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Bone Mineral Density And Trabecular Bone Score In Men With Vertebral Fractures
Journal of Clinical Densitometry: Assessment & Management of Musculoskeletal Health, vol. 21, no. 4, 583 597, 2018 1094-6950/21:583 597/$36.00 https://doi.org/10.1016/j.jocd.2018.05.003
Abstracts from the ISCD Annual Meeting 2018 Conclusions: Low levels of 25OHD are present in a significantly higher percentage in HIV-positive patients compared to healthy controls. The serum 25OHD concentration was not correlated with any particularities of the treatment regimen or disease characteristics in our sample. Clinical guidelines related to the VD status in HIV-positive patients are needed.
BONE MINERAL DENSITY AND TRABECULAR BONE SCORE IN MEN WITH VERTEBRAL FRACTURES D1XV. X PovoroznyukD,2X X A. D3X X MusiienkoD;4X X D.F. Chebotarev Institute of Gerontology NAMS Ukraine, Kyiv, Ukraine
https://doi.org/10.1016/j.jocd.2018.05.004
The aim of this study is to evaluate the trabecular bone score (TBS) and bone mineral density (BMD) in men with osteoporotic vertebral fractures. Materials and methods: We’ve examined 197 men aged 45-89 years, divided according to the gerontologic classification: 45-59 yrs (n=83), 6074 yrs (n=86), 75-89 yrs (n=28). Group A consists of 44 men with vertebral fractures (mean age 63.7§10.8 yrs; mean height 1.73§7.02 m; mean weight 79.4§14.9 kg) and group B 153 men without fractures (mean age 62.3§10.2 yrs; mean height 1.73§6.29 m; mean weight 76.3§8.9 kg). The BMD of lumbar spine L1-L4, femoral neck and total body were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS L1-L4 was assessed by the TBS iNsightÒ software package installed on our DXA machine (Med-Imaps, Pessac, France). Results: In total group we found that men with osteoporotic vertebral fractures 1.027§0.210, B 1.185§0.170; have significantly lower TBS L1-L4 (A F=25.54; p<0.001) and BMD of lumbar spine (A 1.009§0.172 g/cm2, B 0.821§0.143 g/cm2, B 1.150§0.130 g/cm2; p<0.001), femoral neck (A 0.908§0.135 g/cm2; p<0.001), total body (A 1.110§0.117 g/cm2, B 1.183§ 0.094 g/cm2; p<0.001) to compared with men without fractures. When we analyzed BMD depending on age, we found the significantly differences in group A: TBS L1-L4 45-59 yrs 1.025§0.248 vs 1.226§0.156 (p<0.001), 60-74 yrs 1.083§0.170 vs 1.150§0.175 (p=0.195), 75-89 yrs 0.951§0.170 vs 1.183§ 0.174 (p=0.002) and BMD of lumbar spine 45-59 yrs 1.027§0.18 vs 1.154§ 0.13 (p=0.001), 60-74 yrs 1.014§0.16 vs 1.148§0.14 (p=0.002), 75-89 yrs 0.950§0.17 vs 1.182§0.17 (p=0.003); total body 45-59 yrs 1.141§0.11 vs 1.203§0.09 (p=0.02), 60-74 yrs 1.121§0.11 vs 1.179§0.09 (p=0.04), 75-89 yrs 1.040§0.11 vs 1.128§0.08 (p=0.02). Conclusion: Subjects with vertebral fractures have significantly lower TBS and BMD parameters than the healthy men.
IMPACT OF WHEY PROTEIN ON BONE MINERAL DENSITY: A SYSTEMIC REVIEW AND META-ANALYSIS Kamonkiat Wirunsawana MD1, Sikarin Upala MD2; 1University of Hawaii, 2 University of Chicago
Introduction: Previous studies have shown that whey protein and its basic protein fraction, milk basic protein, might have a beneficial effect on bone mass through promoting bone formation and suppressing osteoclast activity. Nonetheless, most studies do not have enough power to examine the potential benefit on bone mass from using whey protein and milk basic protein and the data are contradictory. Objective: The aim of our meta-analysis is to reveal the impact of whey protein and milk basic protein on bone mineral density (BMD). Method: We comprehensively searched the databases of MEDLINE, EMBASE, and Cochrane databases. The inclusion criterion was published randomized control trials (RCT) comparing whey protein supplementation or milk basic protein to placebo or controls (non-whey protein). The primary outcome was the differences in the changes in BMD at the level of lumbar spine, hip, or femoral neck, which was primarily measured by dual-energy xray absorptiometry. We calculated pooled mean difference (MD) with 95% confidence intervals (CI) using random-effects model. Publication bias was assessed using funnel plot and Egger's regression test Results: Six RCTs were included in the meta-analysis involving 562 subjects. Our collected studies utilized varying dose of whey protein from 25 grams to 75 grams per day and the dose of milk basic protein is 40 grams per day during a time frame ranging from six months to two years. There was a statistically significant improvement of BMD at the lumbar spine (MD= 0.014, 95% CI: 0.011 to 0.017, p-value < 0.05) favoring whey protein and milk basic protein group. There is a symmetrical distribution of studies in funnel plot. The Egger's test result was not statistically significant (P = 0.87). There was no enough studies to compare the difference of BMD at the hip or femoral neck. Conclusion: This is the first meta-analysis investigating the impact of whey protein and milk basic protein on BMD. Our study suggested that whey protein supplementation and milk basic protein, the basic protein fraction of whey protein, might have a positive impact on bone mineral density compared to placebo or controls. Using whey protein and milk basic protein should be considered to be a conjunctive treatment with current therapy to improve bone mineral density.
