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E Lespessailles

Publications and source records attributed to E Lespessailles.

At least 19 recordsLinked to original sources

Preserved bone health in adolescent elite rhythmic gymnasts despite hypoleptinemia.

BACKGROUND/AIMS: Leptin is linked to hormonal disturbances occurring in anorexia and positively linked with bone mineral density. The aim of this study was to determine whether hypoleptinemia occurring in rhythmic gymnasts may affect bone health. METHOD: Leptin, insulin, cortisol, IGF1 levels and bone markers were determined in 36 rhythmic gymnasts (EG) and 20 controls (C). Body composition, BMD at the whole body (WBBMD), lumbar spine (LSBMD) and bone ultrasound properties (SOS, BUA) were measured. RESULTS: The rhythmic gymnasts had lower fat mass and leptin level than the controls. There was no difference for IGF1, cortisol and insulin levels. Bone turnover rate was higher in elite gymnasts. The uncoupling index showed that remodeling favored the bone formation. LSBMD, WBBMD, SOS and BUA were higher in elite gymnasts after adjustment for fat mass. Leptin correlated positively with fat mass and negatively with physical activity. CONCLUSION: High impact training is able to counterbalance bone effects usually encountered in hormonally disturbed subjects. Our results suggest that hypoleptinaemia might be related to direct osteogenic effects and indirect hormonal mechanisms including preservation of IGF and cortisol levels.

Adolescent↗

Effect of specimen conditioning on the microarchitectural parameters of trabecular bone assessed by micro-computed tomography.

The best way to preserve the mechanical properties of bone specimens is hydration in NaCl, whereas the reference process in microCT analysis is defatting. However, for finite element modelling (FEM) it is necessary to use the same bone specimens for biomechanical testing and 3D imaging. This study aimed to evaluate the effect of sample conditioning on trabecular bone microarchitectural parameters. Trabecular bones were analysed by microCT under three successive conditions: first, the fatted samples were analysed immersed in NaCl (process N); second, they were hydrated for 24 h then imaged without immersion (process H); third, the samples were defatted before analysis (process D). The microarchitectural parameters bone volume/tissue volume (BV/TV), trabecular spacing (Tb.Sp), number (Tb.N) and thickness (Tb.Th) were calculated. Except for BV/TV, there was no significant difference between the processes N and D. In process H, BV/TV, Tb.Th and Tb.N were higher and BS/BV and Tb.Sp were lower than in process D. Results showed that the process D may be replaced by the process N. The process H induced significant differences in microarchitectural parameters when compared to process D. Nevertheless, this sample conditioning should be used to develop FEM when microCT images are to be acquired during compressive testing.

Biomechanical Phenomena↗

Subchondral bone micro-architectural alterations in osteoarthritis: a synchrotron micro-computed tomography study.

OBJECTIVES: We evaluated the three-dimensional (3D) micro-architecture of subchondral trabecular (Tb) bone in osteoarthritis (OA). Due to high signal-to-noise ratio and high resolution, micro-computed tomography (micro-CT) by synchrotron radiation is considered as the gold standard for bone micro-architecture imaging. DESIGN: Subchondral bone were extracted from femoral heads in OA cases in areas without cartilage (OAc-; n=6) and in adjacent areas with cartilage (OAc+; n=6) and compared to eight subchondral bone cores from osteoporosis cases (OP). The voxel size of images was 10.13 microm. We measured the bone volume fraction (BV/TV) and morphological parameters: Tb thickness (TbTh), Tb spacing (TbSp), Tb number (TbN), and bone surface/bone volume (BS/BV). The degree of anisotropy (DA), the connectivity by the Euler number and the degree of mineralization (DM) were equally assessed. RESULTS: BV/TV and morphological parameters showed significant differences between OAc- and OP samples (P<0.01 except TbTh: P<0.05) and between OAc- and OAc+ (0.05<P<0.01) but no difference between OAc+ and OP except TbN (P<0.01). The connectivity was higher in OAc- comparatively to OAc+ and OP. The DA were significantly different between OA and OP cases (P<0.01) but not between OAc- and OAc+ specimens. The DMs (mean+/-SD) were 0.817+/-0.142 g/cm(3), 0.873+/-0.161 g/cm(3), 0.906+/-0.156 g/cm(3) for OAc-, OAc+, OP (P<0.01), respectively. CONCLUSION: Subchondral bone changes were mainly observed in advanced OA, when cartilage has been deleted and preserved in adjacent area. These data suggest that subchondral bone changes would be rather secondary to the cartilage deterioration than a primitive mechanism of OA. Nevertheless, longitudinal data could bring more accurate conclusions.

