• Clinical Nutrition Research
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• v.12 no.4
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• pp.245-256
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• 2023

A randomized, double-blind, placebo-controlled trial was conducted to confirm whether collagen peptide supplementation for 12 week has a beneficial effect on body fat control in older adults at a daily physical activity level. Participants were assigned to either the collagen group (15 g/day of collagen peptide) or the placebo group (placebo drink). Body composition was measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA). In total, 74 participants (collagen group, n = 37; placebo group, n = 37) were included in the final analysis. The collagen group showed a significant reduction in total body fat mass compared with the placebo group, as evidenced by both BIA (p = 0.021) and DEXA (p = 0.041) measurements. Body fat mass and percent body fat of the whole body and trunk reduced at 12 weeks compared with baseline only in the collagen group (whole body: body fat mass, p = 0.002; percent body fat, p = 0.002; trunk: body fat mass, p = 0.001; percent body fat, p = 0.000). Total fat mass change (%) (collagen group, -0.49 ± 3.39; placebo group, 2.23 ± 4.20) showed a significant difference between the two groups (p = 0.041). Physical activity, dietary intake, and biochemical parameters showed no significant difference between the groups. The results confirmed that collagen peptide supplementation had a beneficial effect on body fat reduction in older adults aged ≥ 50 years with daily physical activity level. Thus, collagen peptide supplementation has a positive effect on age-related changes.

• The Korean journal of internal medicine
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• v.39 no.1
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• pp.148-159
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• 2024

Background/Aims: We evaluated the efficacy and safety of denosumab treatment in severe chronic kidney disease (CKD) patients with osteoporosis. We also investigated whether the treatment affects the coronary artery calcifications. Methods: Twenty-seven postmenopausal women with Stage 3b-4 CKD and osteoporosis were enrolled. Twenty patients received denosumab plus calcium carbonate and vitamin D, and seven controls received calcium carbonate and vitamin D for 1 year. Dual-energy X-ray absorptiometry and coronary artery calcium (CAC) scoring computed tomography were performed before and after treatment. Hypocalcemic symptoms and serum calcium levels were evaluated. Results: After 1 year of treatment, the percent changes of femur neck (3.6 ± 3.2% vs. -0.7 ± 4.4%, p = 0.033) and total hip (3.4 ± 3.8% vs. -1.9 ± 2.1%, p = 0.001) bone mineral density (BMD) were significantly increased in the denosumab treated group compared to the control group. However, the percent change of lumbar spine BMD did not differ between two groups (5.6 ± 5.9% vs. 2.7 ± 3.9%, p = 0.273). The percent change of bone alkaline phosphatase was significantly different in the denosumab-treated group and control group (-31.1 ± 30.0% vs. 0.5 ± 32.0%, p = 0.027). CAC scores did not differ between groups. No hypocalcemic events occurred in both groups. Conclusions: If carefully monitored and supplemented with calcium and vitamin D, denosumab treatment for 1 year provides significant benefits in patients with Stage 3b-4 CKD and osteoporosis. However, denosumab treatment did not affect coronary artery calcifications in these patients.

• Investigative Magnetic Resonance Imaging
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• v.16 no.1
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• pp.16-24
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• 2012

Purpose : The purpose of this study was to determine whether there is a significant correlation between vertebral marrow fat fraction measured using Dixon quantitative chemical shift MRI (QCSI) and BMD on dual-energy X-ray absorptiometry (DXA). Materials and Methods: This retrospective study included 68 healthy individuals [mean age, 50.7 years; range, 25-76; male/female (M/F) = 36/32] who underwent DXA of the L-spine and whole body MRI including QCSI of the L-spine and chemical shift MRI of the liver. The enrolled individuals were divided into subgroups according to sex and T-score [i.e., normal bone density (M/F=27/23) and osteopenia (M/F=9/9)]. Vertebral marrow (Dixon QCSI, TR/TE 10.2/4.8 ms) and hepatic fat fractions (chemical shift technique, TR/TE 110/4.9 and 2.2 ms) were calculated on MRI. We evaluated whether there were significant differences in age, body mass index (BMI), vertebral marrow fat fraction, or hepatic fat fraction among the subgroups. Whether or not the participant had reached menopause was also evaluated in females. The correlations among variables (i.e., age, BMI, vertebral marrow and hepatic fat fractions, BMD) were evaluated using Spearman's correlation method. Results: There were no significant differences in age, BMI, or vertebral marrow and hepatic fat fractions between the two male subgroups (normal bone density vs. osteopenia). In female subjects, mean age in the osteopenic subgroup was greater than that in the normal subgroup (p=0.01). Presence of menopause was more common in the osteopenic subgroup [77.8% (7/9)] than the normal subgroup [26.1% (6/23), p<0.05]. The other variables showed no significant difference between female subgroups. The only significant correlation with marrow fat fraction after partial correlation analysis was that with age in the female subjects (r=0.43, p<0.05). Conclusion: The vertebral marrow fat fraction calculated using the Dixon QCSI does not precisely reflect the mild decrease in BMD for either sex.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.72-78
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• 2009

