Email this article Outpatient dual-energy x-ray osteodensitometry in diagnosis of early disorders of mineral bone density and monitoring of postmenopausal osteoporosis treatment
- Authors: Rubin MP1, Rubin MP1
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Affiliations:
- Issue: Vol 81, No 1 (2009)
- Pages: 29-35
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/33366
- ID: 33366
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Abstract
Aim. To improve quality of densitometric diagnosis of abnormal bone tissue mineral density (BTMD) in postmenopausal women using the results of densitometry of two adjacent lumbar vertebra and proximal regions of both femoral bones.
Material and methods. Densitometry (dual-energy x-ray absorptiometry) was made on densitometer Lunar Prodigy in 7731 women: 969 under 50 years of age, 3081 - aged 50-65 years (early postmenopause) and 3681 - aged 65 years and older. BTMD data were analysed with the system MEDIALOG.
Results. In postmenopause metabolic disorders of bone tissue are detectable with a standard analysis of the results of dual x-ray osteodensitometry in about 2/3 (72.14%) patients (at the stage of osteopeny in 33.13% and osteoporosis - in 39.01%). Diagnostic efficiency in consideration of the T-criterion in the adjacent lumbar vertebra in comparison to the integral value LI-LIV rises in 50-65 year old women in osteoporosis by 7.27% and in osteopeny - by 8.31%; in women over 65 years of age by 10.11 and 3.62%, respectively. Diagnostic value rises in comparison of the results of bilateral examination of the femoral bones with the results of unilateral (left-sided) investigation in women over 50-65 years in osteoporosis by 1.46%, osteopenia - by 1.10%, in women over 65 years - by 3.51 and 2.26%, respectively. Densitometric picture is not permanent, osteoporosis runs in 2 stages.
Conclusion. For early diagnosis of postmenopausal osteoporosis most informative is the analysis of BTMD by three areas: lumbar spine LI-LIV, adjacent vertebra LI-LII, LII-LIII, LIII-LIV and necks of both femoral bones.
Material and methods. Densitometry (dual-energy x-ray absorptiometry) was made on densitometer Lunar Prodigy in 7731 women: 969 under 50 years of age, 3081 - aged 50-65 years (early postmenopause) and 3681 - aged 65 years and older. BTMD data were analysed with the system MEDIALOG.
Results. In postmenopause metabolic disorders of bone tissue are detectable with a standard analysis of the results of dual x-ray osteodensitometry in about 2/3 (72.14%) patients (at the stage of osteopeny in 33.13% and osteoporosis - in 39.01%). Diagnostic efficiency in consideration of the T-criterion in the adjacent lumbar vertebra in comparison to the integral value LI-LIV rises in 50-65 year old women in osteoporosis by 7.27% and in osteopeny - by 8.31%; in women over 65 years of age by 10.11 and 3.62%, respectively. Diagnostic value rises in comparison of the results of bilateral examination of the femoral bones with the results of unilateral (left-sided) investigation in women over 50-65 years in osteoporosis by 1.46%, osteopenia - by 1.10%, in women over 65 years - by 3.51 and 2.26%, respectively. Densitometric picture is not permanent, osteoporosis runs in 2 stages.
Conclusion. For early diagnosis of postmenopausal osteoporosis most informative is the analysis of BTMD by three areas: lumbar spine LI-LIV, adjacent vertebra LI-LII, LII-LIII, LIII-LIV and necks of both femoral bones.
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References
- Ringe J. В кн.: Европейское совещание по роли витамина D в лечении остеопороза. Метафорум 10-11 окт. 2005 г. Дублин; 2007. 1-8.
- Лепарский Е. А. Ранняя диагностика - реальный путь профилактики остеопороза. Качество жизни. Медицина 2006; 5 (16): 58-62.
- Родионова С. С., Рожинская Л. Я. Остеопороз. Патогенез, диагностика и лечение. М.: MSD; 1997.
- Рожинская Л. Я. Системный остеопороз. М.: Издатель Мокеев; 2000.
