Journal of Clinical Densitometry最新文献

{"title":"Vertebral Fracture Risk Thresholds from Phantom-Less Quantitative Computed Tomography-Based Finite Element Modeling Correlate to Phantom-Based Outcomes","authors":"Maria Prado ,&nbsp;Sundeep Khosla ,&nbsp;Hugo Giambini","doi":"10.1016/j.jocd.2023.101465","DOIUrl":"10.1016/j.jocd.2023.101465","url":null,"abstract":"<div><p><em>Introduction</em><span><span>: Osteoporosis<span> indicates weakened bones and heightened fracture susceptibility due to diminished bone quality. Dual-energy x-ray absorptiometry is unable to assess bone strength. Volumetric bone mineral density (vBMD) from </span></span>quantitative computed tomography<span> (QCT) has been used to establish guidelines as equivalent measurements for osteoporosis. QCT-based finite element analysis (FEA) has been implemented using calibration phantoms to establish bone strength thresholds based on the established vBMD. The primary aim was to validate vertebral failure load thresholds using a phantom-less approach with previously established thresholds, advancing a phantom-free approach for fracture risk prediction.</span></span></p><p><em>Methodology</em><span>: A controlled cohort of 108 subjects (68 females) was used to validate sex-specific vertebral fracture load thresholds for normal, osteopenic, and osteoporotic subjects, obtained using a QCT/FEA-based phantom-less calibration approach and two material equations.</span></p><p><em>Results</em><span>: There were strong prediction correlations between the phantom-less and phantom-based methods (R2: 0.95 and 0.97 for males, and R2: 0.96 and 0.98 for females) based on the two equations. Bland Altman plots and paired t-tests showed no significant differences between methods. Predictions for bone strengths and thresholds using the phantom-less method matched those obtained using the phantom calibration and those previously established, with ≤4500 N (fragile) and ≥6000 N (normal) bone strength in females, and ≤6500 N (fragile) and ≥8500 N (normal) bone strength in males.</span></p><p><em>Conclusion</em>: Phantom-less QCT-based FEA can allow for prospective and retrospective studies evaluating incidental vertebral fracture risk along the spine and their association with spine curvature and/or fracture etiology. The findings of this study further supported the application of phantom-less QCT-based FEA modeling to predict vertebral strength, aiding in identifying individuals prone to fractures. This reinforces the rationale for adopting this method as a comprehensive approach in predicting and managing fracture risk.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101465"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138988536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-energy X-ray absorptiometry does not confirm validity of the Craig's test","authors":"Kelsey A. Clark,&nbsp;Savannah Nielsen,&nbsp;Taylor Heywood,&nbsp;Camille Nguyen,&nbsp;Ulrike H. Mitchell","doi":"10.1016/j.jocd.2024.101466","DOIUrl":"10.1016/j.jocd.2024.101466","url":null,"abstract":"<div><p><span>The Craig's test is a clinical assessment used to quantify femoral version. The validity of the Craig's test has been called into question due to instances where the test exhibits relatively poor correlation with three-dimensional imaging. Our study purpose was to use dual-energy X-ray absorptiometry (DXA) to indirectly assess the validity of the Craig's test. Twenty-three volunteers (n = 46; each hip analyzed separately) received two hip DXA scans using two different methods of positioning. During the first scan, a standard-sized wedge, the conventional tool of hip positioning for DXA scans, was used to fixate the legs without regard for individual levels of femoral version. For the second scan, the participants’ hips were manually positioned according to their degree of femoral version determined by the Craig's test. We hypothesized that the bone mineral density (BMD) values from the customized positions would be lower due to the X-ray beams hitting the femoral neck perpendicularly. A paired </span><em>t</em>-test revealed weak evidence of a difference between BMD readings of the conventional and customized positions (<em>p-value = </em>0.065); moreover, contrary to our hypothesis, the BMD readings obtained in the standard position were lower than those obtained in the customized position, albeit not significantly. Our findings suggest that the Craig's test is not a valid clinical assessment of true femoral version. A secondary conclusion is that the widespread use of the standard wedge for hip positioning during DXA scans is a better option than trying to find a customized position that is based on findings of the Craig's test.