Bone mineral density in healthy Syrian women measured by dual energyX-ray absorptiometry

Mohamed Adel Bakir; Kholoud B Hammad; Khuzama M Habil

doi:10.2478/anre-2018-0002

Authors

Mohamed Adel Bakir Radiation Medicine Department, AECS, Damascus, Syria
Kholoud B Hammad Radiation Medicine Department, AECS, Damascus, Syria
Khuzama M Habil Radiation Medicine Department, AECS, Damascus, Syria

DOI:

https://doi.org/10.2478/anre-2018-0002

Keywords:

bone mineral density (BMD), dual-energy X-ray absorptiometry (DXA), osteoporosis, osteopenia, Syrian women

Abstract

Assessment of bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) technique is considered as a standard technique for diagnosing osteopenia and osteoporosis and evaluating the severity of such diseases. Numerous studies have demonstrated the necessity to establish an ethnicspecific reference data for Bone mineral density measurements. Such data are lacking for the Syrian population. The objectives of this study are (1) to establish BMD reference values in a group of healthy Syrian women using DXA technique, (2) to compare with values from other populations, (3) to study the prevalence of osteopenia and osteoporosis in Syrian women using the manufacturer reference values. A total of 951 healthy Syrian women aged 20-79 years participated in this study. Weight, height, and BMI have been determined. BMD measurements were performed using Lunar Prodigy Advance System (GE).

The data were compared with those from other populations. The results have demonstrated the expected decline in BMD with age after peaking at 30-39 years old group. The peak values of the lumbar spine and femur neck were 1.16 (0.12), and 0.95 (0.13) g/cm2, respectively. The results of the Syrian women were compared with those from other populations and the differences were presented. Osteopenia was diagnosed in 35.80% and 60.31% and osteoporosis in 6.23% and 2.72% in lumbar spine and femur neck, respectively, of women 50-59 years of age. These ratios increased to 36.84%, 68.42% and 23.68%, 13.10%, respectively, in the age group more than 59 years. BMD values of the Syrian women were determined for the first time. The results demonstrate the importance of establishing population-specific reference range for BMD values for an accurate assessment of Osteoporosis. High prevalence of osteopenia and osteoporosis was demonstrated in Syrian using the manufacturer reference values.

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References

Bhudhikanok GS, Wng MC, Ecket K, Matkin C, Marcus R, Bachrach LK. 1996. Differences in bonemineral in young Asian and Caucasian Americans may reflect differences in bone size. J Bone Res 111545-56.

Byers, RJ, Hoyland JA, Braidman IP. 2001. Osteoporosis in men: A cellular endocrine perspective of an increasingly common clinical problem. J Endocrinol 168:353-62.

Chan WP, Liu JF, CHI WL. 2004. Evaluation of BoneMineral Density of the Spine and Proximal Femur in Population-based Routine Health Examinations of Healthy Asian. Acta Radiologica 45:59-64.

Cooper C, Campion G, Melton LJ. 1992. Hip fractures in the elderly: a worldwide projection. Osteoporosis Int 2:285-9.

Damilakis J, Adams JE, Guglielmi G, Link TM. 2010. Radiation expousure in X-ray-based imaging techniques used in osteoporosis. Eur Radiol 20:2707-14.

Delezé M1, Cons-Molina F, Villa AR, Morales-Torres J, Gonzalez-Gonzalez JG, Calva JJ, Murillo A, Briceño A, Orozco J, Morales-Franco G, Peña-Rios H, Guerrero-Yeo G, Aguirre E, Elizondo J. 2000. Geographic differences in bone density of Mexico Women. Osteoporosis Int 11:562-9.

Dougherty G, Al-Marzouk N. 2001. Bone density measured by dual-energy X absorptiometry in healthy Kuwaity women. Calcif Tissue Int 68:225-9.

El Maghraoui A, Guerboub AA, Achemlal L, Mounach A, Nouijai A, Ghazi M, Bezza A, Tazi MA. 2006. Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom 9(4):454-60.

El-Desouki M. 1995. Bone mineral density of the spine and femure in normal Saudi population. Saudi Med J 16(1):30-5.

El-Desouki MI. 2003. Osteoporosis in postmenopausal Saudi women using X-ray bone densitometry. Saudi Med J 24:935-6.

El-Sunbaty MR, Abdul-Ghaffar NU. 1996. Vitamin D deficiency in veiled Kuwaiti women. Eur J Clin Nutr 50:315-8.

Fan B, Lu Y, Genant H, Fuerst T, Shepherd J. 2010. Does standardized BMD still remove differences between Hologic and GE-Lunar state-of-the-art, DXA systems? Osteoporos Int 21:1227–36.

Gannagé-Yared MH, Chemali R, Yaacoub N, Halaby G. 2000. Hypovitaminosis D in a sunny country: relation to life style and bone markers. J Bone Minor Res 15:1856-62.

Genant HK, Grampp S, Glüer CC, Faulkner KG, Jergas M, Engelke K, Hagiwara S, Van Kuijk C. 1994. Universal standardrization for dual x-rayabsorptiometry: patient and phantom cross-calibration results. J Bone Miner Res 9:1503-14.

Hadjidakis D, Kokkinakis E, Giannopoulos G, Merakos G, Raptis SA. 1997. Bone mineral density of vertebrae, proximal femur and oscalcis in normal Greek subjects as assessed by dual-energy X-rayabsorptiometry: comparison with other populations. Eur J Clin Invest 27:219-27.

