Bone health measured using quantitative ultrasonography in adult males with muscular dystrophy

Abstract

Objectives: To compare muscle and bone health markers in adult males (aged 20-59 yrs) with and without muscular dystrophy (MD).

Methods: Participants included 11 Fascioscapulohumeral (FSH), 11 Becker's (Be), 9 limb girdle (LG), 11 Duchenne (DMD), and 14 non-dystrophic controls (CTRL). Physical activity was assessed using Bone (BPAQ) and disability specific (PASIPD) questionnaires. Bone QUS provided T- and Z scores from the Distal Radius (DR) and Mid-shaft tibia (MST). Tibialis anterior cross sectional area (TA_ACSA) was measured using B-mode ultrasound. Grip strength was measured in all but DMD.

Results: Physical activity was lower in DMD, FSH and BeMD than CTRL (P<0.05), and lower in DMD than other MDs (P<0.01). T and Z scores were lower in DMD and Be than CTRL (DR, P<0.05); and lower in DMD than CTRL, LG, and FSH (MST, P<0.01). TA_ACSA and grip strength was 35-59% and 50-58% smaller in MD than CTRL, respectively (P<0.01). Within MD, BPAQ correlated with bone QUS measures (r=0.42-0.38, P<0.01). PASIPD correlated with grip strength (r=0.65, P<0.01) and TA_ACSA (r=0.46, P<0.01).

Conclusion: Muscle size, strength, and bone health was lower in adult males with MD compared to adult males without MD, the extent of this is partially determined by physical activity.

Figure 1

Bone Physical Activity Questionnaire (BPAQ) scores with and without muscular dystrophy. CTRL=Control, LG=Limb Girdle, FSH=fascioscapulohumeral, Be=Becker’s, DMD=Duchenne. ^C denotes significant difference from CTRL, ^F denotes significant difference from FSH, ^B denotes significant difference from Be and ^L denotes significant difference from LG (P<0.05). Data are presented as Mean (SD).

Figure 2

Tibialis anterior Anatomical Cross sectional area (TA_ACSA) in adult males with and without muscular dystrophy. CTRL=Control, LG=Limb Girdle, FSH=fascioscapulohumeral, Be=Becker’s, DMD=Duchenne. ^C denotes significant difference from CTRL, ^B denotes significant difference from Be, P<0.05. Data are presented as Mean (SD).

Figure 3

QUS bone health data in adult males with and without muscular dystrophy. Figure A=T score distal radius, B=Z score distal radius, C=T score Mid shaft tibia, D=Z score MST. CTRL=Control, LG=Limb Girdle, FSH=fascioscapulohumeral, Be=Becker’s, DMD=Duchenne. ^C denotes significant difference from CTRL, ^F denotes significant difference from FSH, ^B denotes significant difference from Be and ^L denotes significant difference from LG. Data are presented as Mean (SD).

Figure 4

QUS bone health in adult males with and without (CTRL) muscular dystrophy who are ambulatory (A, n=22) and Non-Ambulatory (NA, n=20). Figure A=T score DR, B=Z score DR, C=T score MST, D=Z score MST. ^C denotes significant difference from CTRL P<0.05, ^A denotes significant difference from Ambulatory P<0.05. Data are presented as Mean (SD).