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Pharmacokinetic study on bone perfusion of vertebra with various bone mineral density
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Abstracts / Bone 47 (2010) S385–S458
242 Identification of the OCRL1 gene mutations in two Chinese families with Lowe's syndrome Yao-Hua Ke, Jing-Wei He, Wen-Zhen Fu, Zhen-Lin Zhang Department of Osteoporosis & Bone Diseases, Metabolic Bone Disease & Genetic Research Unit, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China Objective: Lowe's syndrome (the oculocerebrorenal syndrome of Lowe) is a multisystem disorder which affects the eye, the nervous system and the kidney. The morbidity of this disease is about 1/500,000. Congenital cataract, psychomotor retardation, metabolic disorder (Fanconi-type) and hypophosphatemic rickets/osteomalacia are its common clinical manifestation. Lowe syndrome is an X-linked disease. The mutation of the gene OCRL1 localized at Xq26.1, coding for the enzyme phosphatidylinositol 4, 5-bisphosphate-5-phosphatase, in the trans-Golgi network is responsible for the disease. Here we report the identification of two different mutations in the OCRL1 gene in two unrelated patients with Lowe syndrome. Methods: We describe the clinical evaluation and laboratory studies of 3 patients (in 2 families) with Lowe's syndrome. And the identification of mutations in the OCRL1 gene was carried out. Results: Patient 1 (male, 8 years old) who has a congenital cataract and psychomotor retardation history come to our hospital for his deformities of both lower limbs. His low serum phosphate and elevated ALP level, which also is the only manifestation of patient 2 (male, 24 years old) and patient 3 (patient 2's brother, 22 years old), suggested the possibility of hypophosphatemic rickets. The analysis of the OCRL1 gene mutation showed that a nonsense mutation in exon 10 (P.Glu294X) in patient 1 and an insertion mutation in exon 24 (c.2626dupA,p.Met876AsnfsX8) in patient 2. We also found the patients' mothers are the carriers of these two mutations. Conclusions: The detection of the OCRL1 gene mutation is helpful for the diagnosis of Lowe's syndrome. doi:10.1016/j.bone.2010.09.233
243 Virulence genes and clinical phenotyping: A study of 12 osteopetrosis families Chun Wang, Hao Zhang, Jin-Wei He, Jie-Mei Gu, Wei-Wei Hu, Yun-Qiu Hu, Miao Li, Yu-Juan Liu, Wen-Zhen Fu, Zhen-Lin Zhang Department of Osteoporosis, Metabolic Bone Disease & Genetics Research Unit, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China Objective: Osteopetrosis is an inheritable disease characterized with bone resorption disorder and high bone mass density resulting from the deficiency of osteoclast and/or functional defect. Autosomal recessive osteopetrosis (ARO), intermediate autosomal osteopetrosis (IAO) and autosomal dominant osteopetrosis (ADO) are three major modes of inheritance. ADO I and ADO II are two subtypes of ADO. Chloride channel 7 (CLCN7) gene is reported as the major disease causing gene of osteopetrosis. The aim of this study is to find out the association between characteristics of clinical phenotypes and mutations of several candidate virulence genes in 12 Chinese osteopetrosis families. Methods: At the first visit, the general information, family history, disease history, childbearing history and fracture history were collected by the questionnaire. The hearing test, visual acuity and oral examination, skull and lumbar spine X-ray photography were done at the same time. Furthermore, routine blood test, serum calcium, phosphonium, alkaline phosphatase (ALP), lactic dehydrogenase (LDH), creatine kinase (CK) and its isozyme (CK-MB), parathyroid hormone (PTH) were measured. Bone mineral density (BMD) of lumbar spine 1-4 (L1-4), femoral neck and total hip were measured by DXA. The entire coding region of CLCN7 gene, TCIRG1 gene, low density
