Decreased bone mass and density relationship

decreased bone mass and density relationship

SUMMARY Patients in chronic dialysis show a decrease in total bone mass. .. Relationship between bone mineral density of the spine and strength of back. Moreover, the connection between bone mineral density (BMD) and .. Relation of low bone mineral density and carotid atherosclerosis in. Decreased bone mineral density (BMD) plus an increased risk of both hip and Numerous studies have investigated the relation between demographic and.

All patients gave their written informed consent to participate in the study and the investigation was approved by the teaching and ethical committees from the participating institutions. The variation coefficient for this parameter, with patient's turnover in our laboratory, is 0. Body compartments lean and fat body masses determinations were also obtained by densitometry and expressed in kilograms for each compartment.

In all patients, height and weight anthropometrical measurements were done. Weight was evaluated in kilograms by means of an arm scale and height in centimeters by means of a stadiometer. Statistical analysis All statistical analyses were done with CSS software: We compared anthropometrical parameters and measurements of body composition between males and females by Student's t test for non-paired data.

decreased bone mass and density relationship

In order to calculate correlation coefficients, we performed simple and multiple correlations by using anthropometrical measurements height and weightand body composition determinations lean and fat body massesage, intact PTH, and time on dialysis as independent variables, and TBMC as the dependent variable.

Results are shown for all patients as a whole group or as separated groups of men and women. Women were further analyzed by pre- and postmenopausal. By contrast, TBMC was not correlated with fat body mass or its percentage. In the multiple correlation analysis for the whole group of patients, three variables continued to significantly correlate with TBMC: Table 3 shows the simple correlations of TBMC separately for males and females.

decreased bone mass and density relationship

Males only showed a simple significant positive correlation of TBMC with weight, height and lean body mass, the remaining variables not correlating. Females showed sim A. Total Time on Dialysis.

In premenopausal women, TBMC was only correlated with height. Thus, lean body mass seems to be the body compartment that has the greatest influence on determining body mass in patients on peritoneal dialysis.

decreased bone mass and density relationship

Since lean body mass measured by densitometry is an estimate of the muscular compartment, and since good correlations have been found between regional muscular strength and regional BMD16, it is likely that the good correlations found between lean body mass and TBMC show the importance of the mechanical action of muscles on the skeleton as a determinant of its mineral content.

In a recent study, Woodrow et al.

The relationship between low bone mass and metabolic syndrome in Korean women.

This lean body mass reduction, which expresses a muscular mass reduction, may explain the reduction in BMC that these authors found in a previous study. On the other hand, since lean body mass is also a good indicator of nutritional status, similar to serum albumin, it is likely that the good correlation found between lean mass and mineral content reflects the importance of nutritional status when determining the skeletal mass in these patients.

An essential problem when interpreting studies that try to analyze the relationships between body compartments and bone mass is that different invesCorrelation: Other parameters correct BMD by an estimation of bone volume apparent bone mineral density or by total height.

According to the specific bone mass parameter that is used as dependent variable in the correlation analysis with body composition compartments, different authors have reached different conclusions in normal people: In one of these studies, Khosla et al. In postmenopausal women without hormone replacement, only lean bone mass was an important predictor of TBMC.

In women on peritoneal dialysis in our study, TBMC was correlated with height, as an anthropometrical variable, and negatively with intact PTH.

The relationship between low bone mass and metabolic syndrome in Korean women.

When pre- and postmenopausal women were analyzed separately, TBMC was positively correlated with height and lean body mass, and negatively with intact PTH in the 30 postmenopausal women without hormone replacement, whereas in premenopausal, only height was correlated with bone mass.

Our study suggests that secondary hyperparathyroidism has a greater skeletal impact in postmenopausal women. Other studies21 have also shown that there exists a preponderance of female gender in average bone mineral content loss at the distal radius bone in patients with OCPD.

Few studies have evaluated bone mass and body composition in healthy men. In a study from Reid et al. In our study, we have found that in male patients on peritoneal dialysis, TBMC is exclusively correlated with lean body mass.

The importance of assessing bone mass at different sites such as lumbar spine, hip and distal radius lies on the fact that T score-expressed values predict the fracture risk in postmenopausal women without renal failure. In the chronic renal failure population, the best site for performing bone mass assessments has not yet been precisely defined.

decreased bone mass and density relationship

From the present study, we conclude that, of body compartments, lean body mass is the main determinant in TBMC, especially in men and postmenopausal women. Since lean mass is an expression of muscular mass, the appropriate maintenance of the latter by means of programmed physical activity and appropriate nutrition is a desirable measure in order to maintain bone mass in patients on peritoneal dialysis.

