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DEXA - Top 30 Publications

Evaluation of the anti-osteoporotic effect of Ginkgo biloba L. in Wistar rats with glucocorticoid-induced-osteoporosis by bone densitometry using dual-energy x-ray absorptiometry (DEXA) and mechanical testing.

Evaluate the effect of the extract of Ginkgo biloba in the bone alkaline phosphatase, bone mineral density, in the mechanical properties of the tibia in rats with glucocorticoid-induced-osteoporosis. After osteoporosis induction, the rats were divided into five groups: Osteoporosis; EGb1 (28 mg/Kg); EGb2 (56 mg/Kg); alendronate (0.2 mg/animal) and control. The animals were treated during 20 and 30 days. The control group was compared with the osteoporosis's (Student's t-test), while the other were analyzed by ANOVA test followed by Tukey/Dunnett'T3 (p<0.05). In the osteoporosis group the bone alkaline phosphatase, bone mineral density, the bone stiffness, the maximum load and the resilience were reduced. The bone alkaline phosphatase values increased in the EGb1 and EGb2 groups (30 days). In addition, in the EGb2 and alendronate groups (20 and 30 days) the bone mineral density increased. The extract of Ginkgo biloba restored bone alkaline phosphatase and bone mineral density using dual-energy x-ray absorptiometry.

Differential relationships of hepatic and epicardial fat to body composition in HIV.

HIV-infected patients commonly experience changes in central and peripheral fat content as well as ectopic fat accumulation. However, whether hepatic and epicardial fat stores relate differentially to body composition or how these associations are modified by HIV status has not been well explored. A previously recruited sample of 124 HIV-infected patients and 58 healthy controls had undergone dual energy X-ray absorptiometry (DEXA) and computed tomography (CT) from which body composition measures, liver-spleen ratio, and epicardial fat volume were obtained. Unique to the HIV-infected group, there was a parabolic association between abdominal subcutaneous adipose tissue (SAT) area and liver-spleen ratio (P = 0.03, inflection point 324 cm(2)) such that hepatic fat content was greatest at the extremes of low and high SAT A quadratic model also closely described the relationship between mean leg fat and liver-spleen ratio among patients with HIV (P = 0.02, inflection point 4.7 kg), again suggesting greater liver fat content with both low and high leg fat. Notably, an analogous relationship of epicardial fat with SAT was not evident among HIV-infected individuals or healthy controls. In contrast, visceral adipose tissue (VAT) linearly related to both liver-spleen ratio in HIV and epicardial fat volume irrespective of HIV status in multivariable models. In conclusion, our analyses implicate both low and high SAT as risk factors for hepatic fat accumulation in HIV These findings add to growing evidence of SAT dysfunction in the setting of HIV infection, and highlight key physiologic differences between hepatic and epicardial fat depots.

Adiposity, Dysmetabolic Traits and Earlier Onset of Female Puberty in Adolescent Offspring of Women With Gestational Diabetes Mellitus: A Clinical Study Within the Danish National Birth Cohort.

Offspring of pregnancies affected by gestational diabetes mellitus (GDM) are at increased risk of the development of type 2 diabetes. However, the extent to which these dysmetabolic traits may be due to offspring and/or maternal adiposity is unknown. We examined body composition and associated cardiometabolic traits in 561 9- to 16-year-old offspring of mothers with GDM and 597 control offspring.

Effect of multiparity on bone mineral density, evaluated with bone turnover markers.

Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (five deliveries or more) and nulliparous women in the post-menopausal period.

Examination of Risk for Sleep Disordered Breathing among College Football Players.

Professional football linemen are at risk for sleep disordered breathing (SDB) compared to other types of athletes. It is currently unknown whether collegiate football linemen display a similar risk profile.

Skinfold Prediction Equations Fail to Provide an Accurate Estimate of Body Composition in Elite Rugby Union Athletes of Caucasian and Polynesian Ethnicity.

