Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Kutatasaink azon a munkahipotezisen alapultak, hogy a csont torekenyseget a mennyisegi megfogyas mellett a mikroszerkezetben es a csont rugalmassagaban bekovetkező karosodasok is jelentősen befolyasoljak. Eredmenyeink szerint a periferias osteoporosisos csonttoresek előfordulasaban az ultrahang sebesseg (SOS) csokkenese a densitastol fuggetlen tenyezőkent jatszik szerepet. Ferfiak idiopathias osteoporosisaban a csigolyakompressziora vonatkozoan eszleltuk ugyanezt, vagyis a kompressziot nem befolyasolta a BMD alakulasa, viszont az SOS csokkenesevel erősen osszefuggesben volt. Munkank reszekent uj diagnosztikus kriteriumokat allitottunk fel a csontultrahang alkalmazasahoz az osteoporosisos betegek napi ellatasaban. Az antiporotikus kezelesnek a csontminősegre gyakorolt hatasat elsősorban calcitonin eseteben tanulmanyoztuk, erdemi gyarapodast azonban az ultrahangos parameterek nem mutattak, bar az eletkori csokkenest a szer kivedte. Primaer hyperparathyreosisban nem csak a toressel jellemzett ossealis formaban, hanem a vesekovekkel jellemzett (es ritkan torő) renalis formabban is kisebb csontdensitast talaltunk. Az SOS csokkeneset igazoltuk a dohanyosok osteopeniajaban, valamint D-vitaminhianyos nőkben es ferfiakban egyarant. Haemodialyzalt betegekben az SOS csokkenese kozvetlen kapcsolatban volt az insufficiens D-vitamn statusszal. | Our research project was based on the hypothesis that bone fragility is resulted not only from mineral loss but from deterioration of microstructure and elasticity, too. Our results supported this view. The BMD-independent relationship of SOS to the peripheral fracture rate ensured convincing proof about the role of bone quality in the development of fractures. Similar observations were done in idiopathic male osteoprosis as vertebral compression was found to be independent of spine bMD but strongly connected to the decreased SOS of ultrasound at the heel. New diagnostic criteria were also developed and introduced to the daily medical practice of osteoporosis management. A prospective follow-up of calcitonin treatment in osteoporosis failed to demonstrate significant increase in QUS variables, however, the absence of age -related decrease in BUA and SOS was demonstrated. In primary hyperparathyroidism, a significant bone loss was detected not only in the osseal form with bone fractures but also in renal form (kidney stones, rare fractures). Decreased SOS was observed in smokers as well as in vitamin D deficient men and women. The lower SOS was directly related to insufficient vitamin D status in hemodialyzed patients.

Objectives: The aim of this study was to identify the differences in ultrasound bone variables (QUS) and to test the ability to discriminate male patients with and without vertebral fractures.Methods: We therefore measured broadband ultrasound attenuation (BUA) and speed of sound (SOS) matched for bone mineral density (BMD) and vertebral deformity in idiopathic male osteoporosis.Results: One hundred and seventeen men (age 56.6 range 27-78) were divided into three groups (osteoporosis n = 25, osteopenia n = 58 and age-matched control n = 34) according to BMD T-score by WHO criteria. We found 66 patients (56%) with at least one vertebral deformity during the study. BMD and BUA did not differ, while SOS was lower in osteoporosis (p < 0.001) and control group (p < 0.001) between the patients with and without vertebral compression. Strong positive correlation was demonstrated between BUA and BMD (lumbar spine r = 0.44, p < 0.001, femoral neck r = 0.56, p < 0.001, radius r = 0.40, p < 0.001), while similar association between SOS and BMD values was not shown. There was no relationship between the BUA and vertebral fracture risk (Odds ratio: 1.14 95% CI: 0.80-1.61). However, the relative risk of vertebral fracture by SOS was 1.56 (95% CI: 1.08-2.62). Adjusting for age and BMI the risk of vertebral fracture did not change (odds ratio for SOS 1.50 95% CI: 1.02-2.22). After adjustment for BMD SOS was still associated with fracture risk at all measured sites (odds ratio: 1.43, 95% CI: 1.02-2.22; 1.41, 95% CI: 1.02-2.17 and 1.32, 95% CI: 1.02-2.0).Conclusion: Our results suggest that BUA values are more closely related to density and structure while SOS values are able to predict fractures. (C) 2006 Elsevier Masson SAS. All rights reserved.

