Association of Five Quantitative Ultrasound Devices and Bone Densitometry With Osteoporotic Vertebral Fractures in a Population-Based Sample: The OPUS Study

Glüer, Claus C.; Eastell, Richard; Reid, David M.; Felsenberg, Dieter; Roux, Christian; Barkmann, Reinhard; Timm, Wolfram; Blenk, Tilo; Armbrecht, Gabriele; Stewart, Arthur D.; Clowes, Jackie A.; Thomasius, Friederike; Kolta, Sami

doi:10.1359/jbmr.040304

Cited by 250 publications

(141 citation statements)

References 50 publications

Supporting

Mentioning

129

Contrasting

Unclassified

Order By: Relevance

“…QUS is an established osteodensitometric technique in the diagnosis of postmenopausal osteoporosis and a good predictor of fracture risk. 8,19 This radiation-free technique not only provides information on bone mineral content but also on the micro-architecture of bone, like porosity, trabecular orientation, linkage and elasticity, which are all crucial for the mechanical strength of bone. 5,7 In our study, measurements on 114 term and preterm infants within their first week of life, representing bone mineralization as close as possible to the intrauterine situation and least altered by postnatal influence of nutrition or illness, showed a highly significant correlation of QUS with gestational age and birth weight.…”

Section: Discussionmentioning

confidence: 99%

“…7 Both retrospective and prospective clinical studies have shown that QUS has similar abilities of predicting fracture at the proximal femur and spine in adults as DXA. 8 Although QUS is now widely used in adults and represents a relatively established method for evaluating bone mineral status in the context of diagnosing osteoporosis, QUS has only been employed in mostly small study samples of newborn infants and children. [9][10][11][12][13][14][15][16][17] However, none of these studies provide longitudinal data in regular intervals on QUS measurements in preterm infants simultaneously accounting for growth changes and increase of soft tissue.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

View full text Add to dashboard Cite

Objective: As 80% of intrauterine bone mineralization takes place during the last trimester of pregnancy, preterm infants should be supplemented postnatally with optimal doses of calcium, phosphate and vitamin D. Calcium and phosphate excretion in the urine may be used to monitor individual mineral requirements, but are sometimes difficult to interpret. The objective of this study was to assess the value of quantitative ultrasound (QUS) for the analysis of bone status in neonates.Study Design: All admissions to three independent tertiary neonatal intensive care units were studied. In 172 preterm and term infants with a gestational age between 23 and 42 weeks (mean 33.8 ± 5.0) and a birth weight from 405 to 5130 g (mean 2132±1091 g) bone status was evaluated prospectively by quantitative ultrasound velocity using a standardized protocol. Infants were followed in regular intervals up to their first discharge home. While measurements were conducted in weekly intervals initially (n ¼ 55), 2-week intervals were regarded as sufficient thereafter due to limited changes in QUS values within the shorter period. Infants with a birth weight below 1500 g were followed during outpatient visits until up to 17 months of age.Result: The intra-individual day-to-day reproducibility was 0.62%. QUSvalues from the first week of life correlated significantly with gestational age and birth weight (r ¼ 0.5 and r ¼ 0.6; P<0.001). Small-forgestational-age infants showed lower values for QUS than appropriate-forgestational-age infants allowing for their gestational age. Follow-up measurements correlated positively with age and weight during the week of measurement (r ¼ 0.2 and r ¼ 0.4; P ¼ 0.001). Comparing bone quality at 40 weeks of age in infants born at term versus infants born at 24 to 28 weeks, preterm infants showed significantly lower QUS than term infants (P<.0001).There was a significant correlation of QUS with serum alkaline phosphatase (P ¼ 0.003), the supplementation with calcium, phosphate and vitamin D (P< 0.001 each), as well as risk factors for a reduced bone mineralization. No correlation was found between QUS and calcium or phosphate concentration in serum or urine.Conclusion: QUS is a highly reproducible, easily applicable and radiation-free technique that can be used to monitor bone quality in individual newborns. Further prospective randomized-trials are necessary to evaluate, if therapeutic interventions based on QUS are able to prevent osteopenia of prematurity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