lipoprotein receptor-related protein 5 (LRP5) gene and Sclerostin (SOST) gene were amplified and sequenced directly. Results: In our twelve families, 15 suspected patients were found. Among the total probands, nine probands were diagnosed as ADOII. The average age of onset was 20 years old (from 2 to 34 years old). One proband was diagnosed as ARO at the age of 6 months. Two probands were diagnosed as ADOI or intermediate form. The lumbodorsal pain and sandwich vertebra were two typical clinical manifestations. The BMD of L1-4, femoral neck and total hip of nine ADOII probands were 2.305 ± 0.492 g/cm2, 2.093 ± 0.622 g/cm2 and 1.985 ± 0.311 g/cm2, respectively. Seven ADOII patients had at least one fracture, while one of them had nine fractures. All of these fractures were nonvertebral fracture (femur, humerus and phalanx). The bone turnover markers, such as ALP, CK and CK-MB were increased significantly. Seven mutations of CLCN7 gene were found in nine osteopetrosis families and one mutation of TC1RG1 gene was found in one family. However, in two families no mutation was found in all screened genes. Conclusions: We concluded that CLCN7 gene mutation is the major virulence gene of osteopetrosis in the Chinese population. The carriers of these mutations had significant high BMD, typical sandwich vertebra and high level of bone turnover markers. The association between genotyping and clinical phenotyping will be helpful to identify the role of CLCN7 gene in osteopetrosis in future studies. doi:10.1016/j.bone.2010.09.234
246 Pharmacokinetic study on bone perfusion of vertebra with various bone mineral density Heather T. Ma1, James F. Griffith2, Lina Yang1, David K. Yeung2, Ping-Chung Leung3 1 Department of Electronic & Information Engineering, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China 2 Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China 3 Jockey Club Centre for Osteoporosis Care & Control, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China Objective: Dynamic contrast-enhanced MRI (DCE-MRI) provides a direct measure of bone perfusion. Previous DCE-MRI studies have shown how semi-quantitative perfusion parameters are consistently reduced in osteopenic and osteoporotic bone as compared to normal bone mineral density (BMD) subjects. The purpose of this study was to apply a modified Brix pharmacokinetic model to the investigation of bone perfusion in subjects of varying BMD with a view to increasing our knowledge of the specific bone perfusion anomalies occurring in osteoporosis. Methods: The final cohort included 165 subjects (65 males, 100 females, age>65 years). Dynamic contrast enhancement (DCE) MRI data were acquired in the mid-lumbar sagittal plane for male subjects and in the transverse plane through the mid-L3 vertebral body region for female subjects. A region of interest (ROI) was drawn manually encompassing the cancellous bone within the vertebral body. A pharmacokinetic model was employed to analyze DCE-MRI data. Three quantitative parameters were analyzed as A the amplitude of contrast uptake, kept the rate constant for contrast extraction from interstitial space into the plasma, and kel the eliminating rate constant of the contrast from the plasma. Results: For male subjects, osteoporotic subjects had lower mean A and kel as compared to osteopenic and normal BMD subjects (p<0.01). Product Akep, indicating the vessel permeability, was significantly decreased in osteoporotic and osteopenic male subjects. For female subjects, osteoporotic and osteopenic subjects had lower mean A as compared with normal BMD subjects (p<0.01), while parameter Akep was largest in osteopenic subjects and smallest in normal BMD subjects. The quantitative parameters were
Abstracts / Bone 47 (2010) S385–S458
mapped on the T1-weighted image to improve visualization of perfusion distribution. Discussion: First, a notable reduction in amplitude A in osteoporotic subjects was observed, where fat content may be an influential factor. Secondly, it appears that vascular permeability is reduced as BMD decreases. Permeability may be influenced by factors such as capillary endothelial permeability and intrastitial or intraosseous pressure. Thirdly, a decreased plasma elimination rate kel was found as BMD reduced in both male and female subjects. Therefore, venous return also appears to reduce as BMD decreases. doi:10.1016/j.bone.2010.09.235
