Correlation of serum androgens with anthropometric and metabolic indices in healthy, nonobese postmenopausal women

OBJECTIVE

The role of testosterone in the regulation of metabolic and physiological function in men is well defined, but its role in women remains enigmatic. Thus, the present study sought to assess the contribution of endogenous circulating androgens to the regulation of metabolic function, body morphometry, and physical function in normal naturally postmenopausal women.

METHODS

Using a cross-sectional design, we measured serum androgens in a cohort of 29 naturally postmenopausal women and correlated the results with metabolic, morphometric, and functional outcome parameters. These included insulin sensitivity, whole-body fat and lean body mass, visceral/abdominal fat areasm and aerobic capacity.

RESULTS

Higher serum testosterone levels were related to greater maximal aerobic capacity and reduced adiposity. Additionally, higher serum dihydrotestosterone, dehydroepiandrosterone sulfate, androstenedione, and androstenetriol glucuronidate levels were correlated to greater insulin sensitivity.

CONCLUSION

In naturally postmenopausal women, endogenous androgens may play a role in the maintenance of beneficial patterns of metabolic, morphometric, and functional parameters.

From "overweight" to "about right": evidence of a generational shift in body weight norms

In this article, we describe differences in the self-perception of weight status in the United States between the two most recent National Health and Nutrition Examination Survey (NHANES) periods (1988-1994 and 1999-2004), and test the hypothesis that secular increases in adult mean BMI, adult obesity, and childhood obesity contributed to changes over time in weight perceptions. We find that the probability of self-classifying as overweight is significantly lower on average in the more recent survey, for both women and men, controlling for objective weight status and other factors. Among women, the decline in the tendency to self-classify as overweight is concentrated in the 17-35 age range, and is more pronounced among women with normal BMI than those with overweight BMI. Among men, the shift away from feeling overweight is roughly equal across age groups. Overweight men exhibit a sharper decline in feeling overweight than normal weight men. Despite the declines in feeling overweight between surveys, weight misperception did not increase significantly for men and decreased by a sizable margin among women. We interpret the findings as evidence of a generational shift in social norms related to body weight. As a result, people may be less likely to desire weight loss than previously, limiting the effectiveness of public health campaigns aimed at weight reduction. On the other hand, there may be health benefits associated with improved body image.

Metabolic profiles of fat and glucose differ by gender in healthy 8-year-olds

OBJECTIVE

The aim was to investigate if metabolic markers were associated with anthropometry and weight increase in healthy 8-year-olds.

METHODS

Ninety-seven healthy children, 66 of whom had been examined at the age of 4 years, were investigated. Dual energy X-ray absorptiometry was performed to determine fat (FM) and lean body mass (LBM). Plasma glucose and serum levels of insulin, cholesterol, triglycerides, adiponectin and leptin were analysed and HOMA-indices were calculated.

RESULTS

Despite similar anthropometry, metabolic markers differed by gender. Sixteen % of the children were overweight or obese. Body mass index (BMI) was strongly correlated to FM. Anthropometric measures except LBM correlated to metabolic markers in the girls. Boys had higher concentrations of plasma glucose than girls. In overweight children, insulin was negatively associated with LBM. Leptin and the ratio between leptin and adiponectin, but not adiponectin, were significantly associated with HOMA-IR and body composition.

CONCLUSION

The metabolic profile of plasma glucose, serum leptin, fasting insulin and related HOMA indices differed by gender, despite no difference in BMI or FM. LBM, but not FM correlated to the insulin concentration in the overweight children. Leptin was the best marker of overweight.

Prediction of BMI change in young children with the family nutrition and physical activity (FNPA) screening tool

BACKGROUND

Youth obesity prevention practices would be enhanced if modifiable risk factors can be identified before children become overweight.

PURPOSE

This study evaluated the predictive validity of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess family environments and behaviors that may predispose youth to becoming overweight.

METHODS

Parents from a large urban school district completed the FNPA screening when children were in first grade. One-year change in measured body mass index (BMI) was used as the primary outcome, and this was computed using the relative change in distance from the BMI value at the 50th percentile. Descriptive, correlation, and mixed modeling analyses were used for survey validation.

