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Comparison of single CT scan assessment of bone mineral density, vascular calcification and fat mass with standard clinical measurements in renal transplant subjects: the ABC HeART study.

Kinsella S, Murphy K, Breen M, O'Neill S, McLaughlin P, Coyle J, Bogue C, O'Neill F, Moore N, McGarrigle A, Molloy MG, Maher MM, Eustace JA - BMC Nephrol (2015)

Bottom Line: Quantitative CT (QCT) BMD analysis was conducted using CT lumbar spine (GE Medical Systems Lightspeed VCT & Mindways QCT Pro Bone Mineral Densitometry System Version 4.2.3) to calculate spinal volumetric BMD and compared with standard DXA calculated areal BMD at the spine, hip and distal forearm.Abdominal aortic calcification was assessed by semi-quantitative Aortic Calcification Index (ACI) method and compared with lateral lumbar x-ray Kappuila score and pulse wave velocity (PWV).Visceral and subcutaneous adipose tissue volume (Osirix 16 Ver 3.7.1) was compared with BMI.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal Medicine, Cork University Hospital, Cork, Ireland. sinkinsella@eircom.net.

ABSTRACT

Background: Despite limitations of routine methods, Clinical Practice Guidelines support the assessment of bone mineral density (BMD) and vascular calcification in renal transplant recipients. Changes in fat mass also occur post-transplantation, although they are traditionally difficult to measure accurately. We report the feasibility, convenience and accuracy of measuring the above 3 parameters using a novel CT protocol.

Methods: We conducted a cross-sectional study of 64 first renal allograft recipients (eGFR > 30 ml/min/1.73 m(2)). Quantitative CT (QCT) BMD analysis was conducted using CT lumbar spine (GE Medical Systems Lightspeed VCT & Mindways QCT Pro Bone Mineral Densitometry System Version 4.2.3) to calculate spinal volumetric BMD and compared with standard DXA calculated areal BMD at the spine, hip and distal forearm. Abdominal aortic calcification was assessed by semi-quantitative Aortic Calcification Index (ACI) method and compared with lateral lumbar x-ray Kappuila score and pulse wave velocity (PWV). Visceral and subcutaneous adipose tissue volume (Osirix 16 Ver 3.7.1) was compared with BMI.

Results: Participants were 61 % male, had a mean age of 47 years, median ESKD duration of 5.4 years and a mean eGFR of 54 ml/min. iDXA median T-score at proximal femur was -1.2 and at lumbar spine was -0.2. Median QCT Trabecular T-score at lumbar spine was -1.2. The percent of subjects with a T-score of < 2.5 by site and method was DXA Proximal Femur: 7 %, DXA distal radius: 17 %, DXA spine: 9 %, QCT (American College of Radiology cutoffs): 9 %. CT derived ACI correlated with PWV (r = 0.29, p = 0.02), pulse wave pressure (r = 0.51, p < 0.001), QCT Trabecular (-0.31, p = 0.01) and cortical volumetric BMD and history of cardiovascular events (Mann-Whitney U, p = 0.02). Both visceral and subcutaneous adipose tissue correlated with BMI (r = 0.63 & 0.64, p < 0.001).

Conclusions: Single CT scan triple assessment of BMD, vascular calcification and body composition is an efficient, accurate and convenient method of risk factor monitoring post renal transplantation.

No MeSH data available.


Related in: MedlinePlus

Scatterplot of the relationship between Lumbar Radiograph Measurement of Calcification and CT Determined Aortic Calcification Index
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Fig4: Scatterplot of the relationship between Lumbar Radiograph Measurement of Calcification and CT Determined Aortic Calcification Index

Mentions: 42 patients (64.6 %) had evidence of arterial calcification on CT. Not unexpectedly, the CT assessment identified more patients with aortic calcification than plain radiography appraisal, which identified 25 patients. Lumbar radiograph measurement of aortic calcification correlated closely with Aortic Calcification Index, (r = 0.91, p < 0.001, Fig. 4). The ACI differed significantly with duration of dialysis, with mean arterial pressure, hyperlipidaemia, a history of prior cardiovascular events and with post-transplant allograft function, Table 1. The ACI correlated with arterial Pulse Wave Velocity (Pulse Trace 400) (r = 0.29, p = 0.02) and pulse pressure (r = 0.51, p < 0.001). ACI was negatively correlated with Trabecular BMD (r = −0.31, p = 0.01) and positively with cortical volumetric BMD (r = 0.27, p = 0.03), Table 3.Fig. 4


Comparison of single CT scan assessment of bone mineral density, vascular calcification and fat mass with standard clinical measurements in renal transplant subjects: the ABC HeART study.

