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Aim: This study aimed to investigate the associations between upper‐ and lower‐limb muscle strength, mass, and quality and health‐related quality of life (HRQoL) among community‐dwelling older adults. Methods: A cross‐sectional study was conducted with 428 Brazilian community‐dwelling older adults aged 60 to 80 years. Upper‐ and lower‐limb muscle strength were evaluated through the handgrip strength (HGS) test and the 30‐s chair stand test, respectively. Muscle mass was assessed by dual‐energy X‐ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Muscle quality was evaluated using the muscle quality index (MQI). HRQoL was assessed using the World Health Organization Quality of Life Brief Version questionnaire. Results: Lower‐limb, but not upper‐limb, muscle strength and quality were independently associated with HRQoL, particularly within the domains of physical capacity, environment, and overall HRQoL for both males and females (P < 0.05). DXA‐ and BIA‐derived analyses provided similar results in relation to muscle mass and muscle quality. Conclusions: Lower‐limb, but not upper‐limb, muscle strength and quality were independently associated with HRQoL among community‐dwelling older adults. Moreover, the results obtained from both BIA and DXA were similar, highlighting that BIA can serve as a viable surrogate method for estimating body composition in resource‐limited clinical settings. Geriatr Gerontol Int 2024; 24: 683–692. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the effectiveness of using ultrasonography for sex determination in young carp. Ultrasound images were obtained from anesthetized captive carp aged 11 to 13 months. After sacrifice, the body length and weight, gonadal sex and weight, and gonad-somatic index were measured. Well-developed testes and ovaries filled with granulated eggs were easily distinguishable on ultrasound imaging, based on their visible characteristic morphological features. In contrast, immature, small-sized testes and ovaries lacking granulated eggs were difficult to distinguish. The mean longitudinal thickness of gonads was technically the easiest to scan for measuring gonadal size, and it correlated well with gonadal weight (r = 0.91) and gonad-somatic index (r = 0.89). Based on the area under the curve of the receiver operating characteristic curve, we determined that 6.2 mm was the cutoff value for mean longitudinal gonadal thickness at which sex could be positively determined by ultrasonography, with a sensitivity of 82.6% and specificity of 100%. Ultrasonography therefore represents an effective and non-invasive diagnostic tool for determining sex and maturity in Japanese ornamental carp. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to develop deep learning techniques on total-body PET to bolster the feasibility of sedation-free pediatric PET imaging. Methods: A deformable 3D U-Net was developed based on 245 adult subjects with standard total-body PET imaging for the quality enhancement of simulated rapid imaging. The developed method was first tested on 16 children receiving total-body [18F]FDG PET scans with standard 300-s acquisition time with sedation. Sixteen rapid scans (acquisition time about 3 s, 6 s, 15 s, 30 s, and 75 s) were retrospectively simulated by selecting the reconstruction time window. In the end, the developed methodology was prospectively tested on five children without sedation to prove the routine feasibility. Results: The approach significantly improved the subjective image quality and lesion conspicuity in abdominal and pelvic regions of the generated 6-s data. In the first test set, the proposed method enhanced the objective image quality metrics of 6-s data, such as PSNR (from 29.13 to 37.09, p < 0.01) and SSIM (from 0.906 to 0.921, p < 0.01). Furthermore, the errors of mean standardized uptake values (SUVmean) for lesions between 300-s data and 6-s data were reduced from 12.9 to 4.1% (p < 0.01), and the errors of max SUV (SUVmax) were reduced from 17.4 to 6.2% (p < 0.01). In the prospective test, radiologists reached a high degree of consistency on the clinical feasibility of the enhanced PET images. Conclusion: The proposed method can effectively enhance the image quality of total-body PET scanning with ultrafast acquisition time, leading to meeting clinical diagnostic requirements of lesion detectability and quantification in abdominal and pelvic regions. It has much potential to solve the dilemma of the use of sedation and long acquisition time that influence the health of pediatric patients. [ABSTRACT FROM AUTHOR]

Aims: To explore the correlation between visceral adipose tissue and albuminuria, and whether there is interaction between visceral adipose tissue and diabetes on albuminuria. Methods: The study subjects were adult subjects (age ≥ 18 years) from the National Health and Nutrition Examination Surveys (NHANES) database of the USA in 2017–2018. Visceral fat area (VFA) was measured by dual-energy X-ray absorptiometry (DXA). Subjects were divided into three groups according to VFA: low (VFA 0–60cm2), medium (VFA 60–120 cm2) and high (VFA ≥ 120 cm2). Albuminuria was defined as urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g. The statistical analysis software used is STATA 17.0. Results: Data pertaining to 2965 participants (2706 without albuminuria) were included in the analysis. High VFA is an independent risk factor for albuminuria (OR 1.367, 95% CI 1.023–1.827). In the low-VFA group, there is no significant association between diabetes and albuminuria (OR 1.415, 95% CI 0.145–13.849). In the medium-VFA group, diabetes is an independent risk factor for albuminuria (OR 2.217, 95% CI 1.095–4.488). In the high-VFA group, diabetes is also an independent risk factor for albuminuria (OR 5.150, 95% CI 3.150–8.421). There is an additive interaction between high VFA (VFA ≥ 120 cm2) and diabetes on the effect of albuminuria (RERI 3.757, 95% CI 0.927–6.587, p = 0.009), while no multiplication interaction (OR 1.881, 95% CI 0.997–1.023, p = 0.141). Conclusions: High VFA may represent an independent risk factor for albuminuria. The amount of visceral fat may affect the effect of diabetes on albuminuria. The higher the visceral fat, the stronger the correlation between diabetes and albuminuria should be present. We suppose an additive interaction between VFA and diabetes on the effect of albuminuria. [ABSTRACT FROM AUTHOR]

The effect of gravitational unloading (antiorthostatic hindlimb suspension) and subsequent recovery on the mineral density and mechanical properties of the femoral and tibial bones in Wistar rats was studied during oral administration of a human lactoferrin (LF) biotechnological analog (200 mg/kg) derived from the milk of producer goats. Bone mineral density was determined by dual energy X-ray absorptiometry, while bone strength and stiffness were assessed via the three-point bending test. It was shown that 21-day gravitational unloading led to a decrease in the mineral density of the tibia and femur. Oral LF administration had no significant effect on the mineral density and projected area of the bones. There were no statistically significant differences in mechanical stiffness between the experimental groups, although after readaptation, the ultimate strength was significantly higher in LF-administered groups. Thus, the results may indicate the potential of LF preparations as prophylactic agents for maintaining bone strength. At the same time, the maintaining of bone mineral density under deficit-stimulating conditions requires a consideration of alternative dosages and drug delivery methods. [ABSTRACT FROM AUTHOR]

Data on the effectiveness of denosumab on osteoporosis after kidney transplantation are limited. We investigated the long-term bone mineral density (BMD) changes in kidney transplant recipients (KTRs) treated with denosumab compared to untreated KTRs. We enrolled KTRs treated with denosumab 60 mg/6 months for 4 years. An untreated group of sex and age-matched KTRs with a 1:1 ratio was included. The primary outcome was BMD changes assessed by Dual-energy X-ray Absorptiometry over 4 years. Data on serum creatinine, alkaline phosphatase (ALP), parathyroid hormone, and 25-hydroxyvitamin D were collected. All patients received oral cholecalciferol and calcium supplementation. 23 denosumab-treated KTRs were enrolled, and 23 untreated KTRs. The median time from transplant to the start of denosumab was 4 years (range 0:24). The denosumab group showed a significant increase from baseline in BMD at the lumbar spine (LS) (9.0 ± 10.7%, p < 0.001), and total hip (TH) (3.8 ± 7.9%, p = 0.041). The untreated group showed a significant decrease at all sites (− 3.0 ± 7%, p = 0.041 at the LS; − 6.3 ± 9.2%, p = 0.003 at the TH; − 6.7 ± 9.3%, p = 0.003 at the FN). The between-group differences in percent BMD changes were statistically significant at all sites. Similar results were found for the respective Z-scores. The ALP serum levels significantly decreased from baseline only in the denosumab group, with a significant between-group difference (p = 0.032). No significant differences in serum creatinine, hypocalcaemic events or acute graft rejection rates were observed. Four years of denosumab therapy were associated with increased BMD in KTRs, while untreated KTRs showed significant BMD losses at all sites. [ABSTRACT FROM AUTHOR]

Studies have found associations between sleep, nap duration, and bone mineral density (BMD). However, the longitudinal relationship between sleep, nap duration, and BMD has not been explored. We evaluated the association between the change in sleep and nap duration and BMD in Mexican adults. Data come from 1,337 adult participants of the Health Workers Cohort Study (341 were men and 996 were women, including 450 women < 45 years old and 546 ≥ 45 years old), with two study waves. At each wave, sleep and nap duration was assessed using self-administered questionnaires and BMD in g/cm2 was determined by dual X-ray absorptiometry. We used fixed-effect regression models stratified by sex and adjusted for BMI, diet, physical activity, vitamin supplements, and hormone replacement therapy. Women who changed from < 7 to ≥ 7 h/day of sleep from baseline to follow-up were associated with increases in the total hip (β = 0.012 g/cm2; 95% CI: 0.002, 0.022) and lumbar spine BMD (β = 0.024 g/cm2; 95% CI: 0.009, 0.039). Furthermore, most of these associations were observed in women ≥ 45 years. For women, a changing from 0 to > 60 min/day of napping was associated with a significant increase in total hip BMD of 0.012 g/cm2 (95% CI: 0.004, 0.024) and lumbar spine BMD of 0.027 g/cm2 (95% CI: 0.009, 0.045). No significant associations were observed for men. Our results suggest that increased sleep and nap duration are associated with gains in BMD in Mexican women, emphasizing sleep's role in promoting bone health and supporting established recommendations. [ABSTRACT FROM AUTHOR]

