Skip to main content

Table 1 Literature on clinical pQCT employment for bone status assessment in chronic diseases

From: Peripheral quantitative computed tomography (pQCT) for the assessment of bone strength in most of bone affecting conditions in developmental age: a review

Disease

Type of study

Patients

Controls

Results

References

HIV

Cross-sectional study

30 HIV-infected African–American or Hispanic on ART treatment

 

Markedly abnormal trabecular plate and cortical microarchitecture, and decreased whole bone stiffness

Yin MT et al., 2014 [174]

Cushing’s syndrome

 

30 patients with endogenous Cushing’s syndrome

 

Lower cortical area (CoA), lower cortical thickness (CoTh), lower cortical density and lower total vBMD.

dos Santos CV et al., 2015 [175]

JIA

Longitudinal study

245 patients (172 females, 73 males) with JIA

 

Lower TrabBMD, muscle CSA (muscleCSA), and SSIp. In contrast, JIA showed fatCSA significantly higher than controls. but not with ERA, Longitudinally, we did not find any difference in all JIA patients in comparison with baseline, except for the SSI value that normalized. A significant negative correlation among TrabBMD and systemic and/or intraarticular corticosteroids, and a positive correlation among TNF-α-blocking agents and TrabBMD were observed.

Stagi S et al., 2014 [14]

Cystic Fibrosis (CF)

Cross-sectional study

Thirty young adults with CF

 

↓ bone cross-sectional area and ↓ vBMD. Cortical and trabecular microarchitecture were compromised most notably involving the trabecular bone of the tibia. These differences translated into ↓ estimated bone strength both at the radius and tibia.

Putman MS et al., 2014 [176]

 

Cross-sectional study

Twelve children with CF

Age and sex- matched controls

↓ WBBMC with larger differences at older ages. Periosteal and endosteal circumferences were smaller in CF. Positive relationships of CoA and SSI with age were attenuated with CF.

Bai W et al., 2016 [98]

 

Cross-sectional study

Fifty-three children with CF

 

Pre-pubertal males with CF had greater trabecular vBMD and total vBMD at 4 % tibia, and greater total vBMD at 4 % radius. Pre-pubertal females with CF had greater total vBMD at 66 % tibia and radius, and cortical vBMD at the radius. At puberty, the CF cohort had less BMC at 4 % tibia, and smaller muscleCSA at 66 % tibia. Pubertal CF females had a smaller bone CSA at 4 % tibia, and lower SSI at the tibia and radius sites.

Brookes DS et al., 2015 [99]

Obesity

Cross-sectional study

18 lean and 18 obese children

 

In obese children, radial cortical porosity, cortical pore diameter, tibial trabecular thickness was lower, whereas trabecular number was higher.

Dimitri P et al., 2015 [177]

 

Cross-sectional study

68 subjects with early-onset severe obesity

73 normal-weight controls

In men CoTh in proximal radius together with Tot CSA and SSI in diaphyseal tibia favored the obese over controls, while no difference was observed in other characteristics. In women, most bone characteristics were consistently higher in obese subjects compared with controls.

Viljakainen HT et al., 2015 [178]

Klinefelter syndrome and anorchia

Cross-sectional study

20 young adults (12 KS, 8 anorchia)

 

Reduced tibial CoA and CoTh. Lean mass was positively associated with tibial CoA and radial total, trabecular, and volumetric density.

[Wong SC et al., 2015] [143]

SHOX mutation carriers

Cross-sectional study

22 SHOX mutation carriers

22 controls

Despite a different bone geometry in radius and tibia, subjects with a SHOX mutation presented no differences in BMD or failure load compared to controls, suggesting that mutations in SHOX gene may affect bone microarchitecture albeit not bone strength

Frederiksen AL et al. 2014 [149]

Turner syndrome

Cross-sectional study

22 Turner girls

21 unaffected females

According to pQCT of the radius, total vBMD Z-score and trabecular vBMD Z-score were not significantly different between the TS group and controls. A significant reduction in cortical vBMD and a trend in CoTh at the proximal radius in the TS group suggests that cortical density may be reduced with sparing of trabecular bone, possibily predisposing to fracture

Holroyd CR et al., 2010 [139]

Juvenile systemic lupus erythematosus (JSLE)

 

56 female patients

 

Tb.BMD and SLICC/ACR-DI were independent risk factors for vertebral fracture. JSLE patients present bone microstructure and strength deficits, particularly at the distal radius.

