Reduced bone mineral density (BMD) was sporadically reported in patients with Marfan syndrome. This may or may not place the Marfan patient at increased risk for bone fracture. In comparing the BMDs of our patients with those reported in the literature, it seemed that agreement between values, and hence the degree of osteoporosis or osteopenia reported, was dependent on the instrumentation used. The objective of this study was to statistically assess this impression. Bone mineral density measurements from our previously published study of 30 adults with Marfan syndrome performed on a Lunar DPXL machine were compared with studies published between 1993–2000 measured using either Lunar or Hologic bone densitometry instruments. The differences of our measurements compared with those made on other Lunar machines were not statistically significant, but did differ significantly with published results from Hologic machines (P < 0.001). Before progress can be made in the assessment of BMD and fracture risk in Marfan patients and in the evidence-based orthopedic management of these patients, standardization of instrumental bone density determinations will be required along with considerations of height, obesity, age, and sex.
BMD bone mineral density dual-energy x-ray absorptiometry Marfan syndrome study comparisons
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We acknowledge the assistance of Elizabeth Wood with construction of the database. We also thank Marshfield Clinic Research Foundation for its support through the assistance of Linda Weis, Alice Stargardt, Ingrid Glurich and Jennifer Hayes in the preparation of this manuscript.
This study was supported in part by Children’s Clinical Research Center of Weill Medical College of Cornell University (GCRCMO1RR06020), Adult Clinical Research Center of Weill Medical College (M01RR00047), and the John R. Cobb Scoliosis Research Fund.
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