Osteoporosis in Parkinson's disease: Relevance of distal radius dual-energy x-ray absorptiometry (DXA) and sarcopenia

Tan, Yan Jing and Lim, Shen-Yang and Yong, Voon Wei and Choo, Xing Yan and Ng, Yi-De and Sugumaran, Kavita and Shah, Mohammad Nazri Md and Aman, Raja Rizal Azman Raja and Paramasivam, Sharmila Sunita and Ramli, Norlisah Mohd and Grossmann, Mathis and Tan, Ai Huey (2021) Osteoporosis in Parkinson's disease: Relevance of distal radius dual-energy x-ray absorptiometry (DXA) and sarcopenia. Journal of Clinical Densitometry, 24 (3). pp. 351-361. ISSN 1094-6950, DOI https://doi.org/10.1016/j.jocd.2020.07.001.

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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 hand-grip 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% to 43.0%), vs 3.7% in controls (33.3% to 37.0%) 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 similar to 48.6) and sarcopenia (ORadjusted = 8.4, 95% CI: 1.1 similar to 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.

Item Type: Article
Funders: University of Malaya Faculty Research Grant [GPF018C-2018], Ministry of Higher Education Malaysia Fundamental Research Grant (FRGS) [FP018-2019A]
Uncontrolled Keywords: Parkinson's disease; Osteoporosis; DXA; Distal radius DXA; Sarcopenia; Osteosarcopenia
Subjects: Q Science > QH Natural history
Q Science > QP Physiology
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Biomedical Imaging Department
Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 14 Sep 2022 07:11
Last Modified: 14 Sep 2022 07:11
URI: http://eprints.um.edu.my/id/eprint/34570

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