- Воложин А. И., Оганов В. С. (ред.). Остеопороз. М.: Практ. медицина; 2005.
- Беневоленской Л. И., Лесняк О. М. (ред.). Клинические рекомендации. Остеопороз. Диагностика, профилактика и лечение. М.: Геотар-Медиа; 2005.
- Рубин М. П., Чечурин Р. Е., Зубова О. М. Остеопороз: диагностика, современные подходы к лечению, профилактике. Тер. арх. 2002; 1: 32-37.
- Дамбахер М. А., Шахт Е. Остеопороз и активные метаболиты витамина Д.: Пер. с англ., 1996.
- Оценка риска переломов и ее применение для скрининга постменопаузального остеопороза: Доклад Рабочей группы ВОЗ. Всемирная организация здравоохранения, Женева 1994. М.: Медицина; 1994.
- Sydney Lou Bonnick. Bone densitometry in clinical practice. Humana Press; 2004.
- Скрипникова И. А., Рахманов А. С. Спорные вопросы остеоденситометрии. Остеопороз и остеопатии 2006; 1: 31-33.
- Chen P., Miller P., Binkley N. et al. Use of lowest individual lumbar spine BMD T-score for diagnosis of osteoporosis and for prediction of prevalent and incident vertebral fractures. J. Clin. Densitometry 2007; 10 (2): 201-201.
- Петак С. М. Денситометрия: интерпретация результатов исследования. Методические указания Международного общества клинической денситометрии. Остеопороз и остеопатии 2004; 2: 11-13.
- ISCD Position Development Conference, 2005. J. Clin. Densitometry 2006; 9 (1): 4-4쏃.
- Смирнов А. В. Денситометрия костной ткани. В кн.: Беневоленская Л. И. (ред.). Руководство по остеопорозу. М.: Бином. Лаборатория знаний; 2003. 132-151.
- Лесняк О. М. Постменопаузальный остеопороз. Качество жизни. Медицина 2006; 5 (16): 14-24.
- Беневоленская Л. И., Никитинская О. А. Остеопороз на рубеже XXI века. Качество жизни. Медицина 2006; 5 (16): 10-13.
- Денисов-Никольский Ю. И., Докторов А. А., Матвейчук И. В. Структура и функция костной ткани в норме. В кн.: Беневоленская Л. И. (ред.). Руководство по остеопорозу. М.: Бином. Лаборатория знаний; 2003. 56-76.
- Avioli L. V. Senile and postmenopausal osteoporosis. Adv. Intern. Med. 1976; 21: 391-415.
- Михайлов Е. Е., Беневоленской Л. И. Эпидемиология остеопороза и переломов. В кн.: Беневоленская Л. И. (ред.). Руководство по остеопорозу. М.: Бином. Лаборатория знаний; 2003. 10-51.
- Беневоленской Л. И., Насонов Е. Л. Патогенез остеопороза. В кн.: Беневоленская Л. И. (ред.). Руководство по остеопорозу. М.: Бином. Лаборатория знаний; 2003. 77-104.
- The Writing Group for the ISCD Position Development Conference 2004. Executive Summary International Society for Clinical Densitomatry Position Development Conference, Cincinnai, Ohio, July 25, 2003. J. Clin. Densitometry 2004; 7: 7-12
- The Writing Group for the ISCD Position Development Conference 2004. International Society for Clinical Densitometry Position Development Conference. Introduction, methods, and participants. J. Clin. Densitometry 2004; 7: 13-16
- The Writing Group for the ISCD Position Development Conference 2004. International Society for Clinical Densitometry Position Development Conference. Diagnosis of osteoporosis in men, premenopausal women, and children. J. Clin. Densitometry 2004; 7: 17-26
- The Writing Group for the ISCD Position Development Conference 2004. International Society for Clinical Densitometry Position Development. Conference technical standardization for dual-energy X-ray absorptiomentry. J. Clin. Densitometry 2004; 7: 27-36
- International Society for Clinical Densitometry. 13th Annual Meeting pediatrics to geriatrics. Florida, USA, March 14-17, 2007. Florida; 2007
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