neck when outdoors, whereas 65 consistently had arms, hair, neck, and possibly legs exposed. The quantitative ultrasound scanning (QUS) measurements at the calcaneus were speed of sound (SOS) and broadband ultrasound attenuation (BUA), which were translated into a single clinical value, stiffness index (SI). Dietary intake of vitamin D and calcium was estimated using a validated food frequency questionnaire, and several other risk factors were assessed. There was no significant difference in SI between veiled and unveiled participants (101.30±1.71 vs 99.98±1.86; p=0.721); SOS and BUA were also not significantly different. However, smoking and long-term use of steroid medication were significant predictors of calcaneal bone quality, confirming existing research. Our analysis suggests that clothing style alone does not lead to appreciable differences in the quality of the os calcis in young women in the United Kingdom as assessed by QUS.Ethnic Dress, Vitamin D Intake, and Calcaneal Bone Health in Young Women in the United Kingdom - Corrected ProofRobert Knoss, Lewis G. Halsey, Sue Reeves10.1016/j.jocd.2011.09.005Journal of Clinical Densitometry (2011)2011-12-19Journal of Clinical Densitometry2011-12-19ORIGINAL ARTICLEhttp://www.clinicaldensitometry.com/article/PIIS109469501100179X/abstract?rss=yesAbstract: We undertook this study to establish age-specified bone mineral density (BMD) reference range for Indian females using dual-energy X-ray absorptiometry. BMD at multiple skeletal sites was measured in 2034 healthy women aged 18–85yr. The effect of anthropometry and biochemical parameters on BMD was determined. Peak BMD was observed between 30 and 35yr at the hip, lumbar spine, and radius. Significant positive correlation of height and weight with BMD was observed at 33% radius, femur neck, and lumbar spine, whereas significant negative correlation was seen between serum alkaline phosphatase (ALP) and serum parathyroid hormone levels with BMD at aforementioned sites. On multivariate regression analysis, age, weight, and serum ALP were the most consistent contributors to variance in the BMD. Compared with age-matched US females, BMD of lumbar spine was significantly lower for our subjects in all age groups. Prevalence of osteoporosis among women aged older than 50yr was significantly higher based on Caucasian T-scores as opposed to using peak BMD/standard deviation values from the population under review at lumbar spine but not at femoral neck.Establishment of Age-Specified Bone Mineral Density Reference Range for Indian Females Using Dual-Energy X-ray Absorptiometry - Corrected ProofRaman K. Marwaha, Nikhil Tandon, Parjeet Kaur, Aparna Sastry, Kuntal Bhadra, Archna Narang, Saurav Arora, Kalaivani Mani10.1016/j.jocd.2011.09.006Journal of Clinical Densitometry (2011)2011-12-12Journal of Clinical Densitometry2011-12-12ORIGINAL ARTICLEhttp://www.clinicaldensitometry.com/article/PIIS1094695011001806/abstract?rss=yesAbstract: Bone disorders are common in children with end-stage liver diseases, especially those associated with cholestasis. Abnormal hepatocyte function, disordered vitamin D metabolism and calcium-phosphorous homeostasis, malnutrition, and immunosuppressive treatment are potential risk factors of bone tissue pathology before and after transplantation.The aim of the study was to analyze the long-term effect of successful living-related liver transplantation (LRLTx) on skeletal status and bone metabolism in cholestatic children.Eighteen cholestatic children (1.4±0.5yr old; 12 females [F]/6 males [M]) qualified for LRLTx were analyzed; 16 (5F/11M) of them participated in long-term observation (V4). Serum levels of osteocalcin (OC), procollagen type 1 N-terminal propeptide (P1NP), cross-linked telopeptide of type 1 collagen (CTx), insulin-like growth factor I (IGF-I), IGF-I binding protein 3 (IGFBP-3), parathyroid hormone (PTH), 25-hydroxyvitamin D (25(OH)D), and 1,25-dihydroxyvitamin D (1,25(OH)2D) were assayed before (V0) and 6mo (V1), 12mo (V2), 18mo (V3), and 4.4yr (V4) after LRLTx. Total body bone mineral content (TBBMC) and total body bone mineral density (TBBMD) were measured by dual-energy X-ray absorptiometry (DXA) at the same pattern.Before LRLTx, the OC, P1NP, CTx, IGF-I, and IGFBP-3 levels as well as TBBMC and TBBMD were decreased compared with age-matched control group. The mean serum levels of 25(OH)D and 1,25(OH)2D were within reference ranges from V0 to V4. After LRLTx, the OC, P1NP, CTx, IGF-I, and IGFBP-3 as well as TBBMC and TBBMD reached the age-matched reference values. At V4, the level of P1NP decreased below and the PTH increased above the