Hammoudeh M, Al-Khayarin M, Bener A. 2005. Bone density measured by dual energy X-ray absorptiometry in Qatari women. Maturitas 52:319-27.

Hui SL, Gao S, Zhou XH, Johnston CC Jr, Lu Y, Glüer CC, Grampp S, Genant H. 1997. Universal standardization of bone density measurements: a method with optimal properties for calibration among several instruments. J Bone Miner Res 12:1463-70.

Iki M, Kagamimori S, Kagawa Y, Matsuzaki T, Yoneshima H, Marumo F. 2001. Bone mineral density of the spine, hip and distal forearm in representative samples of the Japanese female population: Japanese population Based Osteoporosis (JPOS) Study. Osteoporosis Int 12:529-37.

Kanis JA 1994. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporosis Int 4:368-81.

Kanis JA. 1997. Diagnosis of osteoporosis. Osteoporosis Int 7:108-16.

Kanis, JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N. 1994. The diagnosis of osteoporosis. J Bone Mineral Res 9:1137-41.

Larijani B, Resch H, Bonjour JP, AghaiMeybodi HR, MohajeryTehrani MR. 2007. Osteoporosis in Iran, Overview and Management. Iranian J Publ Health A supplementary issue on Osteoporosis 1-13.

Looker AC, Orwoll ES, Johnston CC Jr, Lindsay RL, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP. 1997. Prevalence of low femoral bone density in older US adults from NHANES III. J Bone Miner Res 12:1761-8.

Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay RL. 1995. Proximal femur bone levels of US adults. Osteoporosis Int 5:389-409.

Maalouf G, Gannage-Yared MH, Ezzedine J, Larijani B, Rached A, et al. 2007. Middle East and North Africa consensus on osteoporosis. J Musculoskeletel Neuronal Interact 7(2):131-43.

Maalouf G, Salem S, Sandid M, Attallah P, Eid J, Saliba N, Nehmé I, Johnell O. 2000. Bone mineral density of the Lebanese reference population. Osteoporos Int 11:756-64.

Mahussain S, Badr H, Al-Zaabi K, Mohammad M. 2006. Bone mineral density in healthy Kuwaiti women. Arch Osteoporosis 1:51-7.

Marshall D, Johnell O, Wedel H. 1999. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures BMJ 312:1254-9.

Mazess RB, Barden H. 1999. Bone density of the spine and femur in adult white females. CalcifTissueInt 65:91-9.

Mishal AA. 2001. Effects of different dressstyles on vitamin D levels in healthy young Jordanian women. Osteoporosis Int 12:931-5.

ONeill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ. 1996. The prevalence of vertebral deformity in European men and women: the European vertebral osteoporosis study. J Bone Miner Res 11:1010-8.

Paker N, Soy D, Erbil M, Otlu EZ. 2005. Bone mineral density in healthy Turkish woman. J Miner Stoffwechs 12:73-6.

Park AJ, Choi JH, Kang H, Park KJ, Kim HY, Kim SH, Kim DY, Park SH, Ha YC. 2015. Result of proficiency test and comparison of accuracyusing a European Spine Phantom among the three bone densitometries. J Bone Metab 22:45-9.

Patni R. 2010. Normal BMD values for Indian females aged 20-80 years. J Mid life Health 1(2): 70-3.

Pedrazzoni M, Girasole G, Bertoldo F, Bianchi G, Cepollaro C, Del Puente A et al. 2003. Definition of a population-specific DXA reference standard in Italian women: the Densitometric Italian Normative Study (DINS). Osteoporos Int 14(12):978-82.

Reid DM, Mackay I, Wilkinson S, Miller C, Schuette DG, Compston J et al. 2006. Cross-calibration of dual-energy X-ray densitometers for a large, multi-center genetic study of osteoporosis. Osteoporos Int 17:125-32.

Steel S, Peel N. 2011. Reporting dual energy X-ray absorptiometry scans in adults fracture risk assessment. National osteoporosis society. Practical guides for a break free future. Available at: https://nos.org.uk/media/2072/reporting-dxa-scans-at-hipand-spine-in-adults.pdf

Tenenhouse A, Josegh L, Kreiger N, Poliquin S et al. 2001. Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporosis Int 11:897-904.

Tobias JH, Cook DG, Chambers TJ, Dalzeil N. 1994. A comparison of bone mineral density between Caucasian, Asian and Afro-Caribbean women. Clin Sci 87:587-91.

Wehbe J, Cortbaoui C, Chidiac RM, Nehme A, Melki R, Bedran F, Atallah P, Cooper C, Hadji P, Maalouf G. 2003. Age-associated changes in Quantitative Ultrasonometry (QUS) of the oscalcis in Lebanese women-assessment of a Lebanese reference population. J Muscoloskelet Neuronal Interact 3:232-9.

World Health Organization 1994. Assessment of fracture risk and its application to screening for post-menopausal osteoporosis. Geneva, Switzerland: WHO.

Wu XP, Liao EY, Huang G, Dai RC, Zhang H. 2003. A comparison study of reference curves of bone mineral density at different skeletalsites in native Chinese, Japanese and American Caucasian women. Calcif Tissue Int 73:122-32.

Yu W, Qin M, Xu L, Tian J, Xing X, Meng Xet al. 1998. Bone mineral analysis of 445 normal subjects assessed by dual X-raya bsorptiometry. Chin J Radiol 30:625-9.