Purpose: Many modern-day children are at risk of pediatric dynapenia (muscle weakness). We examined the effects of a 12-week resistance training (RT) program on neuromuscular function and body composition parameters in pubertal children with a risk of dynapenia. Methods: Twelve children (13.4 ± 0.9 y) with dynapenia performed a progressive RT program consisting of knee extension and flexion, bench press, abdominal crunch, back extension, lateral pull-down, elbow flexion, and upright row (1–2 sets of 10–15 repetitions/exercise) twice/week for 12 weeks. Outcome measures included one-repetition maximum (1-RM) strength, maximal voluntary isometric contraction (MVIC) torque, rate of torque development (RTD), electromyographic (EMG) activity, muscle thickness (MT), muscle quality (MQ) assessed by echo intensity (MQEI) of the knee extensors and specific tension of MVIC torque to thigh fat-free mass (MQST), and total and regional body and bone composition assessed by dual-energy X-ray absorptiometry. Changes in the measures before and after the 12-week RT and associations among the measures were analyzed by linear mixed models. Results: Significant (p < 0.05) increases in 1-RM (63.9 ± 4.5%), MVIC torque (16.3 ± 17.8%), MT (18.8 ± 5.5%) and MQ (MQEI: -25.9 ± 15.2%; MQST: 15.1 ± 18.8%;) were evident from pre- to post-training. Total fat-free mass (FFM) increased by 2.3 ± 3.2% from baseline (p = 0.01), but no changes (p > 0.05) in the other measures were observed. Significant (p < 0.05) associations between the changes in 1-RM and/or MVIC torque and the changes in quadriceps MT, MQEI, MQST and total body FFM were evident. Conclusions: The 12-week RT was effective for improving neuromuscular and body composition parameters, and thereby reversed the risk of pediatric dynapenia. [ABSTRACT FROM AUTHOR]

Background: There is limited data with respect to body composition changes for laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux‐en‐Y gastric bypass (RYGB). The objective of this study was to analyse changes in body composition between these two procedures during the first year after bariatric surgery. Methods: A prospective study was performed in patients undergoing bariatric surgery at two tertiary hospitals between 2017 and 2023. Body composition was assessed with dual‐energy x‐ray absorptiometry immediately before surgery, and at 1‐, 6‐, 12‐, 18‐ and 24‐months post‐operatively, with a subgroup analysis performed for patients who undertook a scan at 18‐ and 24‐months. Total weight loss (TWL), body mass index (BMI), fat mass (FM), lean body mass (LBM) and bone mineral content (BMC) parameters were compared between SG and RYGB. Results: Forty‐five patients were included in this series (SG n = 30, RYGB n = 15). There was a significant reduction in mean %TWL of 26.94 ± 8.86% and mean BMI of 11.12 ± 3.70 kg/m2 over 12‐months. LBM accounted for 17.8% of TWL over 12‐months, SG and RYGB did not differ in terms of loss of FM or LBM. For both procedures, the loss of LBM appeared to plateau at 6‐months post‐operatively. The only statistically significant finding between the two procedures was that RYGB resulted in an additional 0.06 kg loss compared with SG. Conclusion: SG and RYGB have been shown to have comparable weight loss and body composition changes in the short‐to‐medium term following surgery. LBM reduction was most significant in the early post‐operative period across the entire cohort. [ABSTRACT FROM AUTHOR]

Introduction: Female bone health is influenced by familial resemblance, health parameters and maturational periods (puberty and menopause); this combination has been researched using familial multi-generational cross-sectional studies. Aim: This scoping review aimed to compile bone health research which uses sexually mature (grandmother–) mother–daughter pairs (and triads) and to determine the trends in its methodologies and familial comparisons. Methods: The Joanna Briggs Institute methodology for scoping reviews was used. Extraction included study and population characteristics, methodology (with an emphasis on imaging) and family-based results. Results: Twenty-nine studies were included, and their generations were categorized into four developmental categories: late adolescent to young adult, pre-menopause, mixed-menopause, and post-menopause. Eleven different pair/triad combinations were observed; the most common was pre-menopausal daughters and post-menopausal mothers. Dual-energy X-ray absorptiometry (DXA) was the most utilized imaging modality, and the hip was the most imaged region of interest (ROI). Regardless of pairing, imaging modality and ROI, there was often a trend toward significant familial resemblance and heritability (h2 and h2L). Conclusion: This scoping review highlights the trends in bone health linked to familial resemblance, as well as the importance of menopause and late adolescence. This review compiles the commonalities and challenges within these studies to inform future research. [ABSTRACT FROM AUTHOR]

Background: The effects of excessive ultra-processed food (UPF) consumption on body composition measures or sociodemographic disparities are understudied in Korea. We aimed to investigate the association of UPF intake with percent body fat (PBF) and percent appendicular skeletal muscle mass (PASM) by sociodemographic status in adults. Methods: This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011 (n=11,123 aged ≥40 years). We used a NOVA system to classify all foods reported in a 24-hour dietary recall, and the percentage of energy intake (%kcal) from UPFs was estimated. PBF and PASM were measured by dual-energy X-ray absorptiometry. Tertile (T) 3 of PBF indicated adiposity and T1 of PASM indicated low skeletal muscle mass, respectively. Multinomial logistic regression models were used to estimate odds ratios (OR) with 95% confidence interval (CI) after adjusting covariates. Results: UPF intake was positively associated with PBF-defined adiposity (ORper 10% increase, 1.04; 95% CI, 1.002 to 1.08) and low PASM (ORper 10% increase, 1.05; 95% CI, 1.01 to 1.09). These associations were stronger in rural residents (PBF: ORper 10% increase, 1.14; 95% CI, 1.06 to 1.23; PASM: ORper 10% increase, 1.15; 95% CI, 1.07 to 1.23) and not college graduates (PBF: ORper 10% increase, 1.06; 95% CI, 1.02 to 1.11; PASM: ORper 10% increase, 1.07; 95% CI, 1.03 to 1.12) than their counterparts. Conclusion: A higher UPF intake was associated with higher adiposity and lower skeletal muscle mass among Korean adults aged 40 years and older, particularly in those from rural areas and with lower education levels. [ABSTRACT FROM AUTHOR]

Purpose: To determine the most valid bone health parameter to predict mechanical complications (MCs) following surgery for adult spinal deformity (ASD). Methods: This multicenter study retrospectively examined the records of patients who had undergone fusion of three or more motion segments, including the pelvis, with a minimum two-year follow-up period. Patients with moderate and severe global alignment and proportion scores were included in the study and divided into two groups: those who developed MCs and those who did not. Bone mineral density (BMD) of the lumbar spine and femoral neck was measured using dual-energy X-ray absorptiometry, and Hounsfield units (HUs) were measured in the lumbar spine on computed tomography. Radiographic parameters were evaluated preoperatively, immediately after surgery, and at final follow-up. Results: Of 108 patients, 30 (27.8%) developed MCs, including 26 cases of proximal junctional kyphosis/failure, 2 of distal junctional failure, 6 of rod fracture, and 11 reoperations. HUs were significantly lower in patients who experienced MCs (113.7 ± 41.1) than in those who did not (137.0 ± 46.8; P = 0.02). BMD did not differ significantly between the two groups. The preoperative and two-year postoperative global tilt, as well as the immediately postoperative sagittal vertical axis, were significantly greater in patients who developed MCs than in those who did not (P = 0.02, P < 0.01, and P = 0.01, respectively). Conclusion: Patients who experienced MCs following surgery for ASD had lower HUs than those who did not. HUs may therefore be more useful than BMD for predicting MCs following surgery for ASD. [ABSTRACT FROM AUTHOR]

Kidney transplantation (KT) is the best option for patients with end-stage renal disease, but recipients still have legacy bone mineral disease from the pretransplant period, especially patients with severe secondary hyperparathyroidism (sHPT). Patients who had severe sHPT and underwent KT were analyzed retrospectively. Two groups were identified (patients with severe sHPT who had parathyroidectomy or calcimimetic before KT). Bone mineral density (BMD) was measured in the first year and last follow-up at the femoral neck, total hip, and lumbar spine using the dual-energy X-ray absorptiometry (DXA). Persistent hyperparathyroidism (perHPT) incidence was significantly higher in the calcimimetic group (75% vs. 40%, p=0.007). In patients with parathyroidectomy, BMDs were higher at femoral neck (0.818±0.114 vs. 0.744±0.134, p=0.04) and lumbar spine (1.005±0.170 vs. 0.897±0.151, p=0.01) at the first assessment. The BMD comparison between patients treated with parathyroidectomy and calcimimetic found a significant difference only in the femoral neck at second evaluation (0.835±0.118 vs. 0.758±0.129; p=0.03). In multivariate, linear regression revealed a positive association between the last BMD of the femoral neck with body mass index (CC: 0.297, 95% CI, 0.002–0.017) and parathyroidectomy (CC: 0.319, 95% CI, 0.021–0.156). Parathyroidectomy is associated with a significantly better femoral neck BMD and a lower incidence of perHPT in patients with severe sHPT. [ABSTRACT FROM AUTHOR]