L'objectif de cette étude était d'identifier des différences de variables ultrasonographiques osseuses (USQ) et de tester la capacité de discrimination de la technique entre hommes avec ou sans fractures vertébrales. Nous avons pour cela mesuré le spectre d'atténuation des ultrasons (SAU) et la vitesse des ultrasons (VUS) appariés pour la densité minérale osseuse (DMO) et la déformation vertébrale au cours de l'ostéoporose masculine idiopathique. Cent dix-sept hommes (âge : 56,6 ans [27–78 ans]) étaient répartis en trois groupes (ostéoporose n = 25, ostéopénie n = 58 et témoins appariés pour l'âge n = 34) selon les critères OMS du T-score en DMO. Nous avons trouvé 66 patients (56 %) au cours de l'étude ayant au moins une déformation vertébrale. La DMO et le SAU ne différaient pas alors que la VUS était plus basse dans le groupe ostéoporose (p < 0,001) et dans le groupe témoin (p < 0,001) entre patients avec ou sans tassement vertébral. Une forte corrélation positive était démontrée entre SAU et DMO (rachis lombaire r = 0,44, p < 0,001 ; col fémoral r = 0,56, p < 0,001 ; radius r = 0,40, p < 0,001), alors qu'une telle corrélation n'était pas identifiée entre les valeurs de VUS et de DMO. Il n'y avait pas de relation entre SAU et le risque de fracture vertébrale (Odds ratio : 1,14 ; IC 95 % : 0,80–1,61). En revanche, le risque relatif de fracture vertébrale par VUS était de 1,56 (IC 95 % : 1,08–2,62). L'ajustement pour l'âge et l'IMC (indice de masse corporelle) ne modifiait pas le risque de fracture vertébrale (Odds ration pour la VUS : 1,50 ; IC 95 % : 1,02–2,22). Après ajustement pour la DMO, la VUS restait associée au risque de fracture en tous les sites de mesure (Odds ratio : 1,43, IC 95 % : 1,02–2,22 ; 1,41, IC 95 % : 1,02–2,17 et 1,32, IC 95 % 1,02–2,0). Nos résultats suggèrent que les valeurs de SAU sont étroitement liées à la densité et à la structure osseuse alors que les valeurs de la VUS sont capables de prédire les fractures vertébrales.

Our study was initiated to evaluate whether there are differences between the two sides, depending on hand dominance, in densitometry values and quantitative ultrasound parameters (QUS) of the lower limb. One hundred and six women and 44 men were involved. The hand dominance was determined by interview. The bone mineral density (BMD) of the left and the right femoral necks and the calcanei were measured by dual-energy X-ray absorptiometry (DXA). The QUS examination consisted of measuring the attenuation (BUA), the speed of the ultrasound (SOS) and quantitative ultrasound index (QUI) transversing the left and right calcanei. The density of the neck of femur of the non-dominant side did not differ from that of the dominant side. On the other hand, BMD, BUA and the QUI of the calcaneus were higher on the non-dominant side in both genders (p<0.05 for each parameter). No similar differences were seen for the SOS values. Our study has confirmed the side-to-side differences of the calcaneus in both genders, lower values were found on the dominant side. No similar differences were seen on the femur. The AUC values seemed to be higher on the dominant side, however, these differences were not strictly significant. In the case of peripheral site (heel) measurements, the practical significance of our observations is that they raise the possibility of performing peripheral DXA and QUS examinations of the calcaneus on the dominant side of the patient according to handedness.