Aged↗

Continuation of treatment with infliximab in ankylosing spondylitis: 2-yr open follow-up.

OBJECTIVE: To evaluate the continuation and safety of treatment with infliximab in ankylosing spondylitis (AS) over a 2-yr period. METHODS: This study was an open, observational, 2-yr extension study of an open-label study of three induction infusions of infliximab in refractory AS. The fourth infusion was performed only in case of relapse. Thereafter, infliximab was to be administered as needed according to the rheumatologist's opinion; however, for some patients, infusions were performed systematically. RESULTS: None of the 50 recruited patients was lost to follow-up. Thirteen patients (26%) interrupted their treatment by infliximab: four for inefficacy, seven for adverse events, of which four were for allergic reactions to the infusion, and two for other reasons. For all of the 46 patients who had had three infusions judged efficacious and well tolerated, a fourth infusion was performed because of a flare of the disease, after a mean interval of 20.3+/-9.9 weeks (range 7.3-57.9). Over the 24 months, the mean interval between infusions was 11.6+/-9.0 weeks. This interval was longer when patients were treated only as needed (mean 14.3+/-12.1 weeks) than systematically (mean 9.8+/-5.7 weeks). Side-effects were similar to those noted in shorter-term studies; seven patients suffered serious adverse events. There were no deaths, no malignancies and no tuberculosis. CONCLUSION: This study confirms the long-term treatment continuation of infliximab in AS, and shows an acceptable safety profile. It appears that for some patients the disease can be controlled with long intervals between infusions; these findings warrant further studies.

Adult↗

Cumulative effects of calcium supplementation and physical activity on bone accretion in premenarchal children: a double-blind randomised placebo-controlled trial.

High calcium intake combined with physical activity during childhood have been shown to improve bone mass accrual and bone mineral density. Our aim was to study the combined effect of calcium and exercise on bone gain in children. Two milk-powder products containing either 800 mg of calcium phosphate (calcium) or not (placebo) were randomly allocated to 113 healthy premenarchal girls on a daily basis for 1 year. The group was composed of 63 exercise (7.2 +/- 4 hours of exercise/week) and 50 sedentary (1.2 +/- 0.8 hours of exercise/week) children. The final experiment had 4 groups: exercise/calcium (n = 12), exercise/placebo (n = 42), sedentary/calcium (n = 10), and sedentary/placebo (n = 21). Bone mineral density (BMD) at 6 skeletal sites and body composition were determined by DXA. Bone age was calculated and the daily spontaneous calcium intake was assessed by a frequency questionnaire. All the tests were performed at baseline and 1 year by the same observer. BMD gains were significantly greater in the exercise/calcium group than in other groups at the total body (increase of 6.3 %, p < 0.05), lumbar spine (11 %, p < 0.05), femoral neck (8.2 %, p < 0.02), and Ward's triangle (9.3 %, p < 0.01). There was no difference between the other groups. These data suggest that calcium supplementation increases the effect of physical exercise on bone mineral acquisition in the period preceding puberty, and that calcium supplementation without physical activity does not improve the BMD acquisition during this period. Physical exercise that stimulates bone accretion needs a high calcium intake to be completely effective.

Adolescent↗

Fractal analysis of trabecular bone texture on calcaneus radiographs: effects of age, time since menopause and hormone replacement therapy.