Body composition in elite rugby union athletes is routinely assessed using surface anthropometry, which can be utilised to provide estimates of absolute body composition using regression equations. This study aims to assess the ability of available skinfold equations to estimate body composition in elite rugby union athletes, who have unique physique traits and divergent ethnicity. The development of sport-specific and ethnicity-sensitive equations was also pursued. Forty-three male international Australian rugby union athletes of Caucasian and Polynesian descent underwent surface anthropometry and dual-energy X-ray absorptiometry (DEXA) assessment. Body fat percent (BF%) was estimated using five previously developed equations, and compared to DEXA measures. Novel sport and ethnicity-sensitive prediction equations were developed using forward selection multiple regression analysis. Existing skinfold equations provided unsatisfactory estimates of BF% in elite rugby union athletes, with all equations demonstrating a 95% prediction interval in excess of 5%. The equations tended to underestimate BF% at low levels of adiposity, whilst overestimating BF% at higher levels of adiposity, regardless of ethnicity. The novel equations created explained a similar amount of variance to those previously developed (Caucasians 75%, Polynesians 90%). The use of skinfold equations, including the created equations, cannot be supported to estimate absolute body composition. Until a population-specific equation is established that can be validated to precisely estimate body composition, it is advocated to use a proven method such as DEXA when absolute measures of lean and fat mass are desired, and raw anthropometry data routinely to derive an estimate of body composition change.

Risk of Sarcopenia and Osteoporosis in Male Tuberculosis Survivors: Korea National Health and Nutrition Examination Survey.

Short-term prospective studies have suggested that pulmonary tuberculosis (TB) preludes permanent loss of lean tissue and fat mass even when TB treatment is effective. The aim of this study was to estimate the risk of sarcopenia and osteoporosis among Korean male TB survivors. Data of the population-based, Korea National Health and Nutrition Examination Survey (KNHANES) (2008-2011) were analyzed, including 3,228 males aged 50 years or older who underwent chest X-ray (CXR) and dual-energy x-ray absorptiometry (DEXA). TB survivors having both medical history and TB scars on CXR had increased risk of sarcopenia (odds ratio [OR] 3.44, 95% confidence interval [CI] 1.79-6.68) and osteoporosis (OR 1.75, 95% CI 1.04-2.95) after adjusting for age, height, smoking, alcohol, physical activity, serum 25-hydroxyvitamin D, parathyroid hormone level, education, and fat mass index. Having TB scars on CXR without medical history of TB was an independent risk factor of sarcopenia (OR 2.05, 95% CI 1.05-4.00), but not a risk factor of osteoporosis. Sarcopenia and low bone mineral density are prevalent in pulmonary TB survivors with TB scars on CXR. Medical history of TB with TB scars on CXR is an independent risk factor for sarcopenia and osteoporosis.

Associations of active commuting with body fat and visceral adipose tissue: A cross-sectional population based study in the UK.

The promotion of active travel (walking and cycling) is one promising approach to prevent the development of obesity and related cardio-metabolic disease. However the associations between active travel and adiposity remain uncertain. We used the Fenland study (a population based-cohort study; Cambridgeshire, UK, 2005-15) to describe the association of commuting means with DEXA measured body fat and visceral adipose tissue (VAT) among commuters (aged 29-65years; n=7680). We stratified our sample into those living near (within five miles) and far (five miles or further) from work, and categorised commuting means differently for each group reflecting their different travel options. Associations were adjusted for age, education, Mediterranean diet score, smoking, alcohol consumption, test site and either self-reported physical activity or objective physical activity. Among those living near to work, people who reported regularly cycling to work had lower body fat than those who only used the car (adjusting for self-reported physical activity: women, -1.74%, 95% CI: -2.27% to -0.76%; men, -1.30%, -2.26% to -0.33%). Among those who lived far from work, people who reported regular car-use with active travel had lower body fat (women; -1.18%, 95% CI: -2.23% to -0.13%; men, -1.19%, -1.93% to -0.44%). Findings were similar for VAT and when adjusting for objectively measured physical activity instead of self-reported physical activity. In conclusion, active commuting may reduce adiposity and help prevent related cardio-metabolic disease. If people live too far from work to walk or cycle the whole journey, incorporating some active travel within the commute is also beneficial.

Low skeletal mass is an important predictor of osteoporosis in HIV infected men in India.

This study evaluated prevalence and predictors of osteoporosis and sarcopenia in men with HIV.

Bone mineral density changes of lumbar spine and femur in osteoporotic patient treated with bisphosphonates and beta-hydroxy-beta-methylbutyrate (HMB): Case report.

Currently available approaches to osteoporosis treatment include application of antiresorptive and anabolic agents influencing bone tissue metabolism. The aim of the study was to present bone mineral density (BMD) changes of lumbar spine in osteoporotic patient treated with bisphosphonates such as ibandronic acid and pamidronic acid, and beta-hydroxy-beta-methylbutyrate (HMB).

