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Kerr A, Slater GJ, Byrne N, Nana A. Reliability of 2 Different Positioning Protocols for Dual-Energy X-ray Absorptiometry Measurement of Body Composition in Healthy Adults. J Clin Densitom 2016; 19:282-9. [PMID: 26343822 DOI: 10.1016/j.jocd.2015.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 08/07/2015] [Indexed: 11/23/2022]
Abstract
Dual-energy X-ray absorptiometry (DXA) is an accepted time-efficient method of body composition assessment for total body and regional fat mass (FM), lean mass (LM), and bone mineral content (BMC), but for longitudinal monitoring the measurements must be sufficiently reliable. The aim of this study was to compare the reliability of a new positioning protocol (Nana et al) with the current reference (National Health and Nutrition Examination Survey [NHANES]) protocol and investigate their within-protocol precision. Thirty healthy adults (16 females and 14 males) underwent 4 whole-body DXA scans in succession with full repositioning between scans. The scan order was randomized, with 2 scans undertaken in accordance with the current NHANES protocol and 2 using the Nana et al protocol. Magnitudes of typical errors of measurement and changes in the mean of DXA body composition estimates were assessed as standardized effect sizes. The Nana et al protocol repositioning produced trivial typical errors for total body across all LM estimates except for FM in the arms and trunk which were moderately substantial. The NHANES protocol produced similar typical errors for all measurements in LM except for FM and BMC in the trunk and arms which were substantially larger than the smallest worthwhile effect. The difference between protocols produced substantially large typical errors in estimations of both total body FM and regional FM and BMC, but differences in LM were all less than the smallest worthwhile effect. Although both protocols demonstrated acceptable intratest reliability, the Nana et al protocol produced enhanced precision in regional (arms and trunk) FM and BMC. The protocols were substantially different in body composition assessment especially for FM and thus should not to be interchanged. Anecdotally, subjects felt more comfortable and supported during the scan with the Nana et al protocol.
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Affiliation(s)
- Ava Kerr
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
| | - Gary J Slater
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Nuala Byrne
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Alisa Nana
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand
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152
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Effects of breast-feeding compared with formula-feeding on preterm infant body composition: a systematic review and meta-analysis. Br J Nutr 2016; 116:132-41. [PMID: 27181767 DOI: 10.1017/s0007114516001720] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We conducted a systematic review and meta-analysis to compare the effect of breast-feeding and formula-feeding on body composition of preterm infants. We searched the literature using PubMed, Cochrane Central Library Issue, Ovid (Medline), Embase and other resources such as Google Scholar, electronic databases and bibliographies of relevant articles; two reviewers collected and extracted data independently. All the authors assessed risk of bias independently using the Newcastle-Ottawa Scale (NOS). A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) using the inverse variance method (P≥0·05; χ 2 test). In contrast, a random-effects meta-analysis was carried out. Altogether, 630 articles were identified using search strategy, and the references within retrieved articles were also assessed. A total of six studies were included in this systematic review. In formula-fed infants, fat mass was higher at term (mean difference 0·24 (95 % CI 0·17, 0·31) kg), fat-free mass was higher at 36 weeks of gestational (mean difference 0·12 (95 % CI 0·04, 0·21) kg) and the percentage of fat mass was higher at 36 weeks of gestation (mean difference 3·70 (95 % CI 1·81, 5·59) kg) compared with breast-fed infants. Compared with breast-feeding, formula-feeding is associated with altered body composition from birth to term in preterm infants. The effects of formula-feeding on preterm infant body composition from term to 12-month corrected age are inconclusive in our study. Well-designed studies are required in the future to explore the effects of formula-feeding compared with breast-feeding.