Background and Objective: Segmentation of the femur in Dual-Energy X-ray (DXA) images poses challenges due to reduced contrast, noise, bone shape variations, and inconsistent X-ray beam penetration. In this study, we investigate the relationship between noise and certain deep learning (DL) techniques for semantic segmentation of the femur to enhance segmentation and bone mineral density (BMD) accuracy by incorporating noise reduction methods into DL models. Methods: Convolutional neural network (CNN)-based models were employed to segment femurs in DXA images and evaluate the effects of noise reduction filters on segmentation accuracy and their effect on BMD calculation. Various noise reduction techniques were integrated into DL-based models to enhance image quality before training. We assessed the performance of the fully convolutional neural network (FCNN) in comparison to noise reduction algorithms and manual segmentation methods. Results: Our study demonstrated that the FCNN outperformed noise reduction algorithms in enhancing segmentation accuracy and enabling precise calculation of BMD. The FCNN-based segmentation approach achieved a segmentation accuracy of 98.84% and a correlation coefficient of 0.9928 for BMD measurements, indicating its effectiveness in the clinical diagnosis of osteoporosis. Conclusions: In conclusion, integrating noise reduction techniques into DL-based models significantly improves femur segmentation accuracy in DXA images. The FCNN model, in particular, shows promising results in enhancing BMD calculation and clinical diagnosis of osteoporosis. These findings highlight the potential of DL techniques in addressing segmentation challenges and improving diagnostic accuracy in medical imaging. [ABSTRACT FROM AUTHOR]

Background: changes in body composition (BC) are common in interstitial lung disease, which leads to an increased risk of complications and infections, and are associated with poor quality of life and worse outcomes. BC assessment is important to identify malnutrition and sarcopenia. However, gold-standard techniques are not available in all clinical settings. Aims: this study aimed to evaluate the agreement and reliability of body composition estimated by bioelectric impedance analysis (BIA) and measured using dual-energy X-ray absorptiometry (DEXA) in women with interstitial lung disease. Methods: this is a cross-sectional study. BC (fat mass and appendicular skeletal muscle mass) were assessed using BIA multifrequency and DEXA in standardized conditions. Agreement and reliability between techniques were evaluated using Bland-Altman plots and the intraclass correlation coefficient (ICC). Results: a total of 50 women were evaluated. No differences were observed for FM (BIA, 25.8 ± 10.2 kg and DEXA, 26.3 ± 10.0 kg, p = 0.77) and ASMM (BIA, 14.1 ± 2.7 kg and DEXA, 13.9 ± 2.3 kg, p = 0.83). Based on ICC, good reliability was observed for FM (ICC, 0.98) and ASMM (ICC, 0.93). Conclusion: BC estimated by BIA showed good agreement and reliability with DEXA measurements. In the absence of this method, BIA can replace the DEXA technique for body composition assessment. [ABSTRACT FROM AUTHOR]

Purpose: Physical inactivity is considered an important risk factor for osteoporosis, however, some athletes performing extremely high training volumes can also develop bone mass loss. Moreover, the effect of total body mass or body surface area on bone mineral density remains controversial. Therefore, the aim of this study was to compare the absolute bone mineral density and bone mineral density adjusted to body surface area between amateur triathletes and nonactive women. Methods: Forty-two healthy women (23 amateur triathletes and 19 nonactive individuals) were evaluated for body composition using a dual-energy X-ray absorptiometry system. Results: Compared to nonactive women, amateur triathletes exhibited lower body mass index (p < 0.001), lower bone mineral density (p < 0.001), and body surface area (p < 0.001). However, bone mineral density adjusted by body surface area in the triathletes was higher than in the nonactive women (p = 0.03). Conclusion: These findings showed that amateur triathles presented lower absolute bone mineral density, but higher bone mineral density adjusted to body surface area. Future studies are recommended to identify if the higher bone mineral density adjusted to body surface area are associated with a lower bone fragility. [ABSTRACT FROM AUTHOR]

The impact of temporomandibular joint (TMJ) osseous destruction on bone mineral density (BMD) remains unclear due to controversial findings. Besides, no previous study has explored the relationship between idiopathic condylar resorption (ICR) and body composition. This study aimed to investigate the relationship between ICR and BMD or body composition. Between July 2018 and August 2022, patients evaluated by an experienced dentist and diagnosed with temporomandibular disorders (TMDs) were referred to our center. They were recruited while they received the magnetic resonance image (MRI) examination, BMD and body composition completely. Patients were further categorized into TMDs with or without ICR groups according to MRI findings. One-way analysis of variance was used to compare the variables of BMD and body composition in the two groups. In total, 67 patients were included in the analysis, with 42 categorized as TMDs with ICR and 25 as TMDs without ICR. Patients with ICR had a significantly higher lean mass percentage and lower fat mass percentage; lower android/gynoid fat ratio, and visceral adipose tissue area than those without ICR (P < 0.05). Besides, patients above age 30 with ICR had lower Z scores (P = 0.017) compared with subjects without ICR. TMDs patients with ICR show a relationship with body composition and affect the lean and fat mass distribution, especially android/gynoid fat ratio. The pathophysiological mechanism remains unclear. Further researches to investigate teeth binding, malocclusion and dietary habits are important to understand the association of ICR, BMD and body composition. [ABSTRACT FROM AUTHOR]

Few US Marines earn perfect 300 scores on both their Physical Fitness Test (PFT) and Combat Fitness Test (CFT). The number 300 invokes the legendary 300 Spartans that fought at the Battle of Thermopylae, which inspired high physical fitness capabilities for elite ground forces ever since. Purpose: Determine distinguishing characteristics of the "300 Marines" (perfect PFT and CFT scores) that may provide insights into the physical and physiological requirements associated with this capability. These tests have been refined over time to reflect physical capabilities associated with Marine Corps basic rifleman performance. Materials and methods: Data were analyzed from US Marines, including 497 women (age, 29 ± 7 years; height 1.63 ± 0.07 m; body mass, 67.4 ± 8.4 kg) and 1,224 men (30 ± 8 years; 1.77 ± 0.07 m; 86.1 ± 11.1 kg). Marines were grouped by whether they earned perfect 300 scores on both the PFT and CFT (300 Marines) or not. We analyzed group differences in individual fitness test events and body composition (dual-energy x-ray absorptiometry). Results: Only 2.5% (n = 43) of this sample earned perfect PFT and CFT scores (n = 21 women; n = 22 men). Compared to sex-matched peers, 300 Marines performed more pull-ups, with faster three-mile run, maneuver-under-fire, and movement-to-contact times (each p < 0.001); 300 Marines of both sexes had lower fat mass, body mass index, and percent body fat (each p < 0.001). The lower percent body fat was explained by greater lean mass (p = 0.041) but similar body mass (p = 0.085) in women, whereas men had similar lean mass (p = 0.618), but lower total body mass (p = 0.025). Conclusion: Marines earning perfect PFT and CFT scores are most distinguished from their peers by their maneuverability, suggesting speed and agility capabilities. While both sexes had considerably lower percent body fat than their peers, 300 Marine women were relatively more muscular while men were lighter. [ABSTRACT FROM AUTHOR]

The process of synchronizing our body movements with others is known to enhance rapport, affect, and prosociality. Furthermore, emerging evidence suggests that synchronizing activities may enhance cognitive performance. Unknown, by contrast, is the extent to which people's individual traits and experiences influence their ability to achieve and maintain movement synchrony with another person, which is key for unlocking the social and affective benefits of movement synchrony. Here, we take a dyad-centered approach to gain a deeper understanding of the role of embodiment in achieving and maintaining movement synchrony. Using existing data, we explored the relationship between body competence and body perception scores at the level of the dyad, and the dyad's movement synchrony and complexity while playing a 2.5-min movement mirroring game. The data revealed that dyadic body competence scores positively correlate with movement synchrony, but not complexity, and that dyadic body perception scores are not associated with movement synchrony or complexity. Movement synchrony was greater when the more experienced member of the dyad was responsible for copying movements. Finally, movement synchrony and complexity were stable across the duration of the mirror game. These findings show that movement synchrony is sensitive to the composition of the dyad involved, specifically the dyad's embodiment, illuminating the value of dyadic approaches to understanding body movements in social contexts. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the caffeinated drinks, levels of vitamin D and calcium in the blood, and their relationship to bone mineral density (BMD) in osteoporotic women in Al-Ahsa Saudi Arabia. Design/methodology/approach: This study included 85 women over approximately 18 months with ages ranging from 40 to 70 years who were evaluated in the laboratory via blood analysis. Moreover, sociodemographic data and information on health and nutritional awareness were collected via a questionnaire. The BMD was measured by dual-energy X-ray absorptiometry (DXA) and considered osteopenia when the T value total of the lumbar spine or hip was between −1 and −2.5 and osteoporosis < −2.5. Blood levels of vitamin D and calcium were measured via blood analysis. Findings: There were 54.1% and 45.9% of women who suffered from osteoporosis and low BMD, respectively. There was a significant difference in the number of osteoporotic, and low bone mineral mass groups in marital status (p = 0.04), but no difference was found in age and educational level. A significant difference (p = 0.01) between low bone mass and osteoporosis groups in heights. BMD was significantly and negatively correlated with vitamin D in the blood in individuals with osteoporosis (r = −0.358, P = 0.014). In addition, there was a significant negative correlation between calcium in the blood and total samples (r = −0.355, P = 0.0578). There was a negative significant relationship between calcium supplements and BMD in individuals with low BMD (rt = −0.279, P = 0.041). There was a significant association between cola intake with the occurrence of low BMD (p = 0.027), whereas tea drinking was not associated with risk in both groups. Originality/value: The study indicated that there is a direct relationship between osteoporosis and low bone mass with different variables. This study was conducted to address the lack of research related to the levels of vitamin D and calcium in the blood and their relationship with BMD in women with low BMD and osteoporosis in Al-Ahsa province-KSA. [ABSTRACT FROM AUTHOR]