RESULTS

Over half of the participants exhibited an increase in BMI percentile over the 1-year follow-up with an average change of 0.51 +/- 11.5% which is indicative of trends to overweight. Although baseline BMI predicted BMI at follow-up, the FNPA total score explained unique variance in child BMI at follow-up after accounting for baseline BMI, parent BMI, and other demographic variables (p = 0.049).

CONCLUSIONS

This study demonstrates the potential validity of a simple, easy-to-use screening tool for identifying children that may be at risk for becoming overweight.

Predictive equations for stature in the elderly: A study in three Latin American cities

AIM

The aim of this study was to develop predictive equations based on anthropometric data to estimate stature in people 60 years and older in Latin America.

DESIGN

Population-based cross-sectional study in three Latin American cities.

SUBJECTS

Sample sizes were n=1657 (Sao Paulo, Brazil), n=1004 (Santiago, Chile) and n=995 (Mexico City, Mexico).

METHOD

The prediction equations were fitted by stepwise linear regression analysis. For each country and sex, samples were randomly split into two sub-samples (training and validation sub-samples) using the cross-validation method.

RESULTS

Stepwise regression analysis in the training sample revealed that only knee-height and age had a significant effect on the prediction of height. The values of the shrinkage statistic were below 0.1 indicating the reliability of the prediction equations. The regression equations had standard errors of estimate ranging from 3.3 cm (Chile), 3.6 cm (Brazil) and 4.0 cm (Mexico) for women, and 3.7 cm (Mexico and Chile) and 3.8 cm (Brazil) for men.

CONCLUSIONS

Sex-specific stature prediction equations based on knee-height and age were obtained from large representative samples from selected cities of Latin America.

Malnutrition, poverty, and economic growth

This paper argues that indicators of anthropometric shortfall - especially low height and low weight-for-age - are uniquely suited for assessing absolute deprivation in developing countries. Anthropometric indicators are relatively precise, readily available for most countries, reflect the preferences and concerns of many poor people, consistent with reckoning the phenomenon directly in the space of functionings, intuitive, easy to use for advocacy, and consistent over time and across subgroups. Anthropometric indicators can therefore complement (but not replace) standard indicators of income/consumption poverty, especially for comparisons across subgroups, within households, across countries, and in the long run. In addition, the paper analyses spells of change in malnutrition over time, finding that the association between economic growth and chronic child malnutrition is very small (but statistically significant) and much lower than the elasticity of growth on poverty. The policy implication of this finding is that direct interventions aimed at reducing infant malnutrition are required.

Current prevalence and predictors of protein-energy malnutrition among schoolchildren in rural Peninsular Malaysia

A cross-sectional study was carried out to determine the current prevalence of protein-energy malnutrition (PEM) among Orang Asli schoolchildren and to investigate the potential predictors of malnutrition. A total of 241 (120 males and 121 females) Orang Asli schoolchildren age 7-12 years living in remote areas of Pos Betau, Pahang participated voluntarily in this study. Anthropometric and socioeconomic data were collected and the children were screened for intestinal parasitic infections. The overall prevalences of mild and significant underweight conditions were 52.3% and 37.3%, respectively, and the prevalences of mild stunting and wasting were 43.6% and 43.1%, respectively, while the prevalences of significant stunting and wasting were 43.6% and 5.6%, respectively. There was a significant association between gender (male) and malnutrition (p = 0.029). The results also showed a higher prevalence of stunting among children age < or = 10 years than in older children (p = 0.001). Other independent variables, including socioeconomic status and intestinal parasitic infections, had no significant associations with malnutrition indices. PEM is prevalent among schoolchildren in rural Malaysia and therefore of public health concern since PEM diminishes immune function and impairs cognitive function and educational performance. School-based programs of prevention through health education and interventions should be considered as an essential part of measures to improve the quality of life of schoolchildren in rural Malaysia.

Facial and pituitary morphology are related in Dutch patients with GH deficiency

OBJECTIVE

Classical GH deficiency (GHD) is associated with typical phenotypic features. We have analysed standardized photographs of 137 Caucasian patients with GHD, in order to examine the relations between auxological, biochemical, pituitary and facial morphometric features.