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153
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Singer JP, Diamond JM, Gries CJ, McDonnough J, Blanc PD, Shah R, Dean MY, Hersh B, Wolters PJ, Tokman S, Arcasoy SM, Ramphal K, Greenland JR, Smith N, Heffernan P, Shah L, Shrestha P, Golden JA, Blumenthal NP, Huang D, Sonett J, Hays S, Oyster M, Katz PP, Robbins H, Brown M, Leard LE, Kukreja J, Bacchetta M, Bush E, D'Ovidio F, Rushefski M, Raza K, Christie JD, Lederer DJ. Frailty Phenotypes, Disability, and Outcomes in Adult Candidates for Lung Transplantation. Am J Respir Crit Care Med 2016; 192:1325-34. [PMID: 26258797 DOI: 10.1164/rccm.201506-1150oc] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Frailty is associated with morbidity and mortality in abdominal organ transplantation but has not been examined in lung transplantation. OBJECTIVES To examine the construct and predictive validity of frailty phenotypes in lung transplant candidates. METHODS In a multicenter prospective cohort, we measured frailty with the Fried Frailty Phenotype (FFP) and Short Physical Performance Battery (SPPB). We evaluated construct validity through comparisons with conceptually related factors. In a nested case-control study of frail and nonfrail subjects, we measured serum IL-6, tumor necrosis factor receptor 1, insulin-like growth factor I, and leptin. We estimated the association between frailty and disability using the Lung Transplant Valued Life Activities disability scale. We estimated the association between frailty and risk of delisting or death before transplant using multivariate logistic and Cox models, respectively. MEASUREMENTS AND MAIN RESULTS Of 395 subjects, 354 completed FFP assessments and 262 completed SPPB assessments; 28% were frail by FFP (95% confidence interval [CI], 24-33%) and 10% based on the SPPB (95% CI, 7-14%). By either measure, frailty correlated more strongly with exercise capacity and grip strength than with lung function. Frail subjects tended to have higher plasma IL-6 and tumor necrosis factor receptor 1 and lower insulin-like growth factor I and leptin. Frailty by either measure was associated with greater disability. After adjusting for age, sex, diagnosis, and transplant center, both FFP and SPPB were associated with increased risk of delisting or death before lung transplant. For every 1-point worsening in score, hazard ratios were 1.30 (95% CI, 1.01-1.67) for FFP and 1.53 (95% CI, 1.19-1.59) for SPPB. CONCLUSIONS Frailty is prevalent among lung transplant candidates and is independently associated with greater disability and an increased risk of delisting or death.
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Affiliation(s)
| | | | - Cynthia J Gries
- 3 Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | | | - Beverly Hersh
- 3 Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | | | | | - Nancy Smith
- 5 Department of Surgery, College of Physicians and Surgeons, and
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jasleen Kukreja
- 6 Department of Surgery, University of California, San Francisco, San Francisco, California
| | | | - Errol Bush
- 6 Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Frank D'Ovidio
- 5 Department of Surgery, College of Physicians and Surgeons, and
| | | | | | - Jason D Christie
- 2 Department of Medicine and.,7 Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - David J Lederer
- 4 Department of Medicine.,8 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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154
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Colyer SL, Roberts SP, Robinson JB, Thompson D, Stokes KA, Bilzon JLJ, Salo AIT. Detecting meaningful body composition changes in athletes using dual-energy x-ray absorptiometry. Physiol Meas 2016; 37:596-609. [DOI: 10.1088/0967-3334/37/4/596] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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155
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Abstract
BACKGROUND Individualization of drug doses is essential in kidney transplant recipients. For many drugs, the individual dose is better predicted when using fat-free mass (FFM) as a scaling factor. Multiple equations have been developed to predict FFM based on healthy subjects. These equations have not been evaluated in kidney transplant recipients. The objectives of this study were to develop a kidney transplant specific equation for FFM prediction and to evaluate its predictive performance compared with previously published equations. METHODS Ten weeks after transplantation, FFM was measured by dual-energy X-ray absorptiometry. Data from a consecutive cohort of 369 kidney transplant recipients were randomly assigned to an equation development data set (n = 245) or an evaluation data set (n = 124). Prediction equations were developed using linear and nonlinear regression analysis. The predictive performance of the developed equation and previously published equations in the evaluation data set was assessed. RESULTS The following equation was developed: FFM (kg) = {FFMmax × body weight (kg)/[81.3 + body weight (kg)]} × [1 + height (cm) × 0.052] × [1-age (years) × 0.0007], where FFMmax was estimated to be 11.4 in males and 10.2 in females. This equation provided an unbiased, precise prediction of FFM in the evaluation data set: mean error (ME) (95% CI), -0.71 kg (-1.60 to 0.19 kg) in males and -0.36 kg (-1.52 to 0.80 kg) in females, root mean squared error 4.21 kg (1.65-6.77 kg) in males and 3.49 kg (1.15-5.84 kg) in females. Using previously published equations, FFM was systematically overpredicted in kidney-transplanted males [ME +1.33 kg (0.40-2.25 kg) to +5.01 kg (4.06-5.95 kg)], but not in females [ME -2.99 kg (-4.07 to -1.90 kg) to +3.45 kg (2.29-4.61) kg]. CONCLUSIONS A new equation for FFM prediction in kidney transplant recipients has been developed. The equation may be used for population pharmacokinetic modeling and clinical dose selection in kidney transplant recipients.
