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Comparison between the bone mass measurement obtained by computerized radiogrammetry and dual- or single photon absorptiometry
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EFFECT OF BODY SIZE ON BONE MASS IS NOT INFLUENCED BY ESTRONE LEVELS IN OBESE POSTMENOPAUSAL WOMEN. M K&r&oDer. D N&on. E Peterson, Henry Ford Hospttal, Detroit MI, USA. The protection that obesity appears to offer against osteoporosis In postmenopausal women Is postulated to result from arornatizatlon of We have adrenal androgens to estrone In peripheral tissues. evaluated this In 217 sketetally ‘healthy’ older women (~10 years postmenopause) of whom 143 were white and 64 black and none had been exwsed to postmenopausal estrogen. The mean age of the two groups (63 years) was identical but ihe black women had been menopausal for a longer period (20 vs 17 years, p=O.O17). Both groupsware obese withthe blacks being ~slgnifl&mtly larger (wt 64L16kgvs 77~15. p=O.OOS; ht 162LScm vs 16026, p=O.O23; wt/ht 52~10 vs 46~10. p=O.O15; wt/ht’(EMl} 32~6 vs 30~6, p=O.O54). Serun estradld levels were low (14L6pg/ml vs 1327, p=O.6), but serum estrone levds were abowe the postmenopausal reference interval for most women (66~27pg/ml vs 63~24, p=O.4). Bone mineral density (BMD) by DXA was greater In the blacks In the lumbar spine (l.03~0.18g/cmz vs 0.959t.14, p=O.W2), femoral neck (0.61+0.13 YS 0.71~0.11, p=O.UOl) and forearm (066~0.06 vs 0.6120.07, p=UQOl). Serum estrone and BMD were not related to years postmenopause. The three Indices of body mass were skrnlflcantlv correlated with SMD at all measurement sites but the rejetlonshlps were stronger In blacks than In whites In the lumbar solne (r=0.506.53 vs 0.36-0.41) and femoral neck (r=O.54g.S6 vs $376.&t) but not the forearm~(r=0.31-635 vs 0.35440). These Indices of body mass were correlated to serum estrone only in the whites (0.35-0.37 vs 0.060.09). Serum estrone correlated wlth spinal BMD In the whites (r=O.lS vs 0.05) but not at other sites In either group. In multiple linear regresslon models lncludlng Indices 01 body mass and serum estrone. there was no relatlonshlp between estrone and any measurement of BMD. These data suggest that, Inobese dder women, the effect of body mass on BMD Is minimally Influenced by circulating estrone levels In whltes and not at all in blacks.
VERTEBRAL BODY OSTEOPHYTOSIS IN SPINAL OSTEOPOROSIS. p. Nelson. 1. Tooolewskl. S. Havstad. M. Jgeerekppat Henry Ford Hospital, Detroit. Michigan, USA. We lnvestlgated whether the prevalence of spondyiosis deformans fosteophvtosis~ among osteoporotks is 1)dilferent from iit In the dened population; 2)&a&d to the occurrence of vertebral fractures; and 3)affected by Ruorkfe therapy. We studied lateral splne r-rays in 66 ~partlclpants in our contrdled clinical trial of sodium fluorlde in spinal osteoporosis, and 61 healthy oostmenooausal women in a non-lnterventlon study of skeletal t<h, Mean ages wera67.3 + 5.5 (op) and 64.2 i 5.4 (pm) fp=.OQl). We graded the presence of vertebml body osteophytes f&m TsthrouQh L5. using 10 levels ranging from 0 (none) to 3+ (extreme). Vertebral fractures (endplate. wedge and compression) were assessed by visual inspection of r-rays. A smell but slgnlficant difference was found between the median baselfne (pretreatment) scores for osteoporotic versus healthy women In the thoraclc spine (‘2’ vs ‘2-‘, p-c.001). There was no dffferonce In the median score (V’) for the lumbar spine (p:+.O5). Placebo subjects were dt&fed Into two groups, with and wtthout oateophytsc. Frncturrs were more prevalent In the osteophytes group than In the no osteophytes group (0.28 vs 0.17 fractures per vertebrn, pcO.01). The IncMence of fractures over 3.3 years of follow-up wes not dlfferent In the osteophyte versus no osteophyte Qroups (0.0177 ve. 0.0245, pm .52), There were no slgnillcant dlfferances between placebo and fluoride groups at bearline or owr time (p, -12). A small but se In osteophytosls wes found over time In both treatment groups:meanchange was -31 + .Q for tharaclc and -53 2 1.05 forlumber (pe.01). We conclude that 1) overall, the severity of spondyiosls deformana amorq esteoporotics Is similar to that In healthy otder women; 2)vertebral fractures are more prevalent In women wilh vertebral body osteophytes; 3)fluodde therapy In spinal asteoporosls does not affectosteophyte lnctdence.
