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For many decades, the Chinese have been using herbal medications to treat bone diseases. To examine effects of an extract of ten medicinal herbs on estrogen deficiency bone loss, ten-month-old female rats were randomly divided into three groups: ovariectomized (OVX), OVX treated with herbs (OVX-M) 4 ml/day by gavage, and OVX treated with estrogen (OVX-E) 10 mg subcutaneously (s.c.) twice per week. The bone mineral density (BMD) of the left femur (fBMD), spine (sBMD) and global body (gBMD) were measured at baseline and at 4, 8 and 12 weeks using a Hologic QDR 2000 dual-energy X-ray densitometer. Tibial strength was tested using the Instron Model 5566 electro-mechanical testing machine. The urinary pyridinoline creatinine ratio (Pyd/Cr), deoxypyridinoline creatinine ratio (Dpd/Cr), plasma alkaline phosphatase (ALP), calcium (CA), phosphorus (P) and albumin (ALB) were also determined. Uterine weight was determined at 12 weeks. The results showed that percent changes of fBMD in the OVX (n = 9), OVX-E (n = 8) and OVX-M (n = 8) rats at the 12-week time point were -11.8 ± 4.6^c, 1.8 ± 3.1^a, -7.6 ± 1.9^abc (p < 0.05-0.001, a: vs. OVX, b: vs. OVX-E, c: vs. baseline); sBMD were -10.7 ± 4.6^c, -0.3 ± 5.5^a, -5.9 ± 3.5^abc; and gBMD were -4.8 ± 2.3^c, 0.1 ± 2.4^a, -2.7 ± 2.6^abc, respectively. Further, the tibia maximum breaking stress and flexural modulus of elasticity in OVX-M rats (295 ± 33^a, 18194 ± 3264^a) were significantly higher (p < 0.005-0.001) than that in OVX rats (189 ± 83, 10309 ± 4930), and similar to OVX-E rats (298 ± 35^a, 18766 ± 2620^a). Additionally, the herbal extract reduced the urinary Pyd/Cr, Dpd/Cr and plasma ALP increment followed OVX and was not associated with a rise in uterine weight. In conclusion, the herbal extract demonstrated a therapeutic effect to inhibit bone resorption and to reduce estrogen-dependent bone loss without uterine stimulation. It may have potential as a new approach in treating and preventing postmenopausal osteoporosis (PMOP).

This study was performed to assess the efficacy of α-viniferin (Carex humilis Leyss) on adjuvant-induced arthritis in rats. Adjuvant arthritis was induced by a single subcutaneous injection of 0.1 ml complete Freund's adjuvant (CFA) containing 7.5 mg Mycobacterium butyricum suspended in 1 ml sterile paraffin oil into the right hind paw. Forty female Sprague-Dawley rats were injected. Righting reflex was uniformly lost and considered to be the initial point of arthritis development on day 7 after CFA injection. Rats were divided into four groups, and upon development of arthritis, tested groups were orally administered 3 or 10 mg/kg α-viniferin or 10 mg/kg ketoprofen every day for 14 days. The control group was orally administered 2 ml of physiological saline solution. Bone mineral density (BMD), radiological changes and edematous volumes were measured for 35 days. α-viniferin suppressed the development of inflammatory edema, and inhibited the bone destruction, noted with a decrease in BMD (p<0.05). Hind paw edema volume, BMD and radiological changes did not differ significantly in the ketoprofen and α-viniferin groups during the entire study period. In conclusion, α-viniferin suppressed arthritic inflammation and bony change in rats.

In order to examine the effects of Kami-kihi-to (KKT or Jia-Wei-Gui-Pi-Tang) on osteopenia, we measured bone mineral density using computed X-ray absorptometry and monitored metabolism and bone tissue in an ovariectomized (OVX) rat model.

Bone mineral density was significantly lower in the OVX group than in normal group 3 months after ovariectomy. However, the bone mineral density of the OVX group administered KKT was clearly higher than that of the untreated OVX group.

Locomotor activity was regular in the normal group and in the OVX groups before administration of KKT. After 6-month administration of KKT, in OVX groups, the pattern of locomotor activity became diphasic with clear active and resting phases, as was also observed in the normal group. The locomotor activity did not decrease in the OVX groups after administration of KKT. At 6 months, the continuity of the trabecular bone was higher in the OVX group administered KKT than in the untreated OVX group. These results indicate that KKT improved the menopausal symptoms and increased the locomotor activity of the OVX group, thereby increasing bone mineral density.