Kinsella S, Murphy K, Breen M, O'Neill S, McLaughlin P, Coyle J, Bogue C, O'Neill F, Moore N, McGarrigle A, Molloy MG, Maher MM, Eustace JA - BMC Nephrol (2015)

Scatterplot of the relationship between Lumbar Radiograph Measurement of Calcification and CT Determined Aortic Calcification Index
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4642694&req=5

Fig4: Scatterplot of the relationship between Lumbar Radiograph Measurement of Calcification and CT Determined Aortic Calcification Index
Mentions: 42 patients (64.6 %) had evidence of arterial calcification on CT. Not unexpectedly, the CT assessment identified more patients with aortic calcification than plain radiography appraisal, which identified 25 patients. Lumbar radiograph measurement of aortic calcification correlated closely with Aortic Calcification Index, (r = 0.91, p < 0.001, Fig. 4). The ACI differed significantly with duration of dialysis, with mean arterial pressure, hyperlipidaemia, a history of prior cardiovascular events and with post-transplant allograft function, Table 1. The ACI correlated with arterial Pulse Wave Velocity (Pulse Trace 400) (r = 0.29, p = 0.02) and pulse pressure (r = 0.51, p < 0.001). ACI was negatively correlated with Trabecular BMD (r = −0.31, p = 0.01) and positively with cortical volumetric BMD (r = 0.27, p = 0.03), Table 3.Fig. 4

Bottom Line: Quantitative CT (QCT) BMD analysis was conducted using CT lumbar spine (GE Medical Systems Lightspeed VCT & Mindways QCT Pro Bone Mineral Densitometry System Version 4.2.3) to calculate spinal volumetric BMD and compared with standard DXA calculated areal BMD at the spine, hip and distal forearm.Abdominal aortic calcification was assessed by semi-quantitative Aortic Calcification Index (ACI) method and compared with lateral lumbar x-ray Kappuila score and pulse wave velocity (PWV).Visceral and subcutaneous adipose tissue volume (Osirix 16 Ver 3.7.1) was compared with BMI.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal Medicine, Cork University Hospital, Cork, Ireland. sinkinsella@eircom.net.

ABSTRACT

Background: Despite limitations of routine methods, Clinical Practice Guidelines support the assessment of bone mineral density (BMD) and vascular calcification in renal transplant recipients. Changes in fat mass also occur post-transplantation, although they are traditionally difficult to measure accurately. We report the feasibility, convenience and accuracy of measuring the above 3 parameters using a novel CT protocol.

Methods: We conducted a cross-sectional study of 64 first renal allograft recipients (eGFR > 30 ml/min/1.73 m(2)). Quantitative CT (QCT) BMD analysis was conducted using CT lumbar spine (GE Medical Systems Lightspeed VCT & Mindways QCT Pro Bone Mineral Densitometry System Version 4.2.3) to calculate spinal volumetric BMD and compared with standard DXA calculated areal BMD at the spine, hip and distal forearm. Abdominal aortic calcification was assessed by semi-quantitative Aortic Calcification Index (ACI) method and compared with lateral lumbar x-ray Kappuila score and pulse wave velocity (PWV). Visceral and subcutaneous adipose tissue volume (Osirix 16 Ver 3.7.1) was compared with BMI.

Results: Participants were 61 % male, had a mean age of 47 years, median ESKD duration of 5.4 years and a mean eGFR of 54 ml/min. iDXA median T-score at proximal femur was -1.2 and at lumbar spine was -0.2. Median QCT Trabecular T-score at lumbar spine was -1.2. The percent of subjects with a T-score of < 2.5 by site and method was DXA Proximal Femur: 7 %, DXA distal radius: 17 %, DXA spine: 9 %, QCT (American College of Radiology cutoffs): 9 %. CT derived ACI correlated with PWV (r = 0.29, p = 0.02), pulse wave pressure (r = 0.51, p < 0.001), QCT Trabecular (-0.31, p = 0.01) and cortical volumetric BMD and history of cardiovascular events (Mann-Whitney U, p = 0.02). Both visceral and subcutaneous adipose tissue correlated with BMI (r = 0.63 & 0.64, p < 0.001).

Conclusions: Single CT scan triple assessment of BMD, vascular calcification and body composition is an efficient, accurate and convenient method of risk factor monitoring post renal transplantation.

No MeSH data available.


Related in: MedlinePlus