https://doi.org/10.1016/j.jocd.2018.05.003
HYPOVITAMINOSIS D IN HIV-INFECTED PATIENTS Cristina Capatina MD, PhD., Anca Streinu Cercel MD., Daniela Manolache MD, PhD., Oana Sandulescu MD, PhD., Carmen Barbu MD, PhD., Adrian Streinu Cercel MD, PhD., Catalina Poiana MD, PhD.; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Introduction: Vitamin D (VD) deficiency is highly prevalent among HIVinfected patients and has been associated with a worse disease prognosis. Aim: To determine the prevalence of hypovitaminosis D in a cohort of HIVpositive Romanian patients compared to healthy controls Methods: Plasma samples for the determination of serum 25OHD concentration were collected from HIV-infected patients and healthy controls. 25OHD status was defined as: deficiency <20 ng/mL (severe deficiency <10 ng/ml), insufficiency 20-30 ng/mL, normal >30 ng/mL. Clinical and laboratory parameters were retrospectively extracted from patients'files (CD4+ cell count, CD4+ nadir, HBV/HCV co-infection, ART). Results: We evaluated 118 HIV-positive patients, (72 males, 46 females, aged 36.9±12.2 years). 106 patients (98.14 %) were on complex ART regimens. 9.3% had B/C hepatitis coinfection. We also 119 healthy controls matched by age, sex and menopausal status. The mean serum 25OHD concentration in the HIV-positive patients was significantly lower (19.36 ±11.34 ng/ml) compared to controls (23.74±8.32 ng/ml; p=0.001). Normal VD status was determined in only 15.96% of patients and 12.71% of controls. Severe VD deficiency was found in a higher percentage of HIV positive patients (23.52%) compared to controls (4.2%, p=0.001). The serum 25OHD level in patients was not significantly correlated with gender, age, menopausal status in women, number of years of previous ART treatment or nadir CD 4 positive cell-count.
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Abstracts from the ISCD Annual Meeting 2018 Conclusions: Low levels of 25OHD are present in a significantly higher percentage in HIV-positive patients compared to healthy controls. The serum 25OHD concentration was not correlated with any particularities of the treatment regimen or disease characteristics in our sample. Clinical guidelines related to the VD status in HIV-positive patients are needed.
BONE MINERAL DENSITY AND TRABECULAR BONE SCORE IN MEN WITH VERTEBRAL FRACTURES D1XV. X PovoroznyukD,2X X A. D3X X MusiienkoD;4X X D.F. Chebotarev Institute of Gerontology NAMS Ukraine, Kyiv, Ukraine
https://doi.org/10.1016/j.jocd.2018.05.004
The aim of this study is to evaluate the trabecular bone score (TBS) and bone mineral density (BMD) in men with osteoporotic vertebral fractures. Materials and methods: We’ve examined 197 men aged 45-89 years, divided according to the gerontologic classification: 45-59 yrs (n=83), 6074 yrs (n=86), 75-89 yrs (n=28). Group A consists of 44 men with vertebral fractures (mean age 63.7§10.8 yrs; mean height 1.73§7.02 m; mean weight 79.4§14.9 kg) and group B 153 men without fractures (mean age 62.3§10.2 yrs; mean height 1.73§6.29 m; mean weight 76.3§8.9 kg). The BMD of lumbar spine L1-L4, femoral neck and total body were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS L1-L4 was assessed by the TBS iNsightÒ software package installed on our DXA machine (Med-Imaps, Pessac, France). Results: In total group we found that men with osteoporotic vertebral fractures 1.027§0.210, B 1.185§0.170; have significantly lower TBS L1-L4 (A F=25.54; p<0.001) and BMD of lumbar spine (A 1.009§0.172 g/cm2, B 0.821§0.143 g/cm2, B 1.150§0.130 g/cm2; p<0.001), femoral neck (A 0.908§0.135 g/cm2; p<0.001), total body (A 1.110§0.117 g/cm2, B 1.183§ 0.094 g/cm2; p<0.001) to compared with men without fractures. When we analyzed BMD depending on age, we found the significantly differences in group A: TBS L1-L4 45-59 yrs 1.025§0.248 vs 1.226§0.156 (p<0.001), 60-74 yrs 1.083§0.170 vs 1.150§0.175 (p=0.195), 75-89 yrs 0.951§0.170 vs 1.183§ 0.174 (p=0.002) and BMD of lumbar spine 45-59 yrs 1.027§0.18 vs 1.154§ 0.13 (p=0.001), 60-74 yrs 1.014§0.16 vs 1.148§0.14 (p=0.002), 75-89 yrs 0.950§0.17 vs 1.182§0.17 (p=0.003); total body 45-59 yrs 1.141§0.11 vs 1.203§0.09 (p=0.02), 60-74 yrs 1.121§0.11 vs 1.179§0.09 (p=0.04), 75-89 yrs 1.040§0.11 vs 1.128§0.08 (p=0.02). Conclusion: Subjects with vertebral fractures have significantly lower TBS and BMD parameters than the healthy men.