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101466"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139408373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Pathological fractures in a patient with chronic abnormalities in serum markers following two liver transplantations: A case report and literature review","authors":"Feng Wang ,&nbsp;Jia Gao ,&nbsp;Zheng-Ye Wang ,&nbsp;Tang-Bo Yuan ,&nbsp;Da-Wei Cai ,&nbsp;Hua Wan ,&nbsp;Jian Qin","doi":"10.1016/j.jocd.2023.101463","DOIUrl":"10.1016/j.jocd.2023.101463","url":null,"abstract":"<div><p>Bone disease is a common complication following liver transplantation<span><span>, often overlooked in clinical practice. Clinical diagnosis of post-liver transplantation bone disease is challenging, and there have been few case report in the literature. This case report presents a patient who underwent two liver transplant<span><span> surgeries, exhibited good daily activity, and did not display typical clinical symptoms such as fatigue, bone pain, or spinal deformities<span> associated with prolonged sitting or standing. However, within the fifth year after the second liver transplant, the patient experienced two consecutive fractures. In March 2023, the patient underwent the first bone density test, which revealed osteoporosis<span>. This case highlights the fact that severe fractures after liver transplantation may not necessarily be accompanied by typical symptoms of bone disease. Without timely examination and early prevention, serious consequences may arise. Therefore, this condition requires attention, proactive prevention, early detection, and timely treatment. Additionally, a retrospective analysis of the patient's previous laboratory data revealed persistent abnormalities in serum markers such as </span></span></span>hypocalcemia and </span></span>elevated alkaline phosphatase levels after liver transplantation, emphasizing the importance of monitoring these serum markers.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101463"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138682948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting Fewer Than Four Vertebrae: 2023 Official Positions of the International Society for Clinical Densitometry","authors":"Harold Rosen ,&nbsp;Adrian Lau ,&nbsp;Auryan Szalat ,&nbsp;S. Bobo Tanner ,&nbsp;Diane Krueger ,&nbsp;Tyler Prout ,&nbsp;Alan Malabanan ,&nbsp;Christopher Shuhart","doi":"10.1016/j.jocd.2023.101436","DOIUrl":"10.1016/j.jocd.2023.101436","url":null,"abstract":"<div><p><span>The precision for spine bone mineral density (BMD) worsens as vertebrae are excluded, so recommendations are needed for least significant change (LSC) for spine BMDs based on fewer than 4 vertebrae. The task force recommends re-analysis of each facility's L1-L4 in-house precision study to determine the precision in order to calculate the LSC for each combination of 2 or 3 reported vertebrae. The task force recommended not reporting spine BMDs based on single </span>vertebral bodies<span> for either the diagnosis or monitoring of osteoporosis. Specific data for studies assessing the precision of two non-contiguous vertebrae are mixed, but ultimately the task force recommended that spine BMD based on 2 non-contiguous vertebrae can be used for the diagnosis and monitoring of osteoporosis.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101436"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting of Full-Length Femur Imaging to Detect Incomplete Atypical Femur Fractures: 2023 Official Positions of the International Society for Clinical Densitometry","authors":"Adrian Lau ,&nbsp;Tyler Prout ,&nbsp;Alan Malabanan ,&nbsp;Auryan Szalat ,&nbsp;Diane Krueger ,&nbsp;S. Bobo Tanner ,&nbsp;Harold Rosen ,&nbsp;Christopher Shuhart","doi":"10.1016/j.jocd.2023.101439","DOIUrl":"10.1016/j.jocd.2023.101439","url":null,"abstract":"<div><p><span>Incomplete atypical femur fractures (iAFFs) are associated with the long-term use of anti-resorptive therapies. Although X-rays are typically used to screen for iAFFs, images from dual-energy X-ray absorptiometry (DXA) offer an alternate method for detecting iAFFs. Although a previous 2019 ISCD Official Position on this subject exists, our task force aimed to update the literature review and to propose recommendations on reporting findings related to iAFFs that may be observed on DXA images. The task force recommended that full-length femur imaging (FFI) from DXA can be used as a screening tool for iAFFs. The presence of focal lateral cortical thickening and transverse lucencies should be reported, if identified on the FFI. This task force proposed a classification system to determine the likelihood of an iAFF, based on radiographic features seen on the FFI. Lastly, the task force recommended that the clinical assessment of </span>prodromal symptoms (pain) is not required for the assessment of FFI.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101439"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive Summary of the 2023 Adult Position Development Conference of the International Society for Clinical Densitometry: DXA Reporting, Follow-up BMD Testing and Trabecular Bone Score Application and Reporting","authors":"Christopher Shuhart ,&nbsp;Angela Cheung ,&nbsp;Ranjodh Gill ,&nbsp;Linsey Gani ,&nbsp;Heenam Goel ,&nbsp;Auryan Szalat","doi":"10.1016/j.jocd.2023.101435","DOIUrl":"10.1016/j.jocd.2023.101435","url":null,"abstract":"<div><p>After 15 months of preparation by task force chairs and teams, ISCD's 9th Position Development Conference (PDC) convened in Northbrook, IL, USA on March 28th and 29th, 2023 to approve new ISCD Official Positions in the topic areas of DXA Reporting, Follow-up BMD Testing and TBS Application and Reporting. Three teams of participants work to bring the PDC to fruition: the Steering Committee, Task Forces and Chairs, and the Expert Panel. To reach agreement on draft Official Positions, the PDC follows a scripted process with the UCLA/RAND Appropriateness Method (UCLA/RAM) as its foundation. Multiple rounds of data review, public debate and voting resulted in 32 new or modified Official Positions. Six companion position papers are also published along with this Executive Summary, serving as the detailed substantiation for the Official Positions. This Executive Summary reviews the personnel groups, activities and products of the 2023 PDC, with the entirety of the updated 2023 Official Positions presented in Appendix A. New Official Positions are highlighted in bold.