248 Roles of gap junctional intercellular communication in osteoblastic cells differentiation Xing Ma1, Xiangdong Ma2, Detang Wang2 1 Department of Orthopaedics, First Affiliated Hospital of Medical School, Xian Jiaotong University, Xian, China 2 Department of Gynecology & Obstetrics, Xijing Hospital, Fourth Military Medical University, Xian, China Objective: To investigate mediating and regulatory effects of gap junctional intercellular communication (GJIC) on differentiation of osteoblastic cells in vitro. Methods: Rat calvarial osteoblasts (ROBs) in cultures were divided into three groups according to the different mode of exposures. Group A: vehicle (sodium acetate, SA)-treated group; group B: 1 × 10− 8 mol/l hPTH (1–34) intermittent exposure group and group C: 1 × 10− 8 mol/l hPTH (1–34) +2 × 10− 5 mol/l 1-heptanol exposure group. Forty-eight hour incubation cycles in the three groups were repeated for six times. The expression of gap junctional protein Connexin 43 (Cx43), GJIC and mineralization of cultured ROBs in three groups were detected using immunocytochemistry, Western blot, Lucifer Yellow (LY) scrape loading dye transfer (SLDT) and mineralized nodule staining together with nodule index, respectively. Results: Immunostaining and Western blot showed much higher level of Cx43 expression in groups of B and C as compared with group A. In group C, treatment with the gap junction uncoupler 1-heptanol had no effect on Cx43 expression, whereas intercellular coupling between ROBs was significantly reduced. LY(+) cell numbers in the 3 groups were 7.0± 2.61, 20.33 ± 4.8 and 4.17 ± 1.71 (N= 8), respectively. Diffusion and transfer of LY fluorescent probe was much more noticeably discerned in group B than in group A and group C. Conclusions: Intercellular links of osteoblastic cells via GJIC essentially contribute to low-dose intermittent PTH treatment stimulated bone anabolism. Disruption of GJIC caused by 1-heptanol not only hinders osteoblastic intercellular coordination but also frustrates PTH-induced bone formation activities in vitro. These results therefore suggest that GJIC play important roles in functional differentiation of osteoblasts. Acknowledgment We would like to thank the Key Science and Technology Program of Shaanxi Province for supporting this work under grant number 2008K14-06. doi:10.1016/j.bone.2010.09.236
249 A new approach for predicting osteoporosis from T1-weighted MR images Heather T. Ma1, James F. Griffith2, Alvin F.W. Li2, David K. Yeung2, Jason Leung3, Yixiang Wang2, Ping-Chung Leung3
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Department of Electronic & Information Engineering, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China 2 Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong 3 Jockey Club Centre for Osteoporosis Care and Control, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
Objective: Lumbar spine MRI is a very commonly used imaging study to investigate disorders of the lumbar spine. One of the limitations of MRI is that information on bone mineral density (BMD) is not obtainable. Such information would be helpful in alerting the clinician to the possibility of osteoporosis. T1-signal intensity of the marrow cavity is dependent on the amount of red marrow, fatty marrow and mineral bone content present. These factors vary as the bone becomes more osteoporotic. The purpose of this study was to investigate whether a simple normalized T1-value can predict patient T-score. Methods: The relative T1-signal intensity was investigated on the T1-weighted (TR/TE, 450/11 ms; 4 mm thick) mid-sagittal images (1.5T MR unit) from 177 subjects (82 males, 95 females, age = 72.6 ± 4.6). Relative T1 signal intensity was calculated as the T1 signal intensity of L2 or L3 vertebral body normalized by the T1signal intensity of the immediate pre-vertebral tissue. Bone mineral density (BMD) of lumbar spine was measured by dual X-ray absorptiometry (DXA). Subjects were divided into three groups (control, osteopenia, and osteoporosis) according to T-score and WHO criteria. Results: For both male and female, the