Relationship between bone mineral density of the proximal femur and lumbar spine and quadriceps and hamstrings torque in healthy Japanese subjects

The purpose of this study was to examine the corelations between the muscle torque of the leg extensors (quadriceps femoris) and leg flexors (Hamstrings) and the bone mineral density (BMD) of the proximal femur and lumbar spine. To investigate the decline in BMD of proximal femur and lumbar spine, we examined the relative importance of muscle torque, age, and body weight in the prediction of BMD in 340 healthy volunteers (109 males, and 231 females). Age and body weight were independent predictors of femoral BMD in men. Body weight and quadriceps torque were independent predictors of femoral BMD in premenopausal women. Body weight and years after menopause were independent predictors of BMD in postmenopausal women. The BMD was greatly affected by menopause, whereas the muscle torque was independent of the menopause, and showed the negative relationship to age. These results suggest that muscle-building exercise may have the potentiality to elevate the BMD in the proximal femur in premenopausal women.     

Epidemiological study on the bone mineral density of inhabitants in Miyama Village, Wakayama prefecture (Part II) bone mineral density of the spine and proximal femur

Reference values of bone mineral density (BMD) have mainly been based on hospital volunteers in Japan. Consequently, these values may be inappropriate for the use as a standard in the osteoporotic study. In order to establish reference values, BMD was measured of 400 age-stratified inhabitants of Miyama Village, utilizing dual energy x-ray absorptiometry (DEXA). The mean BMD of L2–L4 in males in each age group was 1.19±0.16 g/cm² (mean±standard deviation) in 40's, 1.15±0.19 g/cm² in 50's, 1.03±0.18 g/cm² in 60's and 1.06±0.25 g/cm² in 70's. The difference of BMD was statistically significant between the 50 and 60 age groups. On the other hand, in females the mean BMD of L2–L4 was 1.18±0.16 g/cm² in 40's; 0.99±0.18 g/cm² in 50's, 0.84±0.19 g/cm² in 60's and 0.78±0.17 g/cm² in 70's. The BMD was significantly lower in the 50 age group than in the 40 age group and was similarly lower in the 60 age group than in the 50 age group.     

Influence of body weight on rates of change in bone density of the spine,hip, and radius in postmenopausal women

Summary Interrelationships between percent of ideal body weight (%IBW), serum estrogen levels, and change in bone mineral density (BMD) and bone mineral content (BMC) were studied in 288 postmenopausal women aged 41–71 years who participated in a 2-year calcium supplement trial. The spine (L2–L4) and femoral neck were measured by dualphoton absorptiometry, and the radius was measured by single-photon absorptiometry. Years since menopause, calcium intake, and initial BMD or BMC were included as independent variables in two-phase regressions of BMD and BMC on %IBW. Increased %IBW protected against loss of spine BMD [regression slope estimate=0.05, 95% C.I.: (0.03, 0.26)] and BMC in women up through about 106 %IBW but not in heavier women. Increased %IBW was not significantly related to BMD or BMC at the femoral neck or radius. Women above 106%IBW had significant gains in spine and femoral neck area (P< 0.05). Serum estrone and estradiol were positively correlated with BMD and BMC at the femoral neck only.     

沈阳地区绝经后妇女绝经年限与股骨近端骨密度的关系分析

目的 探讨绝经年限与股骨近端BMD的关系。方法 随机调查沈阳地区285例健康的绝经后妇女，调查其年龄和绝经年限，测量其身高、体重、股骨近端骨密度(BMD)，应用SPSS软件统计分析。结果 随绝经年限的增加股骨近端各部位BMD有下降的趋势，随绝经年限的增加股骨近端各部位BMD下降速度减慢，并且相对而言Neck、Ward’s区的BMD下降速度高于其他部位。以年龄和体重指数(BMI)为协变量，经协方差分析显示Ward’s区BMD与绝经年限具有显著相关，而其他部位无显著相关。结论 对绝经后妇女应注意绝经早期的股骨近端BMD变化。     

