• 제목/요약/키워드: Lumbar Spine BMD

검색결과 178건 처리시간 0.025초

Bone Mineral Density and Osteoporotic Vertebral Fractures in Traditional, Unassisted, Free-Diving Women (Haenyeos)

  • Seo, Jun-Yeong;Ha, Kee-Yong;Kim, Young-Hoon;Kim, Seong-Chan;Yoon, Eun-Ji;Park, Hyung-Youl
    • Journal of Korean Medical Science
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    • 제33권48호
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    • pp.316.1-316.10
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    • 2018
  • Background: Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. Methods: Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. Results: Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was $72.1{\pm}4.7$ years and that of the controls was $72.7{\pm}4.0$ years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. Conclusion: BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.

급성 골다공증성 요추 골절 환자에서 척추 기립근 및 다열근의 지방침투율과 후만각 변형의 연관 관계 (Correlation of the Deformation of the Kyphotic Angle with the Fat Infiltration Rate of Multifidus and Erector Spinae in Patients with Acute Osteoporotic Fractures of the Lumbar Spine)

  • 전득수;백종민;백승현
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.208-214
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    • 2021
  • 목적: 급성 골다공증성 요추 골절 환자에서 척추 변형의 진행을 예측할 수 있는 여러 인자들 중 척추의 자기공명영상 촬영에서 척추 주변 근육의 정량적 분석을 통해 척추 기립근 및 다열근의 감소와 후만각의 변형의 상관관계를 알아보고자 한다. 대상 및 방법: 이 연구는 2007년 1월부터 2018년 3월까지 단일 분절의 급성 요추 골절로 진단되어 보존적 치료 중인 환자를 대상으로 하였다. 다열근 및 척추 기립근의 감소는 지방으로 변성된 비율을 통해 확인하였고 이는 진단 당시 촬영한 요추 자기공명영상 촬영을 사용하여 측정되었으며, 지방으로 변성된 비율은 총 지방 침윤율로 정의하였다. 1년 추적 관찰에서 요추의 측면 방사선 사진에 기초하여 추체 압박률, 콥스각 및 쐐기각을 측정하였다. 피어슨 상관 계수를 분석하여 통계적 유의성을 확인하였다. 결과: 연구 대상은 129명으로 30명은 남자, 99명은 여자를 대상으로 하였다. 평균 연령은 71.28±9.55세, 평균 BMD 점수는 -3.53±0.79 g/cm2, 평균 지방 침윤율은 15.20%±11.99%였다. 지방침투율은 수상 당시 나이(R=0.373, p<0.001)와 양의 상관 관계가 있었지만, BMD 점수(R=-0.252, p=0.004)와는 음의 상관 관계를 보였다. 1년 후 추적관찰하여 확인한 결과에서 지방 침윤율은 추체 압박률(R=0.369, p<0.001) 및 콥스각(R=0.386, p<0.001)과 양의 상관 관계를 보였다. 요추 골절이 아래 분절로 내려 갈수록 추체 압박률(R=-0.191, p=0.030) 및 후만각(R=-0.428, p<0.001)은 감소하는 경향이 있었다. 결론: 급성 골다공증 요추 골절 환자에서 지방 침윤율은 보존적 치료를 위한 중요한 예측 인자가 될 수 있다. 지방 침윤율이 높은 환자의 예후는 환자 교육 과정에서 설명을 해야 하며 단기 외래 환자 후속 조치를 통해 환자를 면밀한 모니터링이 필요하다.