Background: Low BMD is a common problem in major thalassaemia patient, but the use of DXA in chronic disease children with smaller bones, has some problems. Utilizing bone mineral apparent density (BMAD) helps in preventing this obstacle. Testing the usefulness of this method in resolving the effects of bone size on BMD by comparing the BMD and BMAD of our thalassemics with results of our healthy ones, is our goal. Methods: Sample size was 110 cases with mean age of 9.6 ± 4.3 y/o and contained 73 males. Gauge of BMDs done by dual x-ray absorptiometry. Then BMAD was calculated. We did comparison of BMDs and BMADs results of thalassemic children with results of healthy Iranian pediatrics. Results: Mean of femoral BMD and BMAD, spinal BMD and BMAD was 0.579±0.134 g/cm2, 0.162±0.096 g/cm3, 0.563±0.118 g/cm2 and 0.107±0.015, respectively. When results of 9-18 patients compared with BMDs and BMADs of normal children, BMD of femur and BMD and BMAD of spine of patients found significantly lower (P-values, 0.003, <0.001, <0.001, respectively). BMAD of femur of patients was not significantly different from normals. Conclusion: When bone mineral density of femur modifies by bone mineral apparent density formula, the remarkable difference between BMD of patients and normals; vanishes. Utilizing bone mineral apparent density helps in interpretation of femoral dual X-ray absorptiometry at least in thalassemic patients. As the results of vertebrae, after modification by calculating BMAD, remains significantly different, we cannot bring forward BMAD for mentioned aim in the spine of thalassemics. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress has previously been shown to play a pivotal role in the pathogenesis of vascular calcification. In the present study, we aimed to investigate the association between the composite dietary antioxidant index (CDAI) and abdominal aortic calcification (AAC). Methods: We conducted a cross‐sectional study of United States adults using data from the 2013–2014 National Health and Nutrition Examination Survey. The CDAI was calculated from vitamins A, C, E, selenium, zinc, and caretenoid through two rounds of 24‐h dietary recall interviews. AAC was assessed by a lateral dual‐energy x‐ray absorptiometry scan of the thoraco‐lumbar spine. The association between CDAI and AAC was evaluated with weighted multivariable logistic regression. Results: Overall, an unweighted 1081 participants were analyzed, including 110 with AAC and 971 without AAC. In the multivariable fully adjusted logistic regression model, CDAI was significantly associated with AAC (odds ratio = 0.89, 95% CI 0.81–0.98; P = 0.02). Compared with the lowest quartile, the highest quartile of CDAI was related to a 0.33‐fold risk of AAC (95% CI 0.12–0.90; P = 0.03). Subgroup analysis showed that the significant association between CDAI and AAC was only observed in participants without hypertension (P for interaction = 0.002). Conclusion: A higher CDAI was associated with a lower prevalence of AAC among adults without hypertension in the US. Further large‐scale prospective studies are required to analyze the protective role of the CDAI in AAC progression. [ABSTRACT FROM AUTHOR]

Individuals with type 2 diabetes have lower trabecular bone score (TBS) and increased fracture risk despite higher bone mineral density. However, measures of trabecular microarchitecture from high-resolution peripheral computed tomography are not lower in type 2 diabetes. We hypothesized that confounding effects of abdominal tissue thickness may explain this discrepancy, since central obesity is a risk factor for diabetes and also artifactually lowers TBS. This hypothesis was tested in individuals aged 40 years and older from a large DXA registry, stratified by sex and diabetes status. When DXA-measured abdominal tissue thickness was not included as a covariate, men without diabetes had lower TBS than women without diabetes (mean difference −0.074, P < .001). TBS was lower in women with versus without diabetes (mean difference −0.037, P < .001), and men with versus without diabetes (mean difference −0.007, P = .042). When adjusted for tissue thickness these findings reversed, TBS became greater in men versus women without diabetes (mean difference +0.053, P < .001), in women with versus without diabetes (mean difference +0.008, P < .001), and in men with versus without diabetes (mean difference +0.014, P < .001). During mean 8.7 years observation, incident major osteoporotic fractures were seen in 7048 (9.6%). Adjusted for multiple covariates except tissue thickness, TBS predicted fracture in all subgroups with no significant diabetes interaction. When further adjusted for tissue thickness, HR per SD lower TBS remained significant and even increased slightly. In conclusion, TBS predicts fractures independent of other clinical risk factors in both women and men, with and without diabetes. Excess abdominal tissue thickness in men and individuals with type 2 diabetes may artifactually lower TBS using the current algorithm, which reverses after accounting for tissue thickness. This supports ongoing efforts to update the TBS algorithm to directly account for the effects of abdominal tissue thickness for improved fracture risk prediction. Lay Summary: Individuals with type 2 diabetes are at increased fracture risk despite having higher bone mineral density (BMD). Previous studies suggest that trabecular bone score (TBS), a measure of bone derived from spine DXA images that can be used to assess fracture risk in addition to BMD, may be lower in individuals with type 2 diabetes. However, TBS is artificially lowered by greater abdominal obesity. We showed that abdominal obesity explained the lower TBS measurements that were seen in individuals with type 2 diabetes. However, even when we considered the effect of abdominal obesity, TBS was still able to predict major fractures in both women and men, with and without diabetes. [ABSTRACT FROM AUTHOR]

This study investigates osteoporosis, a condition where bones fracture with minimal force due to mineral loss, affecting both genders, particularly women and the elderly. Dual Energy X-ray Absorptiometry (DEXA) is used to measure Tscore, Z-score and Bone Mineral Density (BMD). Anisotropic Morlet Wavelet Transform (MWT) and Discrete Wavelet Transform (DWT) are employed to calculate energy in various femur regions, especially the neck, head, and trochanter. Conducted at a private center, the study involved 50 Indian women: 18 young women (average age 36.3±8.7 years) and 32 postmenopausal women (average age 58±9.1 years) aged 20-85 years. The energy derived from trabecular patterns of normal bone, processed from enhanced radiographic images, was significantly higher than that from affected groups in the greater trochanter and neck regions. The study's limitation is the absence of women with osteoporotic fractures. [ABSTRACT FROM AUTHOR]

Hip fractures related to osteoporosis are a significant concern due to their substantial impact on mortality, morbidity and loss of mobility and independence. While bone mineral density (BMD) is a key diagnostic metric for osteoporosis, it provides an incomplete assessment of bone strength and fracture risk. This study focused on assessing the geometric properties of the proximal femur in a cohort of 30 Indian women using digital x-ray images. Comparison was made with BMD values obtained through Dual energy x-ray absorptiometry (DXA). The findings revealed associations between these geometric parameters and BMD, as well as anthropometric factors like body height and weight. Notably, osteoporosis and osteopenia were prevalent in 20% and 23% of the studied Indian women, respectively. Moreover, osteoporotic individuals exhibited lower mean values for specific femoral geometrical parameters compared to normal counterparts, with reductions of -53%, -37%, and - 25% observed in the thickness of the medial shaft cortex (SC), lesser trochanter thickness of the medial cortex (NC), and width of the acetabular bone (AW), respectively. [ABSTRACT FROM AUTHOR]

Purpose: To determine the optimal window setting for virtual monoenergetic images (VMI) reconstructed from dual-layer spectral coronary computed tomography angiography (DE-CCTA) datasets. Material and methods: 50 patients (30 males; mean age 61.1 ± 12.4 years who underwent DE-CCTA from May 2021 to June 2022 for suspected coronary artery disease, were retrospectively included. Image quality assessment was performed on conventional images and VMI reconstructions at 70 and 40 keV. Objective image quality was assessed using contrast-to-noise ratio (CNR). Two independent observers manually identified the best window settings (B-W/L) for VMI 70 and VMI 40 visualization. B-W/L were then normalized with aortic attenuation using linear regression analysis to obtain the optimized W/L (O-W/L) settings. Additionally, subjective image quality was evaluated using a 5-point Likert scale, and vessel diameters were measured to examine any potential impact of different W/L settings. Results: VMI 40 demonstrated higher CNR values compared to conventional and VMI 70. B-W/L settings identified were 1180/280 HU for VMI 70 and 3290/900 HU for VMI 40. Subsequent linear regression analysis yielded O-W/L settings of 1155/270 HU for VMI 70 and 3230/880 HU for VMI 40. VMI 40 O-W/L received the highest scores for each parameter compared to conventional (all p < 0.0027). Using O-W/L settings for VMI 70 and VMI 40 did not result in significant differences in vessel measurements compared to conventional images. Conclusion: Optimization of VMI requires adjustments in W/L settings. Our results recommend W/L settings of 1155/270 HU for VMI 70 and 3230/880 HU for VMI 40. [ABSTRACT FROM AUTHOR]