This study also highlights the importance of secondary hyperparathyroidism in reduction of the bone mineral content, especially in postmenopausal women. The effect of chronic renal failure and maintenance he- A. Am J Roentgenol Bone mineral loss during maintenance hemodialysis. Acta Med Scand Bone mineral content in patients on prolonged maintenance hemodialysis: A three year follow-up study.

Change of Bone Mineral Density and Relationship to Clinical Parameters in Male Stroke Patients

Medicina Buenos Aires Direct Photon absorptiometry for long-term monitoring of uremic osteodistrophy. PTH mediated bone loss in primary and secondary hyperparathyroidism. Frane B, Potts JT ed: Clinical disorders of bone and mineral metabolism. Amsterdam, Excerpta Medica, pp.

Bone mass status in different degrees of chronic renal failure. Nefrologia latinoamericana 3 4: Studies of bone morphology, bone densitometry and laboratory data in patients on maintenance hemodialysis treatment.

Men aged from 50 years to 65 years were included to eliminate postmenopausal osteoporosis and to eliminate the influence of senile osteoporosis, and they underwent BMD measurements 3 months to 4 months after their stroke.

Change of Bone Mineral Density and Relationship to Clinical Parameters in Male Stroke Patients

The control group included men from the university healthcare centers who were in the same age group with no history of stroke, no history of drug intake that would affect osteoporosis, and no medical history indicating osteoporosis. As previously stated, patients younger than 50 years or older than 65 years and patients who had a stroke less than 3 months previously were excluded.

This retrospective study collected the age, height, and body mass index BMI of each of the patients. The muscle strength of the hemiplegic lower extremity hip extensor and knee extensor was evaluated using a manual muscle test MMT. Two groups were formed as follows: One group showed MMT grades for both the hip extensor and the knee extensor that are above the F grade, and the other group showed an MMT grade of either the hip extensor or the knee extensor that is below the F grade.

The degree of spasticity in the hemiplegic lower extremity hip flexor or hip extensor was evaluated using the Modified Ashworth Scale MAS ; here, the higher one between the hip flexor and the hip extensor was analyzed. A loss of proprioception regarding the joint position was tested through passive vertical-motion exercises of the fingers and toes on both sides. The possible use of the medications commonly used by stroke patients and that may cause osteoporosis was investigated, specifically steroids, anticoagulants, antiplatelets warfarin, heparinand anticonvulsants phenytoin, phenobarbital, primidone, carbamazepine, and valproic acid ; stroke-related medicines were only considered if they were continuously used for more than 1 month.

The mobility status was classified according to independent walking, independent walking under supervision, walking with assistance, immobility, and wheelchair use. The participants were classified according to their BMI, which is calculated as the weight divided by the square of the height.

A BMI below By varying the resistance a muscle withstood, the MMT was used by the authors to classify the degree of muscle strength, and a grade of 0 to 5 was determined using the factors of gravity, resistance, and range of motion. The MAS is the most commonly used method for evaluating the degree of spasticity, and it was also classified from 0 to 5.

The Spearman correlation analysis was used to determine the presence of any correlations in the experimental group for the BMI, physical characteristics, physical examination, and clinical parameters.

Linear regression was used to determine the independent influence of each risk factor on the BMD; here, p-value is statistically significant below 0.

The group comprises 21 men with the average age of The MMT for the hip and knee joints, which are important for standing and walking, identified 13 patients with both a hip extensor and a knee extensor the F grade and over, and eight patients with a hip extensor or a knee extensor below the F grade.

The average spasticity is 0. The evaluation of the daily-functionality status using the MBI showed an average of For proprioception, which is important for standing and walking, 6 patients indicated a loss of a sense of position and 15 did not.

Stroke-related medications were taken for over a month by 14 participants; whereas 7 had not taken medications. Five patients could walk independently or independently under supervision, 9 walked with minimum-to-maximum assistance, and 7 required a wheelchair.

decreased bone mass and density relationship

Bone density difference between control and experimental groups Men between the ages of 50 years and 65 years with no history of stroke who underwent the BMD test at the university healthcare centers formed the control group.

The stroke patients included in this study underwent the BMD test at the time of transfer or after their admission to the Department of Rehabilitation Medicine, and the average time period that had elapsed after the stroke is The difference between the bone-density values of the two groups is significant.

Correlation between bone density and clinical parameters in stroke patients The clinical parameters and the BMD results of the groups were analyzed using the Spearman correlation. The BMD results of the stroke group for the lumbar and hemiplegic side of the femoral neck correlated significantly with the MMT results of the hemiplegic lower extremity and the MBI results, suggesting that the immobility from a decreased muscle strength and a weakened daily functionality from the stroke reduced the BMD.