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Biomedical subjects

C Mautalen

Publications and source records attributed to C Mautalen.

At least 37 records · Page 2Linked to original sources

Osteomalacia in a patient with severe anorexia nervosa.

A 27-year-old woman with anorexia nervosa since adolescence was referred to our unit for generalized bone pain most severe at the pelvis and an inability to stand. She reported a pelvic fracture diagnosed one year earlier, which had failed to heal. Laboratory tests showed low serum phosphate, normal total serum calcium corrected for serum albumin, and very low urinary calcium excretion. Serum bone alkaline phosphatase and parathyroid hormone levels were elevated, whereas 25-hydroxy-vitamin D was severely decreased. Multiple vertebral and rib fractures were seen on plain radiographs. Radiographic images consistent with osteomalacia were pseudofractures of the left inferior pubic ramus, a bilateral complete fracture of the superior pubic ramus, and a characteristic pseudofracture (Looser zone) in the lateral margin of the right scapula. Vitamin D-deficient osteomalacia with secondary hyperparathyroidism was strongly suspected at this point, but it was decided not to confirm this diagnosis by bone biopsy with histomorphometry and osteoid labeling because of the emotional instability of the patient. Dual-energy X-ray absorptiometry disclosed severe demineralization. After two months on calcium and vitamin D supplements, the bone pain had abated and the patient was able to stand. Serum calcium had increased; serum phosphate, 25-hydroxy-vitamin D, and parathyroid hormone had returned to normal, and the pseudofractures showed evidence of healing. Osteoporosis is a well-known complication of anorexia nervosa. This case shows that osteomalacia can also occur. Vitamin D status should be assessed in patients with long-standing severe anorexia nervosa.

Adult↗

Bone mineral density and bone size in men with primary osteoporosis and vertebral fractures.

The bone mineral density (BMD) at the lumbar spine, proximal femur, and total skeleton was evaluated in 38 men with primary osteoporosis and vertebral fractures. BMD of the patients was significantly reduced over all skeletal areas compared with controls. The Z-score of the lumbar spine (-2.8 +/- 0.9) was less than that of the other areas (P < 0.001) except the legs (-2.5 +/- 1.1) (p.n.s.) showing that bone loss had a tendency to be greater over the axial skeleton. Vertebral dimensions compared with age-matched controls were as follows: projected L2-L4 area (cm 2): 45.7 +/- 5.6 versus 53.7 +/- 3. 6 (P < 0.001); vertebral width (cm): 4.37 +/- 0.44 versus 4.90 +/- 0. 36 (P < 0.001). Serum biochemical parameters and testosterone levels were similar between osteoporotic and control men. We conclude that men with vertebral osteoporotic fractures have reduced vertebral BMD and vertebral dimensions compared with age-matched controls. Thus, these findings indicate that the achievement of a reduced bone size at the end of the growth period or a failure of periosteal increase during adult life is likely to contribute to the pathogenesis of the vertebral fractures observed in older men.

Adult↗

Risk factors for the development of vertebral and total skeleton osteoporosis in patients with primary biliary cirrhosis.

The objectives of this work was to (1) study the bone mineral density (BMD) of the lumbar spine, total skeleton, and body composition in patients with primary biliary cirrhosis (PBC) and (2) evaluate the risk factors (premature menopause, stages of the disease, hyperbilirubinemia) and bone and liver biochemical parameters for the development of osteoporosis. We studied 23 women with a compatible diagnosis of PBC. The BMD and body composition were evaluated by X-ray absorptiometry (Lunar DPX-L). The average age of the population was 56.7 +/- 10.2 years. The BMD of the lumbar spine and of the total skeleton was 1.3 SDs below the normal population matched for sex and age. In the total skeleton, the legs were the most severely affected area (Z score -1.5). The body composition showed no significant difference compared with the normal population. The BMD of 56% of the patients was less than -2.5 SDs from the average normal young values. Patients with a history of vertebral fractures had diminished mineral density of the lumbar spine, as did those who had had no fractures. Of the risk factors studied, patients with premature menopause had a lower bone mass compared with patients with normal menopausal age (Z score of the total skeleton was -2.1 +/- 1.8 versus -1.1 +/- 1.0) but the difference did not reach statistical significance. The bone mass was not affected in patients with regular menstrual cycles. There were no statistically significant differences in high levels of bilirubin, advanced stages of the disease, or the biochemical variables studied. It is concluded that patients with primary biliary cirrhosis present diminished cortical and trabecular bone mass, whereas body composition was unaffected. Premature hormone deficit, possibly triggered by the chronic hepatic pathology, is a contributing factor to the osteoporosis in this population.

