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  1. Jawhar DS, Hassan NA, Shamssain MH
    Med J Malaysia, 2020 01;75(1):47-51.
    PMID: 32008020
    INTRODUCTION: Osteoporosis is a silent disease which has an effect on bone structure. Studies on the association between bone mineral density (BMD) and type 2 diabetes mellitus (T2DM) revealed conflicting results. We conducted a
    study to assess the prevalence of osteoporosis in females with T2DM and compare dual energy x-ray absorptiometry (DXA) scan results between diabetic and non-diabetic females in the United Arab Emirates (UAE).

    MATERIALS AND METHODS: We retrospectively analysed hospital records and DXA scan measurements of 635 patients at tertiary hospital in Ajman, UAE. Patients with T2DM were compared to non-diabetic control group. Data were analysed using SPSS version 20. Student’s t test was used for continuous variables, while chi-square test for categorical variables. Relative risk (RR) and it’s 95% Confidence Interval (95%CI) were calculated for prevalence
    of osteoporosis among the two group.

    RESULTS: In all 141 patients in the diabetic group and 428 patients in the control group, while 66 patients were
    excluded based on exclusion criteria. Prevalence of osteoporosis was significantly higher in diabetic group (RR:
    1.2, 95%CI: 1.1, 1.2). BMD and T-score values were similar in diabetic and control groups. Z-score values of lumbar spine, L1 and L3 were significantly higher in diabetic group. Obese patients have significantly higher BMD than non-obese in both studied groups. Younger diabetic patient had significantly higher value of BMD, T-score and Z-score in left femur total hip.

    CONCLUSION: Although BMD and T-score values were similar between the two groups, women with T2DM had significant higher prevalence of osteoporosis.

    Matched MeSH terms: Absorptiometry, Photon/methods*
  2. Srichan W, Thasanasuwan W, Kijboonchoo K, Rojroongwasinkul N, Wimonpeerapattana W, Khouw I, et al.
    Eur J Clin Nutr, 2016 08;70(8):894-7.
    PMID: 26508460 DOI: 10.1038/ejcn.2015.180
    BACKGROUND/OBJECTIVES: Quantitative ultrasound (QUS) is used to measure bone quality and is known to be safe, radiation free and relatively inexpensive compared with dual-energy X-ray absorptiometry (DXA) that is considered the gold standard for bone status assessments. However, there is no consensus regarding the validity of QUS for measuring bone status. The aim of this study was to compare QUS and DXA in assessing bone status in Thai children.

    SUBJECTS/METHODS: A total of 181 Thai children (90 boys and 91 girls) aged 6 to 12 years were recruited. Bone status was measured by two different techniques in terms of the speed of sound (SOS) using QUS and bone mineral density (BMD) using DXA. Calcium intake was assessed by 24 h diet recall. Pearson's correlation, κ-statistic and Bland and Altman analysis were used to assess the agreement between the methods.

    RESULTS: There was no correlation between the two different techniques. Mean difference (s.d.) of the Z-scores of BMD and SOS was -0.61 (1.27) that was different from zero (P<0.05). Tertiles of Z-scores of BMD and QUS showed low agreement (κ 0.022, P=0.677) and the limits of agreement in Bland and Altman statistics were wide.

    CONCLUSIONS: Although QUS is easy and convenient to use, the SOS measurements at the radius seem not appropriate for assessing bone quality status.

    Matched MeSH terms: Absorptiometry, Photon/methods
  3. Chong KH, Poh BK, Jamil NA, Kamaruddin NA, Deurenberg P
    Biomed Res Int, 2015;2015:232876.
    PMID: 25922831 DOI: 10.1155/2015/232876
    Aim. To validate a radial quantitative ultrasound (QUS) system with dual energy X-ray absorptiometry (DXA), a criterion technique in bone status assessment among children. Methods. Bone health was evaluated using a radial QUS system (Sunlight Omnisense 8000P) to measure the speed of sound (SOS) at one-third distal radius of the nondominant hand and DXA (Hologic QDR) was used to assess whole body bone mineral density (BMD). Results. Some 29.9% of the children were grossly misclassified according to quartiles of BMD and radial SOS. Poor agreement was observed between Z-scores of radial SOS and whole-body BMD (mean difference = 0.6 ± 0.9; 95% limits of agreement = -1.4 to 2.6). With a cut-off value of -1.0, radial SOS yielded satisfactory sensitivity (80%) and specificity (93%) for the detection of children with low BMD. Conclusion. The observed poor agreement in the present study suggests that radial QUS and DXA are not comparable and hence are not interchangeable in evaluating bone status of the children.
    Matched MeSH terms: Absorptiometry, Photon/methods*
  4. Chan CY, Subramaniam S, Mohamed N, Ima-Nirwana S, Muhammad N, Fairus A, et al.
    Arch Osteoporos, 2020 09 12;15(1):142.
    PMID: 32918631 DOI: 10.1007/s11657-020-00821-5
    T-score discordance between hip and spine is a common problem in the diagnosis of osteoporosis based on dual-energy X-ray absorptiometry. Not much information on the prevalence and risk factors of this problem is available in Malaysia. Our study found that factors like age, height, physical activity and menopausal status should be taken into account in the diagnosis of osteoporosis.

