Effectiveness of lifestyle intervention on BMD in postmenopausal osteopenia women

Effectiveness of lifestyle intervention on BMD in postmenopausal osteopenia women

S68 ABSTRACTS / Bone 43 (2008) S38–S75 Weight 8.9%, P b 0.01) and volume (R2 Height 13.4%, Weight 6.7%, P b 0.01). In multiple regression the only s...

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ABSTRACTS / Bone 43 (2008) S38–S75

Weight 8.9%, P b 0.01) and volume (R2 Height 13.4%, Weight 6.7%, P b 0.01). In multiple regression the only significant predictor of total and trabecular FN cross-sectional bone area, related to bone strength in compression, was height accounting for 16% and 7.4% of the variation, respectively. Regarding FN section modulus, a measure of FN strength in bending, both in plane and out of plane measures were related to height at 19.7% and 16.3% of variation, respectively. Conclusions: These results show that in elderly postmenopausal women true three dimensional volumetric FN BMD is not related to body size. This is because although both FN mass and volume are body size dependent, this dependency is proportional and cancels out in the calculation of true BMD. However, FN bone strength in compression and vending is related to stature presumably because of the bone size dependency of these measurements.

doi:10.1016/j.bone.2008.08.082

A81 Peripheral quantitative computed tomography shows changes in radial bone structure in elderly women: A two year cohort study Simon Scott 1, Kun Zhu 2, Richard Prince 1 1 School of Medicine and Pharmacology, University of Western Australia, Perth, Australia 2 Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia Aims: Peripheral quantitative computed tomography (pQCT) is a powerful tool for examining bone structure as it allows 3D determination of bone size and therefore strength. This study aimed to examine the change in bone structure and strength as determined by pQCT in a cohort of 768 community-dwelling Australian women aged 80 ± 2.5 yr at baseline. Methods: Radial bone structure was measured at baseline and two years later at the 4% trabecular site using a XCT-2000 (Norland-Stratec, Germany) pQCT machine. 510 subjects had the structure measured at the 15% cortical site. SSI, measures of bone resistance to torsion (Polar) and bending (x and y direction) were computed. Results: At both sites there was a significant increase in bone volume, which in theory may increase bone strength, but a decrease in bone density associated with a fall in SSI. Total vBMD (mg/cm3)

Total Volume (mm3)

SSI Polar

SSI x

SSI y

4% radius Baseline 24 months Change %

296 ± 70 285 ± 70⁎⁎ -3.1 ± 0.4⁎⁎

283 ± 55 288 ± 65⁎⁎ +2.6 ± 0.6⁎⁎

194 ± 74 167 ± 76⁎⁎ -12 ± 1.0⁎⁎

106 ± 38 92 ± 40⁎⁎ -11.6 ± 1.0⁎⁎

128 ± 54 112 ± 55⁎⁎ -11.1 ± 1.1⁎⁎

15% radius Baseline 24 months Change %

642 ± 109 616 ± 114⁎⁎ -4.0 ± 0.3⁎⁎

117 ± 19 120 ± 22⁎⁎ +2.5 ± 0.4⁎⁎

218 ± 48 215 ± 50⁎⁎ -1.4 ± 0.4⁎⁎

108 ± 24 107 ± 25⁎ -0.8 ± 0.7⁎

147 ± 34 145 ± 35⁎⁎ -1.2 ± 0.4⁎⁎

⁎ P b 0.01cf baseline; ⁎⁎ P b 0.001cf baseline.

Conclusions: The study of radial bone structure by pQCT demonstrates that although the bone has become larger, the type of changes after only two years have made the bone weaker.

doi:10.1016/j.bone.2008.08.083

A83 Effectiveness of lifestyle intervention on BMD in postmenopausal osteopenia women Hua Lin, Xin Chen, Xiu-feng Zhu The Center of Research for Metabolic Bone Disease, The Affiliated Drum Tower Hospital of Medical School, Nanjing University, Nanjing, China Objective: The purpose of this study was to evaluate the clinical effectiveness of lifestyle intervention on BMD in postmenopausal osteopenia women. Methods: Two hundred and forty postmenopausal osteopenia women aged 48–65 years were randomly divided into two groups: Group A—lifestyle intervention, that includes healthy and balanced diet, exposure to sunlight (30m-2h/d, and more than 8h/w), and respect to physical fitness (30m-1h/d, and more than 3-5times/w). All participants were received calcium 600 mg and VitD 125IU daily. Group B—non-intervention controls. During one year of intervention, Bone mineral density (BMD) was measured by DXA on lumbar spine and proximal femur at pre- intervention, 6 months and 12months after intervention. Results: After 6 months of intervention, There are no significant difference of BMD in two groups, but the changes of BMD on lumbar spine has significant difference between two groups (0.010 ± 0.033/-0.008 ± 0.041, p = 0.0439). After 12 months of intervention. There is a significant difference of BMD on lumbar spine in two groups (0.890 ±0.142 g/cm2/0.855 ± 0.138 g/cm2, p = 0.0459), and a significant difference of the changes of BMD on lumbar spine (0.025 ± 0.069/-0.003± 0.095, p = 0.0016) and total hip (0.015 ± 0.105/-0.004 ± 0.096, p = 0.0217) in two groups. Conclusions: Over a period of 1 year lifestyle intervention includes healthy and balanced diet, calcium and vitamin D supplementation, exposure to sunlight, and respect to physical fitness is successful to maintain bone mineral density at the spine and hip in postmenopausal osteopenia women. doi:10.1016/j.bone.2008.08.085

A84 The use of Micro Ct in osteoporosis Banu Kalpakcioglu Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Osteoporosis can be defined as a metabolic disorder characterized by a loss of bone mineral and characterized by the occurrence of atraumatic fractures of the vertebrae, fall-related hip fractures, and Colles fractures of the distal radius. It is characterized by low bone mass and deterioration of skeletal architecture causing increased bone fragility .Based on this definition bone mineral density (BMD) as assessed by dual energy x-ray absorptometry and based on T-scores provide the operational definition of osteoporosis as a gold standard. But, as BMD is assessed as a key component of osteoporosis diagnosis and assessment, it is being realized that BMD alone has a poor sensitivity. Both BMC and BMD, as measured by areal projectional techniques, such as DXA, are strongly influenced by body size, and populations of smaller frame, such as those in the Far East and Africa, have lower bone mineral values than Western populations but do not have higher rates of osteoporotic fracture . Although currently DXA is the gold standard for diagnosis many studies indicate that BMD only partly explains bone strength.There is only a modest relationship between change in bone mass in the individual and reduction of fracture risk. There are numerous methods of noninvasive and/or nondestructive techniques that can provide structural information about bone, beyond simple bone densitometry. Assessment of macro-