Randomized trial of two doses of vitamin D3 in preterm infants <32 weeks: Dose impact on achieving desired serum 25(OH)D3 in a NICU population.

Recommendations for vitamin D supplementation for preterm infants span a wide range of doses. Response to vitamin D supplementation and impact on outcomes in preterm infants is not well understood.

Auto-regulated exercise selection training regimen produces small increases in lean body mass and maximal strength adaptations in strength-trained individuals.

The purpose of this investigation was to compare the effects of auto-regulatory exercise selection (AES) vs. fixed exercise selection (FES) on muscular adaptations in strength-trained individuals. Seventeen males (Mean ± SD; age = 24 ± 5.45 years; height = 180.3 ± 7.54cm, lean body mass [LBM] 66.44 ± 6.59kg; squat and bench press 1RM: body mass ratio 1.87, 1.38 respectively) were randomly assigned into either AES or FES. Both groups trained three times a week for 9 weeks. AES self-selected the exercises for each session, whereas FES was required to perform exercises in a fixed order. LBM was assessed via DEXA and maximum strength via 1RM testing, pre and post training intervention. Total volume load was significantly higher for AES than for FES (AES: 573,288kg ± 67,505, FES: 464,600 ± 95,595, p=0.0240). For LBM, there was a significant main time effect (p=0.009). However, confidence interval analysis (95%CIdiff) suggested that only AES significantly increased LBM (AES: 2.47%, ES: 0.35, 95% CIdiff [0.030kg: 3.197kg], FES: 1.37 %, ES: 0.21, 95% CIdiff [-0.500kg: 2.475kg]). There was a significant main time effect for maximum strength (p≤0.0001). However, 95% CIdiff suggested that only AES significantly improved Bench-press 1RM (AES: 6.48%, ES: 0.50, 95% CIdiff [0.312kg: 11.42kg; FES: 5.14%, ES: 0.43 95%CIdiff [-0.311kg: 11.42kg]. On the other hand for back squat 1RM similar responses were observed between groups, (AES: 9.55%, ES: 0.76 95% CIdiff [0.04kg: 28.37kg], FES: 11.54%, ES: 0.80, 95%CIdiff [1.8kg: 28.5kg]. Our findings, suggest AES may provide a small advantage in LBM and upper body maximal strength in strength-trained individuals.

Combined intraoperative paracetamol and preoperative dexamethasone reduces postoperative sore throat: a prospective randomized study.

Postoperative sore throat (POST) after general anesthesia with endotracheal intubation is a common and undesirable complication. In this study, we evaluated the combined effects of paracetamol and dexamethasone on the prevention of POST in patients after general anesthesia.

Electronic Medical Record Integration for Streamlined DXA Reporting.

Dual-energy X-ray absorptiometry (DXA) is the most frequently performed examination to assess bone mineral density in clinical practice. Aside from images and graphical displays, many numerical values are part of DXA reports. These values are typically manually entered into the formal report through the electronic medical record or PACS workstation. The process takes time and is prone to errors. Exporting the DXA numerical data via HL7 engine to the electronic medical record was proposed to improve reporting efficiency and accuracy. The output from the DXA unit computer was reconfigured to export the report content via the HL7 interface engine into the electronic medical record. Radiology interpretive reporting was subsequently done directly in the electronic medical record. In the evaluation of errors, 100 preliminary DXA reports before the change and 100 after the change were examined. These reports were analyzed for errors that included decimal change, number transposition, negative number issue, other incorrect number error, and failure to include prior exam for comparison. In addition, report turnaround times were evaluated before and after the changes were made. Reporting time evaluations included 1-year volume prior to change (3915 reports) and 1 month post-change (206 reports). Of 100 DEXA exams before the change, 15 final reports contained 25 numerical errors. After the change, no numerical errors in the reports were identified. Exam end to final report time decreased from 2159 to 625 min on average. Automating data transmittal from the DXA modality for report generation improves accuracy and turnaround time. This approach did not require any third party software, and healthcare information security concerns were negated since we are using our standard workstations. Secondary to the affordability and applicability to the large percentage of the population using electronic medical record systems, this type of automated workflow is recommended.

miR155 deficiency aggravates high-fat diet-induced adipose tissue fibrosis in male mice.