An analysis of trabecular bone texture based on fractal mathematics, when applied to trabecular bone images on plain radiographs, can be considered as a reflection of trabecular bone microarchitecture. It has been shown to be able to distinguish postmenopausal osteoporosis cases from controls. This cross-sectional study was carried out to investigate the influence of age, time since menopause and hormone replacement therapy (HRT) on the fractal dimension of trabecular bone texture at the calcaneus in a sample of 537 healthy women. Fractal analysis of texture was performed on calcaneus radiographs and the result expressed as the Hmean parameter (H = 2-fractal dimension). Total hip, femoral neck and lumbar spine bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. There was a statistically significant Hmean parameter decrease with age (p<0.0001) but the degree of correlation was low (r = -0.2) compared with the correlation between age and BMD (r = -0.36 to -0.61 according to the BMD site). We found a weak but statistically significant correlation between time since menopause and Hmean (r = -0.14, p = 0.03) in the 241 postmenopausal women included in the study. Hmean was significantly lower in a group of postmenopausal women without HRT (n = 110) compared with a group of age-matched postmenopausal women with HRT (n = 110): respectively 0.683 +/- 0.043 and 0.695 +/- 0.038 (p = 0.03). In conclusion, this study suggests that there is a menopause- and age-related decrease in the Hmean parameter and that HRT interferes with the results of the fractal analysis of trabecular bone texture on calcaneus radiographs.

Absorptiometry, Photon↗

Osteopenia in patients infected by the human immunodeficiency virus. A case control study.

Summary - In the last few years, the use of highly active antiretroviral therapy has radically modified the prognosis of human immunodeficiency virus (HIV) infection. Osteonecrosis and osteoporosis are among the bone complications recently described in HIV-infected patients. We report a preliminary study comparing 47 HIV-infected patients (31 men and 16 women) to 47 age- and sex-matched controls. Bone mineral density was lower in patients than in controls: in men, 0.919 +/- 0.120 g/cm2 vs. 1.010 +/- 0.139 g/cm2 (P = 0.01) at the total hip and 0.948 +/- 0.100 g/cm2 vs. 1.043 +/- 0.117 g/cm2 (P = 0.0008) at the lumbar spine; in women, 0.912 +/- 0.149 g/cm2 vs. 0.968 +/- 0.090 g/cm2 at the total hip (P = 0.17) and 0.989 +/- 0.152 g/cm2 vs. 1.080 +/- 0.097 g/cm2 (P = 0.01) at the lumbar spine. HIV-infected males were more likely to have osteopenia and osteoporosis, as compared to the male controls (19 vs. 14 and 4 vs. 1, respectively, P = 0.02). None of the women had osteoporosis; nine HIV-infected women and one female control had osteopenia (P = 0.003). No fractures were recorded. In this preliminary study, no evidence supporting a relationship between bone loss and protease inhibitor treatment was found.

Absorptiometry, Photon↗

Efficacy of infliximab in refractory ankylosing spondylitis: results of a six-month open-label study.

OBJECTIVE: To evaluate the efficacy and safety of a loading regimen of the anti-tumour necrosis factor alpha (TNF-alpha) antibody infliximab in predominantly axial severe ankylosing spondylitis (AS). METHODS: We enrolled in this study 50 patients (76% males, 87% HLA-B27(+), median age 35 yr, median disease duration 13 yr) with active AS [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >or=30/100 and serum C-reactive protein concentration >or=15 mg/l) despite treatment with a non-steroidal anti-inflammatory drug, and without peripheral arthritis, uveitis or active inflammatory bowel disease. Other disease-modifying anti-rheumatic drugs were discontinued >or=3 months before inclusion and were not allowed during the study. Patients received three infusions of infliximab (5 mg/kg) at weeks 0, 2 and 6 and were monitored clinically and biologically until week 24. RESULTS: Forty-eight patients completed the treatment. In intention-to-treat analysis, all parameters were significantly improved at week 2 and generally reached maximal improvement at week 8. The proportion of responders, defined by a reduction of >or=20% in the global assessment of pain (GAP) or by the AS Assessment Study Group (ASAS 20%) criteria, and the proportion of patients reaching partial remission were 98, 94 and 70% respectively. Relapse, defined as >or=50% loss of maximal GAP improvement, occurred in 73% of completers, with a median delay of 14 weeks after the third infusion. No serious adverse event related to the treatment was observed. CONCLUSIONS: This study confirms, in a large group of severely affected AS patients, the remarkable efficacy of infliximab. Relapse usually occurred after discontinuation of the drug, but almost one-third of completers were still free of relapse 4 months after the last infusion.