DXA를 이용한 전완부와 요추부 골밀도 검사의 보정계수 및 상관관계 연구 (The Correlation Analysis and Correction factor of BMD in Forearm and Lumbar with DXA)

  • 한만석
    • 디지털융복합연구
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    • 제11권12호
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    • pp.551-556
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    • 2013
  • 전완부와 요추부의 골밀도 검사를 통해 얻은 골밀도 값, T-score 와 Z-score 수치간의 상관관계 및 보정함수를 구해 어느 한 부위의 결과로서 다른 부위의 결과를 유추하는데 목적이 있다. 환자 66명은 연령별로 11명씩 20대에서 70대까지 환자들로 구성하였고 측정된 전완부와 요추부의 골밀도와 T-score와 Z-score를 조사하여 세가지 사항들에 대해 각각 상관관계가 있는지 평가하고 그 상관관계를 구하여 보정계수를 찾는다. 골밀도의 상관계수는 R=0.769 이고 보정계수 식은 Y=1.541X + 0.133 이다. T-score의 상관계수는 R=0.768 이고 보정계수식은 Y=0.715X - 0.4 이다. Z-score의 상관계수는 R=0.635 보정계수식은 Y=0.751X - 0.162 이다. 상관관계와 보정계수식를 통해 어느 한 부위의 결과로서 다른 부위의 결과를 유추할 수 있는 임상적 유용성이 있을 것으로 사료된다.

60세 이상 노년 한국 남성들의 골밀도 수준 및 관련요인 (The Bone Density Level of Korean Men Aged 60 Years and Over, and Its Relevant Factors)

  • 김영란;남해성;이태용
    • 한국산학기술학회논문지
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    • 제14권3호
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    • pp.1180-1190
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    • 2013
  • 본 연구는 국민건강영양조사 제 4기 2차년도(2008), 3차년도(2009), 제 5기 1차 년도(2010)에 참여한 60세 이상 남성노인 2,763명을 대상으로 대퇴경부 골밀도와 요추골밀도의 골밀도 수준을 파악하고, 신체계측, 생활습관, 식이섭취, 골절 과거력, 골다공증 가족력, 병력 등의 제 요인들과 골밀도의 관련성을 알아보고자 시도하였다. 각 변수의 단위별 BMD의 변화를 표현하기 위해 비율차이 계산식 ${\beta}{\times}$(단위/BMD의평균)를 이용한 다중선형회귀분석을 실시하였다. 모든 연속변수의 단위는 1SD를 사용하였다. 연구결과, 남성노인에서 골다공증 유병률은 60대는 6.7%, 70대는 15.8%, 80대이상은 31.4%이었고, 부위별 골다공증 유병률을 보면, 대퇴 경부부위 유병률은 60대는 2.6%, 70대는 8.2%, 80대이상은 24.8%, 요추부위 유병률은 60대는 5.5%, 70대는 11.3%, 80대이상은 15.4%이었다. 또한 대퇴경부 및 요추 골밀도에 조사된 각 독립변수 중 남성노인의 골밀도에 가장 큰 영향을 미치는 것은 제지방량으로 확인되었다. 따라서 남성노인에서는 제지방량을 늘리는 것이 골다공증을 예방하는 효과적인 방안이 될 것이다.

이중 에너지 조사 방식의 장비별 골밀도 측정의 정량적 비교 분석: CT vs DEXA 비교 (Quantitative Analysis of Bone Mineral Measurements in Different Types of Dual-energy Absorptiometry Systems: Comparison of CT vs DEXA)

  • 김명성
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권2호
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    • pp.311-316
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    • 2017
  • 골다공증 검사의 표준검사법은 이중 에너지 X선 흡수율(DEXA) 차이를 이용한 방식이고, 임상에서는 유사한 방식의 이중 에너지 X선 전산화단층영상장치(DECT)가 사용되고 있다. 본 논문의 목적은 기존 방식의 DEXA와 DECT 장비를 활용하였을 때 골밀도 차이를 확인하고 DECT 활용의 유용성을 알아보고자 한다. 기존 방식의 DEXA (QDR 4500W, Hologic)와 DECT (750 HD, GE Healthcare system) 장비를 이용하여 동일한 부위의 허리척추 팬텀 대상으로 검사 시행과 측정을 하였고, 1개월 내 기존 DEXA와 DECT 검사를 동일하게 허리 척추 검사를 시행한 환자 50명을 대상으로 골밀도를 측정 분석하였다. 허리척추 팬텀 대상 골밀도 측정 결과 두 영상장비 간에 통계적으로 높은 상관성(r=0.93, p<0.05)을 나타냈고, 사람을 대상으로 하였을 때도 비교적 높은 상관성(r=0.635, p<0.05; ${\tau}=0.46$, p<0.05)을 나타냈다. DECT를 이용한 골다공증 검사는 일반적으로 시행한 CT 영상 정보를 추가로 분석하여 골밀도 값을 얻는 것으로 추가적인 방사선 노출 없이 유용한 골밀도 정보를 제공해줄 수 있다는 유용성이 있다.