Noncoding RNAs are emerging as regulators of inflammatory and metabolic processes. There is evidence to suggest that miRNA155 (miR155) may be linked to inflammation and processes associated with adipogenesis. We examined the impact of global miRNA-155 deletion (miR155(-/-)) on the development of high-fat diet (HFD)-induced obesity. We hypothesized that loss of miR155 would decrease adipose tissue inflammation and improve the metabolic profile following HFD feedings. Beginning at 4-5 weeks of age, male miR155(-/-) and wild-type (WT) mice (n = 13-14) on a C57BL/6 background were fed either a HFD or low-fat diet for 20 weeks. Body weight was monitored throughout the study. Baseline and terminal body composition was assessed by DEXA analysis. Adipose tissue mRNA expression (RT-qPCR) of macrophage markers (F4/80, CD11c, and CD206) and inflammatory mediators (MCP-1 and TNF-α) as well as adiponectin were measured along with activation of NFκB-p65 and JNK and PPAR-γ Adipose tissue fibrosis was assessed by picrosirius red staining and western blot analysis of Collagen I, III, and VI. Glucose metabolism and insulin resistance were assessed by Homeostatic Model Assessment - Insulin Resistance (HOMA-IR), and a glucose tolerance test. Compared to WT HFD mice, miR155(-/-) HFD mice displayed similar body weights, yet reduced visceral adipose tissue accumulation. However, miR155(-/-) HFD displayed exacerbated adipose tissue fibrosis and decreased PPAR-γ protein content. The loss of miR155 did not affect adipose tissue inflammation or glucose metabolism. In conclusion, miR155 deletion did not attenuate the development of the obese phenotype, but adipose tissue fibrosis was exacerbated, possibly through changes to adipogenic processes.

Celiac disease-related osteopathy among Saudi celiac patients: Are we adherent to recommendations?

There are no reports from Saudi Arabia documenting the picture of osteopathy in celiac disease (CD) and the adherence of physicians to the guidelines and recommendations to screen for bone disease. We conducted this study to document the prevalence of CD-related osteopathy and the Saudi physicians' adherence to the screening recommendations.

The impact of closed versus open kinetic chain exercises on osteoporotic femur neck and risk of fall in postmenopausal women.

[Purpose] This study aimed to investigate how closed and open kinetic chain exercises differed in their impact on bone mineral density (BMD) and fall risk in postmenopausal women with osteoporosis. [Subjects and Methods] The research sample consisted of 40 postmenopausal women with osteoporosis with ages between 51 and 58 years old. They were divided at random into two groups of 20 each, respectively receiving closed and open kinetic chain exercises. These exercises were administered three times per week over a period of four sequential months. Prior to and following the treatment, Dual X-ray Absorptiometry (DEXA) was used to measure the BMD of the femur neck in every participant, while the Biodex Stability System (BSS) was used to estimate how likely each participant was to sustain a fall. [Results] The strongest effect on BMD and fall risk was recorded by the closed kinetic chain exercise. [Conclusion] Osteoporotic postmenopausal women should be prescribed closed kinetic chain exercise to diminish the effects of the disease and minimise their risk of fall.

Fracture liaison service: report on the first successful experience from the Middle East.

This study aims to assess for the first time in the Middle East, the clinical benefits of an FLS model established in a hospital in Beirut, Lebanon. It shows a significant 54% relative risk reduction in re-fracture incidence, confirming the patient-oriented benefit of diffusing this system in the Middle East region.

Concurrent administration effect of antibiotic and anti-inflammatory drugs on the immunotoxicity of bacterial endotoxins.

Pseudomonas aeruginosa (P. aeruginosa) is a gram-negative bacterium that causes a variety of diseases in compromised hosts. Bacterial endotoxins such as lipopolysaccharide (LPS) are the major outer surface membrane components that are present in almost all gram-negative bacteria and act as extremely strong stimulators of innate immunity and inflammation of the airway. This study was undertaken to determine the effect of combined administration of Gentamicin (GENT) as an antibiotic and Dexamethasone (DEXA) as an anti-inflammatory drug on some immunological and histological parameters. After determination of LD50 of P. aeruginosa, mice groups were injected with DEXA, GENT and lipopolysaccharide alone or in combination. Lipopolysaccharide single injection caused a significant increase of total leukocyte count, lymphocytes, neutrophils and levels of IgM and IgG. DEXA induced an increase of neutrophilia and lymphopenia. Immunological examination demonstrated that combined treatment has a significant effect of decreasing lymphocytes and IgG levels than single treatment does. Histological examination demonstrated that the inflammation of thymus, spleen, lymph node and liver decreases in mice that received combined treatment than those that received individual treatment. Concurrent administration of DEXA and GENT has a great effect on protecting organs against damage in case of endotoxemia.