Osteoporosis is a common finding following chronic obstructive pulmonary disease (COPD), but there are few reports on the relationship between bone mineral density (BMD) and the syndrome types described in traditional Chinese medicine (TCM) in patients with COPD. A cross-sectional medical survey was used in this study. Twenty-six male patients with COPD and 26 age-matched male healthy subjects were recruited. The symptom questionnaire survey of TCM was implemented, and thereafter the COPD patients were divided into two subgroups: type of deficiency of the lung and spleen (TDLS) and type of deficiency of the lung, spleen and kidney (TDLSK). BMD of lumbar spine (L2-4), non-dominant femoral neck (Neck), Ward's triangle (Ward's), and great trochanter (Troch) were measured by dual-energy x-ray absorptiometry. In addition, the other bone turnover markers were also examined. The results showed that BMD was much more decreased in TDLSK than that in TDLS patients (p < 0.05), and BMD in the patients of the TDLS subgroup without symptoms of kidney-vacuity has showed the decreased trend from healthy subjects to TDLS patients. Furthermore, there was a higher incidence of osteoporosis in patients with TDLSK compared with that in TDLS (p < 0.05, OR > 2.0). Therefore, the data suggest that: (1) BMD might be a marker more sensitive than the symptom for the diagnosis of kidney-vacuity in COPD patients; (2) the deficiency of kidney would be the key factor of bone mineral loss; and (3) that invigorating the kidney should be performed in the phase of TDLS in COPD patients in advance.

This study aimed to assess the efficacy of a 12-week Baduanjin qigong training program in preventing bone loss for middle-aged women. An experimental design was adopted, and subjects were assigned randomly into an experimental group (n = 44) and a control group (n = 43). The experimental group received a 12-week Baduanjin qigong training program, whereas the control group did not. Interleukin-6 (IL-6) and bone mineral density (BMD) were measured before and after the intervention. The results showed significant differences in IL-6 (t = -5.19, p < 0.000) and BMD (t = 1.99, p = 0.049) between the groups. Baduanjin reduced IL-6 and maintained BMD in the experimental group. In conclusion, this study demonstrates promising efficacy of Baduanjin in preventing bone loss commonly occurring in middle-aged women. Thus, Baduanjin is valuable for promoting and maintaining the health status of middle-aged women.

Bone mineral density (BMD) has been validated not only for the diagnosis of osteoporosis but also for prediction of the risk of osteoporosis-related fractures. The purpose of this paper was to investigate the overall benefits of herbal medicines on BMD using a meta-analytic method. Systematic searches in PubMed, Medline, Cochrane Central, and China National Knowledge Infrastructure were performed for eligible studies. A meta-analysis was conducted to evaluate the benefits of herbal medicine treatment and conventional treatment for BMD. Herbal medicines frequently used for interventions were pooled in the analysis and further investigated. Seventeen studies were pooled in the meta-analysis and showed that BMD was higher in the herbal medicine group than in the control group (standardized mean difference [SMD]: 0.857; 95% confidence interval [CI]: 0.412 to 1.301). Significant benefits of herbal medicine for BMD were found in the lumbar spine, femoral neck, and femoral trochanter and in postmenopausal women (SMD: 0.600, 95% CI: 0.068 to 1.131) by subgroup analysis. Moreover, through the meta-regression analysis, the age at menopause and the menopause duration were found to influence the herbal intervention effects on BMD. In addition, the most prescribed medicine among the effective herbs in the pooled studies was found to be Epimedium brevicornum Maxim. This paper provides evidence that herbal medicine interventions increase BMD more than conventional treatments in individuals with osteoporosis, especially postmenopausal women. The results of this study suggest that herbal medicines are effective for increasing BMD in individuals with osteoporosis.

The fractional quantitative computed tomography (fQCT) to determine both quantity and distribution of bone mineral was evaluated based on the mechanical properties of trabecular bone. Using quantitative computed tomography (QCT), bone mineral density was measured at 46 areas from 5 bovine tibias. Subsequently, fQCT was measured by the proportion of pixels showing a bone mineral density greater than 290 mg/ml. Based on the mechanical properties of the bone specimens, the QCT and the fQCT were compared. The fQCT showed a significant correlation with the compressive strength with superiority to the QCT.