reference range that coincided with reduced Z-scores of both TBBMC (−1.11±1.24) and TBBMD (−1.00±1.19). P1NP and CTx, both measured at V3, correlated with IGF-I at V2 (R=0.86, p=0.014 and R=0.78, p=0.021, respectively) and PTH at V3 for P1NP and V1 for CTx (R=0.64, p=0.048 and R=0.54, p=0.038, respectively). The TBBMC changes between V0 and V4 correlated with IGF-I (R=0.68, p=0.015) and 1,25(OH)2D (R=0.54, p=0.025), both assayed at V1. The change of TBBMC Z-scores between V0 and V4 correlated with P1NP at V1 (R=0.69, p=0.002). The TBBMD changes between V0 and V4 correlated with CTx at V1 (R=0.54, p=0.027) and P1NP change between V0 and V1 (R=0.51, p=0.038).In short-term observation, successful LRLTx led to bone metabolism normalization triggered by probable anabolic action of IGF-I and PTH and manifested by TBBMC and TBBMD increases. In long-term horizon, moderately impaired DXA assessed bone status coincided with disturbances in bone metabolism. Bone metabolism markers, especially P1NP and CTx, appeared to be good predictors of changes in bone status evaluated by DXA.Bone Metabolism in Cholestatic Children Before and After Living-Related Liver Transplantation—a Long-Term Prospective Study - Corrected ProofEdyta Kryskiewicz, Joanna Pawlowska, Pawel Pludowski, Hor Ismail, Elzbieta Karczmarewicz, Mikolaj Teisseyre, Ewa Skorupa, Jozef Ryzko, Piotr Kalicinski, Jerzy Socha, Roman S. Lorenc10.1016/j.jocd.2011.09.007Journal of Clinical Densitometry (2011)2011-12-12Journal of Clinical Densitometry2011-12-12ORIGINAL ARTICLEhttp://www.clinicaldensitometry.com/article/PIIS1094695011001946/abstract?rss=yesAbstract: As a result of the advances in antiretroviral therapy, the life span of human immunodeficiency virus (HIV)-infected patients has increased dramatically. Attendant to these effects are signs of premature aging with notable changes in the musculoskeletal system. Although changes in bone and fat distribution have been studied extensively, far less is known about changes in muscle. This study examined the extent of low muscle mass (LMM) and its relationship with low bone mineral density (BMD) and lipodystrophy (LD) in HIV-positive males. As such, HIV-positive males on therapy or treatment naive underwent dual-energy X-ray absorptiometry total body composition measurements. Appendicular lean mass/(height)2 and lowest 20% of residuals from regression analysis were used to define LMM. BMD criteria defined osteopenia/osteoporosis, and the percent central fat/percent lower extremity ratio defined LD. Several potential risk factors were assessed through chart review. Sixty-six males (57 with treatment and 9 treatment naive) volunteered. Treated individuals were older than naive (44 vs 34 yr) and had HIV longer (108 vs 14 mo). When definitions for sarcopenia (SP) in elderly individuals were applied, the prevalence of LMM was 21.9% and 18.8% depending on the definition used. Low BMD was present in 68.2% of participants. LD with a cutoff of 1.5 and 1.961 was present in 54.7% and 42.2% of participants, respectively. LMM and LD were negatively associated. In conclusion, this study shows that LMM is common in males with HIV and that SP affecting muscle function could be present in a substantial number of individuals. Future research needs to examine what impact decreased muscle mass and function has on morbidity, physical function, and quality of life in individuals with HIV.The Frequency of Low Muscle Mass and Its Overlap With Low Bone Mineral Density and Lipodystrophy in Individuals With HIV—A Pilot Study Using DXA Total Body Composition Analysis - Corrected ProofBjoern Buehring, Elizabeth Kirchner, Zhiyuan Sun, Leonard Calabrese10.1016/j.jocd.2011.10.003Journal of Clinical Densitometry (2011)2011-12-12Journal of Clinical Densitometry2011-12-12ORIGINAL ARTICLEhttp://www.clinicaldensitometry.com/article/PIIS1094695011001958/abstract?rss=yesAbstract: Patients with chronic obstructive pulmonary disease (COPD) often develop osteoporosis. Many hormones regulate bone metabolism and body composition, and some of them are affected in COPD patients vs controls. In 46 COPD patients, we measured hip neck, total hip, lumbar spine, and whole-body T-score with dual-energy X-ray absorptiometry, parameters of body composition (body mass index [BMI], fat mass index [FMI], and fat-free mass index [FFMI]), and adiponectin, leptin, parathormone, osteocalcin, calcitonin, and insulin-like growth factor I (IGF-I) serum levels and correlated them with COPD stage. Our results suggest that total hip bone mineral density (BMD) is affected by FFMI and COPD stage; lumbar spine BMD is affected by FMI and COPD