relative T1 signal intensity showed significant difference (p < 0.01) among three groups. The relative T1 signal intensity at L3 demonstrated the best performance, where its correlation with T-score was − 0.72 (p < 0.001) for male and −0.60 (p < 0.001) for female, respectively. According to receiver operating characteristic (ROC) curve, cutpoints at 0.95 and 1.016 gave a successful rate of 84% and 66% for male and female respectively for predicting osteoporosis. Conclusion: This study provides a new measure, relative T1 signal intensity, to predict lumber vertebral osteoporosis on routine T1-weighted MRI. A relative T1 signal intensity seems to be a reliable parameter for reflecting BMD with the potential to become a simple approach for clinicians use in predicting those patients osteoporosis undergoing MRI examination for other reasons. doi:10.1016/j.bone.2010.09.239
250 Osteoporotic elderly women with hip fractures observational study of iron overload indicator Youjia Xu, Yushang Feng, Hu Liu, Wei Xu, Hongzheng Ai, Kai Li Department of Orthopaedics, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China Objective: Hip fracture is a consequential and common complication of osteoporosis. Recently, we suggested that iron overload could have a causal effect on osteoporosis (A study on the influence of hepcidin out of osteoblasts on iron transportation. Chin J Osteoporosis 2008; 9:611-04). To address our hypothesis, we have ferritin analyzed in 80 hospitalized patients before operation at the Department of Orthopaedics during the period of 2010.04 to 2010.06. Method: Patients were assigned into three groups according to their age, gender and the type of bone diseases: Group 1, for females older than seventy-five with hip fracture (n= 30); Group 2, for males older than seventy-five with hip fracture (n= 20); and Group 3, for females younger than fifty with simple fractures (n= 20). Clinical parameters include: Registration of traumatic history in order to exclude secondary osteoporosis; Singh scoring using hip Xray photography; and serum ferritin and WBC. Results: The fractures in patients younger than 75 years old were either caused by car accident or
Abstracts / Bone 47 (2010) S385–S458
242 Identification of the OCRL1 gene mutations in two Chinese families with Lowe's syndrome Yao-Hua Ke, Jing-Wei He, Wen-Zhen Fu, Zhen-Lin Zhang Department of Osteoporosis & Bone Diseases, Metabolic Bone Disease & Genetic Research Unit, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China Objective: Lowe's syndrome (the oculocerebrorenal syndrome of Lowe) is a multisystem disorder which affects the eye, the nervous system and the kidney. The morbidity of this disease is about 1/500,000. Congenital cataract, psychomotor retardation, metabolic disorder (Fanconi-type) and hypophosphatemic rickets/osteomalacia are its common clinical manifestation. Lowe syndrome is an X-linked disease. The mutation of the gene OCRL1 localized at Xq26.1, coding for the enzyme phosphatidylinositol 4, 5-bisphosphate-5-phosphatase, in the trans-Golgi network is responsible for the disease. Here we report the identification of two different mutations in the OCRL1 gene in two unrelated patients with Lowe syndrome. Methods: We describe the clinical evaluation and laboratory studies of 3 patients (in 2 families) with Lowe's syndrome. And the identification of mutations in the OCRL1 gene was carried out. Results: Patient 1 (male, 8 years old) who has a congenital cataract and psychomotor retardation history come to our hospital for his deformities of both lower limbs. His low serum phosphate and elevated ALP level, which also is the only manifestation of patient 2 (male, 24 years old) and patient 3 (patient 2's brother, 22 years old), suggested the possibility of hypophosphatemic rickets. The analysis of the OCRL1 gene mutation showed that a nonsense mutation in exon 10 (P.Glu294X) in patient 1 and an insertion mutation in exon 24 (c.2626dupA,p.Met876AsnfsX8) in patient 2. We also found the patients' mothers are the carriers of these two mutations. Conclusions: The detection of the OCRL1 gene mutation is helpful for the diagnosis of Lowe's syndrome. doi:10.1016/j.bone.2010.09.233