PATIENTS AND MEASUREMENTS

We analysed pictures of 137 patients: 73 (55 Males/18 Females) with Isolated GHD and 64 (48 M/16 F) with multiple pituitary hormone deficiency (MPHD). Of each patient, standardized frontal and lateral digital pictures were taken and analysed using Adobe Photoshop 5.0.

RESULTS

Canthal index (CI), the relative distance between the eyes, was related to pituitary morphology. Patients with an ectopic posterior pituitary (EPP) had significantly higher CI values than patients without EPP. We found CI > 39 to be a good cut-off value to select children with highest probability of having EPP. The combination of CI > 39 with the presence of hormonal deficiencies additional to GHD strongly predicted EPP: 93% of the patients with a CI > 39 and additional hormonal deficiencies had EPP, in contrast to 77% of the patients with additional hormonal deficiencies but a CI < 39, and 29% of the patients with none of these criteria (P = 0.0001).

CONCLUSION

CI, measured on digital pictures, is associated with ectopia of the posterior pituitary and this might be caused by an altered midline development, affecting both the pituitary and the facial structures of GHD patients.

Anatomic evaluation of the carotid artery bifurcation in cadavers: implications for open and endovascular therapy

Knowledge of carotid bifurcation (CB), common carotid artery (CCA) and its branches and their recognition during diagnostic imaging are also important for vascular surgical procedures in the region, such as carotid endarterectomy or radical neck dissection, catheterization and aneurysms. The surgical anatomy of the carotid arteries was studied in 20 cadavers. Micrometric values of the CB and its relation with surrounding structures, measurements belonging to the external carotid artery (ECA) and internal carotid artery (ICA), and metric data, such as lower face including the greater horn, laryngeal prominence have been evaluated by making linear measures. The diameter of the CCA at the CB under 2 cm and CB diameter was measured as 8.1 +/- 2.24 mm and 12.79 +/- 2.87 mm, respectively. Evaluating data related to the ICA and the ECA in samples, the aspect was measured the ICA and the ECA in the CB discrimination point as 21.52 +/- 20.53 degrees . In the most location of the ECA origin according to the ICA has been determined as medial position in 35 specimens. The origin of the superior thyroid artery (STA) was found to be at the same level with the CB in 40% and below it in 25% specimens. This study has provided measured objective criteria for the arterial features of the neck region, which are crucial during surgery. The origins of the branches of the CCA act as key landmarks for adequate and appropriate placement of the cross-clamp on the carotid arteries.

An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients

BACKGROUND

Studies of urban parturient populations demonstrate increasing prevalence of obesity, which contributes to difficult epidural catheter placement. The aim of this study was to characterize the relationship between lumbar epidural space depth and body mass index in United States parturients from Michigan.

METHODS

We studied the records of 2009 parturients at or beyond 36 weeks' gestation. In addition to lumbar epidural space depth and body mass index, we recorded maternal age, gestational age and vertebral interspace of epidural placement. A multi-linear regression model was created with centimeter depth from skin to lumbar epidural space as the dependent variable and body mass index as the independent variable, adjusted for maternal age, gestational age and vertebral interspace.

RESULTS

Lumbar epidural space depth was (mean +/- SD) 5.3 cm+/-1.21, with more than 96% of catheters placed at L2-3 or L3-4. Mean body mass index was 31.5+/-6.2 kg/m(2). Mean maternal age was 29.3+/-5.7 years while mean gestational age was 39.3+/-1.3 weeks. In a multi-linear regression model, body mass index and maternal age were significant predictors of centimeter depth. When adjusted for maternal age, gestational age and vertebral interspace of catheter placement, body mass index was associated with an increase in depth (P<0.0001, R(2)=0.3646). Maternal age, when adjusted for body mass index and vertebral interspace, was associated with a decreased depth (P=0.0014).

CONCLUSION

When maternal age, gestational age and vertebral interspace are controlled for, increasing body mass index is associated with increasing depth, while increasing maternal age is associated with decreasing depth.