310 RECENT TRENDS IN TX6 E’XX6ASE 0P HIP PRACfU26S
311 IN
Department
of
bt-Luc University &spiral, Brussels,Be&urn. We have shown that from 1977 to fracturesin Belgium increased by 28 Tissue Int 42 : 281, 19E3), while the
diaphysis remained constant. We have analyzed the hip fracturesfrom 1984 to 1988 using the
certaindiminutionof the incteaseof hip fractures. an encouraging had increasedby 9.7 ased furtherbut at a .7 %/yr)from 1982 to 1988, among them the tranquillizers,which had increased by 24.5 % (+ 4.9 %/yr) from 1977 to 1984, are on the decrease - 0.9 % (-0.14 %/yr) from 1982 to 1988. Whetherthis accounts for the plateauingis uncertain,but it is a possibility. In conclusion, nip fractuns in Belgium arc still on the increase, but less so than in the previous periodconsidered,and then is a tendencyto platerming.
COMPARISDN BETWEEN THE BONE MASS OBTAINED BY COMPUl’RRlZED RADIDGRAMMETRY SINGLE PHOTON ARSORPTfOMETRY.
MEASUREMENT AND DUAL- OR
Radiogrammetryof the metak.rp~l~ is the oldest method to approachthe problemof suantiflcationof bone. However.it is timecoitsuming,tklious, and observer-dependent. The availahility of an automatedcomputerizedanalysis circumventsthese shortcomings. We comparedthe results obtained by this method with standard methods of bone mineral content (BMC) and density (BMD) like single photon absorptiometry (SPA) and dual photon absorptiometry @PA). We have compared the simultaneous measurement of rectilinear SPA. using a modified Molsgaard NuclearData instrumenttype 1100, with distal, proximaland midforearmscanningsites, and computerizedradiogrammetryof hands in 73 postmenopausalwomen. The correlation between the two lattermethodswas highly significant (p < 0.001). with correlation coefficients of 0.48,0.62,0.55 for the distal, proximal, and midforearm,respectively. Best correlationis with proximal forearm,a site where cortical bone amounts to 90 95. Measurementsof BMC and BMDof the lumbar spine (L2L4) obtainedby DPA on a Novo Lab 22a instrument were compared with computerized radiogrammetry of simultaneoushandX rays in 79 postmcnopnusal women. Correlation between the two methods was highly significant (p c 0.001). the coefficient of cotrelationbeing 0.45 and 0.50 for BMC and BMD, respectively. In conclusion, the
measurementsprovidedby this new methodcorrelatessignificantly wtth those provided by the more expensive, and less available absorptiometricmethods. This method is thereforevalidated as a screeningtest for osteoporosis.
152
308
EFFECT OF BODY SIZE ON BONE MASS IS NOT INFLUENCED BY ESTRONE LEVELS IN OBESE POSTMENOPAUSAL WOMEN. M K&r&oDer. D N&on. E Peterson, Henry Ford Hospttal, Detroit MI, USA. The protection that obesity appears to offer against osteoporosis In postmenopausal women Is postulated to result from arornatizatlon of We have adrenal androgens to estrone In peripheral tissues. evaluated this In 217 sketetally ‘healthy’ older women (~10 years postmenopause) of whom 143 were white and 64 black and none had been exwsed to postmenopausal estrogen. The mean age of the two groups (63 years) was identical but ihe black women had been menopausal for a longer period (20 vs 17 years, p=O.O17). Both groupsware obese withthe blacks being ~slgnifl&mtly larger (wt 64L16kgvs 77~15. p=O.OOS; ht 162LScm vs 16026, p=O.O23; wt/ht 52~10 vs 46~10. p=O.O15; wt/ht’(EMl} 32~6 vs 30~6, p=O.O54). Serun estradld levels were low (14L6pg/ml vs 1327, p=O.6), but serum estrone levds were abowe the postmenopausal reference interval for most women (66~27pg/ml vs 63~24, p=O.4). Bone mineral density (BMD) by DXA was greater In the blacks In the lumbar spine (l.03~0.18g/cmz vs 0.959t.14, p=O.W2), femoral neck (0.61+0.13 YS 0.71~0.11, p=O.UOl) and forearm (066~0.06 vs 0.6120.07, p=UQOl). Serum estrone and BMD were not related to years postmenopause. The three Indices of body mass were skrnlflcantlv correlated with SMD at all measurement sites but the rejetlonshlps were stronger In blacks than In whites In the lumbar solne (r=0.506.53 vs 0.36-0.41) and femoral neck (r=O.54g.S6 vs $376.&t) but not the forearm~(r=0.31-635 vs 0.35440). These Indices of body mass were correlated to serum estrone only in the whites (0.35-0.37 vs 0.060.09). Serum estrone correlated wlth spinal BMD In the whites (r=O.lS vs 0.05) but not at other sites In either group. In multiple linear regresslon models lncludlng Indices 01 body mass and serum estrone. there was no relatlonshlp between estrone and any measurement of BMD. These data suggest that, Inobese dder women, the effect of body mass on BMD Is minimally Influenced by circulating estrone levels In whltes and not at all in blacks.