IMPACT OF WHEY PROTEIN ON BONE MINERAL DENSITY: A SYSTEMIC REVIEW AND META-ANALYSIS Kamonkiat Wirunsawana MD1, Sikarin Upala MD2; 1University of Hawaii, 2 University of Chicago
Introduction: Previous studies have shown that whey protein and its basic protein fraction, milk basic protein, might have a beneficial effect on bone mass through promoting bone formation and suppressing osteoclast activity. Nonetheless, most studies do not have enough power to examine the potential benefit on bone mass from using whey protein and milk basic protein and the data are contradictory. Objective: The aim of our meta-analysis is to reveal the impact of whey protein and milk basic protein on bone mineral density (BMD). Method: We comprehensively searched the databases of MEDLINE, EMBASE, and Cochrane databases. The inclusion criterion was published randomized control trials (RCT) comparing whey protein supplementation or milk basic protein to placebo or controls (non-whey protein). The primary outcome was the differences in the changes in BMD at the level of lumbar spine, hip, or femoral neck, which was primarily measured by dual-energy xray absorptiometry. We calculated pooled mean difference (MD) with 95% confidence intervals (CI) using random-effects model. Publication bias was assessed using funnel plot and Egger's regression test Results: Six RCTs were included in the meta-analysis involving 562 subjects. Our collected studies utilized varying dose of whey protein from 25 grams to 75 grams per day and the dose of milk basic protein is 40 grams per day during a time frame ranging from six months to two years. There was a statistically significant improvement of BMD at the lumbar spine (MD= 0.014, 95% CI: 0.011 to 0.017, p-value < 0.05) favoring whey protein and milk basic protein group. There is a symmetrical distribution of studies in funnel plot. The Egger's test result was not statistically significant (P = 0.87). There was no enough studies to compare the difference of BMD at the hip or femoral neck. Conclusion: This is the first meta-analysis investigating the impact of whey protein and milk basic protein on BMD. Our study suggested that whey protein supplementation and milk basic protein, the basic protein fraction of whey protein, might have a positive impact on bone mineral density compared to placebo or controls. Using whey protein and milk basic protein should be considered to be a conjunctive treatment with current therapy to improve bone mineral density.
https://doi.org/10.1016/j.jocd.2018.05.003
HYPOVITAMINOSIS D IN HIV-INFECTED PATIENTS Cristina Capatina MD, PhD., Anca Streinu Cercel MD., Daniela Manolache MD, PhD., Oana Sandulescu MD, PhD., Carmen Barbu MD, PhD., Adrian Streinu Cercel MD, PhD., Catalina Poiana MD, PhD.; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Introduction: Vitamin D (VD) deficiency is highly prevalent among HIVinfected patients and has been associated with a worse disease prognosis. Aim: To determine the prevalence of hypovitaminosis D in a cohort of HIVpositive Romanian patients compared to healthy controls Methods: Plasma samples for the determination of serum 25OHD concentration were collected from HIV-infected patients and healthy controls. 25OHD status was defined as: deficiency <20 ng/mL (severe deficiency <10 ng/ml), insufficiency 20-30 ng/mL, normal >30 ng/mL. Clinical and laboratory parameters were retrospectively extracted from patients'files (CD4+ cell count, CD4+ nadir, HBV/HCV co-infection, ART). Results: We evaluated 118 HIV-positive patients, (72 males, 46 females, aged 36.9±12.2 years). 106 patients (98.14 %) were on complex ART regimens. 9.3% had B/C hepatitis coinfection. We also 119 healthy controls matched by age, sex and menopausal status. The mean serum 25OHD concentration in the HIV-positive patients was significantly lower (19.36 ±11.34 ng/ml) compared to controls (23.74±8.32 ng/ml; p=0.001). Normal VD status was determined in only 15.96% of patients and 12.71% of controls. Severe VD deficiency was found in a higher percentage of HIV positive patients (23.52%) compared to controls (4.2%, p=0.001). The serum 25OHD level in patients was not significantly correlated with gender, age, menopausal status in women, number of years of previous ART treatment or nadir CD 4 positive cell-count.
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