Osteoporosis being the one of the most common bone ailment, it has been affecting our societies from a very long time and is mainly described as the disruption of the equilibrium between bone formation and resorption(8). Subsequently this loss of bony constituent creates changes in bone microarchitecture which markedly favours the incidence of fractures, all of which makes it closely related with high morbidity and mortality rates(9).
Reduction in skeletal muscle mass can be linked to decline BMD(10). Since SCr can serve as an indicator for muscle mass, Huh et al assessed the association between SCr and BMD in an elderly population whose kidney function was normal and came to a conclusion that SCr imitated muscle mass, and low levels of SCr was related to low levels of BMD independently(11). Greater muscle mass is said to be related to better results and long life in people with CKD states(12). Proper lifestyle choices, facilitated by choosing a balanced diet and regular exercise can help improve an individual’s maximum bone potential at an early age(13). If there is a vitamin D receptor genotype variant such patients are susceptible to low bone density(14).
Robert H et al., evaluated the linkage between BMD and fractures in partakers with or without CKD by taking health, age and body composition into consideration. They came to a conclusion that BMD values provided information pertaining to fracture risk in the elderly with or without moderate CKD(15). Therefore, by looking at the values we can predict the risk of future fractures in such individuals irrespective of their renal health. Simerjot K Jassal et al., conducted a study to determine the relationship between kidney function and BMD and related it to bone loss, and osteoporotic fracture. They found that measured renal function had declined with age. They concluded that there is an associations between kidney function and BMD which is the strongest when CKD is high, which shows that if a patient has declining renal function the BMD values may be low(16) .
Myong Jun-Pyo Myong et al., conducted a study in Korea to find the relationship between BMD and CKD among general population in Korea and concluded that there was a link between eGFR and BMD in men and women. This study shows that if GFR decreases, there can be a decline in BMD. Therefore, there’s higher risk of osteoporosis or osteopenia in people with reduced renal function(17). Using modern therapy for osteoporosis, it is important to use newer pathogenetic approaches which aim towards the elimination of any imbalances between the relationship of osteoclast – osteoblast while using anabolic support of all bone cells. “Osteomed Forte” is a drug that complies these requirements(18).
In this cross sectional study, 95 participants out of 200 were detected with bone loss (47.5%) and it was observed that most of the participants with bone loss were from the age range from (41-60) about 62.1%. Therefore, as age increases bone density decreases even with good renal health. We also evaluated the average of normal creatinine levels (0.87+0.16) with BMD and independently associated it with the average values of T Score (-0.84+1.46) and Z Score (-0.08+1.32), and the principle finding was that T Score (-0.25) and Z Score (-0.187) were not associated with normal creatinine levels. A negative correlation between BMD and normal kidney function done by evaluating serum creatinine levels cannot give an explanation about the bone health of an individual.
QCT permits measurement of volumetric bone density without any superimposition of cortical bone and other surrounding soft tissue(19). The site most commonly used to measure BMD using QCT is the lumbar spine. The trabecular bone is the main site for osteoporotic bone loss, therefore the density loss in that region is higher than that other sites like in cortical bone(20). Phantom-less CT scans can be used to estimate lumbar BMD with accuracy similar to that of dual energy x-ray absorptiometry (DEXA) scans which is considered a gold standard in detecting BMD. QCT is largely applied to both prospective and retrospective studies which can assess patient bone density and therefore can be helpful for research and clinical practice (21). The QCT machine used for this study was Philips Incisive 128 slice CT. The Philips BMD software can therefore be used as an effective tool to diagnose osteoporosis/osteopenia. In this study we found that out of the 95 patients with bone loss 74 (77.8%) patients had osteopenia and 21 (22.2%) patients had osteoporosis. Moreover, we tested the efficiency of our MDCT system in evaluating BMD without any extra radiation, time and cost to the patient.