Normal measurement of orbital structures: implications for the assessment of Graves' ophthalmopathy

Compute tomography anatomy of the orbits is well described, but only a few reports are available on normal measurements of the extraocular muscles (EOM) and globe position (GP). We obtained CT images from patients who were referred to our department for CT of the paranasal sinuses using a standard protocol for evaluation of normal orbital measurements. Our study suggests that optimum results are attained with the use of a coronal scan at a window level and width setting that results in an optimum image at the maximum muscle width for assessment of EOM and an axial scan at the mid-GP for GP and interzygomatic line. Based on our normal values, a right-to-left ratio of more than 1.4 for EOM diameter or 1.2 for GP is indicative of asymmetry. An absolute diameter of EOM > 8 mm and GP < 2 mm are abnormal.

Sonographic assessment of normal kidney dimensions in the first year of life--a study of 992 healthy infants

The omission of standards for renal length in infants younger than 1 year may result in a statistically significant increase in the frequency of "spurious" nephromegaly. Nonetheless, there are only a few reports specifically dealing with normal kidney dimensions in infants. Based on sonographic assessments performed on a sample of 992 healthy infants, between January 2002 and December 2004, this paper sets up standards for normal kidney dimensions in children aged 0-3 months, 3-6 months, 6-9 months, and 9-12 months and establishes correlations between kidney dimensions (length, width, and volume) and body length and weight. Linear as well as non-linear nomograms, with percentiles for all the kidney variables examined, based on body length, are provided. Also, statistically significant differences in mean values (P=0.000) for all the observed neonatal kidney parameters, depending on gestational age at birth, are demonstrated. Principal advantages of our nomograms are that they are based on a large number of examined healthy infants and that kidney dimensions are related to body length. In addition, subjects are divided into four sub-annual age groups demonstrating gender-related differences in renal growth dynamics. Our linear nomograms are easier to use for routine clinical practice, but the percentile-based non-linear nomograms we present cover a much wider range of variations in normal infant kidney dimensions.

A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review

Obesity is a rapidly increasing public health problem, with surveillance most often based on self-reported values of height and weight. We conducted a systematic review to determine what empirical evidence exists regarding the agreement between objective (measured) and subjective (reported) measures in assessing height, weight and body mass index (BMI). Five electronic databases were searched to identify observational and experimental studies on adult populations over the age of 18. Searching identified 64 citations that met the eligibility criteria and examined the relationship between self-reported and directly measured height or weight. Overall, the data show trends of under-reporting for weight and BMI and over-reporting for height, although the degree of the trend varies for men and women and the characteristics of the population being examined. Standard deviations were large indicating that there is a great deal of individual variability in reporting of results. Combining the results quantitatively was not possible because of the poor reporting of outcomes of interest. Accurate estimation of these variables is important as data from population studies such as those included in this review are often used to generate regional and national estimates of overweight and obesity and are in turn used by decision makers to allocate resources and set priorities in health.

Effect of gender, age and anthropometric variables on plantar fascia thickness at different locations in asymptomatic subjects

PURPOSE

The study was aimed to investigate plantar fascia thickness at different locations in healthy asymptomatic subjects and its relationship to the following variables: weight, height, sex and age.

MATERIAL AND METHODS

The study evaluates 96 feet of healthy asymptomatic volunteers. The plantar fascia thickness was measured at four different locations: 1cm proximal to the insertion of the plantar fascia, at the insertion of the plantar fascia on the calcaneus and separate out 1 cm + 2 cm distal to the insertion. A 10 MHz linear-array transducer was used.

RESULTS

There were statistically significant differences in plantar fascia thickness at the four different locations (p<0.001) although no differences in PF thickness were found between the two distal from insertion locations (1 and 2 cm). Multiple regression analysis showed sex as independent predictor of plantar fascia thickness at 1cm proximal to the insertion. At origin and 1cm distal to insertion weight was an independent predictor of plantar fascia thickness.

CONCLUSIONS

There are differences of thickness at different locations of plantar fascia measured by ultrasonography. Thickness at 1cm proximal to the insertion is influenced by sex and thickness at origin and at 1cm distal to the insertion has a direct relationship with body weight. This could be attributed to the overloading effect that weight has on plantar fascia in healthy symptomatic subjects at these two locations. Height and age did not seem to influence as independent variables in plantar fascia thickness among non-painful subjects.