Adult↗

The effect of olpadronate in ovariectomized thyroxine-treated rats.

Hyperthyroidism increases bone turnover and induces bone loss. This study examines the effect of thyroid hormone excess on two biochemical markers of bone turnover (hydroxyproline and bone alkaline phosphatase) as well as on bone mineral content (BMC) and bone mineral density (BMD). The possible protective role of dimethyl-APD (olpadronate, OLP), on both suppression of bone turnover and bone mineral loss in ovariectomized (ovx) rats, was also studied. Female Sprague-Dawley rats, were assigned to five groups of eight rats each: sham, ovx, ovx OLP treated (0.3 mg/kg per week), ovx T4 treated (250 micrograms/kg per day), and ovx T4-OLP rats. Rats were killed after 5 weeks of treatment. At the end of the study, blood samples were analyzed for serum calcium, phosphorus, T4, total and bone alkaline phosphatase (ALP and b-ALP), and urinary samples for hydroxyproline/creatinine ratio (HOProl/creat). Moreover, total BMC, BMD, and scanned area were determined by DXA. Ovx T4-OLP-treated rats presented higher values of b-ALP than ovx T4-treated, ovx, and sham rats (p < 0.05). Ovx increased HOProl/creat excretion compared with sham (p < 0.05), but it was similar compared with ovx T4-treated rats. OLP treatment reduced HOProl/creat excretion in both ovx T4-treated (p < 0.05) and ovx rats (p < 0.05). The final BMC in ovx was lower than in the sham group, but the difference was not statistically significant (p < 0.08). The lowest BMC was observed in ovx T4 rats (p < 0.05). When final BMC was expressed per body weight (BMC/W), ovx rats presented a significantly lower BMC/W than sham rats (p < 0.05). Ovx OLP rats had BMC/W levels higher than ovx (p < 0.005), ovx T4 (p < 0.01), and ovx T4-OLP rats (p < 0.01). The ovx group had a final BMD lower than sham animals (p < 0.05), but not significantly different than the ovx T4 rats. BMC and BMD of OLP ovx rats, whether they received T4 or not, was similar to the sham group. The highest final BMD was observed in the ovx T4-OLP group. In summary, the prevention of an increase in HOProl excretion accompanied by the fact that final BMD and BMC in OLP-treated animals were comparable to sham control rats may reflect that OLP administration could inhibit bone resorption in both T4-treated or -untreated rats. Although further studies are necessary, these findings may have clinical relevance in estrogen-depleted patients to whom medical management other than the reduction of T4 administration would be desirable.

Alkaline Phosphatase↗

Long-term effect of gluten restriction on bone mineral density of patients with coeliac disease.

AIM: To assess the long-term effect of a gluten-free diet on bone mineral density of adults with untreated coeliac disease. METHODS: Bone mineral density was assessed at baseline and after a mean duration of 37 months of treatment in 25 unselected newly diagnosed coeliac patients. RESULTS: At baseline, osteopenia (> -1 s.d. below normal) was evident in the lumbar spine and total skeleton in 18 (72%) and 21 (84%) patients, respectively. At the end of the study, bone density had increased (mean bone mass Z-score increase: Z-score +1.0 for the lumbar spine and +1.1 for total skeleton) in 22 and 23 patients, respectively. Patients who adhered to strict gluten restriction (n = 15) demonstrated a similar bone remineralization in the spine than those patients with partial compliance (n = 10) (mean Z-score increase: +1.0, in both areas). A greater mean annual change in Z-score in the total skeleton was noted in patients who followed strict gluten restriction (0.4 +/- 0.1) respect to those with partial compliance (0.3 +/- 0.1); however, this difference was not statistically significant. Pre-menopausal women had significantly greater remineralization that post-menopausals (P > 0.05). Remineralization showed an inverse correlation with the degree of basal osteopenia (r = -0.525; P < 0.002). CONCLUSIONS: Long-term treatment with gluten-free diet produces a significant improvement in bone density in coeliac patients. Remineralization was more pronounced in patients who better comply with gluten-free diet, in pre-menopausal women and in patients with the lowest baseline bone mineral density.