The Union Cycliste Internationale has deemed transgender female athlete's ineligible for the female category due to concerns about performance advantages. We conducted a follow-up analysis on laboratory-based performance indicators of sports performance using data from a longitudinally assessed transgender woman athlete undergoing gender-affirming hormone therapy (GAHT). We evaluated laboratory performance indicators in transgender and cisgender women athletes using dual-energy X-ray absorptiometry scanning, handgrip strength measurement, jump testing, and cardiopulmonary exercise. Additionally, we assessed a transgender sub-elite cyclist before and after undergoing GAHT. After one year of GAHT, the transgender athlete showed declines in handgrip strength (7–13 %), countermovement jump (23–29 %), and V̇O2max (15–30 %). After 3 months, several performance indicators (absolute handgrip, peak power, relative peak power, average power, relative average power, V̇O2max and relative V̇O2max) were above the mean of cisgender female athletes, while others (Relative handgrip, countermovement jump and relative countermovement jump) were below. Similar trends were observed at 6 months and 1 year. This hypothetical analysis, although with limited evidence, suggests the transgender athlete could compete equitably in elite cycling events within the female category after one year of GAHT. Adjustments based on competition data would ensure fairness. Further analysis after an additional 12 months is recommended to assess the impact of 2 years of GAHT. An outright ineligibility for the female category for transgender women athletes would hinder a true assessment of performance fairness. [ABSTRACT FROM AUTHOR]

This paper provides two different methods to diagnose osteoporosis in women; the first method is the fractal analysis evaluated by CBCT at two bone locations (the mandible and the second cervical vertebrae) to see if there is any correlation between the two. At the same time, the second method is deep convolutional neural networks (DCNNs). One hundred eighty-eight patients' mandibular CBCT images were used, and DCNN models based on the ResNet-101 framework were employed. Dual X-ray absorptiometry of the hip and lumbar spine revealed that 139 of the 188 postmenopausal women tested had osteoporosis, whereas 49 had average bone mineral density. The second cervical vertebra and the mandible were selected as locations of interest for FD analysis on the CBCT images. Measurement accuracy, both within and between observers' agreements, and correlations between two data sets were all calculated. To evaluate osteoporosis, we used a segmented, three-phase approach. Stage 1 was devoted to the identification of mandibular bone slices. In Stage 2, the coordinates for the mandible's cross-sectional views were established, and Stage 3 calculated the thickness of the mandible bone, emphasizing osteoporotic variations. The average FD values within the interest area of the mandible were significantly lower in people with osteoporosis than in those with average bone mineral density. At the same time, the two groups had no significant difference in FD values at the second cervical vertebra. For the mandibular site, areas beneath the curve were 0.644 (P = 0.008), while the area under the curve for the vertebral site was 0.531 (P = 0.720). DCNN training in the first stage yielded an astounding 98.85% training accuracy, the second stage decreased L1 loss to a meager 1.02 pixels, and the bone thickness computation method used in the last stage had a mean squared error of 0. 8377. We concluded that FD was underutilized even though it distinguished between women with normal BMD and those with osteoporosis in the mandibular area. Additionally, even with small mandibular CBCT datasets, the results show the value of a modular transfer learning approach for osteoporosis detection. [ABSTRACT FROM AUTHOR]

Acrobatics and Tumbling (A&T), an emerging National Collegiate Athletics Association (NCAA) sport, involves athletes with rigorous training backgrounds, usually extending from youth through early adulthood. This study examines the sleep health, diet quality, and lipid profile of A&T athletes clustered by their performance position. Forty-two A&T athletes, clustered as tops (n = 19; age = 19.6 ± 1.0 years; body mass index [BMI] = 22.3 ± 1.7 kg/m2) and bases (n = 23; age = 19.6 ± 1.3 years; BMI = 25.7 ± 2.5 kg/m2), completed preseason sleep and diet quality (Rapid Eating Assessment for Participants–Shortened [REAP-S]) surveys. Fasting blood samples were collected for lipid analysis. Body composition was assessed via dual-energy X-ray absorptiometry. Most athletes (71.4%; base n = 14, top n = 16) reported insufficient sleep (≤7 hours) and "good" sleep quality (90.4%, n = 38; base n = 18, top n = 20). Average REAP-S score was 29.24 ± 3.74. Approximately 31% (n = 13) displayed at least one undesirable lipid concentration according to medical guidelines for normal levels (total cholesterol [TC] < 200 mg/dL, triglycerides [TG] < 150 mg/dL, high-density lipoprotein cholesterol [HDL-C] > 40 mg/dL, low-density lipoprotein cholesterol [LDL-C] < 130 mg/dL). Approximately 20% exhibited elevated TC (top n = 4, base n = 4), 12.5% had elevated TG (base n = 5), 2.5% showed low HDL-C (base n = 1), and 10% presented elevated LDL-C (top n = 2, base n = 2). Most athletes experienced suboptimal sleep (≤7 hours/night) and 31% displayed at least one undesirable lipid concentration (elevated TC, TG, or LDL-C or reduced HDL-C). Tailoring interventions with sports dietitians is recommended, focused on increasing monounsaturated and polyunsaturated fat intake while reducing saturated fat consumption. These interventions could mitigate cardiovascular risks, improve recovery, and possibly enhance athletic performance. [ABSTRACT FROM AUTHOR]

Sarcopenia is a prevalent and clinically significant condition, particularly among older age groups and those with chronic disease. Patients with cancer frequently suffer from sarcopenia and progressive loss of muscle mass, strength, and function. The complex interplay between cancer and its treatment, including medical therapy, radiotherapy, and surgery, significantly contributes to the onset and worsening of sarcopenia. Cancer induces muscle wasting through inflammatory processes, metabolic alterations, and hormonal imbalance. Moreover, medical and radiation therapies exert direct toxic effects on muscles, contributing to the impairment of physical function. Loss of appetite, malnutrition, and physical inactivity further exacerbate muscle wasting in cancer patients. Imaging techniques are the cornerstones for sarcopenia diagnosis. Magnetic resonance imaging, computed tomography, and dual-energy X-ray absorptiometry provide valuable insights into muscle structure and quality. Although each modality has advantages and limitations, magnetic resonance imaging produces high-resolution images and provides dynamic information about muscle function. Despite these challenges, addressing sarcopenia is essential for optimizing treatment outcomes and improving survival rates in patients with cancer. This review explored the factors contributing to sarcopenia in oncologic patients, emphasizing the importance of early detection and comprehensive management strategies. [ABSTRACT FROM AUTHOR]

Background and Objectives: The literature suggests that physiological menopause (MP) seems linked with increased adiposity with a preference for intra-abdominal fat accumulation, greater than what can be attributed only by aging, which could magnify this period's increased cardiovascular risk. Materials and Methods: We retrospectively analyzed two age and body mass index (BMI) propensity-matched subgroups each formed of 90 clinically healthy, 40–60-year-old postmenopausal women, within the first 5 and 5–10 years of MP. The 10-year ASCVD risk was assessed using medical history, anthropometric data, and lipid profile blood tests. The android-to-gynoid (A/G) ratio was computed using Lunar osteodensitometry lumbar spine and hip scans. Results: The A/G ratio was significantly higher for the subgroup evaluated in years 5–10 of MP than in the first 5 years of MP, even after controlling for BMI (1.05 vs. 0.99, p = 0.005). While displaying a significant negative correlation with HDL cholesterol (r = 0.406), the A/G ratio also had positive correlations with systolic blood pressure (BP) values (r = 0.273), triglycerides (r = 0.367), and 10-year ASCVD risk (r = 0.277). After adjusting for smoking, hypertension treatment, and type 2 diabetes, the 10-year ASCVD risk became significantly different for women in the first 5 years (3.28%) compared to those in years 5–10 of MP (3.74%), p = 0.047. Conclusions: In women with similar age and BMI, the A/G ratio appears to vary based on the number of years since menopause onset and correlates with either independent cardiovascular risk parameters like BP, triglycerides, and HDL cholesterol or with composite scores, such as 10-year ASCVD risk. [ABSTRACT FROM AUTHOR]

The association between type 2 diabetes mellitus (T2DM) and skeletal fragility is complex, with effects on bone at the cellular, molecular, and biomechanical levels. As a result, people with T2DM, compared to those without, are at increased risk of fracture, despite often having preserved bone mineral density (BMD) on dual-energy x-ray absorptiometry (DXA). Maladaptive skeletal loading and changes in bone architecture (particularly cortical porosity and low cortical volumes, the hallmark of diabetic osteopathy) are not apparent on routine DXA. Alternative imaging modalities, including quantitative computed tomography and trabecular bone score, allow for noninvasive visualization of cortical and trabecular compartments and may be useful in identifying those at risk for fractures. Current fracture risk calculators underestimate fracture risk in T2DM, partly due to their reliance on BMD. As a result, individuals with T2DM, who are at high risk of fracture, may be overlooked for commencement of osteoporosis therapy. Rather, management of skeletal health in T2DM should include consideration of treatment initiation at lower BMD thresholds, the use of adjusted fracture risk calculators, and consideration of metabolic and nonskeletal risk factors. Antidiabetic medications have differing effects on the skeleton and treatment choice should consider the bone impacts in those at risk for fracture. T2DM poses a unique challenge when it comes to assessing bone health and fracture risk. This article discusses the clinical burden and presentation of skeletal disease in T2DM. Two clinical cases are presented to illustrate a clinical approach in assessing and managing fracture risk in these patients. [ABSTRACT FROM AUTHOR]