Assessment of the health status of Greek centenarians

The present study aims at describing the health status of a sample of relatively functional and healthy Greek centenarians and at exploring the potential gender differences in health in this sample. Its objectives are to add to the accumulation of knowledge about the health status of centenarians and therefore to contribute to the exploration of the mechanisms of healthy longevity. The study employs a non-representative community sample of Greek centenarians of both sexes (N=47). It uses descriptive statistics in order to outline the health status of the participants and non-parametric tests to assess the statistical significance of the observed sex-differences. The study shows that the centenarians of our sample are relatively healthy and functional (15% of the sample was free of any major chronic disease). It also suggests, that the sex-difference in survival is statistical significant (p< or =0.013), and that the morbidity and co-morbidity rates of the Greek centenarians are relatively low (mean value of co-morbidity=1.4+/-0.97, S.D.). Moreover, it provides valuable information on the anthropometric characteristics of the sample, and on health services utilization. These results indicate that exceptional longevity is not necessarily accompanied by disability, disease and total dependence on others.

Körpermaße bei Kindern und Jugendlichen in Deutschland

In the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a number of anthropometric parameters were assessed in a standardised way in 17,641 boys and girls. To this end, body weight and height, head circumference and upper arm length, as well as two skinfold thicknesses (triceps, subscapular) were measured for the entire age range (0-12 years); starting from 6 years of age, elbow breadth and from 11 years of age waist and hip circumference were measured in addition. For all parameters, means with confidence intervals are reported per age (in years) and gender. Median graphs depict the changes with increasing age according to gender for each body measurement. The complex age-related anthropometric developments along with significant gender specificity show the full range of the dynamic physical development in boys and girls. Based on skinfold measurement data, the body fat percentage was estimated. Thickness and location of the skinfolds, as well as the calculated waist-to-hip ratio is used as an indicator for gender-specific fat distribution. Using the frame index, it is attempted to estimate skeletal robustness. For the anthropometric parameters studied, hardly any regional differences were found. However, head circumference, frame index and all parameters strongly associated with body fat show a significant social status gradient. Children and adolescents with migration background have on average a lower height, larger waist circumference and higher percentage of body fat.

The membranous layer of superficial fascia: evidence for its widespread distribution in the body

A discrete membranous layer, "stratum membranosum", in human subcutaneous tissue is classically described as confined to the lower anterior abdominal wall and perineum and referred to as Scarpa's and Colles' fasciae, respectively. Evidence for its existence elsewhere in the body is scanty and therefore the present study was undertaken. Dissection of six embalmed adult cadavers, along with ultrasound imaging on four living subjects, were carried out to determine the existence, topography, and thickness of the membranous layer of superficial fascia in different regions of the body. In all six cadavers, a continuous layer of fibrous membrane in the superficial fascia was found consistently in all the dissected regions of the body and was also confirmed by ultrasonography. The arrangement and thickness of this membranous layer varied according to body region, body surface, and gender. It was thicker in the lower than in the upper extremity, on the posterior than anterior aspect of the body, and in females than in males. The mean thickness of the membranous layer ranged from 39 to 189 mum, being thickest in the leg and thinnest over the dorsum of the hand. The membranous layer was observed to have two or even three components in regions such as the breast, back, thigh, and arm and was seen to split, forming special compartments around subcutaneous major veins of upper and lower extremities, with fibrous septa extending to attach to the vessel wall. Functionally, the membranous superficial fascia may play a role in the integrity of the skin and support for subcutaneous structures particularly veins, by ensuring their patency. Understanding the topographic anatomy of this fascial layer may help explain body-contour deformities and provide the anatomic basis for surgical correction.

Bone age and onset of puberty in normal boys

Many conditions that delay skeletal maturation also delay the onset of puberty, whereas conditions that accelerate skeletal maturation often hasten the onset puberty, raising the possibility that skeletal maturation influences pubertal onset. To determine whether this concordance is also present in normal children, we analyzed data from 30 normal boys participating in a longitudinal study. Height, weight, and serum testosterone concentrations were assessed every 6 months and bone age (Fels method) every year. Pubertal onset was defined by serum testosterone > or =30 ng/dL. The variability in bone age at onset of puberty was not less than the variability in chronological age. In addition, there was no significant correlation between skeletal advancement and pubertal advancement (r=0.01, P=0.9). Similarly, there was not a significant correlation between pubertal advancement and height age advancement, weight age advancement, or BMI age advancement. Our findings do not support the hypothesis that skeletal maturation directly influences the age of pubertal onset in normal boys.