Adult↗

Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients.

BACKGROUND/AIMS: Osteopenia is a common complication of celiac disease. The aims of this study were to evaluate whether treatment produces bone remineralization and whether calcium and vitamin D supplementation are necessary to reduce osteopenia. METHODS: Bone mineral density and biochemical parameters of bone and mineral metabolism were measured in 14 newly diagnosed adult celiac disease patients. All patients were treated with a gluten-free diet and were randomized to receive diet only (n = 7) or diet plus calcium (1.0 g/day) and vitamin D (32,000 IU/wk) supplementation (n = 7). Bone density was measured at baseline and at 6 and 12 months of follow-up. Tests for biochemical determinations were repeated every 3 months. RESULTS: At diagnosis, 11 patients had evidence of osteopenia (> 1 SD below normality) in the spine and total skeleton. After 12 months of gluten restriction, overall bone mass had increased 5.0% (p < 0.01) in the lumbar spine and 5.0% (p < 0.002) in the total skeleton. When one only considers those 11 patients who strictly followed gluten restriction, bone density increased 8.4% in the lumbar spine and 7.7% in the total skeleton. Remineralization occurred throughout the skeleton but was more pronounced in the axial than in the peripheral skeleton. The increase in bone mass was independent of age or menopause. Remineralization in patients treated with diet only was similar to that of patients treated with diet and supplements. Basal biochemical parameters showed a high bone turnover with secondary hyperparathyroidism. Treatment induced a decrease in bone turnover activity. However, a complete restoration of biochemical parameters was not achieved. CONCLUSIONS: Strict gluten avoidance promoted a significant increase in bone mineral density. However, values still remain markedly low after 1 yr in several patients. Although calcium and vitamin D supplementation did not provide additional benefit to that obtained by diet alone in the doses administered, our results do not preclude a possible effect of vitamin D at higher dose.

Adult↗

Longitudinal study on the effect of treatment on body composition and anthropometry of celiac disease patients.

OBJECTIVES: This prospective study was designed to assess the nutritional changes associated with the long-term treatment of celiac disease. In addition, we analyzed whether these changes were related to the degree of compliance with a gluten-free diet. METHODS: We studied nutritional parameters and body composition in 25 newly diagnosed celiac patients after a mean period of 37 months (range 25-49 months) on a gluten-free diet. Body composition parameters (fat, lean tissue, and bone masses) were measured by dual energy x-ray absorptiometry. Anthropometry was measured according to conventional formulas. RESULTS: At diagnosis, fat (-49%), lean tissue (-12%), and bone (-24%) compartments were reduced, compared with that of sex- and age-matched controls. After treatment, we noted a significant increase in body weight (p < 0.0001), fat mass (p < 0.0005), bone mass (p < 0.002), and body mass index (p < 0.005). In contrast, we did not observe a significant increase in lean-tissue mass or muscle mass. Patients who adhered strictly to a gluten-free diet experienced a greater, though nonsignificant improvement in fat mass, body weight, and body mass index than patients whose compliance had been partial. Mean caloric intake at the end of the study was significantly lower among those patients who had adhered strictly to a gluten-free diet, compared with those who had complied only partially with the diet (p < 0.05). CONCLUSIONS: This study shows that the institution of a gluten-free diet in celiac disease patients results in a significant improvement in nutritional parameters, as measured by anthropometry and/or body composition. This effect was more pronounced in patients who followed strict gluten restriction and was related mainly to changes in fat and bone compartments.

Adult↗

[Treatment of Paget's disease with olpadronate. Its efficacy in partial responders to oral pamidronate].

