Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/24846
Title: Osteoporosis in Parkinson's Disease: Relevance of Distal Radius Dual-Energy X-Ray Absorptiometry (DXA) and Sarcopenia.
Austin Authors: Tan, Yan Jing;Lim, Shen-Yang;Yong, Voon Wei;Choo, Xing Yan;Ng, Yi-De;Sugumaran, Kavita;Md Shah, Mohammad Nazri;Raja Aman, Raja Rizal Azman;Paramasivam, Sharmila Sunita;Mohd Ramli, Norlisah;Grossmann, Mathis ;Tan, Ai Huey
Affiliation: Division of Neurology, Department of Medicine; and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Endocrinology
Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Division of Neurology, Department of Medicine; and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Issue Date: 30-Jul-2020
Date: 2020-07-30
Publication information: Journal of Clinical Densitometry 2021; 24(3): 351-361
Abstract: Osteoporotic fractures are common in Parkinson's disease (PD). Standard dual-energy X-ray absorptiometry (DXA) measuring bone mineral density (BMD) at the femoral neck and lumbar spine (central sites) has suboptimal sensitivity in predicting fracture risk in the general population. An association between sarcopenia and osteoporosis in PD has not been studied. We compared BMD and osteoporosis prevalence in PD patients vs controls; determined the osteoporosis detection rates using central alone vs central plus distal radius DXA; and analyzed factors (in particular, sarcopenia) associated with osteoporosis. One hundred and fifty-six subjects (102 patients with PD, 54 spousal/sibling controls) underwent femoral neck-lumbar spine-distal radius DXA. Seventy-three patients and 46 controls were assessed for sarcopenia using whole-body DXA and handgrip strength. Patients underwent clinical and serum biochemical evaluations. PD patients had significantly lower body mass index compared to controls. After adjustment for possible confounders, distal radius BMD and T-scores were significantly lower in PD patients compared to controls, but not at the femoral neck/lumbar spine. With distal radius DXA, an additional 11.0% of patients were diagnosed with osteoporosis (32.0%-43.0%), vs 3.7% in controls (33.3%-37%) additionally diagnosed; this increase was largely driven by the markedly higher detection rate in female PD patients. Female gender (adjusted odds ratio [ORadjusted] = 11.3, 95% confidence interval [CI]: 2.6-48.6) and sarcopenia (ORadjusted = 8.4, 95% CI: 1.1-64.9) were independent predictors for osteoporosis in PD. Distal radius DXA increased osteoporosis detection, especially in female PD patients, suggesting that diagnostic protocols for osteoporosis in PD could be optimized. A close association between osteoporosis and sarcopenia was documented for the first time in PD, which has important implications for clinical management and future research.
URI: https://ahro.austin.org.au/austinjspui/handle/1/24846
DOI: 10.1016/j.jocd.2020.07.001
Journal: Journal of Clinical Densitometry
PubMed URL: 32888777
ISSN: 1094-6950
Type: Journal Article
Subjects: DXA
Parkinson's disease
distal radius DXA
osteoporosis
osteosarcopenia
sarcopenia
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