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2. Concussion-Related Biomarker Variations in Retired Rugby Players and Implications for Neurodegenerative Disease Risk: The UK Rugby Health Study.

Author

Alanazi, Norah, Fitzgerald, Melinda, Hume, Patria, Hellewell, Sarah, Horncastle, Alex, Anyaegbu, Chidozie, Papini, Melissa G., Hargreaves, Natasha, Halicki, Michal, Entwistle, Ian, Hind, Karen, and Chazot, Paul

Subjects
RUGBY football players, NEURODEGENERATION, ALZHEIMER'S disease, RETIREMENT of athletes, AMYOTROPHIC lateral sclerosis
Abstract

The health and well-being of retired rugby union and league players, particularly regarding the long-term effects of concussions, are of major concern. Concussion has been identified as a major risk factor for neurodegenerative diseases, such as Alzheimer's and Amyotrophic Lateral Sclerosis (ALS), in athletes engaged in contact sports. This study aimed to assess differences in specific biomarkers between UK-based retired rugby players with a history of concussion and a non-contact sports group, focusing on biomarkers associated with Alzheimer's, ALS, and CTE. We randomly selected a sample of male retired rugby or non-contact sport athletes (n = 56). The mean age was 41.84 ± 6.44, and the mean years since retirement from the sport was 7.76 ± 6.69 for participants with a history of substantial concussions (>5 concussions in their career) (n = 30). The mean age was 45.75 ± 11.52, and the mean years since retirement was 6.75 ± 4.64 for the healthy controls (n = 26). Serum biomarkers (t-tau, RBP-4, SAA, Nf-L, and retinol), plasma cytokines, and biomarkers associated with serum-derived exosomes (Aβ42, p-tau181, p-tau217, and p-tau231) were analyzed using validated commercial ELISA assays. The results of the selected biomarkers were compared between the two groups. Biomarkers including t-tau and p-tau181 were significantly elevated in the history of the substantial concussion group compared to the non-contact sports group (t-tau: p < 0.01; p-tau181: p < 0.05). Although between-group differences in p-tau217, p-tau231, SAA, Nf-L, retinol, and Aβ42 were not significantly different, there was a trend for higher levels of Aβ42, p-tau217, and p-tau231 in the concussed group. Interestingly, the serum-derived exosome sizes were significantly larger (p < 0.01), and serum RBP-4 levels were significantly reduced (p < 0.05) in the highly concussed group. These findings indicate that retired athletes with a history of multiple concussions during their careers have altered serum measurements of exosome size, t-tau, p-tau181, and RBP-4. These biomarkers should be explored further for the prediction of future neurodegenerative outcomes, including ALS, in those with a history of concussion. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Energy balance and bone mineral density on male and female distance runners

Author

Hind, Karen, Truscott, J., and Evans, T.

Subjects
612.044
Abstract

Reports of lumbar spine (IS) skeletal deficits in female athletes with menstrual disorders are common, although it is not clear whether the deficits are confined to this group. The main factor presumed to be responsible is oestrogen deficiency characterised by amenorrhoea, however emerging evidence indicates that energy deficiency can also disturb bone turnover. This thesis aimed to determine whether male distance runners are at a comparable risk for bone loss and whether there was a relationship between reported energy balance and BMD. Methods: 109 distance runners (18-50 years) participated (65 females, 44 males). A questionnaire assessed menstrual status, performance level and training characteristics. 7-day dietary and exercise records were used to quantify energy balance. LS, dual femur (DF) and total body (TB) BMD were measured using dual-energy X-ray absorptiometry. Bone size was accounted for: bone mineral apparent density (BMAD) = BMD / √Bone area. Results: Male and female IS T-scores were similar (-0.8, -0.8). 41.6% of female and 36.4% of male runners were osteopenic (LS). Age, BMI and body fat- adjusted LS T-scores were lower in male than female runners (p<0.05). Adjusted LS T-scores were lower in male compared to eumenorrhoeic runners (p<0.01). Female runners who used the oral contraceptive pill had similar BMD to amen/oligo-menorrhoeic runners, which were significantly lower than eumenorrhoeic runners (p<0.01). These runners were also more energy deficient (p<0.01). Elite runners had greater energy deficits, lower IS T-scores, BMAD and a smaller bone area than club runners (p<0.001). DF and TB T-scores were normal, did not correlate with weekly mileage and after adjustment for calcium intake, did not correlate with energy balance. IS T-score negatively correlated with stress fracture incidence (p