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101435"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral hip DXA Reporting: 2023 Official Positions of the International Society for Clinical Densitometry","authors":"S. Bobo Tanner ,&nbsp;Diane Krueger ,&nbsp;Auryan Szalat ,&nbsp;Tyler Prout ,&nbsp;Adrian Lau ,&nbsp;Alan Malabanan ,&nbsp;Harold Rosen ,&nbsp;Christopher Shuhart","doi":"10.1016/j.jocd.2023.101438","DOIUrl":"10.1016/j.jocd.2023.101438","url":null,"abstract":"<div><p><em>Introduction</em><span>: This position development conference (PDC) Task Force examined the use and reporting of bilateral hip bone mineral density (BMD) measurements. This was deemed appropriate as increased availability of Dual-energy X-ray Absorptiometry (DXA) technology offering bilateral hip measurement resulted in more routine clinical use. The International Society for Clinical Densitometry Official Positions accept bilateral hip BMD measurement for clinical use but currently do not include recommendations for reporting those studies. </span><em>Methods</em>: Four key questions regarding bilateral hip reporting were proposed by the PDC Steering Committee. Relevant literature was identified using PubMed. Questions included whether bilateral hip measurements are appropriate for diagnostic classification or monitoring, as well as which bilateral hip regions of interest should be reported for diagnosis and monitoring. Additionally, the appropriate nomenclature for bilateral hip acquisition was defined. <em>Results</em><span><span>: The literature review demonstrated that bilateral hip measurement is appropriate and diagnostic classification should be based on the lowest T-score at the right or left side femoral neck or total hip; the mean T-score should not be used for diagnostic purposes. Mean bilateral total hip is preferred for BMD monitoring. The terms hip, or total hip were deemed appropriate nomenclature instead of femur or total </span>proximal femur. </span><em>Conclusion</em>: Bilateral hip acquisition is clinically appropriate and reporting and nomenclature standards are offered herein when a bilateral hip study is acquired. In terms of future research, the impact of discordant hips on diagnosis and monitoring was identified as a significant knowledge gap.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101438"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136129116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Compression Bandage on Dual Energy X-ray Absorptiometry Body Composition Scores","authors":"Yamileth Chacón-Araya ,&nbsp;Elizabeth Carpio-Rivera ,&nbsp;Andrea Quirós-Quirós ,&nbsp;José Moncada-Jiménez","doi":"10.1016/j.jocd.2023.101461","DOIUrl":"10.1016/j.jocd.2023.101461","url":null,"abstract":"<div><p><em>Background</em>: Dual-energy X-ray absorptiometry (DXA) measures are affected by the noise produced by external factors such as textile compression found in loose clothing. The study aimed to determine the effect of a compression bandage (CB) on body composition (BC) assessed by DXA.</p><p><em>Methods</em><span>: Sixty volunteers (age=21.4±4.7yr.) underwent full-body DXA scans on a control (CTRL) condition and after wearing a 30-mmHg CB on the trunk, legs, and arms. ANOVA (2 genders by 2 experimental conditions) determined mean interactions in BC variables tissue body fat% (BF%), region body fat% (RBF%), body tissue (BT), fat mass (FM), lean mass (LM), bone mineral content (BMC), and total mass (TM). Absolute reliability in BC scores was studied by the typical error of the measurement (TEM), the coefficient of variability (CV), and Bland-Altman plots.</span></p><p><em>Results</em>: ANOVA interactions were found on tissue total BF% (p=0.049), RBF% (p=0.048), android lean mass (p=0.004), and android total mass (p=0.019). The CV was small for tissue BF% (2.61±0.93%, CI95%=0.79, 4.43%), RBF% (2.66±1.78%, CI95%=-0.83, 6.15%), BT (4.82±2.19%, CI95%=0.54, 9.10kg), FM (4.17±2.25%, CI95%=-0.24, 8.58kg), LM (3.25±2.44%, CI95%=-1.53, 8.04kg), BMC (4.81±2.96%, CI95%=-0.99, 10.62kg), and TM (2.84±2.80%, CI95%=-2.65, 8.33kg). Bland-Altman plots showed random error for BF%, LM, and BMC. A bias of 0.5% was observed on BF% in males.</p><p><em>Conclusion</em>: A CB worn during a full-body DXA scan elicited similar BC scores than not wearing it. The variation in scores was &lt;10% for most BC variables, and a trivial bias of 0.5% in BF% was detected in male scores.