    INTRODUCTION AND OBJECTIVE: T-score discordance between hip and spine is a common problem in bone mineral density assessment. A difference ≥ 1 standard deviation (SD) (regardless of diagnostic class) is considered minor, and a difference more than one diagnostic class is considered major discordance. This study aimed to determine the prevalence and factors of hip and spine T-score discordance in a population aged ≥ 40 years in Klang Valley, Malaysia.

    SUBJECTS AND METHODS: In this cross-sectional study, subjects answered a demographic questionnaire and underwent body composition and bone health assessment using dual-energy X-ray absorptiometry. Chi-square and binary logistic regression analysis were used to assess the prevalence of T-score discordance among the subjects.

    RESULTS: A total of 786 Malaysians (382 men, 404 women) subjects were recruited. The prevalence of minor and major discordance was 30.3% and 2.3%, respectively. Overall, factors related to T-score discordance were advanced age, decreased height, and being physically active. Sub-analysis showed that decreased height and being physically active predicted T-score discordance in men, being menopausal and Indian (vs Chinese) were predictors in women.

    CONCLUSIONS: T-score discordance between hip and spine is common among Malaysian middle-aged and elderly population. Diagnosis of osteopenia/osteoporosis should be based on the T-score of more than one skeletal site as per the current recommendations.

    Matched MeSH terms: Absorptiometry, Photon/methods*
  5. Jamal N, Ng KH, Looi LM, McLean D, Zulfiqar A, Tan SP, et al.
    Phys Med Biol, 2006 Nov 21;51(22):5843-57.
    PMID: 17068368
    We describe a semi-automated technique for the quantitative assessment of breast density from digitized mammograms in comparison with patterns suggested by Tabar. It was developed using the MATLAB-based graphical user interface applications. It is based on an interactive thresholding method, after a short automated method that shows the fibroglandular tissue area, breast area and breast density each time new thresholds are placed on the image. The breast density is taken as a percentage of the fibroglandular tissue to the breast tissue areas. It was tested in four different ways, namely by examining: (i) correlation of the quantitative assessment results with subjective classification, (ii) classification performance using the quantitative assessment technique, (iii) interobserver agreement and (iv) intraobserver agreement. The results of the quantitative assessment correlated well (r2 = 0.92) with the subjective Tabar patterns classified by the radiologist (correctly classified 83% of digitized mammograms). The average kappa coefficient for the agreement between the readers was 0.63. This indicated moderate agreement between the three observers in classifying breast density using the quantitative assessment technique. The kappa coefficient of 0.75 for intraobserver agreement reflected good agreement between two sets of readings. The technique may be useful as a supplement to the radiologist's assessment in classifying mammograms into Tabar's pattern associated with breast cancer risk.
    Matched MeSH terms: Absorptiometry, Photon/methods*
  6. Deurenberg-Yap M, Deurenberg P
    Food Nutr Bull, 2002 Sep;23(3 Suppl):34-7.
    PMID: 12362808
    Body fat percent (BF%) was measured in 108 adult Chinese, 76 Malays, and 107 Indians in Singapore by densitometry, deuterium oxide dilution (hydrometry), dual energy x-ray absorptiometry (DXA) and a chemical four-compartment model (BF%4c). The hydration of the fat-free mass (FFM) was calculated. Subjects ranged in age from 18 to 69 years and their body mass index ranged from 16 to 40 kg/m2. BF%4c for the various subgroups were: Chinese females (33.5 +/- 7.5%), Chinese males (24.4 +/- 6.1%), Malay females (37.8 +/- 6.3%), Malay males (26.0 +/- 7.6%), Indian females (38.2 +/- 7.0%) and Indian males (28.1 +/- 5.5%). Biases were found between BF%4c and BF% measured by 2-compartment models (hydrometry, densitometry, DXA), with systematic underestimation by DXA and densitometry. On a group level hydrometry had the lowest bias while DXA gave the highest bias. When validated against BF%4c, 2-compartment models were found to be unsuitable for accurate measures of body fat due to high biases at the individual level and the violation of assumptions of constant hydration of FFM and density FFM among the ethnic groups. On a group level the best 2-compartment model for measuring body fat was found to be hydrometry.
    Matched MeSH terms: Absorptiometry, Photon/methods
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