Bisphosphonates are the treatment of choice in patients with Paget's disease. However in patients with an extensive disease it has been difficult to achieve complete biochemical remission. We studied the efficacy of the new bisphosphonate: olpadronate (dimethyl APD) in 37 patients (21 men and 16 women) with Paget's disease of (mean +/- 1SD) 68 +/- 8 years of age: Group I: 12 patients without previous specific treatment. Group II: 25 patients who had been treated before (time free of treatment before olpadronate: 11 +/- 8 months). (Table 1). Olpadronate was given orally in doses of 100 to 200 mg/day. Initial dose and/or increment of the dose during treatment were decided accordingly to the biochemical response. The length of therapy was (mean +/- 1SD) 3.5 +/- 2.4 months (range 0.5-13 months) and was adjusted to the changes produced upon the biochemical indexes of bone turnover. Olpadronate was well tolerated by all the patients except for one who discontinued the treatment due to gastrointestinal symptoms. Mean alkaline phosphatase (APh) decreased in both groups of patients as follows: Group I: basal: 36 +/- 20 KAU, final: 12 +/- 3 KAU (normal range: 5 to 15 KA units) and group II: basal 45 +/- 30 KAU final 14 +/- 10 KAU. (Table 2). Normalization of APh was observed in all patients of group I and in 21/25 patients of group II. Three patients of group II had partial responses (60% of diminution of APh without reaching normal values) and treatment was not effective in 1 patient. The length of remission was 8.7 +/- 5.7 months in group I and 10.4 +/- 8.1 months in group II. There was a significant inverse correlation between duration of remission and APh level post treatment. Fourteen patients of group II (7 women and 7 men) had previously received oral pamidronate (APD) in different cycles during a period of 6.6 +/- 4.2 years. After the first APD cycle, only 2 out of 14 achieved normal APh values and none of the 14 achieved complete biochemical remission after the last APD cycle. Olpadronate caused a significant decrease of serum APh and THP compared to the lowest values observed during APD treatment. Normalization of APh was observed in 12/14 of these partial responders to APD. (Table 3 and Figure 1). In conclusion, oral Olpadronate in a dose of 100 to 200 mg was well tolerated and effective in the treatment of Paget's disease even in those previous partial responders to APD.

Aged↗

Early changes of body composition in asymptomatic celiac disease patients.

BACKGROUND/AIM: This is a study of patients with asymptomatic celiac disease. The aims of this study were: 1) To evaluate the nutritional status of asymptomatic patients with newly diagnosed celiac disease, and 2) to compare these findings with those of untreated/symptomatic and treated patients. MATERIAL: We examined 41 patients with celiac disease divided into three groups: a) 8 asymptomatic (diagnosed in a study of first-degree relatives of probands), b) 20 untreated/symptomatic patients, and c) 13 treated patients. Nutrition of patients from groups A and B was assessed at the time of diagnosis. METHODS: Nutritional status was evaluated by: 1) body composition (fat and lean mass) by dual energy x-ray absorptiometry (DEXA), and 2) anthropometric measurements. RESULTS: Compared with sex and age matched controls (n = 153), asymptomatic patients presented a moderate but significant reduction of the fat compartment (-29%; p < 0.001), but not of the lean-tissue mass (p = NS). Untreated/symptomatic patients showed a more severe depletion of fat (-46%; p < 0.001) and lean mass (-9.0%; p < 0.05) compared with healthy controls. Although fat mass of treated patients was significantly reduced with respect to controls (-24%; p < 0.003), lean mass was not affected. The anthropometric measurements of fat showed a significant correlation with the evaluation by DEXA (multiple regression analysis r = 0.918). CONCLUSION: Asymptomatic patients in our study with an unequivocal diagnosis of celiac disease established by mucosal biopsy exhibited a modified body composition.

Absorptiometry, Photon↗

Body composition in normal and osteoporotic women.

Body composition and bone mineral density using dual-energy X-ray absorptiometry (DEXA) was determined in a large group of normal women and osteoporotic patients with atraumatic vertebral fractures. Between the third and seventh decades, there was an increase of 9.5 kg of body weight and 7.5 kg of fat mass in the normal women. The percentage of fat augmented from 33% to 42%. However, the lean mass showed no modifications over these decades. Fat mass in the osteoporotic women was significantly less than that in the age and sex matched controls (22.4 +/- 1.0 vs 26.6 +/- 1.0 kg; p < 0.006). However, lean tissue mass was similar in the two groups. The decrease in fat mass explain 74% of the difference of body weight between osteoporotics and controls. The fat mass of 13 osteoporotic patients (30%) was lower than the lowest value found in the controls and 20(45%) were lower than minus one standard deviation of the values for controls. The osteoporotic patients had less fat mass in the three subregions evaluated, but the difference was more significant in the trunk (-18%) and legs (-17%) than in the arms (-11%). Fat mass may have an important protective effect on the skeleton. The mechanism has yet to be elucidated.

