Changing Measures to Evaluate Changing Bone

Abstract

Osteoporosis is a silent, progressive disease affecting millions of Americans, costing $23.5 billion annually (). Fragility fractures, painful and costly sequelae of osteoporosis, are frequently underdiagnosed and undertreated partially because of limited assessment measures. Currently, bone mineral density measured by dual-energy x-ray absorptiometry is the surrogate marker of bone health () but has shortcomings predicting fragility fractures. Bone turnover markers and magnetic resonance spectroscopy are promising techniques for earlier, more accurate assessment of bone physiology and structure. Bone turnover markers reflect the dynamic nature of living bone (), thus providing a more comprehensive picture of bone health. Magnetic resonance spectroscopy may hold predictive power in determining fast and slow bone mineral density losers (). The use of these tools may assist with diagnosis of osteoporosis, allowing earlier determination of the effectiveness of prescribed therapies to improve bone health.

Musculoskeletal Health in Menopause

“…The FRAX Tool DXA alone has been identified as an unreliable fracture risk guide [40,41]. Additional fracture risk assessment algorithms like the FRAX and other tools have been developed, which, when used in conjunction with DEXA scanning, provide more accurate assessments of a postmenopausal woman's fracture risk [42].…”

Risk of Fracture During Androgen Deprivation Therapy Among Patients With Prostate Cancer: A Systematic Review and Meta-Analysis of Cohort Studies

“…Research reported that ADT was significantly associated with reduced bone mineral density (BMD) in the lumbar spine, femoral neck, and total hip compared with controls (Kim et al, 2019). Nevertheless, BMD can only explain 60-80% of bone variation, and T-score is lack of complete insight on bone quality and construction (Li et al, 2004;Fitton et al, 2015). The association between fracture risk and ADT has been investigated in previous meta-analyses; however, some studies have not performed subgroup analysis based on disease state of prostate cancer, thus rendering indistinct the risks of pathological and nonpathological ADT-related fractures (Serpa Neto et al, 2010).…”