Published
2004

8. Exploring the impact of exercise and essential amino acid plus cholecalciferol supplementation on physical fitness and body composition in multiple sclerosis : A case study

Author

Ispoglou, Theocharis, Ferentinos, Panagiotis, Prokopidis, Konstantinos, Blake, Cameron, Aldrich, Luke, Elia, Antonis, Lees, Matthew, Hind, Karen, Ispoglou, Theocharis, Ferentinos, Panagiotis, Prokopidis, Konstantinos, Blake, Cameron, Aldrich, Luke, Elia, Antonis, Lees, Matthew, and Hind, Karen

Abstract

Key Clinical MessageIn MS patients, especially those frail or malnourished, combining home-based exercise twice weekly with essential amino acids and vitamin D may improve body composition, strength, and physical performance, enabling long-term functional improvements. Multiple sclerosis (MS) is associated with reduced bone and muscle strength and function. We aimed to investigate the effectiveness of a 24-week intervention in a 57-year-old frail female with MS. The participant completed a 2x/week exercise intervention and ingested 2x/day a supplement containing 7.5 g essential amino acids and 500 IU cholecalciferol. Body composition, 6-m gait speed (GS), handgrip strength (HGS), 30-sec arm-curl test (30ACT), 6-min walking test (6MWT), 30-sec chair-stand test (30CST), and plasma concentrations of 25-hydroxyvitamin D-3 [25(OH)D-3], insulin-like growth factor 1 (IGF-1), and amino acids were assessed at baseline, and at Weeks 12 and 24. Plasma 25(OH)D-3 increased from 23.2 to 41.3 ng/mL and IGF-1 from 131.6 to 140.7 ng/mL from baseline to post-intervention. BMI, total lean tissue mass (LTM), fat mass, bone mineral content, and the sum of 17 amino acids increased by 3.8, 1.0, 3.5, 0.2, and 19%, respectively, at Week 24. There were clinically significant increases in regional LTM (6.9% arms and 6.3% legs) and large increases in GS (67.3%), dominant HGS (31.5%), non-dominant HGS (11.8%), dominant 30ACT (100%), non-dominant 30ACT (116.7%), 6MWT (125.6%), and 30CST (44.4%). The current intervention was effective in improving components of physical fitness and body composition in a female with MS., QC 20230630

Published
2023
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15. Visceral Obesity and Lipid Profiles in Chinese Adults with Normal and High Body Mass Index

Author

Lu, Yutong, Li, Na, 1000010399868, Kamishima, Tamotsu, Jia, Peng, Zhou, Dan, Hind, Karen, Sutherland, Kenneth, Cheng, Xiaoguang, Lu, Yutong, Li, Na, 1000010399868, Kamishima, Tamotsu, Jia, Peng, Zhou, Dan, Hind, Karen, Sutherland, Kenneth, and Cheng, Xiaoguang

