| 1. |
- Lekamwasam, Sarath, et al.
(författare)
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Age-related trends in hip geometry in Sri Lankan women: a cross-sectional study
- 2007
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Ingår i: Journal of Bone and Mineral Metabolism. - : Springer Science and Business Media LLC. - 0914-8779 .- 1435-5604. ; 25:6, s. 431-435
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Tidskriftsartikel (refereegranskat)abstract
- Indices of hip geometry are known to be predictive of hip fractures while sex and ethnic differences in hip geometry have been previously demonstrated. Age-related trends in hip geometry among Asians, however, have not been studied sufficiently. A total of 280 healthy, perimenopausal women, aged between 32 and 97 years, were selected from the Community Study Area of the Faculty of Medicine, Galle, Sri Lanka. Hip DXA images were analyzed further to calculate the hip axis length, neck-shaft angle, and femoral neck width at the narrowest point of the femoral neck. Standard formulae were used to calculate cross-sectional area, cross-sectional moment of inertia, and section modulus in the femoral neck region. Mean (SD) age, weight, height, femoral neck bone mineral density (BMD), hip axis length, neck-shaft angle, neck width, cross-sectional area, and cross-sectional moment of inertia of the study sample were 56.8 (13.0) years, 47.8 (10.1) kg, 1.48 (0.06) m, 0.704 (0.147) g/cm(2), 90.6 (5.6) mm, 123.2 (5.7) degrees, 2.99 (0.24) cm, 2.00 (0.42) cm(2), and 1.62 (0.47) cm(4), respectively. Height and weight of subjects had positive correlations with most of the indices of hip geometry. Femoral neck BMD, cross-sectional area and section modulus showed a rapid reduction during the postmenopausal period. With advancing age, there was a marginal but statistically nonsignificant expansion of the neck width, increase in the hip axis length, and narrowing of the neck-shaft angle. In conclusion, this study demonstrated a gradual loss of BMD in postmenopausal age, accompanied by thinning of the cortical shell and deterioration of the resistance to bending in the femoral neck of this group of healthy women. The clinical relevance of the marginal changes seen in other indices such as neck-shaft angle, hip axis length, and neck width is not known.
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| 2. |
- Lekamwasam, Sarath, et al.
(författare)
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Effect of hip flexion on the measurement of spinal bone mineral density in the Norland Eclipse XR
- 2005
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Ingår i: Journal of Clinical Densitometry. - 1094-6950. ; 8:2, s. 183-186
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Tidskriftsartikel (refereegranskat)abstract
- It is recommended that the hip joints be flexed to 90 degrees during dual-energy X-ray absorptiometry scanning of the lumbar spine in the anteroposterior projection; however, some patients are unable to maintain this position because of the presence of degenerative changes in lower limb joints. This study examines the effect of a lesser degree of hip flexion on the lumbar spine bone mineral density (BMD) measurement and its interpretation. Fifty women were scanned on the Norland Eclipse XR, initially in the standard position with the hips flexed to 90 degrees and then in the adjusted position after allowing for some degree of hip extension to keep them comfortable (hip flexion of 60 degrees -70 degrees ).Higher bone mineral content (BMC), surface area, and BMD values were seen in the standard position compared to the adjusted position, but none of the differences was statistically significant. There were strong correlations for BMC,surface area, and BMD measured in the two positions. In the standard position, 26 women were found to have osteoporosis and 18 had osteopenia. In the adjusted position, osteoporosis was noted in 27 women, and 18 had osteopenia.Four women showed a reduction, whereas 12 women showed an increase in BMD in excess of the least significant change at the 95% confidence level, defined as 2.77 times the precision error (0.008 g/cm(2) x 2.77 = 0.120 g/cm(2)). Our study demonstrates that a lesser degree of hip flexion in women who find it difficult to maintain the recommended 90 degrees hip flexion during the lumbar spine BMD measurement would not affect the patient classification based on T-scores recommended by the World Health Organization; however, variation in hip flexion can be a major confounding factor when interpreting a change in BMD over time.
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| 3. |
- Lekamwasam, Sarath, et al.
(författare)
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Tooth loss and bone mineral density among women: a cross-sectional survey
- 2006
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Ingår i: The Ceylon medical journal. - 0009-0875. ; 51:3, s. 102-105
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We examined the association between total tooth loss and bone mineral density to determine whether the former can be used as a surrogate marker of the latter. DESIGN: A community based cross-sectional survey. SETTING: The community-study area of the Faculty of Medicine, Galle. PARTICIPANTS: A group of randomly selected 327 women volunteers aged 32 to 97 years. MEASUREMENTS: Anthropometry, total number of teeth lost and bone mineral density (BMD) of the lumbar spine and proximal femur. RESULTS: In categorical analysis, after adjusting for possible confounding factors, mean BMDs of the spine and proximal femur showed no significant differences in the thirds of the total tooth loss. In regression analysis, a loss of one tooth was negatively associated with spine BMD of premenopausal women by 0.003 g/cm2 and the trochanteric BMD of postmenopausal and all women by 0.001 g/cm2. These associations, however, were not seen in other skeletal sites. CONCLUSIONS: Total tooth loss did not show a uniform and significant association with bone mineral density, measured at relevant skeletal sites. Total tooth loss as a surrogate marker of low bone density cannot be justified in this population of women.
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| 4. |
- Lenora, Janaka, et al.
(författare)
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Effects of multiparity and prolonged breast-feeding on maternal bone mineral density : a community-based cross-sectional study
- 2009
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 9, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies conducted in Western countries have shown that bone loss associated with pregnancy and breast-feeding is recovered after weaning. However, it is not clear whether recovery takes place after repeated pregnancies followed by prolonged periods of breast-feeding; especially in developing countries where nutritional intake is comparatively low.This study was designed to examine the effects of multiparity and prolonged breast-feeding on maternal bone mineral density (BMD) in a community-based sample of 210 Sri Lankan women, aged between 46 and 98 years.Methods: BMD of the lumbar spine (L 2-L 4) and femoral neck were measured by dual-energy X-ray absorptiometry. Reproductive history was recorded by using a questionnaire. Women were, first, divided into groups according to parity (nulliparous, 1-2, 3-4, and 5 or more children), and BMDs in different groups were compared, initially unadjusted and then adjusted for age. Same subjects were subdivided, again, according to the total duration of breast-feeding (0, 1-48, 49-96, and 97 months or more) and similar analysis was carried out.Results: Women who had 5 or more children and women who had breast-fed for 97 months or more were older than the other women (p < 0.01) but no differences in height, weight or BMI were observed among the groups. Age adjusted BMD at lumbar spine and femoral neck BMDs of women grouped according to parity were not significantly different. Neither was there any difference between lumbar spine or femoral neck BMD in groups based on duration of breast-feeding.Conclusion: From this population-based study conducted in a developing country, we infer that history of multiparity or prolonged breast-feeding has no detrimental effects on maternal BMD in post-menopausal age.
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