容积性定量CT测量股骨近端骨密度准确性研究

目的通过分别对比容积性定量CT(vQCT)、双能X射线吸收法(DXA)与灰化法测量股骨近端骨密度结果,确定并对比相关性,进行指导临床骨质疏松诊断及治疗。方法选取20个尸体股骨近端标本,先使用DXA骨密度仪扫描,测得骨矿含量(BMC)及骨密度(BMD)。再对标本相同部位行64层螺旋CT扫描,数据导入OsteoCAD软件自动分析得出骨密度值。应用灰化法得出标本灰质量密度。所有资料进行统计分析分别确定并对比vQCT及DXA测量的骨密度值与灰密度之间的相关性。结果vQCT测量股骨颈骨密度与灰质量密度线性相关性较好(r=0.852,P0.01),DXA与灰质量密度的相关性略差(r=0.807,P0.01)。结论vQCT测得的骨密度较DXA与灰质量密度线性相关性更好,可靠性高,对于诊断骨质疏松,预测骨质疏松性骨折,评价、指导骨质疏松骨折手术更有应用价值。     

体重体成分与骨密度的关系

为了研究体成分与骨密度（ＢＭＤ）之间的关系，因体重与ＢＭＤ显著相关，体成分各个组成相加等于体重，而体成分与ＢＭＤ的关系仍不清楚。方法随机选取２０６名１６～５２岁健康的男女性汉族人，用双能Ｘ射线吸收法（ＤＸＡ）测量ＢＭＤ与体成分，进行ＢＭＤ与体重，体成分的多元线性回归分析。结果体重，瘦组织（ＬＴＭ）与男女性的ＢＭＤ显著正相关，脂肪组织（ＦＴＭ）仅对女性全身，腰椎ＢＭＤ起显著性作用。结论影响男女性ＢＭＤ的体成分中，ＬＴＭ是主要因素，ＦＴＭ仅对女性ＢＭＤ有影响。本文较全面地研究了体成分与ＢＭＤ的关系。     

Bone mineral density of the proximal femur and lumbar spine in glucocorticoid-treated asthmatic patients

The importance of the proximal femur as a site of osteoporotic fractures, the development of techniques for bone mineral density (BMD) measurement at this site and the apparent selectivity of the osteopenic effects of glucorticoids have focused attention on the assessment of proximal femoral BMD in steroid-treated subjects. We have, therefore, measured BMD (Lunar DPX) in the lumbar spine and proximal femur of 31 asthmatic patients receiving long-term glucocorticoid therapy (mean ± SEM dose 16 ± 1 mg prednisone/day, mean duration 10 ± 2 years). BMD values expressed as the percentage of normal age- and sex-appropriate mean values, after weight adjustment, were as follows: lumbar spine 80 ± 2%, femoral neck 83 ± 2%, Ward's triangle 78 ± 3% and trochanter 86 ± 2%. All these values were significantly less than control (p<0.0001) and the decrement in BMD was more marked in Ward's triangle than at the other two femoral sites (p<0.05). In all regions BMD was unrelated to dose or duration of steroid treatment. It is concluded that there are reductions in the BMD of the lumbar spine and proximal femur in glucocorticoid-treated asthmatics, probably reflecting the mixed cortical/trabecular makeup of both regions.     

Comparison between menopause-related changes in bone mineral density of the lumbar spine and the proximal femur in Japanese female athletes: A long-term longitudinal study using dual-energy X-ray absorptiometry

This longitudinal study examined whether bone mineral density (BMD) of the lumbar spine and the proximal femur is maintained in pre-, peri-, and postmenopausal women by regular exerise. BMD was measured using dualenergy X-ray absorptiometry (DXA). Twenty-six Japanese women (mean age 47.8 years) were followed 4–5 years. Twenty-two subjects from volleyball or jogging clubs had participated in the same exercise for more than 5 years at the initial BMD measurement. Longitudinally, for these 22 athletes, the rate of change per year in BMD of the lumbar spine was -0.17% in the premenopause group and -2.60% in the perimenopause group. In the proximal femur of the athletes, BMD increased (rate of increase per year 1.80%) in the premenopause group, but decreased (rate of decrease per year 1.07%) in the perimenopause group. In the premenopause group, BMD of the proximal femur increased in all athletes. However, in the proximal femur, the nonexercise group showed a 0.31% decrease, a significant difference (P <0.05) compared with the athletes. These findings suggest that women can achieve continuous gains in bone mass in the proximal femur before menopause by regular intense exercise. However, continued high-level physical activity in the perimenopausal women was not able to prevent bone loss.     