We investigated whether controlled dynamization enhanced regenerate bone healing in callotasis of the tibia in 12 adult mongrel dogs. An average of 2 cm (≒ 10%) lengthening was obtained. The left hindlimb was allowed dynamization of 1 mm, 2 mm, and 3 mm in magnitude when 1 cm (≒ 5%) of lengthening was achieved, whereas the right hindlimb was not dynamized and served as a control. Bone mineral density (BMD) of the regenerate bone was measured periodically until nine weeks after the end of distraction. After sacrifice, uniaxial compression testing was performed. Relative BMD ratio and mechanical properties of the regenerate bone were significantly higher in the dynamization group than in the nondynamization group; no significant difference was found among dynamization subgroups, however. We conclude that 1 mm to 3 mm of elastic dynamization accelerates regenerate bone healing in callotasis of the canine tibia.

Since most of our current knowledge about the concept of bone gain during adolescence or early adulthood comes from the cross-sectional studies, we aimed to evaluate natural course of changes in bone mineral density prospectively during early adulthood in a cohort. Twenty-two volunteers (15 female, 7 male) with the mean age of 20.0 ± 0.69 years were enrolled into the study. Subjects with any known secondary cause of osteoporosis were excluded from the study. Demographic variables, anthropometric measurements were recorded. Subjects underwent an interview about risk factors for osteoporosis. Physical activity level and calcium intake were evaluated by European Vertebral Osteoporosis Study questionnaire. Lumbar and femoral bone mineral densities were measured using Dual Energy X-ray Absorptiometry (DXA) at baseline and two years after. L1-4 BMD increased from 0.925 ± 0.099 g/cm² to 0.957 ± 0.094 g/cm²(p = 0.002) and total femur BMD increased from 0.866 ± 0.113g/cm² to 0.908 ± 0.108g/cm²(p = 0.0001). BMC of L1-4 increased significantly (p = 0.022), however there was no change in bone area measurements (p = 0.82). In case of femoral total measurements, both BMC and bone area demonstrated significant increase over the study period (p = 0.0001 and p = 0.0001). There were significant positive differences in bone mineral densities for L3, L4 measurements in males and for L3 measurements in females (p = 0.028, p = 0.018 and p = 0.02 respectively). Different from the bone gain during adolescent years which is usually attributed to volumetric expansion of the bones; we were able to demonstrate that bone gain continues through early years of adulthood. It would be rational to extend preventive measures beyond adolescence, into early adulthood to optimize the bone mass.

We thought that grip strength in patients with IDDM would be associated with hand BMD of patients and we thought that patients with IDDM have lower hand BMD than normal subjects.Therefore in this study, the evaluation of the relationship between hand grip strength and hand bone mineral density in healthy children and in children with insulin dependent diabetes mellitus was studied. The hand grip strength, hand and axial bone mineral density of patients were also compared to age-matched healthy controls.

We studied 31 consecutive outpatients with insulin dependent diabetes mellitus defined in accordance to the World Health Organization criteria, who attended to the diabetic outpatient clinic. Thirty two healthy children were included as control group.

There were no differences in the age, body mass index, bone age, serum Ca and P levels between the diabetic patients and the controls (p > 0.05). There were no significant differences between the groups in hand grip strength, total hand and axial bone mineral density (p > 0.05). There were significant correlations between hand grip strength and hand bone mineral density r = 0.824, p = 0.000), axial bone mineral density (r = 0.714, p = 0.000), bone age (r = 0.830, p = 0.000) and duration of insulin dependent diabetes mellitus in the diabetic group (r = 0.463, p = 0.009).

When linear multiple regression analysis was performed hand grip strength and bone age were independent predictors of hand BMD (p < 0.05).

We found that hand grip strength significantly correlated with the hand and axial bone mineral density in patients with insulin dependent diabetes mellitus. We suggest that strengthening exercises should be encouraged to increase bone mineral density in these patients.