Adult↗

[Bone evaluation in ten adults with cutaneous mastocytosis].

BACKGROUND: To systematically evaluate the bone status, searching for osteoporosis in patients with cutaneous mastocytosis. PATIENTS AND METHODS: In a prospective study from March 1997 to June 2000, we included all new patients examined for cutaneous signs of mastocytosis. Past history, physical examination, skin biopsy, laboratory tests, bone densitometry, cytology and histopathology of bone marrow and other complementary investigations were performed in all these patients. RESULTS: Ten patients were included. Two patients had osteoporosis. Five others had osteopenia. Four patients had bone marrow involvement due to mastocytosis. One of these four patients had myelodysplasia. DISCUSSION: This study suggests better investigation of bone density and bone marrow in patients who have cutaneous mastocytosis. Systematic histopathology of bone marrow and osteodensitometry help to detect patients with systemic involvement. Bone densitometry is particularly effective for early detection of patients at risk for fracture and is of practical interest since patients with osteoporosis can now be treated with Pamidronate.

Adult↗

[Digital purpura revealing septicaemical rat-bite fever].

INTRODUCTION: Infection with Streptobacillus moniliformis is an uncommon illness which can lead to death if untreated. We report the case in which initially cutaneous signs permitted diagnosis and further identification of the organism. CASE REPORT: A 42 year-old woman presented with a three-day history of acrally distributed purpuric macules on her fingers. Two days later, she was admitted for arthritis of the knees and wrists. There were two large pustules on the left elbow and the right knee. Laboratory studies showed inflammatory changes. The diagnosis of streptobacillary rat-bite fever was made after isolation of Gram-negative bacilli from a blood-culture and from cutaneous lesions. Finally identification of the organism was made by molecular biology analysis. The patient received intravenous ofloxacin and imipenem with complete resolution of arthritis and the cutaneous lesions. DISCUSSION: Streptobacillary rat-bite fever is a systemic infectious disease. It is caused by Streptobacillus moniliformis, organism found in the oropharyngeal flora of small rodents, especially rats. The illness is uncommon in urban settings. It starts by fever, followed by arthritis and rash. Septicaemical rat-bite fever may start only with cutaneous involvement such as acral purpura, like in our case. This clinical manifestation must be recognized by the dermatologist, because the illness can lead to death if untreated.

Adult↗

Fractal analysis of radiographic trabecular bone texture and bone mineral density: two complementary parameters related to osteoporotic fractures.

Trabecular bone microarchitecture and bone mineral density (BMD) are two main factors related to osteoporotic fractures. Currently, however, microarchitecture is not evaluated. We have developed and validated a trabecular bone texture analysis from radiographic images. The objective was to determine if the fractal analysis of texture was able to distinguish osteoporotic fracture groups from control groups, either in vertebrae, hip, or wrist fractures, and to determine if this indicator and BMD were independent and complementary. In this cross-sectional unicenter case-control population study in postmenopausal women, 107 fracture cases were enrolled and age-matched with 197 control cases. This population comprised 40 vertebral fractures (with 70 controls), 30 hip fractures (55 controls), and 37 wrist fractures (62 controls). Hip and lumbar spine BMD were measured by double-energy X-ray absorptiometry. Fractal analysis of texture was performed on calcaneus radiographs and the result was expressed as the H parameter (H = 2-fractal dimension). The H parameter showed a lower value (0.679 +/- 0.053 SD) in fracture cases versus control cases (0.696 +/- 0.030; p = 0.007), the statistical significance persisting after adjustment for age and for lumbar spine (LS) or hip BMD. This result was confirmed in vertebral fractures (p = 0.0001) and hip fractures (p = 0.003) but not wrist fractures (p = 0.07). We determined the threshold between high and low H values and then the odds ratios (OR) of fracture for low H for BMD < or = -2.5 SD in T score and for the combinations of both parameters. The OR of fracture for low H was 1.6 (95% CI, 1.1-2.6). For LS BMD < or = -2.5 SD the OR of 6.1 (3.4-10.8) shifted to 9.0 (4.0-20.4) when we added low H and for hip BMD it shifted from 5.6 (3.3-9.4) to 8.1 (4.0-16.8). In vertebral, hip, and wrist fracture cases the results were also significant. These data have shown that the fractal analysis of texture on calcaneus radiographs can distinguish osteoporotic fracture groups from control groups. This analysis and BMD provide independent and complementary information. These data suggest that we can improve the fracture risk evaluation by adding information related to microarchitecture, derived from analysis of conventional radiographic images.