Lumbar vertebral bone mineral density in Japanese infants and children: Measurement with dual x-ray absorptiometry

Dual x-ray absorptiometry (DXA) (Hologic QDR-1000/W; Hologic, Inc.) was used to measure lumbar vertebral bone mineral density (BMD) in 83 healthy Japanese infants and children (55 boys and 28 girls) aged 0–17 years, and the values obtained were correlated with age, body weight and body height. The lumbar BMD (average of L1–L4 values) increased with age, with a nearly twofold increase found from preschool age to adolescence. It also increased with body weight and body height. Our results on normal Japanese infants and children appear almost similar to those reported in French and American studies. Because of its great precision and accuracy, low radiation exposure and rapid scanning, DXA may be the most suitable for use in infants and children. With normal Japanese data now available with this technique, pediatricians can better detect metabolic bone diseases in infants and children and follow the bone response to medical intervention in patients with these conditions.     

股骨近端骨密度的测量

双能X线骨密度仪检测骨密度是诊断骨质疏松症和疗效随访的金标准,特别是髋部骨密度的测量对于骨折的预测尤其测定部位本身骨折的预测作用较大.由于脊柱部位的骨密度测量值易受到脊柱退行性疾病的病理改变如退行性侧凸、骨赘增生、腰椎间盘突出等影响,测量的准确性下降.因而近年来欧美国家临床试验也好或者骨质疏松诊疗也好,大都以股骨近端的BMD测定为标准.本文就股骨近端解剖特点、骨密度测量的意义、方法以及测量的注意点作一个综述,以期帮助临床医生或技术员全面评估股骨近端骨密度测定的意义.     

A comparison of quantitative dual-energy radiographic absorptiometry and dual photon absorptiometry of the lumbar spine in postmenopausal women

Summary Noninvasive bone densitometry is an important aspect in the detection and management of osteoporosis and other forms of metabolic disease of calcified tissue. A system using quantitative dual-energy digital projection radiography (QDR) of the lumbar spine was systematically tested against dual-photon absorptiometry (DPA) of the lumbar spine in 131 women over 55 years of age and free from major risk factors for osteoporosis. All subjects were scanned by both QDR and DPA under the same conditions. Measurements for a given subject were made within 15 minutes of each other. Bone mineral densities (BMD) were determined for four individual levels in the lumbar spine (L1-L4). Regression equations for BMD vs. age, height, and weight were calculated. The results of this investigation indicate that DPA- and QDR-derived BMD values are comparable. BMD values derived by QDR were consistently lower than those obtained by DPA (DPA=1.115 QDR+0.137, r=0.942). The L2 lumbar region was the most strongly correlated determination.     

The effects of high potassium consumption on bone mineral density in a prospective cohort study of elderly postmenopausal women

Summary  Few studies have investigated the long-term effects of potassium intake on BMD. In a cohort of 266 elderly women, we found that baseline potassium intake as reflected by 24-hour urine potassium excretion had positive association with BMD measured at 1 and/or 5 years later, suggesting a role of dietary potassium on osteoporosis prevention. Introduction  High dietary potassium intake has been suggested to be beneficial for bone structure, but few studies have investigated the long-term effects of potassium intake on BMD in elderly women. We examined the relationship between potassium intake as reflected by 24-hour urine potassium excretion and bone density in a cohort of elderly women. Methods  The study subjects were 266 elderly postmenopausal women aged 70–80 years. Twenty-four-hour urinary potassium excretion was determined at baseline. At one year hip DXA BMD was measured, at 5 years hip and total body DXA BMD and distal radius and tibia pQCT vBMD were measured. The effects of potassium were evaluated by ANCOVA according to the quartile of baseline urinary potassium excretion. Results  After adjustment for confounding factors, subjects in the highest quartile of urinary potassium excretion had significantly higher total hip BMD at 1 (5%) and 5 years (6%), and significantly higher total body BMD (4%) and 4% distal tibia total (7%) and trabecular vBMD (11%) at 5 years than those in the lowest quartile. Conclusions  Potassium intake shows positive association with bone density in elderly women, suggesting that increasing consumption of food rich in potassium may play a role in osteoporosis prevention.     