243 Virulence genes and clinical phenotyping: A study of 12 osteopetrosis families Chun Wang, Hao Zhang, Jin-Wei He, Jie-Mei Gu, Wei-Wei Hu, Yun-Qiu Hu, Miao Li, Yu-Juan Liu, Wen-Zhen Fu, Zhen-Lin Zhang Department of Osteoporosis, Metabolic Bone Disease & Genetics Research Unit, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China Objective: Osteopetrosis is an inheritable disease characterized with bone resorption disorder and high bone mass density resulting from the deficiency of osteoclast and/or functional defect. Autosomal recessive osteopetrosis (ARO), intermediate autosomal osteopetrosis (IAO) and autosomal dominant osteopetrosis (ADO) are three major modes of inheritance. ADO I and ADO II are two subtypes of ADO. Chloride channel 7 (CLCN7) gene is reported as the major disease causing gene of osteopetrosis. The aim of this study is to find out the association between characteristics of clinical phenotypes and mutations of several candidate virulence genes in 12 Chinese osteopetrosis families. Methods: At the first visit, the general information, family history, disease history, childbearing history and fracture history were collected by the questionnaire. The hearing test, visual acuity and oral examination, skull and lumbar spine X-ray photography were done at the same time. Furthermore, routine blood test, serum calcium, phosphonium, alkaline phosphatase (ALP), lactic dehydrogenase (LDH), creatine kinase (CK) and its isozyme (CK-MB), parathyroid hormone (PTH) were measured. Bone mineral density (BMD) of lumbar spine 1-4 (L1-4), femoral neck and total hip were measured by DXA. The entire coding region of CLCN7 gene, TCIRG1 gene, low density
lipoprotein receptor-related protein 5 (LRP5) gene and Sclerostin (SOST) gene were amplified and sequenced directly. Results: In our twelve families, 15 suspected patients were found. Among the total probands, nine probands were diagnosed as ADOII. The average age of onset was 20 years old (from 2 to 34 years old). One proband was diagnosed as ARO at the age of 6 months. Two probands were diagnosed as ADOI or intermediate form. The lumbodorsal pain and sandwich vertebra were two typical clinical manifestations. The BMD of L1-4, femoral neck and total hip of nine ADOII probands were 2.305 ± 0.492 g/cm2, 2.093 ± 0.622 g/cm2 and 1.985 ± 0.311 g/cm2, respectively. Seven ADOII patients had at least one fracture, while one of them had nine fractures. All of these fractures were nonvertebral fracture (femur, humerus and phalanx). The bone turnover markers, such as ALP, CK and CK-MB were increased significantly. Seven mutations of CLCN7 gene were found in nine osteopetrosis families and one mutation of TC1RG1 gene was found in one family. However, in two families no mutation was found in all screened genes. Conclusions: We concluded that CLCN7 gene mutation is the major virulence gene of osteopetrosis in the Chinese population. The carriers of these mutations had significant high BMD, typical sandwich vertebra and high level of bone turnover markers. The association between genotyping and clinical phenotyping will be helpful to identify the role of CLCN7 gene in osteopetrosis in future studies. doi:10.1016/j.bone.2010.09.234
246 Pharmacokinetic study on bone perfusion of vertebra with various bone mineral density Heather T. Ma1, James F. Griffith2, Lina Yang1, David K. Yeung2, Ping-Chung Leung3 1 Department of Electronic & Information Engineering, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China 2 Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China 3 Jockey Club Centre for Osteoporosis Care & Control, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China Objective: Dynamic contrast-enhanced MRI (DCE-MRI) provides a direct measure of bone perfusion. Previous DCE-MRI studies have shown how semi-quantitative perfusion parameters are consistently reduced in osteopenic and osteoporotic bone as compared to normal bone mineral density (BMD) subjects. The purpose of this study was to apply a modified Brix pharmacokinetic model to the investigation