Purpose: Bone mineral density (BMD) measurements need to be precise enough to be capable of detecting small changes in bone mass of rats. Using a regular dual-energy X-ray absorptiometry (DXA), we measured many BMD of various skeletal sites in rats to examine precision of DXA in relation to the repositioning on the bones of rats. Materials and Methods: Using DXA and small animal software, scans were performed 4 times in all 12 male rats without repositioning (Group 1a). Another four scans for 6 of 12 rats were done with repositioning between scans (Group 2). Customized regions of interest (ROIs), encapsulate the right hind limb, L1-4, skull and pelvic bones were drawn at each measurement. The precision of the measurements was evaluated by measuring the coefficient of variation (CV) of four measurements of BMD at each skeletal site of all rats with or without repositioning. Significance of differences between group 1b (six rats out of group 1a, which were come under group 2) and group2 were evaluated with Wilcoxon Signed Rank Sum Test. Results: CVs obtained at different skeletal sites of all measurements in Group 1b and 2. It was $3.51{\pm}1.20$, $ 2.62{\pm}1.20$ for the hindlimb (p=0.173), $3.83{\pm}2.02$, $4.59{\pm}2.02$ for L1-4 (p=0.600), $3.73{\pm}1.87$, $1.53{\pm}0.89$ for skull (p=0.046), and $2.92{\pm}0.60$, $1.45{\pm}0.60$ for pelvic bones (p=0.075). Conclusion: Our study demonstrates that the DXA technique has the precision necessary when used to assess BMD for various skeletal sites in rats regardless of repositioning.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.361-370
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• 2009

The image quality management of bone mineral density is the responsibility and duty of radiologists who carry out examinations. However, inaccurate conclusions due to lack of understanding and ignorance regarding the methodology of image quality management can be a fatal error to the patient. Therefore, objective of this paper is to understand proper image quality management and enumerate methods for examiners and patients, thereby ensuring the reliability of bone mineral density exams. The accuracy and precision of bone mineral density measurements must be at the highest level so that actual biological changes can be detected with even slight changes in bone mineral density. Accuracy and precision should be continuously preserved for image quality of machines. Those factors will contribute to ensure the reliability in bone mineral density exams. Proper equipment management or control methods are set with correcting equipment each morning and after image quality management, a phantom, recommended from the manufacturer, is used for ten to twenty-five measurements in search of a mean value with a permissible range of ${\pm}1.5%$ set as standard. There needs to be daily measurement inspections on the phantom or at least inspections three times a week in order to confirm the existence or nonexistence of changes in values in actual bone mineral density. in addition, bone mineral density measurements were evaluated and recorded following the rules of Shewhart control chart. This type of management has to be conducted for the installation and movement of equipment. For the management methods of inspectors, evaluation of the measurement precision was conducted by testing the reproducibility of the exact same figures without any real biological changes occurring during reinspection. Bone mineral density inspection was applied as the measurement method for patients either taking two measurements thirty times or three measurements fifteen times. An important point when taking measurements was after a measurement whether it was the second or third examination, it was required to descend from the table and then reascend. With a 95% confidence level, the precision error produced from the measurement bone mineral figures came to 2.77 times the minimum of the biological bone mineral density change. The value produced can be stated as the least significant change (LSC) and in the case the value is greater, it can be stated as a section of genuine biological change. From the initial inspection to equipment moving and shifter, management must be carried out and continued in order to achieve the effects. The enforcement of proper quality control of radiologists performing bone mineral density inspections which brings about the durability extensions of equipment and accurate results of calculations will help the assurance of reliable inspections.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.229-236
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• 2006

Purpose: This study was conducted to search for the type of technical error in DEXA(dual-energy X-ray absorptiometry) and the effect of error to measurement of BMD. Materials and Methods: The changes of BMD($g/cm^2$, T-score) by patients information(Age, Weight, Height, Manopause age) input error and Confirming ROI error were investigated. Using spine phantom, we canned 10 times by age(5, 10), weight(10, 20 kg), height(5, 10 cm), manopause age(5, 10) increase & decrease respectively. Scanning region(L-spine, femur, Forearm) of 10 patients was calculated by changing ROI respectively. Analysis of difference for mean(precision 1%) were carried out. Results: The error of patient information(Age, Weight, Height, Manopause age) was not changed differently. In confirming ROI, the BMD and T-score of L-spine involving T-12 was decreased to $0.063\;g/cm^2$, 0.3 and involving L-5 increased to $0.077\;g/cm^2$, 0.5. In narrowing 1 cm of vertical line of ROI, the BMD and T-score decreased to $0.006\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.15, each. In hip ROI, Upper and left shift(0.5 cm) of line was not influenced BMD and T-score. In 0.5 cm lower shift(lesser trochanter below), the BMD and T-score increased $0.031\;g/cm^2$, 0.3 and in 1 cm $0.094\;g/cm^2$, 0.65, each. In forearm ROI, the BMD and T-score decreased $0.042\;g/cm^2$, 0.9 involving 1 cm lower wrist. And expanding 1 cm of vertical line, the BMD and T-score decreased $0.008\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.3, each. The L-spine, hip, forearm ROI error was changed differently. Conclusion: There are so many kinds of technical error in BMD processing. Errors according to age, weight, height, manopause age did not influent to $BMD(g/cm^2)$ and T-score. There are mean differences BMD and T-score in confirming ROI. For the precision exam, in L-spine processing, L1-4 have to confirmed without shift of ROI vertical line. In hip processing, the ROI have to included greater trochanter, femur head and lesser trochanter. In forearm processing, the ROI have to included wrist, radius and ulnar.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.271-276
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• 2009