Abstract

Background: This study examined the prevalence of visceral obesity in Chinese adults across different body mass index (BMI) groups and their associated lipid profiles and demographic risk factors. Methods: A total of 1653 Chinese adults were recruited for the study. Abdominal quantitative computed tomography (CT) imaging was performed to derive the visceral adipose tissue (VAT) at the lumbar vertebrae (L2-L3) levels. Visceral obesity was defined using established cutoff values. Fasting serum total cholesterol, total glucose, high-density lipoprotein, and low-density lipoprotein were measured. Results: Visceral obesity was prevalent in 35% of men and 22% of women with normal BMI (18.5-24 kg/m(2)) and 86% of men and 78% of women with high BMI (>= 24 kg/m(2)). In both sexes, participants with normal BMI and visceral obesity had higher levels of TC, TG and LDL and lower HDL compared to those with normal VAT. The risk factors for visceral obesity in women with normal BMI were an age >= 50 years and BMI >= 22.3 kg/m(2) and in men included a BMI >= 22.5 kg/m(2). Conclusion: Visceral obesity was observed in the participants with normal BMI and was associated with an adverse lipid profile. The BMI cutoff points were lower than the normally accepted values.

Published
2022

19. Relationship between body composition and bone mass in normal-weight and overweight adolescents.

Author

Augusto Bim, Mateus, de Araujo Pinto, André, Colares de Angelo, Hector Cris, Gonzaga, Isadora, de Azevedo Guimarães, Adriana Coutinho, Gomes Felden, Érico Pereira, Gomes de Carvalho, Wellington Roberto, Hind, Karen, and Pelegrini, Andreia

Subjects
BONE density, BODY composition, BONE health, OVERWEIGHT children, TEENAGERS, DUAL-energy X-ray absorptiometry, BODY mass index
Abstract

Adolescence is a period characterized by large accumulation of bone mass. Body composition is an important determinant of bone mass. This study aimed to assess the relationship of bone mass with lean mass (LM) and fat mass (FM) in normal-weight and overweight adolescents with consideration of sex, sexual maturation and physical activity covariates. A total of 118 adolescents (60 girls and 58 boys) aged between 10 and 14 years participated in the study. Individuals were classified as normal weight or overweight according to body mass index. Bone mineral density (BMD), bone mineral content (BMC), LM, and FM were measured by dual-energy X-ray absorptiometry. In normal-weight adolescents, LM (β D0:725, p < 0.001) and FM (β D0:185, p D 0.019) were associated with lumbar spine BMC, whereas in overweight adolescents only LM (β D 0:736, p < 0.001) was associated with lumbar spine BMC. Furthermore, in the normal-weight group, FM and LM were associated with total body less head BMD (LM, β D0:792, p < 0.001; FM, β D0:257, p D 0.007) and lumbar spine BMD (LM, β D0:553, p < 0.001; FM, β D0:199, p < 0.035). In the overweight group, only LM was associated with total body less head BMD (β D0:682, p < 0.001) and lumbar spine BMD(β D0:528, p<0.001). LM was the main predictor of bone mass in normal-weight and overweight adolescents. FM was associated with bone mass in normal-weight adolescents only. LM may be considered an important and useful marker in adolescents, when investigating bone health in this population. Activities that promote LM gain to reduce the risk of bone fractures and diseases in adulthood are recommended. [ABSTRACT FROM AUTHOR]

Published
2022
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20. Toward Complete, Candid, and Unbiased International Consensus Statements on Concussion in Sport

Author

Universitat Rovira i Virgili, Casper, Stephen T.; Bachynski, Kathleen E.; Buckland, Michael E.; Comrie, Don; Gandy, Sam; Gates, Judith; Goldberg, Daniel S.; Henne, Kathryn; Hind, Karen; Morrison, Daniel; Ortega, Francisco; Pearce, Alan J.; Philpott-Jones, Sean; Sandel, Elizabeth; Tatos, Ted; Tucker, Sally; Finkel, Adam M., Universitat Rovira i Virgili, and Casper, Stephen T.; Bachynski, Kathleen E.; Buckland, Michael E.; Comrie, Don; Gandy, Sam; Gates, Judith; Goldberg, Daniel S.; Henne, Kathryn; Hind, Karen; Morrison, Daniel; Ortega, Francisco; Pearce, Alan J.; Philpott-Jones, Sean; Sandel, Elizabeth; Tatos, Ted; Tucker, Sally; Finkel, Adam M.

Abstract

Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuries especially when they recur.