Context The association of obesity with bone fragility fractures is complex and non-linear. Despite good efficacy on weight loss, bariatric surgery (BS) is also associated with bone loss. However, we lack information on risk factors of the long-term deleterious effects of BS on the skeleton. Objective We aimed to assess the factors associated with low bone mineral density (BMD) performed a long time after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Methods This cross-sectional study involved patients at a long distance from their BS that underwent dual-energy x-ray absorptiometry (DXA) with biological factors (vitamins, micronutrients, bone and inflammation biomarkers). Simple and multiple linear models (stepwise and parsimony approach) were developed. Results A total of 131 patients (91 RYGB, 40 SG) underwent DXA (51.8 ± 11.08 years, 87.8% women). At a mean of 6.8 ± 3.7 years after surgery, the mean weight loss was –28.6 ± 9.6%, and only 6 patients (5.7%) had a T -score less than or equal to -2.5. On univariate analysis, BMD was lower in the RYGB than in the SG group (P <.001) at all sites, despite similar fat and fat-free mass and weight loss. Serum parathyroid hormone and phosphate levels were higher in RYGB than SG patients. A total of 10.1% of patients showed vascular calcifications. On multivariable analysis, BMD remained different between surgery groups after adjustment for age, body mass index, ethnicity, and sex. The model-adjusted R 2 values were 0.451 for the total hip; 0.462 the femoral neck, and 0.191 the lumbar spine for the inflammation model; 0.458, 0.462, and 0.254, respectively, for the bone marker model; and 0.372, 0.396, and 0.142 for the vitamin model. Serum zinc, ferritin, and uric acid levels were the markers associated with BMD to a low extent. Conclusion BMD differed depending on the BS procedure. A few biological markers may be associated weakly with BMD well after the surgery. [ABSTRACT FROM AUTHOR]

Objectives: Despite the beneficial effects of "vegetarian style" diet on atherosclerosis, it is also proven potentially detrimental to bone health. The influence of muscle health or atherosclerosis on major osteoporotic fracture (MOF) risk in vegetarians has rarely been explored. This prospective study aimed to investigate an association of MOF risk with muscle health and atherosclerosis in vegetarians. Materials and Methods: We conducted a questionnaire survey with the Mini-Nutritional Assessment (MNA) on 39 vegetarians. The 10-year probability of MOF was determined using the Taiwanese Fracture Risk Assessment (FRAX®) calculator. Appendicular skeletal muscle (ASM) mass and bone mineral density were measured with dual-energy X-ray absorptiometry. Physical performance was evaluated using the 6-min walk test (6MWT). Common carotid artery intima-media thickness (ccIMT) was determined using sonography. Serum levels of parathyroid hormone (PTH), Vitamin D, adiponectin, and leptin were measured. Results: Eleven (28.2%) of 39 vegetarians had a moderate-high risk of MOF, defined by FRAX-calculated risk =10%. These subjects had lower ASM (P < 0.005) and 6MWT distances (P < 0.01) but greater ccIMT than those with low risk. The MOF risk was negatively correlated with ASM (r = -0.51, P < 0.001) and 6MWT distances (r = -0.62, P < 0.001) but positively correlated with ccIMT (r = 0.56, P < 0.001). Linear regression analysis revealed that MOF risk scores were negatively associated with ASM and 6MWT distance while positively associated with ccIMT. There was no significant association of MOF risk with MNA scores, serum levels of PTH, Vitamin D, adiponectin, or leptin. Conclusion: Decreased ASM mass, reduced physical performance, and atherosclerosis are significantly associated with MOF risk in vegetarians. [ABSTRACT FROM AUTHOR]

Background: For dosimetry, the demand for whole-body SPECT/CT imaging, which require long acquisition durations with dual-head Anger cameras, is increasing. Here we evaluated sparsely acquired projections and assessed whether the addition of deep-learning-generated synthetic intermediate projections (SIPs) could improve the image quality while preserving dosimetric accuracy. Methods: This study included 16 patients treated with 177Lu-DOTATATE with SPECT/CT imaging (120 projections, 120P) at four time points. Deep neural networks (CUSIPs) were designed and trained to compile 90 SIPs from 30 acquired projections (30P). The 120P, 30P, and three different CUSIP sets (30P + 90 SIPs) were reconstructed using Monte Carlo-based OSEM reconstruction (yielding 120P_rec, 30P_rec, and CUSIP_recs). The noise levels were visually compared. Quantitative measures of normalised root mean square error, normalised mean absolute error, peak signal-to-noise ratio, and structural similarity were evaluated, and kidney and bone marrow absorbed doses were estimated for each reconstruction set. Results: The use of SIPs visually improved noise levels. All quantitative measures demonstrated high similarity between CUSIP sets and 120P. Linear regression showed nearly perfect concordance of the kidney and bone marrow absorbed doses for all reconstruction sets, compared to the doses of 120P_rec (R2 ≥ 0.97). Compared to 120P_rec, the mean relative difference in kidney absorbed dose, for all reconstruction sets, was within 3%. For bone marrow absorbed doses, there was a higher dissipation in relative differences, and CUSIP_recs outperformed 30P_rec in mean relative difference (within 4% compared to 9%). Kidney and bone marrow absorbed doses for 30P_rec were statistically significantly different from those of 120_rec, as opposed to the absorbed doses of the best performing CUSIP_rec, where no statistically significant difference was found. Conclusion: When performing SPECT/CT reconstruction, the use of SIPs can substantially reduce acquisition durations in SPECT/CT imaging, enabling acquisition of multiple fields of view of high image quality with satisfactory dosimetric accuracy. [ABSTRACT FROM AUTHOR]

Background: Morbid obesity is a complex chronic condition characterized by a body mass index of 40 kg/m2 or higher. The incidence of the condition is on the rise in developed countries, and bariatric surgery has been proposed as a potential solution to address this trend. Nonetheless, bariatric surgery may also result in adverse effects, including a reduction in bone mineral density (BMD) and muscle mass, as well as an increased risk of fractures. The present study aims to elucidate the effects of bariatric surgery and whole-body vibration (WBV) training on body composition, microbiota, physical fitness, quality of life, and cardiometabolic markers. Methods: Twenty-eight participants (14 females), aged 18 to 50 years, will undergo sleeve gastrectomy surgery. They will be randomly allocated into a control group or a WBV training group. The WBV group will train three times per week with increasing intensities and duration ranging from 30 to 45 min over the 4-month training period. Measurements of body composition (dual-energy X-ray absorptiometry and peripheral quantitative computed tomography), physical fitness (muscular strength, agility, cardiorespiratory fitness, and balance), gait biomechanics, cardiometabolic markers, gut microbiota, quality of life, and physical activity levels will be collected at four different time points: (1) prior to the surgery, (2) 45 days post-surgery, (3) 6 months post-surgery, and (4) 18 months post-surgery. Discussion: Both groups are expected to experience improvements in most of the aforementioned variables. Nonetheless, we expect the WBV group to show larger improvements proving that the training is effective and safe. Trial registration: Clinicaltrials.gov NCT05695599. Registered on January 25, 2023. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BrCa) is a predominant malignancy, with metastasis occurring in one in eight patients, nearly half of which target the bone, leading to serious complications such as pain, fractures, and compromised mobility. Structural rigidity, crucial for bone strength, becomes compromised with osteolytic lesions, highlighting the vulnerability and increased fracture risk in affected areas. Historically, two-dimensional radiographs have been employed to predict these fracture risks; however, their limitations in capturing the three-dimensional structural and material changes in bone have raised concerns. Recent advances in CT-based Structural Rigidity Analysis (CTRA), offer a promising, more accurate non-invasive 3D approach. This study aims to assess the efficacy of CTRA in monitoring osteolytic lesions' progression and response to therapy, suggesting its potential superiority over existing methodologies in guiding treatment strategies. Methods: Twenty-seven female nude rats underwent femoral intra-medullary inoculation with MDA-MB-231 human breast cancer cells or saline control. They were divided into Control, Cancer Control, Ibandronate, and Paclitaxel groups. Osteolytic progression was monitored weekly using biplanar radiography, quantitative computed tomography (QCT), and dual-energy X-ray absorptiometry (DEXA). CTRA was employed to predict fracture risk, normalized using the contralateral femur. Statistical analyses, including Kruskal-Wallis and ANOVA, assessed differences in outcomes among groups and over time. Results: Biplanar radiographs showed treatment benefits over time; however, only certain time-specific differences between the Control and other treatment groups were discernible. Notably, observer subjectivity in X-ray scoring became evident, with significant inter-operator variations. DEXA measurements for metaphyseal Bone Mineral Content (BMC) did not exhibit notable differences between groups. Although diaphyseal BMC highlighted some variance, it did not reveal significant differences between treatments at specific time points, suggesting a limited ability for DEXA to differentiate between treatment effects. In contrast, the CTRA consistently demonstrated variations across different treatments, effectively capturing bone rigidity changes over time, and the axial- (EA), bending- (EI), and torsional rigidity (GJ) outcomes from the CTRA method successfully distinguished differences among treatments at specific time points. Conclusion: Traditional approaches, such as biplanar radiographs and DEXA, have exhibited inherent limitations, notably observer bias and time-specific inefficacies. Our study accentuates the capability of CTRA in capturing real-time, progressive changes in bone structure, with the potential to predict fractures more accurately and provide a more objective analysis. Ultimately, this innovative approach may bridge the existing gap in clinical guidelines, ushering in enhanced Clinical Decision Support Tool (CDST) for both surgical and non-surgical treatments. [ABSTRACT FROM AUTHOR]