VERTEBRAL BODY OSTEOPHYTOSIS IN SPINAL OSTEOPOROSIS. p. Nelson. 1. Tooolewskl. S. Havstad. M. Jgeerekppat Henry Ford Hospital, Detroit. Michigan, USA. We lnvestlgated whether the prevalence of spondyiosis deformans fosteophvtosis~ among osteoporotks is 1)dilferent from iit In the dened population; 2)&a&d to the occurrence of vertebral fractures; and 3)affected by Ruorkfe therapy. We studied lateral splne r-rays in 66 ~partlclpants in our contrdled clinical trial of sodium fluorlde in spinal osteoporosis, and 61 healthy oostmenooausal women in a non-lnterventlon study of skeletal t<h, Mean ages wera67.3 + 5.5 (op) and 64.2 i 5.4 (pm) fp=.OQl). We graded the presence of vertebml body osteophytes f&m TsthrouQh L5. using 10 levels ranging from 0 (none) to 3+ (extreme). Vertebral fractures (endplate. wedge and compression) were assessed by visual inspection of r-rays. A smell but slgnlficant difference was found between the median baselfne (pretreatment) scores for osteoporotic versus healthy women In the thoraclc spine (‘2’ vs ‘2-‘, p-c.001). There was no dffferonce In the median score (V’) for the lumbar spine (p:+.O5). Placebo subjects were dt&fed Into two groups, with and wtthout oateophytsc. Frncturrs were more prevalent In the osteophytes group than In the no osteophytes group (0.28 vs 0.17 fractures per vertebrn, pcO.01). The IncMence of fractures over 3.3 years of follow-up wes not dlfferent In the osteophyte versus no osteophyte Qroups (0.0177 ve. 0.0245, pm .52), There were no slgnillcant dlfferances between placebo and fluoride groups at bearline or owr time (p, -12). A small but se In osteophytosls wes found over time In both treatment groups:meanchange was -31 + .Q for tharaclc and -53 2 1.05 forlumber (pe.01). We conclude that 1) overall, the severity of spondyiosls deformana amorq esteoporotics Is similar to that In healthy otder women; 2)vertebral fractures are more prevalent In women wilh vertebral body osteophytes; 3)fluodde therapy In spinal asteoporosls does not affectosteophyte lnctdence.
310 RECENT TRENDS IN TX6 E’XX6ASE 0P HIP PRACfU26S
311 IN
Department
of
bt-Luc University &spiral, Brussels,Be&urn. We have shown that from 1977 to fracturesin Belgium increased by 28 Tissue Int 42 : 281, 19E3), while the
diaphysis remained constant. We have analyzed the hip fracturesfrom 1984 to 1988 using the
certaindiminutionof the incteaseof hip fractures. an encouraging had increasedby 9.7 ased furtherbut at a .7 %/yr)from 1982 to 1988, among them the tranquillizers,which had increased by 24.5 % (+ 4.9 %/yr) from 1977 to 1984, are on the decrease - 0.9 % (-0.14 %/yr) from 1982 to 1988. Whetherthis accounts for the plateauingis uncertain,but it is a possibility. In conclusion, nip fractuns in Belgium arc still on the increase, but less so than in the previous periodconsidered,and then is a tendencyto platerming.
COMPARISDN BETWEEN THE BONE MASS OBTAINED BY COMPUl’RRlZED RADIDGRAMMETRY SINGLE PHOTON ARSORPTfOMETRY.
MEASUREMENT AND DUAL- OR
Radiogrammetryof the metak.rp~l~ is the oldest method to approachthe problemof suantiflcationof bone. However.it is timecoitsuming,tklious, and observer-dependent. The availahility of an automatedcomputerizedanalysis circumventsthese shortcomings. We comparedthe results obtained by this method with standard methods of bone mineral content (BMC) and density (BMD) like single photon absorptiometry (SPA) and dual photon absorptiometry @PA). We have compared the simultaneous measurement of rectilinear SPA. using a modified Molsgaard NuclearData instrumenttype 1100, with distal, proximaland midforearmscanningsites, and computerizedradiogrammetryof hands in 73 postmenopausalwomen. The correlation between the two lattermethodswas highly significant (p < 0.001). with correlation coefficients of 0.48,0.62,0.55 for the distal, proximal, and midforearm,respectively. Best correlationis with proximal forearm,a site where cortical bone amounts to 90 95. Measurementsof BMC and BMDof the lumbar spine (L2L4) obtainedby DPA on a Novo Lab 22a instrument were compared with computerized radiogrammetry of simultaneoushandX rays in 79 postmcnopnusal women. Correlation between the two methods was highly significant (p c 0.001). the coefficient of cotrelationbeing 0.45 and 0.50 for BMC and BMD, respectively. In conclusion, the
measurementsprovidedby this new methodcorrelatessignificantly wtth those provided by the more expensive, and less available absorptiometricmethods. This method is thereforevalidated as a screeningtest for osteoporosis.
152