View full text Add to dashboard Cite

show abstract

“…OPUS is a prospective population-based study from five European centres and detailed information relating to the population demography and participant recruitment has been published previously (19). The study was approved at each institution according to the Declaration of Helsinki and written consent was obtained from all participants.…”

Section: Osteoporosis and Ultrasound Studymentioning

confidence: 99%

THRA and DIO2 mutations are unlikely to be a common cause of increased bone mineral density in euthyroid post-menopausal women

Gogakos

Logan

Waung

et al. 2014

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Objective: A new autosomal dominant disorder due to mutation of THRA, which encodes thyroid hormone receptor a, is characterised by severely delayed skeletal development but only slightly abnormal thyroid status. Adult mice with disrupted thyroid hormone action in bone due to a mutation of Thra or deletion of Dio2, encoding the type 2 deiodinase, have high bone mass and mineralisation despite essentially euthyroid status. No individuals with DIO2 mutations have been described and the adult phenotype of patients with THRA mutations is largely unknown. We hypothesised that screening euthyroid adults with high bone mineral density (BMD) could be used to identify individuals with mutations of THRA or DIO2. Design: The Osteoporosis and Ultrasound Study (OPUS) is a 6-year prospective study of fracture-related factors from five European centres. Methods: A cohort of 100 healthy euthyroid post-menopausal women with the highest BMD was selected from the OPUS population. We sequenced the intron-exon boundaries and critical exons of THRA and DIO2 in these subjects. TSH, free 3,5,3 0 -L-triiodothyronine, free thyroxine, vitamin D, parathyroid hormone and bone turnover marker concentrations, and BMD measurements were available in all OPUS participants. Results: No coding sequence or splice site mutations affecting THRA or DIO2 were identified. Conclusions: Mutations affecting THRA or DIO2 are not a common cause of high BMD in healthy euthyroid post-menopausal women.European Journal of Endocrinology (2014) 170, 637-644 IntroductionThyroid hormones (thyroxine (T 4 ) and 3,5,3 0 -L-triiodothyronine (T 3 )) are essential for skeletal development, post-natal growth, and bone maturation. In adults, thyroid hormones regulate bone turnover, and normal euthyroid status is required to maintain optimal bone mass and mineralisation (1). Accordingly, thyrotoxicosis is a well-established cause of osteoporosis, and hypothyroidism is associated with an increased risk of fracture (2).The thyroid gland secretes T 4 and T 3 in a ratio of about 15:1, but T 4 is a pro-hormone and must be converted to T 3 in the peripheral tissues (3). Conversion of T 4 to T 3 in target cells is catalysed by type 2 iodothyronine deiodinase (DIO2), and the activity of this enzyme regulates intracellular availability of T 3 . Two nuclear receptors, TRa and TRb, mediate T 3 action in the target cells, and their relative levels of expression vary between tissues. European Journal of Endocrinology Clinical StudyA Gogakos and others THRA and DIO2 in women with high bone density For example, TRa is expressed at high levels in bone and cartilage, whereas TRb predominates in the hypothalamus and pituitary, where it mediates feedback control of the hypothalamic-pituitary-thyroid (HPT) axis (4). The syndrome of resistance to thyroid hormone (RTH) was described in 1967 (5) and the first THRB mutations affecting TRb were identified in 1989 (6). Heterozygous mutations of THRA were finally reported in three families in 2012 and 2013 (7, 8, 9, 10). Affected individuals a...

show abstract

“…The QUS parameters, BUA (broadband sound attenuation) and SOS (speed of sound) depend not only on mineral bone mass, but also on micro architecture and physical properties of bone tissue. A number of studies showed that the values of parameters measured with QUS are lower in woman with the history of osteoporotic fractures, regardless of the bone mineral density determined by DXA (Hernandez, 2004, Gluer, 2004. Thus, QUS parameters are independent risk indicator for hip fractures.…”

Section: Quantitative Ultrasound Of the Heelmentioning

confidence: 99%