Bone density in white Brazilian women: Rapid loss at the time around the menopause

Dual energy x-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) of the lumbar spine and proximal femur (neck, Ward's triangle, and trochanter) in 417 normal women (aged 20–79) living in São Paulo, Brazil. Bone density decreased with age at all sites. At the spine, the greatest decrease occurred during the sixth decade, with an average 11.4% bone loss compared with the previous decade. Stratifying the subjects according to menopausal status revealed that the fastest bone occurred at the time around the menopause (ages 45–60) when the rate of bone loss (-0.66%/year) was almost twice as rapid as in postmenopausal women (-0.39%/year). Although significant linear rates of bone loss were detected in all proximal femur sites before the menopause, a menopause-dependent pattern was less evident that at the spine. Lifetime rates of bone loss at the appendicular skeleton were-0.43,-0.62, and-0.35%/year at the femoral neck, Ward's triangle, and trochanteric area, respectively. After the menopause, BMD declined with menopausal age at all sites, although the rate of bone loss was faster at the femoral neck (-0.62%/year) and Ward's triangle (-0.84%/year) than at the spine-0.49%/year). The results are consistent with the notion that in women, the fastest bone loss occurs at the time round the menopause, most likely consequent to ovarian failure; and that faster rates of bone loss are detected at the proximal femur than at the lumbar spine in late postmenopausal women.     

Bone mineral density of the spine in normal Japanese subjects using dual-energy X-ray absorptiometry: Effect of obesity and menopausal status

Summary Bone mineral density (BMD) of the lumbar spine was measured to determine normal Japanese values and to examine the effect of obesity and menopausal status on BMD. Normal Japanese subjects (N=1,296, 1,048 women and 248 men) were examined using dual-energy X-ray absorptiometry. BMD for men peaked between age 20 and 29. For women, there was abrupt bone loss after age 50. Obese women within the same age bracket had a higher BMD than thin women after age 40–49. We determined that BMD began to decline during the irregular menstruation period before the onset of menopause. We conclude that there is a positive correlation between obesity and BMD, particularly in postmenopausal women. In addition, we found that bone loss related to menopause begins during the irregular menstruation period before menopause.     

体成分对男性2型糖尿病患者骨密度的影响

目的 应用双能X线骨密度仪（DXA）探讨体成分对男性2型糖尿病患者骨密度的影响。方法 选择年龄50～60岁在我科住院的男性2型糖尿病患者107例,分为正常体重组、超重组和肥胖组,分别测定其身高、体重,计算体重指数（BMI）,利用全自动生化分析仪测定血糖、血脂,高压液相色谱法测定糖化血红蛋白（HbA1c）,采用双能Ｘ线骨密度仪测定腰椎、左股骨大转子骨密度（BMD）及体成分,并进行统计学分析。结果 3组男性2型糖尿病患者腰椎BMD分别为1.12±0.05,1.21±0.07,1.36±0.09,左股骨大转子BMD分别1.12±0.06,1.22±0.08,1.41±0.08,与骨密度呈正相关;全身各部位肌肉含量与骨密度成正相关,且大腿＞上肢＞躯干;不同部位脂肪含量对骨密度的影响是不同的,其中上肢脂肪和大腿脂肪与骨密度成正相关,而躯干脂肪与骨密度成负相关;年龄、糖化血红蛋白、血脂对男性2型糖尿病患者骨密度无明显影响,而体重指数、肌肉含量及脂肪含量影响明显。结论 体重指数、肌肉含量和脂肪含量对男性2型糖尿病患者骨密度有直接影响。男性2型糖尿病患者加强锻炼,减少腹部脂肪含量,增加四肢肌肉含量,可以预防骨质疏松症的发生。     

Determination of bone mineral density by dual x-ray absorptiometry in patients with uncemented total hip arthroplasty.

Bone remodeling is an expected sequela with total hip arthroplasty (THA). Although there are several methods of estimating bone response in THA patients from radiographs, there are no accurate and generally accepted methods for quantitative determinations in vivo. In this study, we describe an application of dual x-ray absorptiometry (DXA) for measuring bone mineral content and bone mineral density in the proximal femur following THA. DXA is a noninvasive technique with minimal radiation exposure (< 5 mrem). Various aspects of measurement error (accuracy and reliability) of this application of DXA were determined in a series of studies reported here. Accuracy error (how similar are the measured and actual values) was < 1% determined in bone phantoms of four densities. Precision error (how reproducible are the measurements) was also < 1% at all four densities in the phantoms and was only slightly elevated (0.9-1.5%) in repeated measurements of implanted cadaver femora. Precision error in vivo, determined both from multiple replicates on five patients and from duplicate scans on 30 patients, was further elevated but remained < 5%. Contributions to precision error, rotation of the leg, and interoperator variability were assessed; none was found to elevate precision error appreciably. We suggest that DXA is a feasible method for quantifying bone response following THA, and will allow discrimination of small changes (> 5%) not previously measurable.     

