Secondary Osteoporosis

Secondary osteoporosis is complex to manage as it is “osteoporosis” or bone loss leading to an increased risk of fragility fracture induced by other pathologies affecting bone – or the pharmacological treatments prescribed to cure the latter.
Bone changes linked to primary (or “natural”) osteoporosis are quite well known and recognized as a slow process, whereas secondary osteoporosis would occur in patients of different conditions / ages etc, complexifying diagnosis and treatment decision process as multiple factors may affect patients’ health. The changes observed on bones in case of secondary osteoporosis may lead to differential impacts at each bone compartment (for instance, hyperparathyroidism can have an anabolic effect at the trabecular compartment and catabolic at the cortical one). An impact on trabecular bone would lead to an important increase of fracture risk without potentially be observed on the standard density examination (as trabecular bone is less dense than the cortical bone). Such patients – at increased risk of fracture – are the ones currently underdiagnosed by standard tool and bone densitometry (aBMD alone).
Hence the necessity of advanced bone measurements such as 3D measurements of cortical and trabecular bone (from hip DXA scans).
Several type of population and pathologies have been – and are continuously being – investigated using 3D-SHAPER®, as our understanding of the 3D measurements in such population grow.

List of presented studies:

  • Breast Cancer: “Trabecular and cortical bone health in postmenopausal women receiving aromatase inhibitors for early breast cancer treatment: the B-ABLE prospective cohort study”, X. Nogués et al, SEIOMM 2018, Presentation available here
  • Glucocorticoids: “Low daily dose of glucocorticoids induces trabecular and cortical bones impairment at the femur: a 3D analysis using DXA-based modeling”, E. Leib et al, ASBMR 2018, Poster here
  • Chronic kidney disease: “Assessment of Chronic Kidney Disease (CKD) impact at the proximal femur using a DXA-based 3D modeling approach”, R. Winzenrieth et al., WCO-IOF-ESCEO 2018, poster available here
  • Hyperparathyroidism and parathyroidectomy: “3D femur assessment using DXA in patients with primary hyperparathyroidism (PHPT) before and one year after parathyroidectomy”, E. Koumakis et al, ASBMR 2017, poster available here
  • Hyperparathyroidism and biochemical, “Effect of Primary hyperparathyroidism (PHPT) on cortical and trabecular bone”, G. Guglielmi et al, WCO-IOF-ESCEO 2017, poster available here
  • Hematology / Allogeneic stem cell transplant, “Volumetric Hip DXA Indicates Rapid Deterioration of Both Cortical and Trabecular Bone Compartments After Allogeneic Hematologic Stem Cell Transplant”, M. Almohaya et al, ASBMR 2017, abstract available here
  • High Bone Mass, “Cortical and trabecular bone analysis of patients with high bone mass from the Barcelona Osteoporosis Cohort using 3-dimensional dual-energy X-ray absorptiometry: A case-control study”, G. Orduna et al, JCD 2017, publication here
  • HIV, “Analyzing the cortical and trabecular bone of Tenofovir-treated HIV patients using 3D-DXA”, R. Güerri-Fernandez et al., WCO-IOF-ESCEO 2017; presentation here
  • Type 1 Diabetes, “Analyzing the cortical and trabecular bone of type 1 diabetes patients using 3D-DXA – a longitudinal study”, L. Humbert et al., ASBMR 2016, poster available here
  • Short stature/Small bone size, the study of 1 case, “Clinical Applicability of 3D-DXA in Individuals with Small Bone Size and Low Bone Mineral, B.M. Camargos et al, WCO-IOF-ESCEO 2016
  • Type 2 Diabetes and LADA (latent autoimmune diabetes in adults), “Cortical and trabecular bone analysis with 3D-DXA in patients with Type 2 Diabetes, Long Latent Autoimmune Diabetes in adults (LADA) and healthy controls: a preliminary report”, M. A. Guagnelli, WCO-IOF-ESCO 2016

CKD Study design, Courtesy of Dr. Renaud Winzenrieth

3D distribution at the cortex, differences CKD versus controls, Courtesy of Dr. Renaud Winzenrieth

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