Anthropometric characteristics of elderly people: observations at a large diarrheal hospital in Dhaka, Bangladesh

There is a lack of evidence-based information to assist health policy makers in preparing for appropriate health, nutrition, and social-support guidelines for the elderly in Bangladesh. We examined selected indicators of the nutritional status of elderly people attending the Dhaka Hospital of ICDDR,B, Dhaka, Bangladesh. The population constituted of 1,196 individuals (718 men and 478 women), aged 60 to 106 years, who attended the hospital between 1 January 1993 and 31 December 2003. Patients were recruited from a hospital-based systematic sampling, regardless of age and gender, that presented to the facility. Men were heavier, and taller than women were (p < 0.001 for both comparisons). Using MUAC cut-off of < 22 cm for females and < 23 cm for males, at least 50% of the elderly were peripherally wasted (malnourished). Among all the study population, 40% had a BMI within the optimal range (18.5-24.9 kg/m(2)). Using the chronic energy deficiency (CED) classification, at least half of elderly (> or= 60 year) women were chronic energy deficient (BMI < 18.5). A significantly higher proportion of elderly women (7%) compared to men (2%) were overweight (BMI > or = 25, p < 0.001). Among the elderly ( > or = 60 year), males and females from a higher socioeconomic status (SES) had significantly higher BMI (p < 0.001, p = 0.001, respectively) and MUAC values (p < 0.001, p < 0.001, respectively) than their less well-off SES counterparts. We consider that, although our data were not valid for assessing the country situation, they are still useful as baseline information for longitudinal studies and for highlighting the need for studies in other geographical locations and in other population groups.

A standard weight equation to assess the body condition of pejerrey Odontesthes bonariensis

We developed a standard weight equation Ws to aid in the analysis of pejerrey Odonthestes bonariensis body condition over time and across populations using the relative weight index Wr. Weight--length data were compiled from 73 populations of pejerrey (N=16.022) from the Argentine pampas region. We used the regression-line-percentile technique, which provides a 75th-percentile standard by length intervals of 10 mm, to develop the Ws equation. The proposed equation is log 10 Ws=-5,267+3,163 log10 Lst; Ws is weight in grams and Lst is standard length in millimeters. This equation is proposed for use with pejerrey between 120 and 520 mm of Lst. Values for Wr calculated with the Ws equation did not consistently increase or decrease as function of fish length, indicating absence of length bias. We analyze the values and distribution of Wr for pejerrey and suggest how to interpret its results. The equation of Ws that intends to calculate the index of Wr, represents a useful tool of analysis, because not only it allows to statistically compare the physical condition of the pejerrey, independently of its size, capture moment or the individual origin, but also it facilitates to relate it with other variables.

Improved estimates of the benefits of breastfeeding using sibling comparisons to reduce selection bias

OBJECTIVE

Better measurement of the health and cognitive benefits of breastfeeding by using sibling comparisons to reduce sample selection bias.

DATA

We use data on the breastfeeding history, physical and emotional health, academic performance, cognitive ability, and demographic characteristics of 16,903 adolescents from the first (1994) wave of the National Longitudinal Study of Adolescent Health. The sample includes 2,734 sibling pairs.

STUDY DESIGN

We examine the relationship between breastfeeding history and 15 indicators of physical health, emotional health, and cognitive ability, using ordinary least squares and logit regression. For each indicator, we estimate, in addition to the usual between-family model, a within-family model to see whether differences in siblings' outcomes are associated with differences in the siblings' breastfeeding histories.

PRINCIPAL FINDINGS

Nearly all of the correlations found in the between-family model become statistically insignificant in the within-family model. The notable exception is a persistent positive correlation between breastfeeding and cognitive ability. These findings hold whether breastfeeding is measured in terms of duration or as a Yes/No variable.