Absorptiometry, Photon↗

A new method for three-dimensional skeleton graph analysis of porous media: application to trabecular bone microarchitecture.

This paper introduces a new three-dimensional analysis of complex disordered porous media. Skeleton graph analysis is described and applied to trabecular bone images obtained by high resolution magnetic resonance imaging. This technique was developed bearing in mind topological considerations. The correspondence between vertices and branches of the skeleton graph and trabeculae is used in order to get local information on trabecular bone microarchitecture. In addition to real topological parameters, local structural information about trabeculae, such as length and volume distributions, are obtained. This method is applied to two sets of samples: six osteoporosis and six osteoarthritis bone samples. We demonstrate that skeleton graph analysis is a powerful technique to describe trabecular bone microarchitecture.

Femur Head↗

Fractal dimension of trabecular bone projection texture is related to three-dimensional microarchitecture.

The purpose of this work was to understand how fractal dimension of two-dimensional (2D) trabecular bone projection images could be related to three-dimensional (3D) trabecular bone properties such as porosity or connectivity. Two alteration processes were applied to trabecular bone images obtained by magnetic resonance imaging: a trabeculae dilation process and a trabeculae removal process. The trabeculae dilation process was applied from the 3D skeleton graph to the 3D initial structure with constant connectivity. The trabeculae removal process was applied from the initial structure to an altered structure having 99% of porosity, in which both porosity and connectivity were modified during this second process. Gray-level projection images of each of the altered structures were simply obtained by summation of voxels, and fractal dimension (Df) was calculated. Porosity (phi) and connectivity per unit volume (Cv) were calculated from the 3D structure. Significant relationships were found between Df, phi, and Cv. Df values increased when porosity increased (dilation and removal processes) and when connectivity decreased (only removal process). These variations were in accordance with all previous clinical studies, suggesting that fractal evaluation of trabecular bone projection has real meaning in terms of porosity and connectivity of the 3D architecture. Furthermore, there was a statistically significant linear dependence between Df and Cv when phi remained constant. Porosity is directly related to bone mineral density and fractal dimension can be easily evaluated in clinical routine. These two parameters could be associated to evaluate the connectivity of the structure.

Femur Head↗

Long-term corticosteroid therapy induces mild changes in trabecular bone texture.