Background: Osteoarthritis of any joint may exert different effects on bone mineral density that may be the result of several mechanisms including change in the pattern of weight load distribution. In this cross-sectional study we tried to find correlations between unilateral knee osteoarthritis and bone mineral density of hips and lumbar vertebrae. Methods: Forty three patients with knee osteoarthritis (unilateral or more severe in one side) were recruited in this study. The American college of Rheumatology Criteria was followed for the diagnosis of osteoarthritis. Dual X-Ray absorptiometry was used to obtain the T score and the Z score of the hips and lumbar vertebrae. Results: The T score and Z score of the hip and T score of the femoral neck, at the side with ipsilateral knee osteoarthritis was lower than the other side (p < 0.05). The mean Z score and T score of the vertebrae was negative irrespective of the side of osteoarthritis. Conclusions: Bone mineral density of the hip with ipsilateral knee osteoarthritis was lower than the other side, which suggests that BMD may be sensitive to some extent in detecting osteoporosis in these patients; it has also been observed that osteoarthritis might not affect bone mineral density of the hips and lumbar vertebrae in the same manner or to the same extent.

Finite element models (FEMs) derived from QCT-scans were developed to evaluate vertebral strength but QCT scanners limitations are restrictive for routine osteoporotic diagnosis. A new approach considers using bi-planar dual energy (BP2E) X-rays absorptiometry to build vertebral FEM. The purpose was to propose a FEM based on BP2E absorptiometry and to compare the vertebral strength predicted from this model to a QCT-based FEM. About 46 vertebrae were QCT scanned and imaged with BP2E X-rays. Subject-specific vertebral geometry and bone material properties were obtained from both medical imaging techniques to build FEM for each vertebra. Vertebral body volumetric bone mineral density (vBMD) distribution and vertebral strength prediction from the BP2E-based FEM and the QCT-based FEM were compared. A statistical error of 7mg/cm³ with a RMSE of 9.6% and a $R^2$ of 0.83 were found in the vBMD distribution differences between the BP2E-based and qCT-based FEM. The average vertebral strength was 3321$\mathrm{\text{N}}\pm 1657$ and 3768$\mathrm{\text{N}}\pm 1660$ for the qCT-based and BP2E-based FEM, respectively, with a RMSE of 641N and $R^2$ of 0.92. This method was developed to estimate vBMD distribution in lumbar vertebrae from a pair of 2D-BMD images and demonstrated to be accurate to personalize the mechanical properties in vitro.

The aim of this retrospective study was to determine whether prior regional osteoporosis in the knee associates the 10-year outcome of total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA). About 63 knees of 45 RA patients underwent cruciate-retaining Deltafit TKA. Overall, long-term results of the RA disease activity were based on dual-energy X-ray absorptiometry (DXA) to evaluate osteoporosis; the Japanese Orthopedic Association (JOA) functional knee score, a disease activity score of 28 joints; and the neck large joint score 12 for joint destruction, which were investigated over 10 years. Multivariate analysis of factors affecting the JOA score at 10 years was performed. Factors affecting the JOA score at 10 years correlated with the DXA results at the distal femoral condyle, patient age, and neck large joint score 12. Prior regional osteoporosis in the knee based on DXA negatively correlated the 10-year outcome of TKA in patients with RA.

The purpose of this study was to evaluate the relationship between isometric quadriceps muscle strength and measurements of bone density (BMD), mass (BMC) and ultrasound properties. A total of 113 individuals were included, 53 men and 60 women aged 22-85 years. Isometric quadriceps muscle strength correlated significantly to BMD of the total body for both men (r=0.63, p=0.02) and women r=0.77, p=0.04) after adjustments for age, weight and height. In women, there was also an association between isometric quadriceps muscle strength and BMD of the lumbar spine (r=0.67, p=0.04). These correlations were evident in premenopausal women for BMD at the lumbar spine, femoral neck and total body whereas no significant relationships were seen in postmenopausal women or any age group of men. For isometric quadriceps muscle strength and the ultrasound measurements of the heel, a positive correlation was seen in men and women aged 41-60 years. The findings point to a role of endogenous sex steroids, primarily estrogens, in the correlation between BMD and isometric quadriceps muscle strength.