Hormone replacement therapy after treatment for cervical cancer: Are we adhering to standard of care?

The aim of this study was to assess hormone replacement therapy (HRT) and bone care health maintenance practices for cervical cancer patients with iatrogenic menopause, and, secondarily, to investigate the potential impact of specific demographic and clinical factors.

The effect of high-dose vitamin D3 supplementation on bone mineral density in subjects with prediabetes.

The rationale of this study was to determine the effect of high-dose vitamin D3 supplementation on bone mineral density (BMD). Prediabetic males given vitamin D had significantly less reduction in BMD at the femoral neck compared to the controls. The clinical implications of our findings require further investigation.

The associations between dietary patterns and bone health, according to the TGF-β1 T869→C polymorphism, in postmenopausal Iranian women.

Recent studies have shown that dietary variants and genetic variants play a decisive role in the risk of developing osteoporosis. Therefore, the objective of the present study was to examine associations between dietary pattern and bone health, according to the TGF-β1 T869→C polymorphism, in postmenopausal Iranian women.

Intravenous dexamethasone as an adjunct to improve labor analgesia: A randomized, double-blinded, placebo controlled clinical trial.

To study the role of intravenous (i.v.) dexamethasone as an analgesic adjunct in labor analgesia.

Influence of hip prosthesis size and its coating area on bone remodelling.

We developed a numerical model to describe the bone remodelling process in periprosthetic bone tissues and validated it by means of dual energy X-ray absorptiometry methods (DEXA) with different types of hip implants. In this study we applied the numerical model to investigate the influence of implant size and of the size of the porous coated area on bone remodelling in a periprosthetic human femur in an effort to define properties of implants which would reduce bone remodelling after total hip arthroplasty. Two different sizes of a newly designed implant and three different coating area sizes were investigated in this study. The results show that the smaller the implant, the less bone remodelling occurs. Reducing prosthesis size by 2 mm from all sides has decreased bone remodelling by 14.4%. Extending the coating area on both, lateral and medial parts of the implant, has decreased bone remodelling in the lateral part of the femur and increased it in the medial part. In conclusion, depending on these results, the oversized hip replacement would cause more bone resorption in the femur. Concerning the coating area, the manufacturer must find a compromise between the small coating area with less bone remodelling in the medial part of the femur as well as less primary stability and the bigger coating area with less bone remodelling in the lateral part of the femur, but with higher bone remodelling in its medial part and more primary stability.

Visceral Adipose Tissue as a Risk Factor for Diabetes Mellitus in Patients with Chronic Pancreatitis: A Cross-sectional, Observational Study.

Visceral adipose tissue (VAT) is a risk factor for diabetes and we investigated the amount of VAT in patients with chronic pancreatitis (CP).

The Pedicles Are Not the Densest Regions of the Lumbar Vertebrae: Implications for Bone Quality Assessment and Surgical Treatment Strategy.

Cadaver study.

Increased Lipolysis, Diminished Adipose Tissue Insulin Sensitivity and Impaired β-cell Function Relative to Adipose Tissue Insulin Sensitivity in Obese Youth with Impaired Glucose Tolerance (IGT).

Despite evidence of insulin resistance and β-cell dysfunction in glucose metabolism in youth with prediabetes, the relationship between adipose tissue insulin sensitivity (ATIS) and β-cell function remains unknown. We investigated whole-body lipolysis, ATIS and β-cell function relative to ATIS [adipose disposition index (DI)] in obese youth with IGT vs. normal glucose tolerance (NGT). Whole-body lipolysis (glycerol appearance rate [GlyRa] ([(2)H5]glycerol at baseline and during a hyperinsulinemic-euglycemic clamp)), lipid oxidation (indirect calorimetry), insulin secretion (2-hr hyperglycemic clamp), and body composition (DEXA) were examined. Adipose DI was calculated as ATIS (1/GlyRa x fasting insulin) x 1(st)-phase insulin secretion. Despite similar percent body fat, IGT vs. NGT youth had higher GlyRa, lower ATIS at baseline and during hyperinsulinemia, and higher lipid oxidation. Adipose DI was ∼43% lower in IGT youth and correlated positively with glucose DI. The lower ATIS and diminished adipose DI in IGT vs. NGT is in line with the compromised glucose metabolism reflected in impaired β-cell function relative to peripheral insulin resistance. We conclude that IGT youth manifest a global decline in insulin sensitivity, including impaired insulin action in suppressing lipolysis and lipid oxidation, accompanied by β-cell dysfunction in fat and glucose metabolism enhancing their risk of type 2 diabetes.