The relative roles of bone mineral density (BMD) decrease and of microarchitectural changes in corticosteroid-induced osteoporosis (CIOP) are debated. Our objective has been to evaluate both bone microarchitecture (by a fractal analysis of texture on radiographs) and BMD in corticosteroid (CS)-treated patients. In this study, 60 patients from a rheumatology unit with a mean age of 60.6+/-14.8 years taking CS therapy for more than 6 months and a cumulative dose of prednisone over 1 g and 57 controls among age-matched patients and hospital staff were recruited. Bone diseases and bone-modifying drugs (except calcium, vitamin D, and hormonal replacement therapy [HRT]) were considered as exclusion criteria. A fractal analysis of trabecular bone texture was performed on calcaneus radiographs after an oriented analysis in 18 directions. The fractal analysis was based on the fractional Brownian motion model. Results were expressed by H parameter (H = 2 - fractal dimension) in each direction, Hmean being the average of 18 directions, Hmini the minimum, and Hmaxi the maximum. BMD was measured by double-energy X-ray absorptiometry (DEXA) at the femoral neck (FN) and lumbar spine (LS). The odds ratios (OR) were calculated for a variation of 1 SD. The mean duration and dose of CS therapy was 5.6+/-6.6 years and 16.9+/-19.7 g. CS therapy was significantly correlated to a decrease in FN or LSBMD: OR = 1.95, 95% confidence interval (CI, 1.29-2.97) and OR = 3.19 (CI, 1.80-5.66), respectively. The Hmean and Hmaxi were significantly lower in the cases than in the controls: P = 0.03 and P = 0.02; OR = 1.67 (CI, 1.10-2.54) and OR = 1.75 (CI, 1.05-2.37). A similar trend was observed with Hmini but the difference did not reach the level of statistical significance: P = 0.06, OR = 1.57 (CI, 1.05-2.37). This study was repeated among cases and controls who had never taken HRT (respectively, n = 40 and n = 39). The results were similar. Among patients taking CS therapy, the presence of nontraumatic fractures was inversely related to BMD values but not to texture parameters. These data have shown that long-term CS therapy induces both BMD decrease and trabecular bone texture changes. The effect of CS therapy was much stronger on BMD than on the fractal H parameter. These results are in accordance with previous studies showing a lower effect of CS therapy on bone microarchitecture than on bone mass. These results can be contrasted with those observed in women with postmenopausal osteoporosis and vertebral crush fractures in which the variations in the fractal parameters are more significant than the BMD variations.

Adrenal Cortex Hormones↗

Glucocorticoid-induced osteoporosis: is the bone density decrease the only explanation?

BACKGROUND: Glucocorticoids may increase bone fragility via mechanisms independent from their bone mass reducing effect. OBJECTIVE: To study relationships between osteoporotic fractures and bone mineral density in patients on long-term glucocorticoid therapy. PATIENTS AND METHODS: We studied 121 women with a mean age of 60.4 +/- 14.3 years on long-term glucocorticoid therapy (cumulative dose > or = 1 g of prednisone equivalent, duration > or = 6 months) for rheumatoid arthritis (n = 38), polymyalgia rheumatica or giant cell arteritis (n = 26), connective tissue disease (n = 15), asthma (n = 14), another inflammatory joint disease (n = 14), or another condition (n = 14). The control group was composed of 125 subjects who had the same mean age and met the same exclusion criteria as the case group. Bone mineral density was measured at the lumbar spine and femoral neck using a Hologic QDR 4500 unit. In subjects with back pain, radiographs of the thoracic and lumbar spine were obtained to look for fractures. RESULTS: The odds ratio for a bone mineral density decrease of one standard deviation at the femoral neck was 1.68 (1.20-2.35) in patients with a cumulative glucocorticoid dose of 10 g of prednisone equivalent and 1.67 (1.22-2.29) in those with a glucocorticoid therapy duration of 2 years. Sixty-eight fractures were recorded in 56 patients (46% of the overall patient group). Even after adjustment on age, glucocorticoid therapy duration, and dose, mean bone mineral density values at the lumbar spine and femoral neck were significantly lower in the subgroup of patients with fractures than in the subgroup without fractures. Sensitivity and specificity of bone mineral density at the femoral neck and/or lumbar spine for the diagnosis of vertebral fracture and/or peripheral fracture were 73% and 51%, respectively. In the stepwise logistic regression model, factors explaining the presence of fractures were as follows, in hierarchical order: age; absence of calcium/vitamin D supplementation, femoral neck T-score, and glucocorticoid dose. CONCLUSION: Our data are compelling evidence that bone mineral density is a major determinant of the fracture risk in patients with glucocorticoid-induced osteoporosis.

Bone Density↗

Skull bone mass deficit in prepubertal highly-trained gymnast girls.