Absorptiometry, Photon↗

Vitamin D prophylaxis in children with a single dose of 150000 IU of vitamin D.

OBJECTIVE: To determine the efficacy of a single oral dose of 150,000 IU of vitamin D2 at the beginning of autumn for preventing winter vitamin D deficiency in children in Ushuaia (55 degrees S). DESIGN: The study was prospective. SUBJECTS: 79 children clinically healthy with 8.6 +/- 1.4 y of age (X +/- s.d.). INTERVENTIONS: Fasting serum venous samples and 2 h urine samples were obtained immediately before and 6 w and 5 mon after the vitamin D dose. Parents informed consent was obtained previous to the study. In a subgroup of 30 children serum levels of calcium (sCa), phosphorus (sP), total alkaline phosphatase (TAP), 25 hydroxyvitamin D (25 OHD), parathyroid hormone (PTH) and the urine calcium/creatinine ratio in a 2 h urine sample (UCa/UCreat) were measured. In the whole group sCa and the ratio uCa/ucreat were measured. RESULTS: After 150,000 IU of vitamin D2 administration, serum 25 OHD levels at the end of winter (17.0 +/- 9.4 ng/ml) were similar to those at the beginning of autumn (18.7 +/- 10.7 ng/ml), but significantly higher from those obtained in a previous study without vitamin D (9.8 +/- 3.8 ng/ml, P < 0.001). PTH levels were higher at the end of winter (P < 0.02), but this augmentation was lower than the increment observed without vitamin D. Plasma calcium levels and the urine calcium/creatinine ratio were lower at 5 months after vitamin D2 dose (P < 0.02 and P < 0.05 respectively). In the total group the serum calcium was lower after the fifth month (P < 0.05). The Uca/Ucreat ratio was lower at 6 w and 5 mon (P < 0.05 and P < 0.001). CONCLUSION: A single dose of 150,000 IU of vitamin D maintained appropriate levels of 25 OHD without inducing hypercalcemia nor hypercalciuria, but a winter increment of PTH (smaller than in the group without vitamin D) was not inhibited.

Alkaline Phosphatase↗

Regression of calcinosis during diltiazem treatment in juvenile dermatomyositis.

An 8-year-old girl with juvenile dermatomyositis (DM) developed dystrophic calcifications 26 months after diagnosis. She also had severe steroid induced bone loss (osteoporosis). The calcifications turned into generalized heterotopic calcinosis with an exoskeleton-like pattern, despite successful treatment of her myopathy with methylprednisolone and immunosuppressive drugs. She was subsequently treated with oral diltiazem (5 mg/kg/day) to control calcinosis and oral pamidronate (4 mg/kg/day) in addition to calcium and vitamin D supplementation, which she had been taking for 3 years. After 21 months of treatment, clinical and radiological examination revealed dramatic regression of the calcinosis. Bone mass reached normal levels, as determined by bone absorptiometry. Diltiazem alone or in combination with other drugs could be a useful therapy in patients with juvenile DM and pronounced calcifications.

Calcinosis↗

Hormone replacement therapy increases trabecular and cortical bone density in osteoporotic women.

Twenty five postmenopausal Caucasian women with established osteoporosis or severe osteopenia were treated with continuous combined estrogen/progesterone (2 mg 17 beta estradiol and 5 mg medroxiprogesterone) and 1000 mg of calcium daily. The mean age of the patients was 57 +/- 6 years (range 44 to 69 years), and the average postmenopausal interval was of 10.7 +/- 4.2 years. The bone mineral density (BMD) of the lumbar spine and proximal femur was determined using DXA densitometer at baseline, 12 and 24 months of treatment. Serum and urine measurements were done at baseline and 12 months. After 24 months of treatment bone mineral density increased at the trochanter 10.2% p < 0.001, lumbar spine 9.6% p < 0.001, Ward's triangle 8.6% p < 0.005 and femoral neck 5.7% p < 0.001 in comparison to basal levels. In the first year of treatment serum alkaline phosphatase and urinary hydroxiproline diminished significantly in comparison to basal levels (p < 0.001, for both). In conclusion, this study indicates that continuous combined estrogen progesterone therapy decreases bone turnover and increases BMD of the spine, femoral neck and trochanter in established osteoporosis.

Adult↗

Solar ultraviolet B radiation and photoproduction of vitamin D3 in central and southern areas of Argentina.