Impact of beverage consumption, age, and site dependency on dual energy X-ray absorptiometry (DEXA) measurements in perimenopausal women: a prospective study.

The aim of this study was to determine the best site for bone mineral density (BMD) measurements based on T-scores, age, and beverage consumption.

Elevated serum 14-3-3η protein may be helpful for diagnosis of early rheumatoid arthritis associated with secondary osteoporosis in Chinese population.

Osteoporosis (OP) is one of the signs of bone damage in rheumatoid arthritis (RA). The 14-3-3η protein is an inflammatory protein, which has been reported to be associated with rheumatoid arthritis (RA). This is to determine the serum levels of 14-3-3η protein, evaluate its diagnostic value in early RA, and clear out its significance in RA with secondary osteoporosis. Two hundred fifty-nine RA patients and 80 age and sex-matched healthy controls were included. Assays of serum 14-3-3η protein were done for all participants by enzyme-linked immunosorbent assay (ELISA). Dual-energy X-ray absorptiometry (DEXA) was used to measure bone mineral density (BMD). Serum 14-3-3η protein level was significantly high in RA (2.49/4.72), compared with controls (P < 0.0001). Positive rate of 14-3-3η protein in RA was 97.3%, which was higher than that in controls (χ (2) = 276.641, P < 0.0001). Serum 14-3-3η protein level in early RA was significantly higher than that in established RA (3.91/4.82 vs 2.01/3.29, Z = 2.624, P < 0.05). The positive rate among three groups (normal control, early RA group, established RA group) differed from each other (χ (2) = 131.396, P < 0.0001). Results of ROC curve indicated the cutoff point of 14-3-3η protein for diagnosis of early RA was 0.879 ng/ml (P < 0.0001). Linear correlation analysis found that serum 14-3-3η protein positively correlated with VAS and HAQ (P < 0.0001), negatively correlated with BMD at lumbar spine and femur in RA (P < 0.0001). Serum 14-3-3η protein among groups of bone mass normal (2.73/3.79), osteopenia (3.15/4.86), and osteoporosis (6.34/6.42) was different in early RA patients (χ (2) = 7.974, P < 0.05). Serum 14-3-3η protein levels increase significantly in patients with RA (especially in early RA). There are close relationships between serum 14-3-3η protein and clinical symptoms and osteoporosis in patients with RA.

Serum level of chemerin and bone mineral density in patients with Graves disease.

To investigate relationships between serum chemerin and bone mineral density (BMD) in patients with newly diagnosed Graves disease (GD).
 Methods: A total of 120 newly diagnosed GD patients with a course more than 3 months were enrolled from the Department of Endocrinology between June 2013 and June 2015. Sixty age- and sex-matched healthy people served as a normal control. Serum levels of chemerin, β-crosslaps (β-CTX), and N-MID-osteocalcin (N-MID-OT) were measured by ELISA. Fat mass and BMD were evaluated by dual energy X-ray absorptiometry (DEXA).
 Results: Compared with the normal control, the fat mass, lean weight, fat mass index (FMI) and body mass index (BMI) in the GD group were decreased, and BMD in all skeletal sites was decreased. There was a positive correlation between them (all P<0.05). Serum level of chemerin was increased and it was positively correlated with β-CTX or N-MID-OT level and negatively correlated with fat mass, FMI or BMI in the GD group. There was a negative correlation between chemerin level and BMD in femoral neck, total hip, lumbar or right forearm distal 1/3 (rs=-0.352, -0.279, -0.379, -0.289, -0.394; P<0.05). After adjusting for age, fat mass or BMI, the correlation of chemerin with total hip or bone mineral density remained significant (rs=-0.273, -0.378; P<0.05). Multiple linear regression analysis revealed that chemerin or BMI was correlated with BMD (P<0.05).
 Conclusion: The decrease of bone mineral density in patients with GD is not only related to the direct or indirect effect of excessive thyroid hormones on systemic and osteoblastic cells, but it is also related to the negative regulation of bone metabolism due to the elevated chemerin level.