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. 2019 Sep;18(3):1661-1668.
doi: 10.3892/etm.2019.7746. Epub 2019 Jul 8.

A novel quantitative method for estimating bone mineral density using B-mode ultrasound and radiofrequency signals-a pilot study on patients with rheumatoid arthritis

Violeta-Claudia Bojincă  1 , Claudiu C Popescu  2 , Raluca-Daniela Decianu  1 , Andrei Dobrescu  1 , Șerban Mihai Bălănescu  3 , Andra-Rodica Bălănescu  1 , Mihai Bojincă  4
Affiliations

A novel quantitative method for estimating bone mineral density using B-mode ultrasound and radiofrequency signals-a pilot study on patients with rheumatoid arthritis

Violeta-Claudia Bojincă et al. Exp Ther Med. 2019 Sep.

Abstract

The objective of the present study was to evaluate whether an innovative quantitative ultrasound (QUS) technique, Radiofrequency Echographic Multi Spectromety, which combines B-mode ultrasound and radiofrequency signals, is reliable in typical Romanian patients compared to previous results obtained using dual-energy X-ray absorptiometry (DXA). The study prospectively included previously unscreened post-menopausal females with rheumatoid arthritis (RA) and age-matched healthy controls. Bone mineral density (BMD) measurements were performed with an EchoS machine (Echolight®), which combines B-mode ultrasound and radiofrequency signals. The study included 106 RA patients, with a median disease duration of 3.2 (0.5-22) years and 119 controls. RA patients had a significantly lower body weight, body mass index (BMI) and basal metabolic rate (BMR) than the controls, while the prevalence of obesity and body fat differed insignificantly. RA patients had a significantly lower spine and hip BMD, higher fracture risk and higher prevalence of osteoporosis. Compared to RA patients without osteoporosis, those with osteoporosis were significantly older and had a longer menopause duration, but they had a significantly lower BMI, body fat, BMR and prevalence of obesity. Among the controls and RA patients, the median spine and hip BMD became significantly higher as the BMI increased from underweight to obesity. In conclusion, osteoporosis is prevalent among RA patients, as a part of a complex transformation of body mass composition, involving BMI and fat mass. The novel QUS scanning technique was able to replicate the results of the established DXA measurement of BMD and is potentially suitable for screening wide populations for osteoporosis.

Keywords: osteoporosis; quantitative ultrasound; rheumatoid arthritis.

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Figures

Figure 1.
Figure 1.
Differences in BMD between RA patients and controls, measured at (A) the lumbar spine (median, 0.87 vs. 0.87 g/cm2; *P=0.035, t-test) and (B) the left femoral neck (median, 0.67 vs. 0.71 g/cm2; #P=0.021, t-test). RA, rheumatoid arthritis; BMD, bone mineral density.
Figure 2.
Figure 2.
Differences in body fat between rheumatoid arthritis patients with osteoporosis (median 28.1%) and without osteoporosis determined with QUS (median, 36.7%; P<0.001; Mann-Whitney U-test). QUS, quantitative ultrasound.
Figure 3.
Figure 3.
Distribution of median BMD among RA patients and controls at the spine, left and right femoral neck according to weight category. (A) For RA patients: Underweight (n=5; sBMD=0.69 g/cm2; lfnBMD=0.45 g/cm2; rfnBMD=0.47 g/cm2), normal weight (n=43; sBMD=0.83 g/cm2; lfnBMD=0.58 g/cm2; rfnBMD=0.62 g/cm2), overweight (n=33; sBMD =0.87 g/cm2; lfnBMD=0.69 g/cm2; rfnBMD=0.64 g/cm2) and obese (n=25; sBMD=0.98 g/cm2; lfnBMD=0.85 g/cm2; rfnBMD=0.78 g/cm2). (B) For controls: Underweight (n=2), normal weight (n=34; sBMD=0.84 g/cm2; lfnBMD=0.61 g/cm2; rfnBMD=0.61 g/cm2), overweight (n=49; sBMD=0.91 g/cm2; lfnBMD=0.72 g/cm2; rfnBMD=0.72 g/cm2) and obese (n=34; sBMD=0.99 g/cm2; lfnBMD=0.82 g/cm2; rfnBMD=0.85 g/cm2). All comparisons were tested with Kruskal-Wallis tests (P<0.001 for all). RA, rheumatoid arthritis; sBMD, spine bone mineral density; l/rfn, left/right femoral neck.
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References

    1. Bliuc D, Alarkawi D, Nguyen TV, Eisman JA, Center JR. Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: The Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 2015;30:637–646. doi: 10.1002/jbmr.2393. - DOI - PubMed
    1. Diamantopoulos AP, Hoff M, Skoie IM, Hochberg M, Haugeberg G. Short- and long-term mortality in males and females with fragility hip fracture in Norway. A population-based study. Clin Interv Aging. 2013;8:817–823. doi: 10.2147/CIA.S45468. - DOI - PMC - PubMed
    1. Gutzwiller JP, Richterich JP, Stanga Z, Nydegger UE, Risch L, Risch M. Osteoporosis, diabetes, and hypertension are major risk factors for mortality in older adults: An intermediate report on a prospective survey of 1467 community-dwelling elderly healthy pensioners in Switzerland. BMC Geriatr. 2018;18:115. doi: 10.1186/s12877-018-0809-0. - DOI - PMC - PubMed
    1. Fujiwara S, Zhao X, Teoh C, Jaffe DH, Taguchi Y. Disease burden of fractures among patients with osteoporosis in Japan: Health-related quality of life, work productivity and activity impairment, healthcare resource utilization, and economic costs. J Bone Miner Metab. 2019;37:307–318. doi: 10.1007/s00774-018-0916-1. - DOI - PubMed
    1. Weycker D, Li X, Barron R, Bornheimer R, Chandler D. Hospitalizations for osteoporosis-related fractures: Economic costs and clinical outcomes. Bone Rep. 2016;5:186–191. doi: 10.1016/j.bonr.2016.07.005. - DOI - PMC - PubMed