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Analysis of volumetric BMD in people with Down syndrome using DXA-based 3D modeling

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Abstract

Summary

We analyzed volumetric bone mineral density, by 3D analysis, in 76 people with Down syndrome and 76 controls. People with Down syndrome, particularly men, have a lower hip volumetric bone mineral density than the general population. Besides, volumetric bone mineral density declines more rapidly in Down syndrome.

Introduction

People with Down syndrome (DS) have a lower areal bone mineral density (aBMD) estimated by dual-energy X-ray absorptiometry (DXA). However, they have smaller-sized bones, which could influence the measurements. Therefore, our objective was to determine volumetric BMD in these patients.

Materials and methods

We included 76 outpatients with DS and 76 control healthy volunteers matched for age and sex distribution. Clinical data were obtained with a standardized interview and physical exam, including age, sex, height, weight, and body mass index (BMI). aBMD was measured by dual-energy X-ray at the femoral neck (FN) and total hip (TH). The 3D-SHAPER® software (version 2.8, Galgo Medical, Barcelona, Spain) was used to derive 3D analysis from participants’ hip DXA scans.

Results

DS femurs had a similar 3D geometry, compared with the femurs of controls. However, 3D analysis showed that participants with DS had smaller cortical thickness (1.84 mm ± 0.17 vs. 2.02 ± 0.20 mm; p < 0.0001), cortical vBMD (777 ± 49 mg/cm3 vs. 809 ± 43 mg/cm3; p < 0.0001), and cortical sBMD (143 ± 19 mg/cm2 vs. 164 ± 22 mg/cm2; p < 0.0001). After adjustment for age and BMI, all 3D measurements remained lower in DS than in controls. These differences were more marked in men than in women. vBMD decreased with age in controls and DS, but the decline was greater in DS for all 3D parameters.

Conclusion

People with DS, particularly men, have a lower hip vBMD than the general population. Besides, vBMD declines more rapidly in DS.

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Authors and Affiliations

  1. Department of Internal Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain

    Marta García Hoyos, Zaida Salmón, José A. Riancho & Carmen Valero

  2. Galgo Medical, Barcelona, Spain

    Ludovic Humbert

Authors
  1. Marta García Hoyos
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  2. Ludovic Humbert
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  3. Zaida Salmón
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  4. José A. Riancho
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  5. Carmen Valero
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Corresponding author

Correspondence to Carmen Valero.

Ethics declarations

The study protocol was approved by the Institutional Review Board and all patients gave written informed consent.

Conflict of interest

L. Humbert is stockholder and employee of Galgo Medical. Marta García Hoyos, José A. Riancho, and Carmen Valero declare that they have no conflicts of interest.

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García Hoyos, M., Humbert, L., Salmón, Z. et al. Analysis of volumetric BMD in people with Down syndrome using DXA-based 3D modeling. Arch Osteoporos 14, 98 (2019). https://doi.org/10.1007/s11657-019-0645-7

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