This study aims to establish the validity and reliability of the prone Yo-YoIRL1 in elite female rugby league players (part one) and determine the anthropometric and physical characteristics contributing to 15m prone Yo-YoIRL1 performance (part two). Part one, 21 subjects completed one Yo-YoIRL1, one 20m and two 15m prone Yo-YoIRL1 tests over four sessions, with 7–14 days in-between. Part two, ten subjects completed a testing battery, including body mass, height, dual-energy x-ray absorptiometry, isometric mid-thigh pull, isometric bench-press, 10m and 20m sprints and an incremental treadmill test (V˙O2max). The 15m prone YoYoIRL1 demonstrated poor reliability with a typical error of 68m (21%) and a smallest worthwhile change of 54m (9%). Validity analysis found the prone versions of the YoYoIRL1 were not sensitive measures of intermittent running performance. Both prone YoYoIRL1 test distances demonstrated large mean bias (76% and -37% respectively) and typical error of the estimate (19% and 21%, respectively) in comparison to the YoYoIRL1. Body mass (r = -0.89), lean mass (r = -0.64), body fat % (r = -0.68), V˙O2max (l∙min-1) (r = -0.64), IMTP (r = -0.69), IBP (r = -0.15), 10m (r = -0.77) and 20m (r = -0.72) momentum displayed large negative relationships with 15m prone Yo-YoIRL1 performance. Due to the poor validity of the 20m prone YoYoIRL1, the poor validity and reliability of the 15m prone YoYoIRL1, and the anthropometric and physical characteristics which negatively impact performance, practitioners should reconsider the use of the prone YoYoIRL1 test to monitor high intensity intermittent running performance. [ABSTRACT FROM AUTHOR]

Objective: Despite the fact that China amounts to one-fifth of the world’s population, has a higher proportion of the elderly, and has a higher prevalence of osteoporosis and fracture, limited studies have investigated the association between dietary patterns and bone mineral density (BMD) as well as fracture risk among the elderly Chinese population. We aimed to investigate the association between different dietary patterns and BMD as well as the risk of fractures, and this association may vary between elderly women and men. Methods: Building upon the China Osteoporosis Prevalence Study, we included 17,489 subjects aged ≥40 years old randomly sampled across 44 counties/ districts of 11 provinces or municipalities in China who completed a food frequency questionnaire. BMD was measured by dual x-ray absorptiometry. Vertebral fracture was defined based on lateral spine radiographs using the semi-quantitative technique of Genant. Results: A diet rich in “carnivorous”, “vegetarian”, “dairy, fruit, and egg” was significantly associated with higher BMD at total hip (TH), femoral neck (FN), and lumbar spine 1–4 (L1–4). Yet, a diet rich in “beverage and fried food” was associated with a lower BMD at the FN and L1–4. High quartiles of the carnivorous diet were associated with 34%–39% reduced risk of clinical fracture in the past 5 years and vertebral fracture. Stronger associations were observed among women. Sensitivity analysis among postmenopausal women presented even stronger positive associations between carnivorous and vegetarian diets and high BMD, as well as between carnivorous diet and reduced risk of fractures. Conclusions: Our study suggested that a diet rich in meat, vegetables, and dairy, fruit, and eggs might be associated with greater BMD and a lower fracture risk, while beverage and fried foods may be associated with a lower BMD at L1–4, especially among elderly women. These findings are relevant to provide recommendations on dietary nutrition regarding the elderly population at high risk of osteoporosis and fractures, especially postmenopausal women. [ABSTRACT FROM AUTHOR]

Individuals in isolated and extreme environments can experience debilitating side-effects including significant decreases in fat-free mass (FFM) from disuse and inadequate nutrition. The objective of this study was to determine the strengths and weaknesses of three-dimensional optical (3DO) imaging for monitoring body composition in either simulated or actual remote environments. Thirty healthy adults (ASTRO, male = 15) and twenty-two Antarctic Expeditioners (ABCS, male = 18) were assessed for body composition. ASTRO participants completed duplicate 3DO scans while standing and inverted by gravity boots plus a single dual-energy X-ray absorptiometry (DXA) scan. The inverted scans were an analog for fluid redistribution from gravity changes. An existing body composition model was used to estimate fat mass (FM) and FFM from 3DO meshes. 3DO body composition estimates were compared to DXA with linear regression and reported with the coefficient of determination (R2) and root mean square error (RMSE). ABCS participants received only duplicate 3DO scans on a monthly basis. Standing ASTRO meshes achieved an R2 of 0.76 and 0.97 with an RMSE of 2.62 and 2.04 kg for FM and FFM, while inverted meshes achieved an R2 of 0.52 and 0.93 with an RMSE of 2.84 and 3.23 kg for FM and FFM, respectively, compared to DXA. For the ABCS arm, mean weight, FM, and FFM changes were −0.47, 0.06, and −0.54 kg, respectively. Simulated fluid redistribution decreased the accuracy of estimated body composition values from 3DO scans. However, FFM stayed robust. 3DO imaging showed good absolute accuracy for body composition assessment in isolated and remote environments. [ABSTRACT FROM AUTHOR]

This study aimed to compare tumor lesion detectability and diagnostic accuracy of whole-body magnetic resonance imaging (WB-MRI) and radioiodine-labeled meta-iodo-benzylguanidine (mIBG) imaging techniques in patients with metastatic pheochromocytoma and paraganglioma (PPGL). This retrospective study included 13 patients had pheochromocytoma and 5 had paraganglioma, who were all suspected of having metastatic tumors. Each patient underwent WB-MRI and 123I-mIBG as a pretreatment screening for 131I-mIBG therapy. Two expert reviewers evaluated WB-MRI, 123I-mIBG images, and post-therapy 131I-mIBG images for the presence of metastatic lesions in the lungs, bones, liver, lymph nodes, and other organs. Diagnostic measures for detecting metastatic lesions, including sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC)—area under the curve (AUC), were calculated for each imaging technique. We analyzed WB-MRI images for detecting metastatic lesions, which demonstrated sensitivity, specificity, accuracy, PPV, NPV, and AUC of 82%, 97%, 90%, 96%, 86%, and 0.92, respectively. These values were 83%, 95%, 89%, 94%, 86%, and 0.90 in 123I-mIBG images and 85%, 92%, 89%, 91%, 87%, and 0.91 in post-therapy 131I-mIBG images, respectively. Our results reveal the comparable diagnostic accuracy of WB-MRI to one of the mIBG images. [ABSTRACT FROM AUTHOR]

Screening for osteoporosis is crucial for early detection and prevention, yet it faces challenges due to the low accuracy of calcaneal quantitative ultrasound (QUS) and limited access to dual-energy X-ray absorptiometry (DXA) scans. Recent advances in AI offer a promising solution through opportunistic screening using existing medical images. This study aims to utilize deep learning techniques to develop a model that analyzes chest X-ray (CXR) images for osteoporosis screening. This study included the AI model development stage and the clinical validation stage. In the AI model development stage, the combined dataset of 5122 paired CXR images and DXA reports from the patients aged 20 to 98 years at a medical center was collected. The images were enhanced and filtered for hardware retention such as pedicle screws, bone cement, artificial intervertebral discs or severe deformity in target level of T12 and L1. The dataset was then separated into training, validating, and testing datasets for model training and performance validation. In the clinical validation stage, we collected 440 paired CXR images and DXA reports from both the TCVGH and Joy Clinic, including 304 pared data from TCVGH and 136 paired data from Joy Clinic. The pre-clinical test yielded an area under the curve (AUC) of 0.940, while the clinical validation showed an AUC of 0.946. Pearson's correlation coefficient was 0.88. The model demonstrated an overall accuracy, sensitivity, and specificity of 89.0%, 88.7%, and 89.4%, respectively. This study proposes an AI model for opportunistic osteoporosis screening through CXR, demonstrating good performance and suggesting its potential for broad adoption in preliminary screening among high-risk populations. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the value of five indicators in predicting OVCF through a retrospective case–control study, and explore the internal correlation of different indicators. Method: We retrospectively enrolled patients over 50 years of age who had been subjected to surgery for fragility OVCF at China Japan Friendship Hospital from January 2021 to September 2023. Demographic characteristics, T-score based on dual-energy X-ray absorptiometry (DXA), CT-based Hounsfield unit (HU) value, vertebral bone quality (VBQ) score based on magnetic resonance imaging (MRI), relative cross-sectional area (rCSA) and the rate of fat infiltration (FI) of paraspinal muscle were collected. A 1:1 age- and sex-matched, fracture-free control group was established from patients admitted to our hospital for lumbar spinal stenosis or lumbar disk herniation. Results: A total of 78 patients with lumbar fragility OVCF were included. All the five indicators were significantly correlated with the occurrence of OVCFs. Logistic regression analysis showed that average HU value and VBQ score were significantly correlated with OVCF. The area under the curve (AUC) of VBQ score was the largest (0.89). There was a significantly positive correlation between average T-score, average HU value and average total rCSA. VBQ score was significantly positive correlated with FI. Conclusion: VBQ score and HU value has good value in predicting of fragility OVCF. In addition to bone mineral density, we should pay more attention to bone quality, including the fatty signal intensity in bone and the FI in paraspinal muscle. [ABSTRACT FROM AUTHOR]

