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

@entity1 @entity470 @entity730 @entity729 @entity122
BACKGROUND: Despite limitations of routine methods, Clinical Practice Guidelines support the assessment of bone mineral density (BMD) and @entity729 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 ( @entity470   >   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. @entity730 was assessed by semi-quantitative @entity730 Index (ACI) method and compared with lateral lumbar x-ray Kappuila score and pulse wave velocity ( @entity122 ). Visceral and subcutaneous adipose tissue volume (Osirix 16 Ver 3.7.1) was compared with BMI. RESULTS: @entity1 were 61  % male, had a mean age of 47  years, median ESKD duration of 5.4  years and a mean @entity470 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 @entity122 (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, @entity729 and body composition is an efficient, accurate and convenient method of risk factor monitoring post renal transplantation.