Paupitz JA et al., 2016 [113]

 

Longitudinal study

56 JSLE patients

 

JSLE subjects present a reduced peak bone mass with high risk of osteoporosis in early adulthood. JSLE patients had significantly lower TrabBMD, SSI, but not muscleCSA and CBA values, while CortBMD and fatCSA were significantly increased. At longitudinal evaluation, TrabBMD, fatCSA, but not muscleCSA and CBA, remained lower in patients, but SSI and CortBMD did not differ from controls.

Stagi S et al., 2014 [114, 115]

Hemophilia A and B

Cross-sectional study

18 patients with hemophilia A and hemophilia B ($18 year old)

 

Lower nondominant distal tibia and radius totalBMD, trabecular BMD, and corticalBMD. In addition, PWH had significantly lower Tb.N in the distal tibia, but not radius, and increased Tb.Sp at both tibia and radius. Ct.Th was significantly lower at both sites, but not Ct.Po.

Lee A et al., 2015 [179]

Neurofibromatosis 1

Cross-sectional study

18 children with NF1

 

Trabecular density was more severely compromised than cortical. Peripheral QCT-derived estimates of bone strength and resistance to bending and stress were poorer among children with NF1

[Armstrong L et al., 2013] [145]

Crohn’s disease

Cross-sectional study

65 CD patients

650 reference partecipants

pQCT in CD showed a marked reduction of trabecular vBMD and cortical dimensions at diagnosis; while the trabecular vBMD improved significantly diagnosis and treatment of CD, deficits in cortical dimensions progressed

Tsampalieros A et al., 2014 [101]

 

Cross-sectional study

10 CD patients

 

pQCT and DXA revealed important differences in the associations with auxological and disease-related factors, indicating that the measures of spine BMD may not capture disease and treatment effects on trabecular bone in IBD patients

Werkstetter KJ et al., 2013 [102]

Hypovitaminosis D

Cross-sectional study

333 girls, 230 boys

 

In girls, aBMD and BMC of femoral necks, CoA, CoTh, total vBMD, and trabecular thickness were significantly correlated with 25(OH)VitD levels. In boys, aBMD of bilateral femoral necks, BMC of the dominant femoral neck, CoA, CoTh, total vBMD, trabecular vBMD, BV/TV, and trabecular separation were significantly correlated with 25(OH)Vit-D levels.

Cheung TF et al., 2016 [168]

Nephrotic Syndrome

Cross-sectional study

29 affected children

29 healthy controls

Bone CSA was greater in NS group at both the metaphysis and diaphysis (p = 0.014); greater endosteal and periosteal circumferences (both p < 0.01), resulting in reduced CoTh (p = 0.018), but similar cortical CSA (p = 0.22).

Moon RJ et al., 2014 [131]

 

Cross-sectional study

56 NS children

>650 reference partecipants

GC therapy was associated with increases in CortBMD-Z, potentially related to suppressed bone formation and greater mineralization. Conversely, greater expansion of CortArea-Z was associated with declines in CortBMD-Z in NS.

Tsampalieros A et al., 2013 [128]

CKD

Cross-sectional study

88 CKD cases

>650 controls

LS and WB DXA suggested greater trabecular BMD and lower cortical BMC in CKD, consistent with pQCT results. LS-BMD-Z and TrbBMD-Z were greater in CKD, while WBBMC-Z (p < 0.0001) and CortBMC-Z (p < 0.0001) were lower than controls.

Griffin LM et al., 2012 [127]