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156
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Majd S, Apps LD, Hudson N, Hewitt S, Eglinton E, Murphy A, Bradding P, Singh S, Green R, Evans R. Protocol for a feasibility study to inform the development of a multicentre randomised controlled trial of asthma-tailored pulmonary rehabilitation versus usual care for individuals with severe asthma. BMJ Open 2016; 6:e010574. [PMID: 27009149 PMCID: PMC4809086 DOI: 10.1136/bmjopen-2015-010574] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Pulmonary rehabilitation with core components of exercise training and multiprofessional education is an integral part of the management of patients with chronic lung disease. International guidelines for individuals with asthma recommend exercise as exercise improves symptoms, indices of cardiopulmonary efficiency, health status and psychosocial outcome. However, there is little published evidence evaluating safety and acceptability of exercise training for individuals with severe asthma and there are concerns regarding exercise-induced asthma. We propose a feasibility study for a multicentre randomised controlled trial (RCT) of asthma-tailored pulmonary rehabilitation (asthma-tailored PR) versus usual care in individuals with severe asthma. METHODS AND ANALYSIS The study will be conducted in three stages. Adults with severe asthma will be included if they have persistent symptoms despite being at step 4 or 5 of the British Thoracic Society guidelines. Stage 1: semistructured interviews will be used in a sample of 20-30 individuals with severe asthma to understand the experience and attitudes of this population towards exercise. Stage 2: eight focus groups of at least six healthcare professionals involved in the care of patients with severe asthma will be conducted to understand their attitudes towards exercise for this population. Stage 3: a small-scale RCT of the proposed multicentre RCT of asthma-tailored PR versus usual care for individuals with severe asthma will be conducted. The primary outcome measures will be recruitment, retention and adverse event rates. Semistructured interviews with participants of stage 3 will be used to identify further barriers or facilitators to participation in PR and the trial. Thematic analysis will be used for the interpretation of all interviews. ETHICS AND DISSEMINATION The study results will inform the design of a larger multicentre RCT. The National Research Ethics Service Committee East Midland approved the study protocol. TRIAL REGISTRATION NUMBER ISRCTN96143888.