双能X线骨密度仪测定成都市城区771例健康人骨密度结果分析

目的观察成都市城区健康人群骨密度变化规律,建立该型骨密度仪成都地区骨密度正常值,为骨质疏松诊断、防治提供参考依据。方法①采用EXPERT-XL双能X线骨密度仪(美国 LUNAR公司生产)测定成都市城区健康体检者771例,其中男性300例,女性471例,测量部位包括腰椎1～4和髋部;②按年龄、性别分别输入数据,以10岁为一年龄组,分别计算各组骨密度值,结果以x-±s表示。结果男性腰椎及股骨近端骨密度峰值出现在30～39岁,女性腰椎及股骨近端骨密度峰值出现在20～29岁,随着年龄增加,骨密度逐渐降低,男性在70岁后腰椎骨密度有反弹,而女性在50～59岁间骨密度下降迅速。结论本组健康人群骨密度数据将为成都地区骨质疏松诊断、防治提供参考依据;分析男性腰椎骨密度时应结合股骨近端骨密度;女性50岁后应注意预防、治疗骨质疏松,男性骨质疏松不容忽视。     

Age changes in the bone mineral of the lumbar spine in normal women

Summary The bone mineral content (BMC) and the bone mineral areal content (BMAC) were determined with dual-photon absorptiometry in the third lumbar vertebra in a random sample of 214 women between 35 and 80 years of age in the city of G?teborg, Sweden. A continuous aging decrease (1%/year) of both the BMC and the BMAC was noted after age 35. The rate at which bone loss occurred was similar for all age groups when analyzed by 5 year intervals. No clear acceleration of bone loss was noted around the usual time of the menopause.     

去卵巢对大鼠骨密度的影响

目的：探讨去卵巢对大鼠骨密度（BMD）的影响。方法；20只3．5月龄SD雌性大鼠分别除双侧卵巢（OVX）或假性去卵巢（Sham)，术后14周处死，应用QDR－4500A型扇形束双能X射线吸收法（DXA）测量大鼠全身、离体股骨、胫骨、腰维及兴趣区的BMD。结果：①术后6周OVX组全身BMD显低Sham组（P＝0．048），术后14周两组无显性差异；②术后14周OVX组离体股骨BMD显低于Sham组（P＜0．01），股骨远侧干骺端平均降低11．6％（P＜0．001）；③术后14周右侧离体胫骨BMD两组间差异无显性，但OVX组胫骨的端干骺端BMD显低于Sham组（P＜0．001）；④术后14周OVX组腰椎（L4－L6）的BMD显低于Sham组（P＝0．014），第六腰椎降低明显，平均降低8．1％（P＝0．005）。结论：去卵巢所致骨丢失以松质骨含量丰富的兴趣区明显。     

High bone mineral density is associated with high body mass index

Summary  High BMD is an infrequent finding. In this retrospective cohort study of women 50 years and older, we documented a strong association between high BMD and high BMI. Introduction  High bone mineral density (BMD) has been associated with genetic disorders and a variety of dietary, endocrine, metabolic, infectious and neoplastic diseases that in many cases warrant medical attention. Since body mass index (BMI) is closely correlated with BMD, we sought to explore the relationship between these two parameters in older women. Methods  We conducted a retrospective clinical cohort study of 16,500 women 50 years and older who underwent baseline BMD testing between May 1998 and October 2002. Mean T-scores and Z-scores, and the proportions of women with high BMD (T-score +2.5 or greater, Z-score +2.0 or greater), were assessed according to BMI category. Results  Higher BMI category was associated with higher mean T-scores and Z-scores at all sites (P < 0.001). The proportion of women with high BMD increased with each BMI category (P for trend <0.05). In women with a lumbar spine T-score of +2.5 or more, 43.5% were obese with BMI > 30 kg/m² (55.6% for the femoral neck and 73.1% for the total hip). For women with a lumbar spine Z-score of +2.0 or more, 37.2% were obese (42.0% for the femoral neck and 50.9% for the total hip). There was no evidence of a paradoxical increase in fracture rates in women with high BMD. Conclusions  High BMD is closely associated with elevated BMI in women. This should be taken into consideration prior to initiating extensive investigations for rare pathologies. This study was supported in part by an unrestricted educational grant from the CHAR/GE Healthcare Development Awards Programme.