The incidence of nutritional rickets in the southern part of Argentina is 8-12 times higher than in the rest of the country. Winter 25(OH)D serum levels in normal population of southern areas are lower than in central and northern areas. To elucidate these differences, we compared the photoconversion of provitamin D3 (7-DHC) to previtamin D3 in two cities: Ushuaia (latitude 55 degrees S) and Buenos Aires (34 degrees S). Ampules containing 7-DHC were exposed to sunlight one day in the middle of each month either from 10:30 a.m. to 2:30 p.m. or from 8:00 a.m. to 5:00 p.m. The percentages of photoproducts formed were determined by high performance liquid chromatography (HPLC). Previous studies have proved that this is a valid model to assess "in vitro" the photoproduction of vitamin D3 in human skin. Previtamin D3 + vitamin D3 formed in Ushuaia were less (p < 0.02) than those found in Buenos Aires during all seasons: summer, (X +/- SEM) 6.4 +/- 0.8% vs. 13.2 +/- 1.8%; autumn, 1.2 +/- 0.7% vs. 6.3 +/- 1.3%; winter, 0.8 +/- 0.7% vs. 3.6 +/- 0.7%; spring, 3.4 +/- 0.5% vs. 9.1 +/- 1.1%. The photoproducts produced from 10:30 a.m. to 2:30 p.m. were similar for each month and latitude to those formed when the ampules were exposed from 8:00 a.m. to 5:00 p.m. We conclude that in Ushuaia there is a prolonged "vitamin D winter" during which cutaneous synthesis of vitamin D is absent, leading to lower serum values of 25(OH)D and contributing to the higher incidence of rickets.

Argentina↗

Ultrasound and dual X-ray absorptiometry densitometry in women with hip fracture.

To assess the usefulness of the measurement of the os calcis by ultrasound, a method that probably reflects bone quality as well as density, we have studied 54 women with hip fracture of the proximal femur and a control group. Ultrasound evaluation of the os calcis [broadband ultrasound attenuation (BUA), speed of the sound (SOS), and a combined index ("stiffness")], and bone mineral density (BMD) determination over the proximal femur by dual X-ray absorptiometry (DXA) were performed. Weight, BMD, and ultrasound values in the hip fracture patients were significantly lower than controls (P < 0.001). The Z-scores for BUA and stiffness were not different than that for femoral neck, Ward's triangle or trochanteric BMD (between -1.7 and -1.5). The odds ratios determined by receiver-operating characteristics (ROC) analysis were greater at the femoral neck (25.1) and BUA (24.4). Intermediate values were found at stiffness (16.9), Ward's triangle (12.8), and trochanter (11.1), and lower values were obtained at SOS (4.2). In turn, patients with trochanteric hip fractures had a significantly lower femoral neck and Ward's triangle BMD, stiffness, and BUA than patients with cervical hip fractures. Comparing a subgroup of 30 women with hip fractures without vertebral fractures with an age-matched group of 87 women with osteoporotic vertebral fractures, both groups were of similar weight and BMD but all ultrasound values were significantly lower in the hip fractures compared with vertebral fracture patients (P < 0.05 - P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Discrimination of total body bone mineral density measured by dexa in vertebral osteoporosis.

The assessment of bone mineral density (BMD) is the usual study to detect patients at risk for developing osteoporosis. The aim of this study was to compare the discriminative ability of total body BMD and its different subregions with the more usual measurements of BMD of the lumbar spine and femoral neck in women with osteoporotic fractures of the spine. The BMD was determined in 61 osteoporotic (at least one vertebral wedge fracture visible in the lateral X-ray film of the thoracic or lumbar spine) and 61 age-matched control women. Measurements were made by dual X-ray absortiometry (DXA) with a total body scanner. The BMD of the osteoporotic women was significantly lower at all skeletal areas compared with control (P < 0.001). The diminution was less pronounced but still significant at the arms (P < 0.05). The areas with the largest Z score in the osteoporotic group were antero-posterior lumbar spine (-1.78), femoral neck (-1.71), legs (-1.67), and total body (-1.59). There was no significant difference among the Z scores of the four above-mentioned measurements. The Z score of the arms (-0.79), spine (-1.12), and head (-1.29) were significantly lower than the Z score of the total body. The Z score of the pelvis was lower than the Z score of the total body but the difference only approached statistical significance (0.05 > P < 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