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Affiliation(s)
- Sally Majd
- Centre for Exercise Rehabilitation Science, Leicester, UK
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Lindsay D Apps
- Centre for Exercise Rehabilitation Science, Leicester, UK
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Nicky Hudson
- School of Applied Social Sciences, DeMontfort University, Leicester, UK
| | - Stacey Hewitt
- Centre for Exercise Rehabilitation Science, Leicester, UK
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | | | - Anna Murphy
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, UK
- School of Pharmacy, DeMontfort University, Leicester, UK
| | - Peter Bradding
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, UK
| | - Sally Singh
- Centre for Exercise Rehabilitation Science, Leicester, UK
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, UK
| | - Ruth Green
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, UK
| | - Rachael Evans
- Centre for Exercise Rehabilitation Science, Leicester, UK
- Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
- Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, UK
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157
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Quantifying fat and lean muscle in the lower legs of women with knee osteoarthritis using two different MRI systems. Rheumatol Int 2016; 36:855-62. [DOI: 10.1007/s00296-016-3455-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/25/2016] [Indexed: 12/21/2022]
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158
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Langer RD, Borges JH, Pascoa MA, Cirolini VX, Guerra-Júnior G, Gonçalves EM. Validity of Bioelectrical Impedance Analysis to Estimation Fat-Free Mass in the Army Cadets. Nutrients 2016; 8:121. [PMID: 26978397 PMCID: PMC4808851 DOI: 10.3390/nu8030121] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/28/2016] [Accepted: 02/17/2016] [Indexed: 01/10/2023] Open
Abstract
Background: Bioelectrical Impedance Analysis (BIA) is a fast, practical, non-invasive, and frequently used method for fat-free mass (FFM) estimation. The aims of this study were to validate predictive equations of BIA to FFM estimation in Army cadets and to develop and validate a specific BIA equation for this population. Methods: A total of 396 males, Brazilian Army cadets, aged 17–24 years were included. The study used eight published predictive BIA equations, a specific equation in FFM estimation, and dual-energy X-ray absorptiometry (DXA) as a reference method. Student’s t-test (for paired sample), linear regression analysis, and Bland–Altman method were used to test the validity of the BIA equations. Results: Predictive BIA equations showed significant differences in FFM compared to DXA (p < 0.05) and large limits of agreement by Bland–Altman. Predictive BIA equations explained 68% to 88% of FFM variance. Specific BIA equations showed no significant differences in FFM, compared to DXA values. Conclusion: Published BIA predictive equations showed poor accuracy in this sample. The specific BIA equations, developed in this study, demonstrated validity for this sample, although should be used with caution in samples with a large range of FFM.
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Affiliation(s)
- Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas-SP 13083-887, Brazil.
| | - Juliano H Borges
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas-SP 13083-887, Brazil.
| | - Mauro A Pascoa
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas-SP 13083-887, Brazil.
| | - Vagner X Cirolini
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas-SP 13083-887, Brazil.
| | - Gil Guerra-Júnior
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas-SP 13083-887, Brazil.
| | - Ezequiel M Gonçalves
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas-SP 13083-887, Brazil.
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159
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Makimura H, Stanley TL, Suresh C, De Sousa-Coelho AL, Frontera WR, Syu S, Braun LR, Looby SE, Feldpausch MN, Torriani M, Lee H, Patti ME, Grinspoon SK. Metabolic Effects of Long-Term Reduction in Free Fatty Acids With Acipimox in Obesity: A Randomized Trial. J Clin Endocrinol Metab 2016; 101:1123-33. [PMID: 26691888 PMCID: PMC4803166 DOI: 10.1210/jc.2015-3696] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
CONTEXT Increased circulating free fatty acids (FFAs) have been proposed to contribute to insulin resistance in obesity. Short-term studies have investigated the effects of acipimox, an inhibitor of hormone-sensitive lipase, on glucose homeostasis, but longer-term studies have not been performed. OBJECTIVE To test the hypothesis that long-term treatment with acipimox would reduce FFA and improve insulin sensitivity among nondiabetic, insulin-resistant, obese subjects. DESIGN, SETTING, PATIENTS, AND INTERVENTION At an academic medical center, 39 obese men and women were randomized to acipimox 250 mg thrice-daily vs identical placebo for 6 months. MAIN OUTCOME MEASURES Plasma lipids, insulin sensitivity, adiponectin, and mitochondrial function via assessment of the rate of post-exercise phosphocreatine recovery on (31)P-magnetic resonance spectroscopy as well as muscle mitochondrial density and relevant muscle gene expression. RESULTS Fasting glucose decreased significantly in acipimox-treated individuals (effect size, -6 mg/dL; P = .02), in parallel with trends for reduced fasting insulin (effect size, -6.8 μU/mL; P = .07) and HOMA-IR (effect size, -1.96; P = .06), and significantly increased adiponectin (effect size, +668 ng/mL; P = .02). Acipimox did not affect insulin-stimulated glucose uptake, as assessed by euglycemic, hyperinsulinemic clamp. Effects on muscle mitochondrial function and density and on relevant gene expression were not seen. CONCLUSION These data shed light on the long-term effects of FFA reduction on insulin sensitivity, other metabolic parameters, and muscle mitochondrial function in obesity. Reduced FFA achieved by acipimox improved fasting measures of glucose homeostasis, lipids, and adiponectin but had no effect on mitochondrial function, mitochondrial density, or muscle insulin sensitivity.