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The objective of the present work is to estimate the prevalence of low bone mass in Indian men and women for the assessment of osteoporosis and fracture risk using quantitative ultrasound and dual energy X-ray absorptiometry (DEXA) and carryout a comparative evaluation for early prediction of osteoporosis. Data collected in this study is analyzed to assess the diagnostic performance of the ultrasound and how its performance compares to DEXA bone mineral density (BMD). Quantitative ultrasound assessment of osteoporosis is carried out by measuring broadband ultrasound attenuation (BUA) and speed of sound (SOS) through calcaneus bone to provide a clinical measure called the stiffness index (SI). The SI is a measure of bone density used to predict the risk of bone fracture due to osteoporosis. Bone mineral density (BMD) measurement is performed in lumbar region (L1–L4) of the spine in anterior-posterior direction using DEXA. In both studies the data is found to be significant in men and women subjects with p<0.0005 and percentage bone loss in men and women are significantly matching in both studies. Ultrasound performance correlates moderately well with DEXA (r=0.60 to 0.68) and provides comparable diagnostic sensitivity to spine BMD in predicting osteoporotic fractures.

Physical activity has shown to maintain bone mineral density (BMD) through the effects of mechanical loading on bone metabolism. However, the effects of exercise on the calcium-regulating hormones and other metabolic variables are not known. PURPOSE: To compare the effects of strength and endurance exercise on blood pH, total serum calcium, ionized calcium, parathyroid hormone (PTH) and calcitonin (CT) between males with different levels of physical activities. METHODS: The experimental group consisted of 9 physically active males (runners) and the control group consisted of 10 males who had not exercised regularly for the past year. Subjects were asked to perform both strength (eccentric action) and endurance exercises (VO₂ peak). The blood pH, total serum calcium, ionized calcium, PTH and CT were measured before and after exercise. A two-way ANCOVA was used for data analysis. RESULTS: (1) When the control group did anaerobic exercise, the free ionized calcium increased significantly (p < 0.05). (2) Mode and intensity of physical activity have no significant effects on the body's calcium regulating hormones. (3) The level of physical activity plays a major role in increasing bone density. High levels of physical activities plus strength exercises can have an additive effect on bone density. CONCLUSION: Regular high intensity exercise will help increase bone density. Strength exercises can maintain bone density not only through mechanical loading, but also through blood pH and biochemical changes in free ionized calcium, which can positively affect bone density.

Micro-computed tomography (micro-CT) is widely used for in vitro studies to characterize bone structure at the resolution of 10–100 microns. However, a densitometric calibration protocol is necessary to convert the X-ray attenuation coefficient provided by micro-CT in bone mineral density (BMD). The lastest one has an important role to improve the accuracy of subject-specific finite element models. This work presents a simple calibration protocol based on the use of solid hydroxyapatite phantoms with the correction of the beam hardening effect. The method was validated in comparison to ashing measures of cortical and trabecular human bone. In addition, bone samples tissue mineral density (TMD) was calculated with two different methods. The correlation between ash density and BMD was linear both for cortical ($R^2=0.91$) and trabecular bone ($R^2=0.91$). The analysis stratified by tissue type versus the pooled analysis confirmed the validity of a common linear model for both types of tissue ($R^2=0.99$). Despite its simplicity, the correlation obtained in this work does not depend on the acquisition settings of the micro-CT. TMD was shown to be dependent on the tissue investigated, with values in the range of 1.15–1.21mg/mm³ for trabecular bone, and 1.19–1.29mg/mm³ for cortical bone. Results are of some interest for generating micro finite elements models.

Objective: To study the effects of square dance on bone mineral density (BMD) and bone turnover markers in patients with postmenopausal osteoporosis.

Methods: Fifty postmenopausal women (aging 45–60) with osteoporosis were randomly assigned to a research group and a control group. The patients in the research group received 600mg of calcium combined with square dance (5 times a week, 30 to 60 minutes each time) for 6 months while those in the control group only received 600mg of calcium. BMD, changes in bone turnover markers and bone pain were assessed before and after the treatment.

Results: (1) After the 6-month treatment, BMD of L${}_{2-4}$ and the femoral neck significantly increased in the research group ($p<0.05$). No significant change was observed in BMD of the Ward’s region. BMD in the control group did not change significantly ($p>0.05$). (2) No significant difference was found in serum levels of calcium, phosphorus and alkaline phosphatase between the two groups both before and after the treatment ($p>0.05$). Serum levels of P1NP had a significant increase, while $\beta$-CTX’s level did not change significantly. (3) The bone pain in both groups has been effectively relieved. The pain in the research group was relieved significantly compared to the control group.

Conclusions: By improving the BMD and relieving the pain, square dancing can exert positive effects on women with postmenopausal osteoporosis. Square dancing may become a feasible strategy for osteoporosis prevention and treatment.