CONCLUSIONS

This study provides persuasive evidence of a causal connection between breastfeeding and intelligence. However, it also suggests that nonexperimental studies of breastfeeding overstate some of its other long-term benefits, even if controls are included for race, ethnicity, income, and education.

Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study

BACKGROUND

The relationship of weight changes to the incidence, progression, and remission of sleep-disordered breathing (SDB) is not well defined. This study aims to determine the relationship between change in weight and progression or remission of SDB by polysomnography.

METHODS

We performed a longitudinal cohort study of the cardiovascular consequences of sleep apnea in diverse US communities. Sleep apnea and polysomnographic indicators of SDB were assessed 5 years apart.

RESULTS

A total of 2968 men and women (mean age, 62 years) participated in the study. Men were more likely to have an increase in Respiratory Disturbance Index (RDI) with a given increase in weight than were women, and this was not explained by differences in starting weight, waist circumference, age, or ethnicity. In a linear regression analysis, both men and women had a greater increase in RDI with weight gain than a decrease in RDI with weight loss. In a categorical analysis of larger degrees of change, this sex difference was also evident. Associations were similar in diverse ethnic groups. However, SDB progressed over time, even in those with stable weight.

CONCLUSION

Modest changes in weight were related to an increase or decrease in SDB, and this association was stronger in men than in women.

Clinical implications of alignment of upper and lower cervical spine

AIMS AND OBJECTIVES

The alignment of upper and lower cervical spine is presumed to be closely interrelated and the knowledge of this is mandatory when performing occipito-cervical and upper cervical fusions. The aim of this study was to establish standard values for upper and lower cervical spine alignment in the Indian population.

MATERIALS AND METHODS

Five hundred eighteen asymptomatic volunteers (261 males and 257 females) between 12 and 80 years of age underwent lateral radiography with their neck in the neutral position. Angles for occipital to 2nd cervical (Oc-C2), 1st to 2nd cervical (C1-C2) and sagittal alignment of 2nd to 7th cervical vertebrae (C2-C7) were measured. Statistical analyses were performed using a statistical package SPSS 10 for windows and the students 't' test.

RESULTS

The mean Oc-C2, C1-C2 and C2--C7 angles were 14.66+9.5 degrees , 25.6+7.9 degrees and 16.8+12.7 degrees in male, while same angles in female were 15.59+8.26 degrees, 26.9+6.8 degrees and 9.11+10.4 degrees respectively. Weak statistically significant negative correlation was observed between the measured angles of the upper (Oc-C2 and C1-C2) and lower (C2-C7) cervical spines, which means if the lordosis of the occiput and upper cervical spine increases (if the Oc-C2 angle increases), the alignment of lower cervical spine becomes kyphotic and vice versa. This negative correlation was stronger between the Oc-C2 and C2-C7 angles than between the C1-C2 and C2-C7 angles.

CONCLUSIONS

Relationship between alignment of the upper and the lower cervical spine should be taken into consideration when performing cervical fusion.

Densitometric analysis of the human first tarsometatarsal joint

The first tarsometatarsal (TMT) joint has a complex role in regulating joint pressure in the midfoot. Despite its importance, there have been only a few studies of the functional morphology and biomechanical function of this joint. Here we report about the densitometric pattern of the subchondral bone layer of the articulating elements of the human first TMT joint. We studied dry bones of the first metatarsal and medial cuneiform bones in 64 human cadavers to establish the pattern of the density distribution and to correlate it with the biomechanical function of the joint. The articular surfaces of both the bones were analyzed planimetrically. Half of the specimens (n=32) were sectioned in the sagittal plane and the other 32 articulations were in the transverse plane. In all the sections, the subchondral bone density of the first TMT joint was measured. We found that in sagittal slices the dorsal area of the lateral parts and intermediate parts in females and the dorsal area of the lateral parts, the medial parts and intermediate parts in males were denser than the plantar area and that its density decreased towards the plantar area. The dorsal parts of transverse slices in males were the densest and its density decreased towards the plantar part. In the dorsal, middle and plantar parts in females in transverse slices, the lateral and intermediate areas were denser than the medial areas (P<0.05). There was no significant difference between the bone densities of females and males.