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Affiliation(s)
- Hideo Makimura
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Takara L Stanley
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Caroline Suresh
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Ana Luisa De Sousa-Coelho
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Walter R Frontera
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Stephanie Syu
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Laurie R Braun
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Sara E Looby
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Meghan N Feldpausch
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Martin Torriani
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Hang Lee
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Mary-Elizabeth Patti
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Steven K Grinspoon
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
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160
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Shah A, Bross R, Shapiro BB, Morrison G, Kopple JD. Dietary energy requirements in relatively healthy maintenance hemodialysis patients estimated from long-term metabolic studies. Am J Clin Nutr 2016; 103:757-65. [PMID: 26864370 PMCID: PMC4763489 DOI: 10.3945/ajcn.115.112995] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 12/16/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Studies that examined dietary energy requirements (DERs) of patients undergoing maintenance hemodialysis (MHD) have shown mixed results. Many studies reported normal DERs, but some described increased energy needs. DERs in MHD patients have been estimated primarily from indirect calorimetry and from nitrogen balance studies. The present study measured DERs in MHD patients on the basis of their dietary energy intake and changes in body composition. OBJECTIVE This study assessed DERs in MHD patients who received a constant energy intake while changes in their body composition were measured. DESIGN Seven male and 6 female sedentary, clinically stable MHD patients received a constant mean (±SD) energy intake for 92.2 ± 7.9 d while residing in a metabolic research ward. Changes in fat and fat-free mass, measured by dual-energy X-ray absorptiometry, were converted to calorie equivalents and added to energy intake to calculate energy requirements. RESULTS The average DER was 31 ± 3 kcal · kg(-1) · d(-1) calculated from energy intake and change in fat and fat-free calories, which was 28 ± 197 kcal/d over the 92 d of the study. DERs of MHD patients correlated strongly with their body weight (r = 0.81, P = 0.002) and less closely with their measured resting energy expenditure expressed as kcal/d (r = 0.69, P = 0.01). Although the average observed DER in MHD patients was similar to published estimated values for normal sedentary individuals of similar age and sex, there was wide variability in DER among individual patients (range: 26-36 kcal · kg(-1) · d(-1)). CONCLUSIONS Average DERs of sedentary, clinically stable patients receiving MHD are similar to those of sedentary normal individuals. Our data do not support the theory that MHD patients have increased DERs. Due to the high variability in DERs, careful monitoring of the nutritional status of individual MHD patients is essential. This trial was registered at clinicaltrials.gov as NCT02194114.
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Affiliation(s)
- Anuja Shah
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Rachelle Bross
- UCLA Clinical and Translational Science Institute at the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, CA
| | - Bryan B Shapiro
- Medical School for International Health at Ben-Gurion University, Be'er Sheva, Israel; and
| | - Gillian Morrison
- UCLA Clinical and Translational Science Institute at the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, CA
| | - Joel D Kopple
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Fielding School of Public Health, Los Angeles, CA
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161
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Guimarães MFBR, da Costa Pinto MR, Raid RGSC, Andrade MVMD, Kakehasi AM. Which is the best cutoff of body mass index to identify obesity in female patients with rheumatoid arthritis? A study using dual energy X-ray absorptiometry body composition. REVISTA BRASILEIRA DE REUMATOLOGIA 2016; 57:S0482-5004(16)00020-6. [PMID: 26924005 DOI: 10.1016/j.rbr.2015.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 08/03/2015] [Accepted: 09/16/2015] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Standard anthropometric measures used to diagnose obesity in the general population may not have the same performance in patients with rheumatoid arthritis. OBJECTIVE To determine cutoff points for body mass index (BMI) and waist circumference (WC) for detecting obesity in women with rheumatoid arthritis (RA) by comparing these standard anthropometric measures to a dual-energy x-ray absorptiometry (DXA)-based obesity criterion. PATIENTS AND METHOD Adult female patients with more than six months of diagnosis of RA underwent clinical evaluation, with anthropometric measures and body composition with DXA. RESULTS Eighty two patients were included, mean age 55±10.7 years. The diagnosis of obesity in the sample was about 31.7% by BMI, 86.6% by WC and 59.8% by DXA. Considering DXA as golden standard, Cutoff points were identified for anthropometric measures to better approximate DXA estimates of percent body fat: for BMI value ≥ 25kg/m2 was the best for definition of obesity in female patients with RA, with sensitivity of 80% and specificity of 60%. For WC, with 80% of sensitivity and 35% of specificity, the best value to detect obesity was 86cm. CONCLUSION A large percentage of patients were obese. The traditional cutoff points used for obesity were not suitable for our sample. For this female population with established RA, BMI cutoff point of 25kg/m2 and WC cutoff point of 86cm were the most appropriate to detect obesity.
