Correlation of Clinical, Densitometric, and Histomorphometric Data in Osteoporosis

A B S T R A C T 21 paraplegic patients with recent traumatic spinal cord injury were orally administered 400 (n = 7) or 1,600 (n = 7) mgld of disodium dichloromethylene diphosphonate (Cl2MDP) and compared with a placebo group (n = 7) to test the preventive effects of the drug on acute bone loss and osteoclastic resorption. C12MDP therapy was initiated at a mean of 17.6 d after the onset of paraplegia. The study lasted at least 6 mo, consisting of a 3.5-mo treatment period, and a variable follow-up period. The effects of C12MDP were assessed by blood and urine biochemistry, bone histomorphometry on transilial samples, photon absorptiometry of the tibia and fibula, and radiomorphometry of the femur. The elevation in serum and urinary calcium and in urine hydroxyproline observed in the placebo group did not appear under treatment. With both doses of C12MDP there was no further decrease in the bone mineral content. In the treated groups, a smaller percentage increase in osteoclastic population was also noted when compared with the placebo group, but this difference was not significant. There was no mineralization defect induced by C12MDP, as shown by tetracycline double labeling. It thus appears that at doses ranging between 400 and 1,600 mg, given as early as possible, C12MDP can prevent or reduce the development of the acute bone loss of paraplegic patients, without adverse side effects, though it does not prevent the development of heterotopic ossification.

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“…This is in fact not surprising because there is no established correspondence between axial and peripheral bone (19).…”

Section: Discussionmentioning

confidence: 99%

Effects of disodium dichloromethylene diphosphonate on bone loss in paraplegic patients.

Minaire¹,

Bérard²,

Meunier³

et al. 1981

J. Clin. Invest.

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“…However, marked differences of histomorphometric parameters were found when different sections of iliac crest biopsies of one individual were studied [9]. In contrast to metabolic bone disease [10], there is evidence that normal or subnormal bone mineral density of the forearm may not necessarily reflect uniform changes of the structural parameters of the iliac crest in primary osteoporosis [1]. An unexplained negative correlation between osteodensitometry of the forearm and a radiological index obtained by subjective assessment of conventional skeletal x-ray readings has been reported [ 1].…”

Section: Discussionmentioning

confidence: 92%

Section: Microradiography--o Steodensitometrymentioning

confidence: 84%

“…However, no linear correlation was found when the trabecular mineral content, assessed by osteodensitometry, was correlated with volume density quantified by Send offprint requests to J. Kovarik, Second Medical Department of Internal Medicine, University of Vienna, Garnisongasse 13, A-1090 Vienna, Austria histomorphometric means [1]. In primary osteoporosis, subnormal values of both these parameters were found in only 60% of the patients examined [1]. Because of the discrepancy of these findings and in order to specify the diagnostic and clinical value of osteodensitometry, as well as histomorphometric and microradiographic analysis of bone biopsy, we correlated these parameters in untreated women with primary osteoporosis.…”

mentioning

confidence: 96%

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Evidence for negative correlation between quantitative histological studies and microradiography of iliac crest bone and forearm osteodensitometry in elderly women with osteoporosis

et al. 1982

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Quantitative histomorphometric and microradiographic analysis of iliac crest bone biopsy specimens of 10 unselected and untreated postmenopausal women with osteoporosis was performed and the results were correlated with the values measured by osteodensitometry on the right forearm. No positive correlation between histomorphometry or microradiography and osteodensitometry was observed. Moreover, the data of various histomorphometric parameters and those of the bone mineral content measured by microradiography revealed a significant negative correlation when compared to the values obtained by osteodensitometry. Our results suggest, that evaluation of one skeletal site is not necessarily representative of the entire skeleton in patients with postmenopausal osteoporosis.

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“…By far the most important metabolic bone disease is postmenopausal osteoporosis in terms of frequency, morbidity, mortality, and cost (27). No single bone measurement has been able to separate totally an osteoporotic population from age and sex-matched normals when the definition of osteoporosis was the presence of fracture (34)(35)(36)(37). However, if such a definition is used, it is hardly surprising that there is considerable overlap between patients and controls.…”

Section: Discussionmentioning

confidence: 99%

Regional and total skeletal measurements in the early postmenopause

Stevenson¹,

Banks²,

Spinks³

1988

Maturitas

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In a cross-sectional study of 70 early postmenopausil women, regional bone measurements were compared with total body calcium (TBC*). Spinal and forearm trabecular bone were mainly related to age and time since menopause. In contrast, TBCa and forearm integral (cortical and trabecular) and cortical bone were unrelated to age, although the time since menopause also had some influence. Forearm integral and cortical bone measurements were quite well correlated with TBCa (r = 0.84 and 0.73, respectively, P < 0.001). The correlation between spinal bone measurements and any of the forearm measurements, even purely trabecular bone,' was weak (r < 0.52, P < 0.001). Our results show quite clearly that forearm bone measurements cannot be used to predict bone density in the vertebrae. Loss of ovarian function affects bone in general, and trabecular bone in particular. Bone measurements at specific anatomical sites are clearly necessary for studies of metabolic bone diseases and their response to treatment.

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Correlation of Clinical, Densitometric, and Histomorphometric Data in Osteoporosis

Cited by 7 publications

References 4 publications

Effects of disodium dichloromethylene diphosphonate on bone loss in paraplegic patients.

Effects of disodium dichloromethylene diphosphonate on bone loss in paraplegic patients.

Evidence for negative correlation between quantitative histological studies and microradiography of iliac crest bone and forearm osteodensitometry in elderly women with osteoporosis

Regional and total skeletal measurements in the early postmenopause

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