Published
2021

21. Age- and Sex-Specific Reference Intervals for Visceral Fat Mass in Adults

Author

Swainson, Michelle, Batterham, Alan, Hind, Karen, Swainson, Michelle, Batterham, Alan, and Hind, Karen

Abstract

Background/Objectives Dual-energy X-ray absorptiometry (DXA) is becoming a method of choice for the assessment of visceral adipose tissue (VAT) but the lack of robust reference ranges presents a challenge to the interpretation of VAT in clinical practice, research settings, and the athletic environment. The objective of this study was to develop age- and sex-specific reference intervals for DXA-derived VAT mass. Subjects/Methods The reference group comprised 3219 adults (1886 general population, 42% women; 1333 athletes, 11% women) in the United Kingdom, aged 18–83 years. Total body scans were performed using a GE Lunar iDXA and VAT analyses were enabled through Corescan software (Encore version 15.0). Age-specific reference ranges were derived in samples stratified by sex and general population/ athlete status. We modelled the mean and SD of Box-Cox transformed VAT mass as a function of age with a generalised least squares method using fractional polynomials (Stata® -xrigls- program). Centile values were then back-transformed to provide reference intervals on the original scale. Results In general population samples, average VAT mass increases with age up until around 65–70 years, and then begins to decline at older ages, though data are relatively sparse at the upper end of the age range. In athletes, on average, VAT mass increases with advancing age in men and women. Both 95 and 98% reference ranges are presented in 5-year increments in all samples, and we provide equations to enable the calculation of any centile, for any age within the range. Conclusions These reference data can aid the interpretation of VAT mass specific to an individual’s sex, age, and athletic status, increasing the utility and applicability of DXA-derived VAT assessments. Additional research is needed in adults over 65 years and female athletes, with different DXA devices, across different ethnic groups and specific sports.

Published
2020

23. Associations of Muscle Size and Density With Proximal Femur Bone in a Community Dwelling Older Population

Author

Yin, Lu, primary, Xu, Zhengyang, additional, Wang, Ling, additional, Li, Wei, additional, Zhao, Yue, additional, Su, Yongbin, additional, Sun, Wei, additional, Liu, Yandong, additional, Yang, Minghui, additional, Yu, Aihong, additional, Blake, Glen Mervyn, additional, Wu, Xinbao, additional, Veldhuis-Vlug, Annegreet G., additional, Cheng, Xiaoguang, additional, Hind, Karen, additional, and Engelke, Klaus, additional

Published
2020
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29. Measurement of muscle health in ageing

Author

Francis, Peter, Lyons, Mark, Piasecki, Mathew, Mc Phee, Jamie, Hind, Karen, and Jakeman, Philip M.

Subjects
sarcopenia, healthy aging, muscle strength, functional capability
Abstract

peer-reviewed Muscle health is a critical component in the struggle against physical frailty and the efforts to maintain metabolic health until the limit of chronological age. Consensus opinion is to evaluate muscle health in terms of muscle mass, strength and functional capability. There has been considerable variability in the components of muscle health which have been investigated in addition to variability in the tools of assessment and protocol for measurement. This is in stark contrast to the validated measurement of bone health across the adult life span. The purpose of this review was to identify indices of muscle mass, strength and functional capability most responsive to change with ageing and where possible to provide an estimate of the rate of change. We suggest lean tissue mass (LTM) or skeletal muscle (SM) is best evaluated from the thigh region due to its greater responsiveness to ageing compared to the whole body. The anterior compartment of the thigh region undergoes a preferential age-related decline in SM and force generating capacity. Therefore, we suggest that knee extensor torque is measured to represent the force generating capacity of the thigh and subsequently, to express muscle quality (strength per unit tissue). Finally, we suggest measures of functional capability which allow participants perform to a greater maximum are most appropriate to track age-related difference in functional capacity across the adult lifespan. This is due to their ability encompass a broad spectrum of abilities. This review suggests indices of muscular health for which reference ranges can be generated across the lifespan. PUBLISHED peer-reviewed

Published
2017

31. Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables.

