Secondary osteoporosis and the microanatomy of trabecular bone

Aaron, Jean E.; Johnson, Dwayne; Paxton, Stephen; Kanis, John А.

doi:10.1007/bf02207240

Cited by 23 publications

(14 citation statements)

References 5 publications

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“…Trabecular bones (typical of lumbar area) are known to have a more rapid rate of deprivation in early post-menopausal state in comparison to cortical bone (typical of proximal femur) [12]. Moreover, most of the etiologies of the secondary osteoporosis (such as glucocorticoid excess, hyperthyroidism, malabsorption, liver disease, rheumatoid arthritis, and medications) first affect spinal column [13]. This will lead to higher prevalence of lumbar osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Discordance in diagnosis of osteoporosis using spine and hip bone densitometry

et al. 2005

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BackgroundDiagnostic discordance for osteoporosis is the observation that the T-score of an individual patient varies from one key measurement site to another, falling into two different diagnostic categories identified by the World Health Organization (WHO) classification system. This study was conducted to evaluate the presence and risk factors for this phenomenon in a large sample of Iranian population.MethodsDemographic data, anthropometric measurements, and risk factors for osteoporosis were derived from a database on 4229 patients referred to a community-based outpatient osteoporosis testing center from 2000 to 2003. Dual-energy X-ray absorptiometry (DXA) was performed on L1–L4 lumbar spine and total hip for all cases. Minor discordance was defined as present when the difference between two sites was no more than one WHO diagnostic class. Major discordance was present when one site is osteoporotic and the other is normal. Subjects with incomplete data were excluded.ResultsIn 4188 participants (3848 female, mean age 53.4 ± 11.8 years), major discordance, minor discordance, and concordance of T-scores were seen in 2.7%, 38.9% and 58.3%, respectively. In multivariate logistic regression analysis, older age, menopause, obesity, and belated menopause were recognized as risk factors and hormone replacement therapy as a protective factor against T-score discordance.ConclusionThe high prevalence of T-score discordance may lead to problems in interpretation of the densitometry results for some patients. This phenomenon should be regarded as a real and prevalent finding and physicians should develop a particular strategy approaching to these patients.

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Section: Discussionmentioning

confidence: 99%

Discordance in diagnosis of osteoporosis using spine and hip bone densitometry

et al. 2005

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“…Trabecular bones usually have a faster rate of loss compared to cortical bones like the femur . Additionally, most etiologies of secondary osteoporosis first affect the spine . Weight bearing is also a cause for physiologic dissimilarity with increased bone density in the hip and femur region .…”

Section: Discussionmentioning

confidence: 99%

“…24 Additionally, most etiologies of secondary osteoporosis first affect the spine. 25 Weight bearing is also a cause for physiologic dissimilarity with increased bone density in the hip and femur region. 26 Early identification of osteoporosis is essential to prevent or delay the possibility of osteoporotic fractures and their consequences and discordance assumes significance as it can alter the diagnostic and therapeutic plan for a patient.…”

Section: Discussionmentioning

confidence: 99%

Can sleep apnea be a secondary cause of osteoporosis in young people?

Yüceege

Dülgeroğlu

Fırat

et al. 2015

Sleep and Biological Rhythms

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We aimed to evaluate the impact of obstructive sleep apnea (OSA) on bone mass densities (BMD) in young people with sleep apnea. Ninety five consecutive patients, referred to our sleep clinic for sleep apnea symptoms were enrolled in the study. The study complied with the declaration of Helsinki and was approved by the local research ethics committee. All patients underwent in‐laboratory polysomnography (PSG) and BMD analysis with dual‐energy X‐ray absorptiometry (DXA) in lumbar spine (L1–4) and total femur region. Patients with total sleep time less than 4 h, chronic renal, pulmonary, cardiac, thyroid disease, diabetes mellitus, hypertension, steroid usage and known osteoporosis were excluded from the study. Totally 85 patients with mean age of 35.7 ± 5.7 were enrolled in the study. 47 patients: normal, 33 patients: osteopenic, five patients were found osteoporotic. Osteopenic and osteoporotic patients were considered as one group in statistic tests. Mean femur neck T score and total femur T score values were higher, while mean total lumbar T scores and lumbar BMD values were less in patients with severe OSA. apnea–hypopnea index (AHI) was inversely correlated with total Lombar T scores (r = −0.250, P = 0.021) and positively correlated with Total Femur T scores (r = 0.242, P = 0.029. AHI ≥ 30 was related with 4.26‐fold (95% CI 1496–12.1) increased risk of lumbar osteopenia and osteoporosis. We have found that OSA is associated with low BMD especially in lumbar region and suggest OSA to be remembered as one of the secondary causes of osteoporosis in young patient groups.

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“…[14] Additionally, most etiologies of secondary osteoporosis first affect the spine. [15] Weight bearing is also a cause for physiologic dissimilarity with increased bone density in the hip and femur region. [16]…”

Section: Discussionmentioning

confidence: 99%

Major and minor discordance in the diagnosis of postmenopausal osteoporosis among Indian women using hip and spine dual-energy X-ray absorptiometry

2012

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Objective:To determine discordance in the diagnosis of osteoporosis among postmenopausal Indian women using hip and spine Dual-energy X-ray Absorptiometry.Materials and Methods:The study included postmenopausal women who underwent bone mineral densitometry (BMD) for suspected osteoporosis at a referral hospital at Hyderabad, India. The BMD measures at the hip and spine were used to derive T-scores and to determine the prevalence of discordance. Factors potentially associated with discordance were explored in univariate and a multivariate regression model.Results:The mean age of the 348 postmenopausal women in the study was 53.62 ± 8.94 years (median 53.00 years, range 27.00 to 84.00 years). Major discordance was seen in 16.67% (95% confidence intervals [CI]: 12.73, 20.60) of the study population and minor discordance in 34.48% (95% CI: 29.46, 39.50%) of the study population. Age >50 years (adjusted odds ratios [OR]: 2.60, 95% CI: 1.24, 5.46, P value = 0.01), premature menopause (adjusted OR: 2.94, 95% CI: 1.27, 6.81, P value = 0.03), and multiple pregnancies (adjusted OR: 2.64, 95% CI: 1.28, 5.41, P value = 0.008) were found to be significantly associated with major discordance.Conclusions:The large prevalence of discordance may reflect the differences in osteoporosis in different populations and suggests the need to redefine ranges and risk factors used for the diagnosis of osteoporosis in India.

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Secondary osteoporosis and the microanatomy of trabecular bone

Cited by 23 publications

References 5 publications

Discordance in diagnosis of osteoporosis using spine and hip bone densitometry

Discordance in diagnosis of osteoporosis using spine and hip bone densitometry

Can sleep apnea be a secondary cause of osteoporosis in young people?

Major and minor discordance in the diagnosis of postmenopausal osteoporosis among Indian women using hip and spine dual-energy X-ray absorptiometry

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