Angiotensin converting enzyme I/D and M235T angiotensinogen gene polymorphism in patients with acromegaly
Dana Bucuras, Dorin Grigoras, Doru Anastasiu & Dan Poenaru
Backgound: ESRD is associated with a sustained decrease in bone mineral density compared with aged-matched healthy controls. DXA is the standard noninvasive method to asses BMD. QUS is inexpensive, mobile, easy to perform, radiation free, recognize for screening abilities and risk fracture prediction in normal population. This study assessed the ability of QUS versus DXA in determine low bone mass in haemodialised population.
Materials and methods: Patients in the evidence of the Haemodialysis and Renal Transplantation Center from the County Hospital nr.1, performed DXA (anteroposterior technique, Delphi W device, Hologic Inc.), and also QUS (Sahara device, Hologic Inc). Receiver operator characteristic curves (ROC) were plotted for BUA, SOS and QUI and used to define cut-off values for best sensitivities and specificities for all parameter. Bone demineralisation was defined as a T score on DXA lower than 1, with increased markers of bone turnover.
Results: We analised 131 patients (63 females and 68 males), mean age 47.776±12, 32 years, being in haemodialysis for a mean period of mean 51.488±4.686 months. BUA (r=0.613/0.447) and QUI (r=0.613/0.502) seem to be the parameters of choice when considering BMD at cortical level. Areas under ROC for BUA and SOS in diagnosis of osteoporosis and osteopenia, have a sensitivity of 76, 1%76, 1%, respectively a specificity of 72, 5%77, 8%. The identified cutoff levels for QUI are 76.1 (osteopenia) and 69.6 (osteoporosis). The diagnostic value of QUS,when reporting QUI, are even higher when we did define the proper interval.
Conclusion: DXA and QUS parameters correlate significantly. The best QUS diagnostic parameter comoared to DXA is QUI. It has the ability to identify low bone mass (sensitivity of 60/80%), but also can discriminate very well the healthy bone subjects (specificity of 75%).