Author

Swainson, Michelle, Batterham, Alan, Tsakirides, Costas, Rutherford, Zoe, Hind, Karen, Swainson, Michelle, Batterham, Alan, Tsakirides, Costas, Rutherford, Zoe, and Hind, Karen

Abstract

Background The conventional measurement of obesity utilises the body mass index (BMI) criterion. Although there are benefits to this method, there is concern that not all individuals at risk of obesity-associated medical conditions are being identified. Whole-body fat percentage (%FM), and specifically visceral adipose tissue (VAT) mass, are correlated with and potentially implicated in disease trajectories, but are not fully accounted for through BMI evaluation. The aims of this study were (a) to compare five anthropometric predictors of %FM and VAT mass, and (b) to explore new cut-points for the best of these predictors to improve the characterisation of obesity. Methods BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist/height0.5 (WHT.5R) were measured and calculated for 81 adults (40 women, 41 men; mean (SD) age: 38.4 (17.5) years; 94% Caucasian). Total body dual energy X-ray absorptiometry with Corescan (GE Lunar iDXA, Encore version 15.0) was also performed to quantify %FM and VAT mass. Linear regression analysis, stratified by sex, was applied to predict both %FM and VAT mass for each anthropometric variable. Within each sex, we used information theoretic methods (Akaike Information Criterion; AIC) to compare models. For the best anthropometric predictor, we derived tentative cut-points for classifying individuals as obese (>25% FM for men or >35% FM for women, or > highest tertile for VAT mass). Results The best predictor of both %FM and VAT mass in men and women was WHtR. Derived cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting visceral obesity was 0.59 in both sexes. Conclusions In the absence of more objective measures of central obesity and adiposity, WHtR is a suitable proxy measure in both women and men. The proposed DXA-%FM and VAT mass cut-offs require validation in larger studies, but offer potential for improvement of obesity characterisation a

Published
2017

40. Recovery of bone mineral density and fertility in a former amenorrheic athlete.

Author

Hind, Karen

Subjects
*BONE density, *WOMEN runners, *PHYSICAL fitness, *DISEASES in women athletes, *WOMEN'S health, *AMENORRHEA, *PHYSIOLOGY
Abstract

Inadequate dietary intake and prolonged amenorrhea in women athletes can lead to bone loss, particularly at the spine, which may be irreversible. This report presents the case of a woman endurance runner, followed prospectively over 6 years after presenting with the female athlete triad. Bone mineral density (BMD) and body composition were assessed by dual-energy Xray absorptiometry. At baseline, lumbar spine (LS), total hip and total body (TB) BMD Z-scores were -2.2, -0.5 and -0.3 respectively. At 6 years, following a recovery plan of cognitive behavioural therapy (CBT), weight gain, improved dietary intake and reduced training load, the athlete regained menstrual function and BMD. LS, TB and hip BMD Z-scores improved to -0.6, -0.1 and 0.1 respectively. Restoration of fertility was indicated by pregnancy, following only 4 months of regular menstruation. This case report suggests that bone density and fertility may not be completely jeopardised in formerly amenorrheic and osteopenic athletes, providing recovery through diet, weight gain, and return of menstruation is achieved within the third decade. Longitudinal studies tracking bone changes in women with amenorrhea and low BMD are required and would have important implications for the treatment of the female athlete triad. [ABSTRACT FROM AUTHOR]

Published
2008

41. Modeling the shape and composition of the human body using dual energy X-ray absorptiometry images

Author

Bo Fan, Stephen B. Kritchevsky, Michael C. Nevitt, Timothy F. Cootes, Steven R. Cummings, John A. Shepherd, Peggy M. Cawthon, Bennett K. Ng, Adam J. Santanasto, Ann V. Schwartz, and Hind, Karen

