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LETTERS TO THE EDITOR
Year : 2022  |  Volume : 25  |  Issue : 2  |  Page : 291-292
 

Bone mineral density and body composition in males with motor neuron disease: A study from teaching hospital in Southern Part of India


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission03-May-2021
Date of Acceptance18-Jul-2021
Date of Web Publication07-Jan-2022

Correspondence Address:
Mahmood D Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.aian_386_21

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How to cite this article:
Al-Mendalawi MD. Bone mineral density and body composition in males with motor neuron disease: A study from teaching hospital in Southern Part of India. Ann Indian Acad Neurol 2022;25:291-2

How to cite this URL:
Al-Mendalawi MD. Bone mineral density and body composition in males with motor neuron disease: A study from teaching hospital in Southern Part of India. Ann Indian Acad Neurol [serial online] 2022 [cited 2022 Jul 1];25:291-2. Available from: https://www.annalsofian.org/text.asp?2022/25/2/291/335253




Sir,

Sooragonda et al.[1] assessed bone mineral density (BMD), bone mineral parameters, and body composition in Indian patients with motor neuron disease – amyotrophic lateral sclerosis (MND-ALS) – and compared these with healthy controls. They found that MND-ALS patients and healthy controls had similar BMDs [as measured by Dual-energy X-ray absorptiometry (DXA) scan]. However, bone turnover markers (BTMs) were significantly higher in the MND-ALS group, indicating a high turnover state.[1] Accordingly, they recommended testing for serum calcium, 25-hydroxy vitamin D, BTMs, and BMD in MND-ALS patients.[1] Besides few study limitations mentioned by Sooragonda et al.,[1] I presume that the following methodological limitation is also relevant. It is obvious that BMD reference intervals (BMDRIs) are required to interpret BMD estimates measured by DXA scan. BMDRIs are determined by many factors, namely age, gender, race, weight, pubertal stage, and socio-economic class,[2],[3] and normative BMDRIs have been generated for certain populations. These normative BMDRIs are utilized in clinical settings and researchcenters. Interestingly, India has already constructed its indigenous BMDRIs.[4] Instead of employing Indian normative BMDRIs, Sooragonda et al.[1] have inadvertently employed the International Society of Clinical Densitometry (ISCD) criteria released in 2004[5] to define osteoporosis and normal BMD on interpreting the calculated BMD values. We feel that this limitation in their methodology might affect the interpretation of the study findings and recommendations addressed by Sooragonda et al.[1] It was solicited from Sooragonda et al.[1] to add in the limitations of their study that they could not employ the new Indian reference data, released in 2021,[4] as it was not launched at the time of conducting their study. The data in the Indian BMDRIs was recruited from a limited number of subjects (825 subjects: men = 380; women = 445)[4] and needs further substantiation. Hence, they have used international criteria.[5]

Acknowledgement

None

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Sooragonda BG, Agarwal S, Benjamin RN, Prabhakar AT, Sivadasan A, Kapoor N, et al. Bone mineral density and body composition in males with motor neuron disease: A study from teaching hospital in southern part of India. Ann Indian Acad Neurol 2021;24:211-6.  Back to cited text no. 1
  [Full text]  
2.
Arabi A, Nabulsi M, Maalouf J, Choucair M, Khalifé H, Vieth R, et al. Bone mineral density by age, gender, pubertal stages, and socioeconomic status in healthy Lebanese children and adolescents. Bone 2004;35:1169-79.  Back to cited text no. 2
    
3.
Wu Q, Lefante JJ, Rice JC, Magnus JH. Age, race, weight, and gender impact normative values of bone mineral density. Gend Med 2011;8:189-201.  Back to cited text no. 3
    
4.
Aggarwal A, Pal R, Bhadada SK, Ram S, Garg A, Bhansali A, et al. Bone mineral density in healthy adult Indian population: The Chandigarh Urban Bone Epidemiological Study (CUBES). Arch Osteoporos 2021;16:17.  Back to cited text no. 4
    
5.
Writing Group for the ISCD Position Development Conference. Position statement: Executive summary. The writing group for the International society for clinical densitometry (ISCD) position development conference. J Clin Densitom 2004;7:7-12.  Back to cited text no. 5
    




 

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