The goal of this study is to assess the feasibility of emerging CT-based tools to measure changes in central and peripheral bone density, micro-structure, and marrow adipose tissue (MAT) among patients treated with oral steroids.
This study aims to prove that emerging CT-based tools are suitable to measure changes in central and peripheral bone density, geometry, micro-structure, and marrow adipose tissue (MAT) among patients treated with oral steroids. To do this, investigators will recruit 10 non-smokers (defined as \< 10 pack-year smoking history) age 25-45 years with a diagnosis of severe, persistent asthma who either chronically use oral steroids or do not use any oral steroids. Participants will undergo dual-energy X-ray absorptiometry (DXA), dual-energy mid-tibia CT, high-resolution single-energy ankle CT, and low-radiation hip CT scans at baseline and 6-month follow-up visits. The images obtained will be used to analyze cross-sectional differences in central and peripheral bone density, geometry, micro-structure, and MAT between patients using oral steroids versus those who do not use any oral steroids. Differences in imaging at baseline and six-month follow visits will be used to analyze longitudinal bone changes among patients with oral steroid treatment.
Study Type
OBSERVATIONAL
Enrollment
12
Dual-energy mid-tibia CT, high-resolution single energy MDCT imaging of the distal tibia (ankle), and low radiation hip CT scans
Basic DXA scans will be performed to measure areal BMD and body composition measures at the whole body, spine, and hip
Questionnaire designed to quantify lifetime oral glucocorticoid intake
University of Iowa
Iowa City, Iowa, United States
RECRUITINGMarrow Adipose Tissue
Marrow adipose tissue fraction at 14-16% location of the distal tibia from DECT ankle scans will be computed and compared between oral steroid and control groups.
Time frame: Baseline
Cortical Bone Density
Cortical bone density will be computed through CT scanning at 4-6% and 12-14% distal tibia locations and compared between oral steroid and control groups.
Time frame: Baseline
Peripheral Bone Density
Peripheral bone density will be computed through CT scanning at 4-6% and 12-14% distal tibia locations and compared between oral steroid and control groups.
Time frame: Baseline
Bone Geometry and Microstructure
Hip MDCT scans will be used compute volumetric bone mineral density (vBMD) measures over trabecular and cortical bone compartments at femoral head, femoral neck, greater trochanter, and lesser trochanter. These measurements will be compared between oral steroid and control groups.
Time frame: Baseline
DXA Body Composition Analysis (fat mass, lean mass, percent fat)
DXA scans will be used to acquire bone and soft tissue measures that will allow for the calculation of body composition measures, which will then be compared between oral steroid and control groups.
Time frame: Baseline
DXA Bone Mineral Density
DXA Bone Mineral Density score will be obtained using standard DXA scans and compared between oral steroid and control groups.
Time frame: Baseline
Marrow Adipose Tissue
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Marrow adipose tissue fraction at 14-16% location of the distal tibia from DECT ankle scans will be computed and evaluated over time in the oral steroid group.
Time frame: Change from baseline to 6-month follow up visit
Cortical Bone Density
Cortical bone density will be computed through CT scanning at 4-6% and 12-14% distal tibia locations and evaluated over time in the oral steroid group.
Time frame: Change from baseline to 6-month follow up visit
Peripheral Bone Density
Peripheral bone density will be computed through CT scanning at 4-6% and 12-14% distal tibia locations and evaluated over time in the oral steroid group.
Time frame: Change from baseline to 6-month follow up visit
Bone Geometry and Microstructure
Hip MDCT scans will be used compute volumetric bone mineral density (vBMD) measures over trabecular and cortical bone compartments at femoral head, femoral neck, greater trochanter, and lesser trochanter. Changes in these measurements from baseline to 6-month follow up visits will be computed for the oral steroid group.
Time frame: Change from baseline to 6-month follow up visit
DXA Body Composition Analysis (fat mass, lean mass, percent fat)
DXA scans will be used to acquire bone and soft tissue measures that will allow for the calculation of body composition measures. Change over time from baseline to 6-month follow up visit will be computed for the oral steroid group.
Time frame: Change from baseline to 6-month follow up visit
DXA Bone Mineral Density
DXA Bone Mineral Density score will be obtained using standard DXA scans. These scores will be compared at baseline and 6-month follow up visits for the oral steroid group.
Time frame: Change from baseline to 6-month follow-up visit