</p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101461"},"PeriodicalIF":2.5,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138566014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixed and Relative Positioning of Scans for High Resolution Peripheral Quantitative Computed Tomography","authors":"Annabel R. Bugbird ,&nbsp;Rachel E. Klassen ,&nbsp;Olivia L. Bruce ,&nbsp;Lauren A. Burt ,&nbsp;W. Brent Edwards ,&nbsp;Steven K. Boyd","doi":"10.1016/j.jocd.2023.101462","DOIUrl":"10.1016/j.jocd.2023.101462","url":null,"abstract":"<div><p><em>Introduction</em><span>: High resolution peripheral quantitative computed tomography (HR-pQCT) imaging protocol requires defining where to position the ∼1 cm thick scan along the bone length. Discrepancies between the use of two positioning methods, the relative and fixed offset, may be problematic in the comparison between studies and participants. This study investigated how bone landmarks scale linearly with length and how this scaling affects both positioning methods aimed at providing a consistent anatomical location for scan acquisition.</span></p><p><em>Methods</em>: Using CT images of the radius (<em>N</em><span> = 25) and tibia (</span><em>N</em><span> = 42), 10 anatomical landmarks were selected along the bone length. The location of these landmarks was converted to a percent length along the bone, and the variation in their location was evaluated across the dataset. The absolute location of the HR-pQCT scan position using both offset methods was identified for all bones and converted to a percent length position relative to the HR-pQCT reference line for comparison. A secondary analysis of the location of the scan region specifically within the metaphysis was explored at the tibia.</span></p><p><em>Results</em><span>: The location of landmarks deviated from a linear relationship across the dataset, with a range of 3.6 % at the radius sites, and 4.5 % at the tibia sites. The consequent variation of the position of the scan at the radius was 0.6 % and 0.3 %, and at the tibia 2.4 % and 0.5 %, for the fixed and relative offset, respectively. The position of the metaphyseal junction with the epiphysis relative to the scan position was poorly correlated to bone length, with </span><em>R</em>² = 0.06 and 0.37, for the fixed and relative offset respectively.</p><p><em>Conclusion</em><span>: The variation of the scan position by either method is negated by the intrinsic variation of the bone anatomy with respect both to total bone length as well as the metaphyseal region. Therefore, there is no clear benefit of either offset method. However, the lack of difference due to the inherent variation in the underlying anatomy implies that it is reasonable to compare studies even if they are using different positioning methods.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101462"},"PeriodicalIF":2.5,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138565942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture Risk with Modified FRAX in Men Living with HIV","authors":"Alline Peralta Castro ,&nbsp;Kamylla Batista Brito ,&nbsp;Thirza Damasceno Ramos Oliva ,&nbsp;Isabella Mesquita Sfair Silva ,&nbsp;Beatriz de Souza Kato ,&nbsp;Gisele Alves Morikawa Caldeira ,&nbsp;Flávia Marques Santos ,&nbsp;Rosana Maria Feio Libonati","doi":"10.1016/j.jocd.2023.101460","DOIUrl":"10.1016/j.jocd.2023.101460","url":null,"abstract":"<div><p><em>Background</em><span><span>: Aging of the HIV-infected population and prolonged use of ARTs, produced metabolic alterations, including increased fracture risk. FRAX is a validated, computer-based clinical fracture risk calculator which estimates 10-year risk of major fracture, and </span>hip fracture<span>. However may underestimate risk in HIV-infected individuals. Several experts recommend considering HIV a cause of secondary osteoporosis.</span></span></p><p><em>Methodology</em>: Were included 52 men living with HIV, classified as high, moderate and low risk using ABRASSO graphic tool.</p><p><em>Results</em><span><span>: High risk prevalence found for major fracture and hip fracture were both 2 (4.2 %) using FRAX; while 10 (20.8 %) and 14 (29.2 %) using modified FRAX, respectively. Considering bone densitometry, 5 (12.8 %) were high risk for hip fracture and was noticed an increase in high risk major fracture from 4.2 % with FRAX to 5.1 % with FRAX considering bone densitometry. As for the low risk, 19 (39.6 %) for major fracture and 23 (47.9 %) for hip fracture with FRAX. While low risk modified FRAX were 0 (0 %) for major fracture and 8 (16.7 %) for hip fracture. It was also evidenced an association of high risk for major fracture and hip fracture with modified FRAX using </span>Fisher's exact test [p=0.0273 (bilateral)].</span></p><p><em>Conclusion</em><span>: It was concluded is recommended using modified FRAX for people living with HIV for better control and therapeutic decision-making about osteometabolic alterations provocated for the virus and ARTs.</span></p></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"27 1","pages":"Article 101460"},"PeriodicalIF":2.5,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138566455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}