of bone perfusion in subjects of varying BMD with a view to increasing our knowledge of the specific bone perfusion anomalies occurring in osteoporosis. Methods: The final cohort included 165 subjects (65 males, 100 females, age>65 years). Dynamic contrast enhancement (DCE) MRI data were acquired in the mid-lumbar sagittal plane for male subjects and in the transverse plane through the mid-L3 vertebral body region for female subjects. A region of interest (ROI) was drawn manually encompassing the cancellous bone within the vertebral body. A pharmacokinetic model was employed to analyze DCE-MRI data. Three quantitative parameters were analyzed as A the amplitude of contrast uptake, kept the rate constant for contrast extraction from interstitial space into the plasma, and kel the eliminating rate constant of the contrast from the plasma. Results: For male subjects, osteoporotic subjects had lower mean A and kel as compared to osteopenic and normal BMD subjects (p<0.01). Product Akep, indicating the vessel permeability, was significantly decreased in osteoporotic and osteopenic male subjects. For female subjects, osteoporotic and osteopenic subjects had lower mean A as compared with normal BMD subjects (p<0.01), while parameter Akep was largest in osteopenic subjects and smallest in normal BMD subjects. The quantitative parameters were
Abstracts / Bone 47 (2010) S385–S458
mapped on the T1-weighted image to improve visualization of perfusion distribution. Discussion: First, a notable reduction in amplitude A in osteoporotic subjects was observed, where fat content may be an influential factor. Secondly, it appears that vascular permeability is reduced as BMD decreases. Permeability may be influenced by factors such as capillary endothelial permeability and intrastitial or intraosseous pressure. Thirdly, a decreased plasma elimination rate kel was found as BMD reduced in both male and female subjects. Therefore, venous return also appears to reduce as BMD decreases. doi:10.1016/j.bone.2010.09.235
248 Roles of gap junctional intercellular communication in osteoblastic cells differentiation Xing Ma1, Xiangdong Ma2, Detang Wang2 1 Department of Orthopaedics, First Affiliated Hospital of Medical School, Xian Jiaotong University, Xian, China 2 Department of Gynecology & Obstetrics, Xijing Hospital, Fourth Military Medical University, Xian, China Objective: To investigate mediating and regulatory effects of gap junctional intercellular communication (GJIC) on differentiation of osteoblastic cells in vitro. Methods: Rat calvarial osteoblasts (ROBs) in cultures were divided into three groups according to the different mode of exposures. Group A: vehicle (sodium acetate, SA)-treated group; group B: 1 × 10− 8 mol/l hPTH (1–34) intermittent exposure group and group C: 1 × 10− 8 mol/l hPTH (1–34) +2 × 10− 5 mol/l 1-heptanol exposure group. Forty-eight hour incubation cycles in the three groups were repeated for six times. The expression of gap junctional protein Connexin 43 (Cx43), GJIC and mineralization of cultured ROBs in three groups were detected using immunocytochemistry, Western blot, Lucifer Yellow (LY) scrape loading dye transfer (SLDT) and mineralized nodule staining together with nodule index, respectively. Results: Immunostaining and Western blot showed much higher level of Cx43 expression in groups of B and C as compared with group A. In group C, treatment with the gap junction uncoupler 1-heptanol had no effect on Cx43 expression, whereas intercellular coupling between ROBs was significantly reduced. LY(+) cell numbers in the 3 groups were 7.0± 2.61, 20.33 ± 4.8 and 4.17 ± 1.71 (N= 8), respectively. Diffusion and transfer of LY fluorescent probe was much more noticeably discerned in group B than in group A and group C. Conclusions: Intercellular links of osteoblastic cells via GJIC essentially contribute to low-dose intermittent PTH treatment stimulated bone anabolism. Disruption of GJIC caused by 1-heptanol not only hinders osteoblastic intercellular coordination but also frustrates PTH-induced bone formation activities in vitro. These results therefore suggest that GJIC play important roles in functional differentiation of osteoblasts. Acknowledgment We would like to thank the Key Science and Technology Program of Shaanxi Province for supporting this work under grant number 2008K14-06. doi:10.1016/j.bone.2010.09.236