stage; and whole-body BMD is affected by BMI, COPD stage, and leptin. Adiponectin, parathormone, osteocalcin, calcitonin, and IGF-I levels were not significantly correlated to BMD at any of the measured sites. Our findings are in agreement with the current literature in that a decline in lung function is correlated to a decline in BMD.Association of Bone Mineral Density, Parameters of Bone Turnover, and Body Composition in Patients With Chronic Obstructive Pulmonary Disease - Corrected ProofGeorgios A. Fountoulis, Markos Minas, Panagiotis Georgoulias, Ioannis V. Fezoulidis, Konstantinos I. Gourgoulianis, Marianna Vlychou10.1016/j.jocd.2011.10.004Journal of Clinical Densitometry (2011)2011-12-12Journal of Clinical Densitometry2011-12-12ORIGINAL ARTICLEhttp://www.clinicaldensitometry.com/article/PIIS1094695011002095/abstract?rss=yesAbstract: Many studies demonstrated the importance of using ethnic-specific normal database in the diagnosis of osteoporosis (OP). Aims of this study were to assess diagnostic agreement, prevalence of OP, and diagnostic misclassification between Caucasian, Japanese, and Thai normal databases.The cross-sectional study of 3181 Thai women who had bone mineral density (BMD) measurement between January 2008 and December 2010 was performed. BMDs at lumbar spine (LS), femoral neck (FN), and total hip (TH) were derived to T-score by using Caucasian, Japanese, and Thai standard references. Kappa statistic was used to assess diagnostic agreement and misclassification.Diagnostic agreements between Caucasian and Thai reference databases were 0.39 for LS and 0.90 for FN. No statistical agreement was found in TH region (0.01, p value=0.264). Applying the Japanese reference, diagnostic agreements were 0.71 for LS, 0.76 for FN, and 0.94 for TH regions. Prevalence of OP in postmenopausal women was 64.1%, 37.7%, and 41.4% using Caucasian, Japanese, and Thai standard references. Percentage of misclassification was varied by menopausal status and reference database from 11.2% to 48.7%. When applying Japanese databases instead of Caucasian normal databases, overall diagnostic misclassification decreased from 35.1% to 16.1%.Choice of reference database has a significant effect on the diagnosis of low bone mass and OP. Japanese reference database has better diagnostic agreement with previously studied Thai reference database in 1999 than Caucasian reference database.Bone mineral density has been shown to be different in different ethnic groups. Importance of using the ethnic-specific reference database for T-score derivation in the diagnosis of osteoporosis instead of standard Caucasian and the National Health and Nutrition Examination Survey III reference databases has been reported in some countries.Importance of Ethnic Base Standard References for the Diagnosis of Osteoporosis in Thai Women - Corrected ProofSirianong Namwongprom, Sattaya Rojnastein, Ampica Mangklabruks, Supasil Soontrapa, Chanpen Wongboontan, Boonsong Ongphiphadhanakul10.1016/j.jocd.2011.10.005Journal of Clinical Densitometry (2011)2011-12-12Journal of Clinical Densitometry2011-12-12ORIGINAL ARTICLEhttp://www.clinicaldensitometry.com/article/PIIS1094695011002101/abstract?rss=yesAbstract: Menopause is the major risk factor for the loss of bone mineral density (BMD) and bone mineral content (BMC) in women. In this study, we determined the prevalence of osteoporosis in postmenopausal women in Kuwait and compared it with that of other Middle East and west countries. Two thousand two hundred ninety-six postmenopausal women ranging in age from 40 to 87yr were included in the study and divided into 4 age groups by decade. We measured body weight, height, body mass index (BMI), BMD, and BMC. The mean age, height, and weight were 59.1+7.9yr, 154.7+6.5cm, and 77.3+14.9kg, respectively. The mean BMI and BMC were 32.4+6.6kg/m2 and 0.9+0.14g/cm2, respectively. The average T-scores for the hip and lumbar spine were −0.280+1.2 and −1.297+1.33, respectively. BMC significantly decreased with age from 0.95 to 0.81g/cm2. Four hundred forty-four (19.3%) were found to have osteoporosis. The incidence of osteoporosis significantly increased from 4.3% to 39.9% with age, which is lower than that reported for Saudi (40%) and Moroccan women (39.6%) and higher than that for US/European (31%) and Lebanese women (11%).Evaluation of Bone Mineral Density in Postmenopausal Women in Kuwait - Corrected ProofRenu Gupta, Osama Al-saeed, Fawaz Azizieh, Abdullatif Albusairi, Pushpak Gupta, Ahmed Mohammed10.1016/j.jocd.2011.10.006Journal of Clinical Densitometry (2011)2011-12-12Journal of Clinical Densitometry2011-12-12ORIGINAL ARTICLE