INTRODUCTION:Smoking is a risk factor for osteoporosis. In a previous study, the authors showed lower bone density among smokers in a group of postmenopausal women.AIMS:After this finding, the primary goal of current research was to investigate how smoking could influence bone quality.METHODS:Forty-five (age range: 25-72 ys) smoker women were compared with 45 nonsmoker women adjusted for age and anthropometric parameters. Quantitative ultrasound method was used to determine the speed of ultrasound and the ultrasound attenuation transmitting the left heel (Achilles In Sight, GE Lunar). Dual photon absorptiometry method was applied to investigate the bone mineral density of lumbar spine and left femoral neck (Prodigy, GE Lunar) and single photon absorptiometry was used to determine the bone mineral content of radius at the non dominant side (NK-364, Gamma).RESULTS:No difference was found between smokers and non-smokers among the premenopausal group, however, postmenopausal smoker women had slightly lower speed of ultrasound and ultrasound attenuation values than non-smoker women. Postmenopausal smoker women suffering from bone fracture had significantly lower speed of ultrasound than postmenopausal non-smoker women (1508.9 vs. 1525.3 m/s, respectively), despite their bone density did not differ from each other.CONCLUSION:These data augment the knowledge about the injurious effect of smoking. The increased risk for bone fracture among smokers could be explained not only with the decrease of bone mass, which was previously described, but also with a decreased bone elasticity.

Our aim was to investigate whether pollen-allergy can affect bone mass and fractures in postmenopausal women.

INTRODUCTION:A strong positive association between body mass index and bone mineral density is well defined in postmenopausal osteoporosis, but not in men.AIMS:The primary goal of the current research was to investigate this association in case of men.METHODS:According to WHO criteria (T-score below -1.0 at all measure site) seventy-two (mean age 55.7 +/- 0.99, range 38-78 yr normal density) healthy male with normal density were recruited. Exclusion criteria were the absence of any risk factors or signs of metabolic disease. Bone mineral measurements at the lumbar spine (L2-4) and femoral neck were performed by the dual-energy X-ray absorptiometry (DEXA, Lunar DPX-L, USA), bone mineral content of the non-dominant radius was measured with single photon absorptiometry (SPA, NK-364, Hungary). Participants were divided into three groups according to body mass index normal weight (18.5-24.9 kg/m2), moderate overweight (25-29.9 kg/m2) and obese subjects (> 30 kg/m2).RESULTS:Femur neck density was significantly lower in the normal weight than in the overweight counterparts (0.969 +/- 0.03 vs 1.062 +/- 0.02 p = 0.01). There was a strong positive association between BMI and femur neck BMD (r = 0.412 p < 0.001). Body mass was an independent predictor of femur neck bone mineral density (regression coefficients 0.382, p = 0.001). There was not correlation at the lumbar spine and the radius sites.CONCLUSION:Bone density at femur neck sites is lower in the normal weight men than in obese subjects, therefore the risk factors for proximal femur osteoporosis are higher in these cases. Prevention strategy is needed for men in the lowest quintile of body mass to prevent further decrease in BMD and reduce the risk of hip fracture.

The purpose of this review was to summarise the causes of vertebral deformity. Osteoporosis as the most frequent disease lies in the background of vertebral deformity which is the most common type of fractures. Vertebrae cannot resist mechanical loadings so they deform and/or break because of their decreased mineral density and changed trebecular microarchitecture. The diagnosis of vertebral deformity presents several problems in the practice. For example, patients with vertebral fractures do not report having symptoms even when present (asymptomatic deformity), moreover plain radiograph does not show high enough sensitivity to diagnose vertebral fractures. The two methods most likely used in clinical research would be the semiquantitative assessment of vertebral deformities, which is based on visual evaluation, and the quantitative approach, which is based on different morphometric criteria. Absorptiometric morphometry and digital technology are developing, though presently they are not widespread. The compression of vertebrae is followed by heavy pain and functional disability (symptomatic deformity), and in these cases plain radiographs show the following pictures: wedge, biconcave and crush deformity, which enable us to make the diagnosis. Its high occurrence, the increased mortality rate, the decreasing quality of life and the prevalence of subsequent fracture make osteoporotic vertebral deformity so significant. The bone strength is determined not only by bone mass and bone microarchitecture, but also by its quality and turnover. From this follows that besides osteoporosis there are several diseases with vertebral deformity and increased fragilibility. The main diseases are: developmental disorders, osteochondrosis, heritable disorders, postural conditions, traumas, inflammatory diseases, storage diseases, other metabolic bone diseases, hematological diseases and spondyloarthropathy.