249 A new approach for predicting osteoporosis from T1-weighted MR images Heather T. Ma1, James F. Griffith2, Alvin F.W. Li2, David K. Yeung2, Jason Leung3, Yixiang Wang2, Ping-Chung Leung3
S421
1
Department of Electronic & Information Engineering, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China 2 Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong 3 Jockey Club Centre for Osteoporosis Care and Control, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
Objective: Lumbar spine MRI is a very commonly used imaging study to investigate disorders of the lumbar spine. One of the limitations of MRI is that information on bone mineral density (BMD) is not obtainable. Such information would be helpful in alerting the clinician to the possibility of osteoporosis. T1-signal intensity of the marrow cavity is dependent on the amount of red marrow, fatty marrow and mineral bone content present. These factors vary as the bone becomes more osteoporotic. The purpose of this study was to investigate whether a simple normalized T1-value can predict patient T-score. Methods: The relative T1-signal intensity was investigated on the T1-weighted (TR/TE, 450/11 ms; 4 mm thick) mid-sagittal images (1.5T MR unit) from 177 subjects (82 males, 95 females, age = 72.6 ± 4.6). Relative T1 signal intensity was calculated as the T1 signal intensity of L2 or L3 vertebral body normalized by the T1signal intensity of the immediate pre-vertebral tissue. Bone mineral density (BMD) of lumbar spine was measured by dual X-ray absorptiometry (DXA). Subjects were divided into three groups (control, osteopenia, and osteoporosis) according to T-score and WHO criteria. Results: For both male and female, the relative T1 signal intensity showed significant difference (p < 0.01) among three groups. The relative T1 signal intensity at L3 demonstrated the best performance, where its correlation with T-score was − 0.72 (p < 0.001) for male and −0.60 (p < 0.001) for female, respectively. According to receiver operating characteristic (ROC) curve, cutpoints at 0.95 and 1.016 gave a successful rate of 84% and 66% for male and female respectively for predicting osteoporosis. Conclusion: This study provides a new measure, relative T1 signal intensity, to predict lumber vertebral osteoporosis on routine T1-weighted MRI. A relative T1 signal intensity seems to be a reliable parameter for reflecting BMD with the potential to become a simple approach for clinicians use in predicting those patients osteoporosis undergoing MRI examination for other reasons. doi:10.1016/j.bone.2010.09.239
250 Osteoporotic elderly women with hip fractures observational study of iron overload indicator Youjia Xu, Yushang Feng, Hu Liu, Wei Xu, Hongzheng Ai, Kai Li Department of Orthopaedics, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China Objective: Hip fracture is a consequential and common complication of osteoporosis. Recently, we suggested that iron overload could have a causal effect on osteoporosis (A study on the influence of hepcidin out of osteoblasts on iron transportation. Chin J Osteoporosis 2008; 9:611-04). To address our hypothesis, we have ferritin analyzed in 80 hospitalized patients before operation at the Department of Orthopaedics during the period of 2010.04 to 2010.06. Method: Patients were assigned into three groups according to their age, gender and the type of bone diseases: Group 1, for females older than seventy-five with hip fracture (n= 30); Group 2, for males older than seventy-five with hip fracture (n= 20); and Group 3, for females younger than fifty with simple fractures (n= 20). Clinical parameters include: Registration of traumatic history in order to exclude secondary osteoporosis; Singh scoring using hip Xray photography; and serum ferritin and WBC. Results: The fractures in patients younger than 75 years old were either caused by car accident or