Chronic kidney disease–mineral and bone disorder (CKD-MBD) frequently occurs in hemodialysis patients and is a common cause of osteoporosis. Regular dual-energy X-ray absorptiometry (DXA) scans are used to monitor these patients, but frequent, cost-effective, and low-dose alternatives are needed. This study proposes an automatic CKD-MBD assessment model using histogram equalization and a squeeze-and-excitation block-based residual U-Net (SER-U-Net) with hand diagnostic radiography for preliminary classification. The process involves enhancing image contrast with histogram equalization, extracting features with the SE-ResNet model, and segmenting metacarpal bones using U-Net. Ultimately, a correlation analysis is carried out between the calculated dual metacarpal cortical percentage (dMCP) and DXA T-scores. The model's performance was validated by analyzing clinical data from 30 individuals, achieving a 93.33% accuracy in classifying bone density compared to DXA results. This automated method provides a rapid, effective tool for CKD-MBD assessment in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: Body image distortion and/or dissatisfaction may occur primarily due to body fat accumulation and/or distribution. The aim of this study was to evaluate the frequency of body image perception and (dis)satisfaction categories in adult men and women according to the adiposity classification. Methods: This is a cross-sectional study (n = 514; 33–79 years; 265 women) that is part of a prospective cohort (Pró-Saúde study). Adiposity measurements were determined by two methods: anthropometry, used to calculate the body mass index (BMI) and dual-energy X-ray absorptiometry (DXA), to estimate body fat percentage. Participants were grouped as "no excess adiposity" and "excess adiposity", considering BMI and body fat percentage (>30% for men, >40% for women). Perception and (dis)satisfaction with body image were evaluated using the Kakeshita scale, composed by 15 silhouettes, developed for the Brazilian population. Degree of distortion (perceived BMI ‐ real BMI) and dissatisfaction (perceived BMI ‐ desired BMI) were calculated. Results: A high proportion of men (58.6%; 74.3%), and especially of women (82.6%; 86.8%), presented body size overestimation and dissatisfaction due to excess weight, respectively. A relevant fraction of the women (32.6%) and men (30.8%) who were dissatisfied due to excess weight did not present excess adiposity, especially if classified by DXA. Variability in degree of distortion was hardly explained by anthropometric and DXA variables in women (<5%) and men (∼22%). Both anthropometric and DXA measurements accounted for ∼30% and ∼50% of the variability in degree of dissatisfaction among women and men, respectively. Conclusion: Our results suggest a high frequency of body image distortion in Brazilian adult individuals, as well as dissatisfaction with excess weight, especially among women with excess adiposity. The findings indicate that anthropometric measurements explain much of the variability in degree of body image dissatisfaction in men, with no apparent advantage of the use of more refined DXA measurements. [ABSTRACT FROM AUTHOR]

Patients with systemic sclerosis (SSc) have a disproportionately high prevalence of reduced bone mineral density (BMD). Polymorphisms of the vitamin D receptor (VDR) gene have been associated with osteoporosis in patients with autoimmune diseases. The aim of this study was to investigate the prevalence and possible effects of VDR polymorphism on BMD and bone metabolism in patients with SSc. In patients with SSc measurement of BMD was performed using dual-energy X-ray absorptiometry. VDR polymorphisms (FokI, BsmI) were genotyped using restriction fragment length polymorphism analysis. Markers of bone metabolism (calcium, osteocalcin, β-crosslaps) were determined. Primary endpoint was the prevalence of VDR gene polymorphisms and the association with reduced BMD. Secondary endpoints included associations between bone metabolism and VDR gene polymorphism. 79 Caucasian patients with SSc were included. Overall, 83.5% had reduced BMD (51.9% osteopenia, 31.6% osteoporosis). The prevalence of VDR gene polymorphism (73% BsmI, 77% FokI) was comparable to studies in healthy and rheumatic populations. The homozygous presence of FokI polymorphism, but not BsmI, was significantly associated with reduced axial BMD. Fokl polymorphism was significantly associated with reduced CTX levels, although changes remained within the reference limits. VDR polymorphisms can frequently be found in patients with SSc in comparable prevalence to healthy and rheumatic populations. The homozygous presence of FokI polymorphism, but not BsmI, was significantly associated with reduced axial BMD. This could be a possible contributor for the high prevalence of reduced BMD in 83.5% of patients with SSc in this study. Trial registration. DRKS00032768, date: 05.10.2023, retrospectively registered. [ABSTRACT FROM AUTHOR]

Osteoporotic vertebral fractures represent a significant sociomedical problem that impairs the quality of life of the elderly population. Clinical examination, supplementary diagnostic methods (X-ray, Computed Tomography - CT, Dual-Energy X-ray Absorptiometry - DXA, Lateral Vertebral Assessment - LVA) and fracture risk assessment tool (FRAX) are crucial for effective assessment of fracture severity, timely decision on treatment method, and initiation of rehabilitation. Of great practical importance is the effect of antiresorptive therapy on callus formation. In patients who suffer from osteoporosis, and despite treatment have a fracture, it is recommended not to interrupt bisphosphonate therapy, which was started several months before the diagnosed fracture. Bisphosphonates should be introduced into the treatment in a period of 2-4 months from the occurrence of the fracture, depending on the location of the fracture, that is, the time required for callus formation. Recombinant parathyroid hormone is an effective anabolic therapy that accelerates bone regeneration during fractures, increases callus volume and faster bone strength. Osteoporosis therapy should not be started without checking the total and ionized Ca, P, 25(OH)D, and PTH as well as general biochemical analyses, and then introducing antiresorptive or anabolic therapy. Rehabilitation treatment is individually designed and includes balance exercises, strength exercises, range of motion and postural training leading to improvement of spinal mobility, muscle strength and overall functionality. The aim of this review was to highlight the timely diagnosis, evaluation, and treatment of osteoporotic vertebral fractures. [ABSTRACT FROM AUTHOR]

Age-related changes in body composition have been associated with reduced physical performance. However, the relationship of fat and lean mass indexes with physical performance in the setting of frailty is yet to be clearly established. We investigated the association between fat and lean mass indexes and physical performance in prefrail and frail older women. Fifty-one community-dwelling women 65 years and older (mean age 76 years) were classified as prefrail or frail according to a modified frailty phenotype. Body composition was estimated by dual-energy X-ray absorptiometry, while physical performance was assessed via the following tests: Berg balance scale, timed-stands, timed up-and-go test, 6-minute walk test, and the short performance physical battery. Correlation coefficients were determined to assess the association between body composition and physical performance parameters. Associations between continuous variables with a p-value <0.05 were included in a linear regression analysis. All fat mass indexes predicted a reduced performance in at least one functional test. Among the lean mass indexes, only leg lean mass adjusted by body fat mass was directly associated with better physical performance. Our findings indicate that fat mass indexes may have a greater impact on physical performance than lean mass in frail and prefrail older women. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to examine the associations of 24-h movement behaviors (moderate to vigorous physical activity [MVPA], light physical activity [LPA], sedentary behavior [SB], and sleep) with age-, sex-, and race-specific a real bone mineral density (aBMD) z-score parameters at clinical sites in young pediatric cancer survivors. Methods: This cross-sectional multicenter study was carried out within the iBoneFIT framework in which 116 young pediatric cancer survivors (12.1 ± 3.3 yr old; 42%female) were recruited. We obtained anthropometric and body composition data (i.e., body mass, stature, body mass index, and region-specific lean mass), time spent in movement behaviors over at least seven consecutive 24-h periods (wGT3x-BT accelerometer, ActiGraph), and aBMD z-score parameters (age-, sex-, and race-specific total at the body, total hip, femoral neck and lumbar spine). Survivors were classified according to somatic maturity (pre or peri/postpubertal depending on the estimated years from peak height velocity). The adjusted models' coefficients were used to predict the effect of reallocating time proportionally across behaviors on the outcomes. Results: In prepubertal young pediatric cancer survivors, reallocating time to MVPA from LPA, SB, and sleep was significantly associated with higher aBMD at total body (B = 1.765, P = 0.005), total hip (B = 1.709, P = 0.003), and lumbar spine (B = 2.093, P = 0.001). In peri/postpubertal survivors, reallocating time to LPA from MVPA, SB, and sleep was significantly associated with higher aBMD at all sites (B = 2.090 to 2.609, P = 0.003 to 0.038). Reallocating time to SB from MVPA or LPA was significantly associated with lower aBMD atmost sites in prepubertal and peri/postpubertal survivors, respectively. Finally, reallocating time to sleep from MVPA, LPA, and SB was significantly associated with lower aBMD at total body (B = -2.572, P = 0.036) and total hip (B = -3.371, P = 0.015). Conclusions: These findings suggest that every move counts and underline the benefits of increasing MVPA or LPA, when low MVPA levels are present, for bone regeneration after pediatric cancer treatment completion. [ABSTRACT FROM AUTHOR]

We established a protocol for assessing the areal bone mineral density (BMD) of the proximal humerus using dual-energy X-ray absorptiometry (DXA). We also investigated the correlation between the BMD of the proximal humerus and that of the lumbar spine and proximal femur to predict the BMD of the proximal humerus. We included female patients aged >60 years who underwent bone density evaluation using DXA. The BMD of the proximal humerus was calculated at seven regions of interest (ROIs): the head of the humerus, lesser tubercle, greater tubercle in two locations, and proximal metaphysis in three locations. The intra- and inter-examiner reliabilities in the setting of the ROIs were examined using intraclass correlation coefficients (ICCs) (1.1) and (2.1), respectively, and the intra-examiner reliability in DXA was examined using ICCs (1.1). The intra- and inter-examiner reliabilities in the setting of ROIs and the intra-examiner reliability in DXA were high in all regions. The BMD of the lumbar spine and proximal femur correlated weakly with that of the humeral head and diaphysis. Our method for measuring the BMD of the proximal humerus was found to be reliable and may be applied in future studies. [ABSTRACT FROM AUTHOR]