It is known that impact loading sport can increase the bone mineral density in the stressed sites of the skeleton in athletes. However, non weight-bearing sites are seldom studied in healthy young girl athletes. In order to study the effects of a long term intensive training on the non-stressed region of the skeleton (skull), we investigated both highly-trained girl athletes, involved in sports requiring or not significant impact loading on the skeleton and a girl control group. Bone mineral content (BMC) and density (BMD) were measured in the whole body, at lumbar spine, femoral neck, trochanter, Ward's triangle, radius, head and ribs, in 60 prepubertal girls including 12 swimmers, 32 gymnasts and 16 controls. Measurements were made by DXA. There were no statistical differences between the groups as regards age, height, body weight, body mass index, lean tissue mass and dietary calcium intake. Mean BMD in gymnasts was statistically higher than in other groups for radius (p < 0.001), femoral neck (p < 0.05) and Ward's triangle (p < 0.05) while there was no difference between swimmers and controls. Head BMC was significantly lower in gymnasts compared to other groups (241.9+/-41 g vs. 285.8+/-34.7 g and 291.1+/-50.2 g respectively in swimmers and controls, p < 0.001). The same observation was made for head BMD (p < 0.01). When body weight was used as a covariant, the contribution of the head BMC to the whole body was significantly lower (p < 0.001) in gymnasts (24.97%) than in swimmers (27.88%) and controls (27.77%). When compared between groups, the slopes of the regressions for head/whole body BMC or BMD were significantly lower in gymnasts (p < 0.05) than in other groups. These data suggest that in prepubertal children the increased bone density induced by gymnastic training in the stressed sites of the body could be related to a decreased skull bone mass.

Bone Density↗

Bone material acquisition and somatic development in highly trained girl gymnasts.

The present study was conducted to investigate both skeletal and somatic developments in a group of highly trained prepubertal girl gymnasts at the beginning of their peak bone mass acquisition. The experimental group included 14 gymnasts who had trained 12-15 h per wk for 3 y before starting the study. The control group consisted of 15 non-exerciser children and 6 swimmers training for 5-6 h/wk. Body composition and bone mineral density (BMD) of the total body, lumbar spine, non-dominant hip and radius were measured using dual-energy X-ray absorptiometry. Calculation of bone age and measurement of body height and weight were done. All measurements and analyses were carried out twice with a 1-y interval by the same technician. There were no differences between groups in age, bone age, body height and weight and lean tissue mass at the start of the study and 1 y later. The somatic changes observed between the first and second years tended to be greater in gymnasts compared to controls, except for body height. At the first and second investigations, BMD values in the gymnasts were statistically higher than in the controls at all skeletal sites, but not for the whole body (from p < 0.05 to p < 0.001, depending on the site). Percentage changes in BMD pre-investigation compared with post-investigation tended to be greater in gymnasts. Variations in lean mass, bone age and fat mass were found to be the best independent predictors of annual changes in BMD for total body, lumbar spine, trochanter and femoral neck sites. These results suggested that high-volume impact loading training could promote a higher annual gain in bone mineral acquisition at the strained body sites in prepubertal girls without affecting somatic growth dimensions.

Body Height↗

Long-term reproducibility optimization of an x-ray process for bone architectural evaluation during osteoporosis.

Non-invasive and in vivo assessment of bone architectural changes at high resolution is of considerable interest in osteoporosis. In this note, the use of an x-ray acquisition system in the evaluation of the architectural quality of trabecular bone by radiographic texture analysis is optimized to achieve good long-term reproducibility. First, radiographic and digitization processes are modelled and defined. Procedures to make radiographs and their digital images are fixed. Then, measurements of the modulation transfer function (MTF) of the entire acquisition chain were completed. These measurements provide an MTF in excess of 30% at a spatial frequency of 2.5 lp/mm. Also, results of a fractal texture analysis made on digital images of calcaneus radiographs show a mean coefficient of variation of 2.07%. These data show that good long-term reproducibility can make the x-ray acquisition system efficient for patient follow-up, or evaluation of treatment regimes for osteoporosis. Finally, it is shown that fractal texture parameters are statistically different in an osteoporotic population and in a control group. Therefore, this system should also be of medical interest.

Bone and Bones↗