골다공증성 흉요추부 압박 골절에서의 보존적 치료 (Conservative treatment of Osteoporotic Compression Fractures in Thoracolumbar spine)

  • 강규복;고영도
    • Journal of Trauma and Injury
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    • 제18권2호
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    • pp.107-111
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    • 2005
  • Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

폐경 후 여성의 골격상태에 영향을 미치는 요인분석 (Some Factors Affecting Bone Mineral Status of Postmenopausal Women)

  • 오세인;이행신;이미숙;김초일;권인순;박상철
    • 대한지역사회영양학회지
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    • 제7권1호
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    • pp.121-129
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    • 2002
  • Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

중년여성의 칼슘섭취 수준과 골밀도와의 관계 (The Relationship between of Calcium Intake and BMD in Middle-aged Women)

  • 이종은;이인숙;김순례
    • 지역사회간호학회지
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    • 제16권1호
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    • pp.77-85
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    • 2005
  • Purpose: This study was to determine the effects of calcium intake on bone mineral density (BMD) in pre and post menopause women and to provide basic data for enhancing bone health of middle aged women. Methods: A total of 700 middle-aged women living in Seoul and Geonggi Province were interviewed during the period from June 2003 through January 2004 to investigate their social. demographic and physiological characteristics, health and daily activity performance, and their dietary patterns, and bone mineral density was measured. The survey of dietary intake was 24 hour recalls, and the individual calcium intake was calculated using food frequency. Data of 618 subjects was used for the analysis. Of the calcium intake levels, BMD values of the subjects of 20% of high level. 60% of middle level and 20% of low level were analyzed and compared. Results: The level of calcium intake according to general characteristics of the subjects was significantly related to age (p=0.001), education levels (p=.003) and marital status (p=.001). The BMD of the lumbar vertebrae and femur of the subjects taking a high level of calcium showed significantly higher than that of the subjects taking a middle level and low level of calcium. Femoral T-score was also significantly higher in subjects taking a high level of calcium than that of those taking a middle level and lower levels of calcium. Lumber spine T-score was higher in the high level group than that of the middle level group. Conclusion: The study revealed that women taking a high level of calcium had better bone health. Therefore. calcium intake is extremely important in daily dietary intake so that the intake of calcium-rich foods is highly recommended.

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운동이 중년이후 여성의 골밀도에 미치는 효과에 대한 메타 분석 (A Meta Analysis on the Effects of Exercise on Bone Mineral Density among Middle-aged and Older Women)

  • 유지수;박지원;이숙정
    • 지역사회간호학회지
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    • 제20권3호
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    • pp.285-295
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    • 2009
  • Purpose: This study was to examine the effectiveness of exercise for bone mineral density (BMD). Methods: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges'g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. Results: Weight bearing exercise was effective(Q=20.1, p>.05, ES=0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q=4.15, p=.98, ES=0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q=19.5, p>.05, ES=0.33). In contrast, marked heterogeneity (Q=33.3, p<0.01) was apparent in 7 study groups evaluating trochanter. Conclusion: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.

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Use of Dual-Energy X-ray Absorptiometry in Children with Inflammatory Bowel Disease: A Large Single Centre Study

  • Jois, Asha;Perera, Sajini;Simm, Peter;Alex, George
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권6호
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    • pp.473-480
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    • 2022
  • Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.