The aim of this study was to evaluate the effect of Bone Mineral Density(BMD) at mandible. So, we studied how to measure the BMD at mandible using DEXA(Dual energy X-ray absorptiometry, DEXA) by Horner er al (1996) and knew reproducibility of the measurements. Thirty-five patients (13 men, 22 women, mean age : 25.4 years) were examined using the GE Lunar Prodigy Advance(LUNAR Corporation, madison, USA). They were examined in Semiprone position of their body and true lateral position of their mandible selected the Lumbar lateral mode. We used the custom mode in analysis when ROI (area $30{\times}2.5\;mm^2$). Three ROIs ($30{\times}2.5\;mm^2$, $50{\times}2.5\;mm^2$, $20{\times}2.5\;mm^2$) were located each at the two different sites of the mandible (angle of mandible and mental symphysis) and BMD was measured. Differences in BMD measurement was statistically compared according to the size and location of ROI. BMD was $1.320{\pm}0.358g/cm^3$ in men and was $1.152{\pm}0.340g/cm^3$ in women. BMD at the angle of mandible was $1.201{\pm}0.361g/cm^3$ in men and was $1.025{\pm}0.377g/cm^3$ in women. BMD of men at the mental symphysis was $1.434{\pm}0.341g/cm^3$ and that of women was $1.19{\pm}0.358g/cm^3$. With the ROI of $20{\times}2.5\;mm^2$, BMD was $1.262{\pm}0.384g/cm^3$ in men and was $1.113{\pm}0.357g/cm^3$ in women. With the ROI of $50{\times}2.5\;mm^2$, BMD of men was $1.320{\pm}0.358g/cm^3$ and that of women was $1.129{\pm}0.340g/cm^3$. There was a statistically significant difference of BMD according to the size and location of ROI. When measuring mandible BMD, there are good for increasing ROI and locate between ramus and mental symphysis. Especially following exam, refer to same size and location with fore exam. According to study which measure mandible BMD, It's correct to measure better a portion of mandible then whole of BMD. Using DEXA protocol is studied good for the additional study to compare the BMD at mandible. Later date, It will be good for measurement value in implant and bone graft quantitatively. Using DEXA method gain BMD threshold value in korean.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.187-201
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• 2024

Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.427-440
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• 2023

Purpose This study aimed to investigate the correlation between the fat signal fraction (FF) of the fat-dominant bone tissue of the knee joint, measured using the MRI Dixon method (DIXON) technique, and bone mineral density (BMD). Materials and Methods Among the patients who underwent knee DIXON imaging at our institute, we retrospectively analyzed 93 patients who also underwent dual energy X-ray absorptiometry within 1 year. The FFs of the distal femur metaphyseal (Fm) and proximal tibia metaphyseal (Tm) were calculated from the DIXON images, and the correlation between FF and BMD was analyzed. Patients were grouped based on BMD of lumbar spine (L), femoral neck (FN), and common femur (FT) respectively, and the Kruskal-Wallis H test was performed for FF. Results We identified a significant negative correlation between TmFF and FN-BMD in the entire patient group (r = -0.26, p < 0.05). In female patients, TmFF showed a negative correlation with FN-BMD, FT-BMD, and L-BMD (r = -0.38, 0.28 and -0.27, p < 0.05). In male patients, FmFF was negatively correlated with only FN-BMD and FT-BMD (r = -0.58 and -0.42, p < 0.05). There was a significant difference in the TmFF between female patients grouped by BMD (p < 0.05). In male patients, there was a significant difference in FmFF (p < 0.05). Conclusion Overall, we found that FF and BMD around the knee joints showed a negative correlation. This suggests the potential of FF measurement using DIXON for BMD screening.

• Journal of the Korea Society of Computer and Information
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• v.17 no.9
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• pp.165-169
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• 2012

To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine at age. It is based on 62 cases who visited the out-patient department. They were classified into three groups by age, group I (30~40 yr) and II (40~60 yr) and III (60~80 yr). Then we evaluated the average and the degree of correlation between the three groups and analyzed the correlation of the three sites according to the BMD result and T & Z-score through the t-test analysis. The results are listed below, first, if rise in age T-score is lower and over 60age occurred osteopenia, second, compared three groups, the correlation of BMD results was some of the highest between Lumbar spine and Proximal femur of T-score & Z-score. the correlation of BMD results is very high. It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.