Subjects
Upper Arms, Models, Anatomic, Male, Aging, Physiology, lcsh:Medicine, 030204 cardiovascular system & hematology, Diagnostic Radiology, Body Mass Index, Correlation, 0302 clinical medicine, Mathematical and Statistical Techniques, Absorptiometry, Photon, Models, Statistics, Medicine and Health Sciences, Medicine, lcsh:Science, Musculoskeletal System, Medicine(all), Metabolic Syndrome, Principal Component Analysis, Multidisciplinary, medicine.diagnostic_test, Agricultural and Biological Sciences(all), Anthropometry, Continental Population Groups, Radiology and Imaging, Anatomic, Torso, Photon, Bone Imaging, 3. Good health, medicine.anatomical_structure, Physiological Parameters, Principal component analysis, Physical Sciences, Body Composition, Legs, Female, Anatomy, Statistics (Mathematics), Type 2, Research Article, Imaging Techniques, Death Rates, General Science & Technology, 030209 endocrinology & metabolism, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Predictive Value of Tests, Diabetes Mellitus, Humans, Statistical Methods, Absorptiometry, Mortality, Dual-energy X-ray absorptiometry, Demography, Aged, business.industry, Biochemistry, Genetics and Molecular Biology(all), Prevention, lcsh:R, Body Weight, Limbs (Anatomy), Racial Groups, Biology and Life Sciences, Statistical model, Human body, Stepwise regression, X-Ray Radiography, Good Health and Well Being, Diabetes Mellitus, Type 2, Multivariate Analysis, People and Places, lcsh:Q, business, Mathematics
Abstract

There is growing evidence that body shape and regional body composition are strong indicators of metabolic health. The purpose of this study was to develop statistical models that accurately describe holistic body shape, thickness, and leanness. We hypothesized that there are unique body shape features that are predictive of mortality beyond standard clinical measures. We developed algorithms to process whole-body dual-energy X-ray absorptiometry (DXA) scans into body thickness and leanness images. We performed statistical appearance modeling (SAM) and principal component analysis (PCA) to efficiently encode the variance of body shape, leanness, and thickness across sample of 400 older Americans from the Health ABC study. The sample included 200 cases and 200 controls based on 6- year mortality status, matched on sex, race and BMI. The final model contained 52 points outlining the torso, upper arms, thighs, and bony landmarks. Correlation analyses were performed on the PCA parameters to identify body shape features that vary across groups and with metabolic risk. Stepwise logistic regression was performed to identify sex and race, and predict mortality risk as a function of body shape parameters. These parameters are novel body composition features that uniquely identify body phenotypes of different groups and predict mortality risk. Three parameters from a SAM of body leanness and thickness accurately identified sex (training AUC = 0.99) and six accurately identified race (training AUC = 0.91) in the sample dataset. Three parameters from a SAM of only body thickness predicted mortality (training AUC = 0.66, validation AUC = 0.62). Further study is warranted to identify specific shape/composition features that predict other health outcomes.

Published
2017
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42. Exploring the impact of exercise and essential amino acid plus cholecalciferol supplementation on physical fitness and body composition in multiple sclerosis: A case study.

Author

Ispoglou T, Ferentinos P, Prokopidis K, Blake C, Aldrich L, Elia A, Lees M, and Hind K

Abstract

Key Clinical Message: In MS patients, especially those frail or malnourished, combining home-based exercise twice weekly with essential amino acids and vitamin D may improve body composition, strength, and physical performance, enabling long-term functional improvements., Abstract: Multiple sclerosis (MS) is associated with reduced bone and muscle strength and function. We aimed to investigate the effectiveness of a 24-week intervention in a 57-year-old frail female with MS. The participant completed a 2×/week exercise intervention and ingested 2×/day a supplement containing 7.5 g essential amino acids and 500 IU cholecalciferol. Body composition, 6-m gait speed (GS), handgrip strength (HGS), 30-sec arm-curl test (30ACT), 6-min walking test (6MWT), 30-sec chair-stand test (30CST), and plasma concentrations of 25-hydroxyvitamin D 3 [25(OH)D 3 ], insulin-like growth factor 1 (IGF-1), and amino acids were assessed at baseline, and at Weeks 12 and 24. Plasma 25(OH)D 3 increased from 23.2 to 41.3 ng/mL and IGF-1 from 131.6 to 140.7 ng/mL from baseline to post-intervention. BMI, total lean tissue mass (LTM), fat mass, bone mineral content, and the sum of 17 amino acids increased by 3.8, 1.0, 3.5, 0.2, and 19%, respectively, at Week 24. There were clinically significant increases in regional LTM (6.9% arms and 6.3% legs) and large increases in GS (67.3%), dominant HGS (31.5%), non-dominant HGS (11.8%), dominant 30ACT (100%), non-dominant 30ACT (116.7%), 6MWT (125.6%), and 30CST (44.4%). The current intervention was effective in improving components of physical fitness and body composition in a female with MS., Competing Interests: No conflict of interest has been reported., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Published
2023
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43. Opportunistic Screening Using Low-Dose CT and the Prevalence of Osteoporosis in China: A Nationwide, Multicenter Study.

Author

Cheng X, Zhao K, Zha X, Du X, Li Y, Chen S, Wu Y, Li S, Lu Y, Zhang Y, Xiao X, Li Y, Ma X, Gong X, Chen W, Yang Y, Jiao J, Chen B, Lv Y, Gao J, Hong G, Pan Y, Yan Y, Qi H, Ran L, Zhai J, Wang L, Li K, Fu H, Wu J, Liu S, Blake GM, Pickhardt PJ, Ma Y, Fu X, Dong S, Zeng Q, Guo Z, Hind K, Engelke K, and Tian W

Subjects
Absorptiometry, Photon, Adult, Aged, Aged, 80 and over, Bone Density, China epidemiology, Early Detection of Cancer, Female, Humans, Male, Prevalence, Prospective Studies, Tomography, X-Ray Computed, Lung Neoplasms, Osteoporosis diagnostic imaging, Osteoporosis epidemiology
Abstract

Opportunistic screening for osteoporosis can be performed using low-dose computed tomography (LDCT) imaging obtained for other clinical indications. In this study we explored the CT-derived bone mineral density (BMD) and prevalence of osteoporosis from thoracic LDCT in a large population cohort of Chinese men and women. A total of 69,095 adults (40,733 men and 28,362 women) received a thoracic LDCT scan for the purpose of lung cancer screening between 2018 and 2019, and data were obtained for analysis from the China Biobank Project, a prospective nationwide multicenter population study. Lumbar spine (L 1 -L 2 ) trabecular volumetric bone mineral density (vBMD) was derived from these scans using quantitative computed tomography (QCT) software and the American College of Radiology QCT diagnostic criteria for osteoporosis were applied. Geographic regional differences in the prevalence of osteoporosis were assessed and the age-standardized, population prevalence of osteoporosis in Chinese men and women was estimated from the 2010 China census. The prevalence of osteoporosis by QCT for the Chinese population aged >50 years was 29.0% for women and 13.5% for men, equating to 49.0 million and 22.8 million, respectively. In women, this rate is comparable to estimates from dual-energy X-ray absorptiometry (DXA), but in men, the prevalence is double. Prevalence varied geographically across China, with higher rates in the southwest and lower rates in the northeast. Trabecular vBMD decreased with age in both men and women. Women had higher peak trabecular vBMD (185.4 mg/cm 3 ) than men (176.6 mg/cm 3 ) at age 30 to 34 years, but older women had lower trabecular vBMD (62.4 mg/cm 3 ) than men (92.1 mg/cm 3 ) at age 80 years. We show that LDCT-based opportunistic screening could identify large numbers of patients with low lumbar vBMD, and that future cohort studies are now required to evaluate the clinical utility of such screening in terms of fracture prevention and supporting national health economic analyses. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).., (© 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).)

Published
2021
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