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Affiliation(s)
| | - Maria Raquel da Costa Pinto
- Serviço de Reumatologia, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Renata G Santos Couto Raid
- Faculdade de Tecnologia em Radiologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Marcus Vinícius Melo de Andrade
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Adriana Maria Kakehasi
- Serviço de Reumatologia, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil; Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
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162
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Coates DB, Dixon RM, Mayer RJ, Murray RM. Validation of single photon absorptiometry for on-farm measurement of density and mineral content of tail bone in cattle. ANIMAL PRODUCTION SCIENCE 2016. [DOI: 10.1071/an15068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A validation study examined the accuracy of a purpose-built single photon absorptiometry (SPA) instrument for making on-farm in vivo measurements of bone mineral density (BMD) in tail bones of cattle. In vivo measurements were made at the proximal end of the ninth coccygeal vertebra (Cy9) in steers of two age groups (each n = 10) in adequate or low phosphorus status. The tails of the steers were then resected and the BMD of the Cy9 bone was measured in the laboratory with SPA on the resected tails and then with established laboratory procedures on defleshed bone. Specific gravity and ash density were measured on the isolated Cy9 vertebrae and on 5-mm2 dorso-ventral cores of bone cut from each defleshed Cy9. Calculated BMD determined by SPA required a measure of tail bone thickness and this was estimated as a fraction of total tail thickness. Actual tail bone thickness was also measured on the isolated Cy9 vertebrae. The accuracy of measurement of BMD by SPA was evaluated by comparison with the ash density of the bone cores measured in the laboratory. In vivo SPA measurements of BMD were closely correlated with laboratory measurements of core ash density (r = 0.92). Ash density and specific gravity of cores, and all SPA measures of BMD, were affected by phosphorus status of the steers, but the effect of steer age was only significant (P < 0.05) for steers in adequate phosphorus status. The accuracy of SPA to determine BMD of tail bone may be improved by reducing error associated with in vivo estimation of tail bone thickness, and also by adjusting for displacement of soft tissue by bone mineral. In conclusion a purpose-built SPA instrument could be used to make on-farm sequential non-invasive in vivo measurements of the BMD of tailbone in cattle with accuracy acceptable for many animal studies.
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Sex-specific relationships of physical activity, body composition, and muscle quality with lower-extremity physical function in older men and women. Menopause 2015; 22:297-303. [PMID: 25137244 DOI: 10.1097/gme.0000000000000313] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aims to determine the sex-specific relationships of physical activity, body composition, and muscle quality with lower-extremity physical function in older men and women. METHODS Seventy-nine community-dwelling men (n = 39; mean [SD] age, 76.1 [6.2] y; mean [SD] body mass index, 27.3 [3.8] kg/m(2)) and women (n = 40; mean [SD] age, 75.8 [5.5] y; mean [SD] body mass index, 27.0 [3.8] kg/m(2)) were assessed for physical activity via questionnaire, body composition via dual-energy x-ray absorptiometry scanning, leg extension power using the Nottingham power rig, and muscle quality (W/kg; the ratio of leg extension power [W] to lower-body mineral-free lean mass [kg]). A composite measure of physical function was obtained by summing Z scores from the 6-minute walk, 8-ft up-and-go test, and 30-second chair-stand test. RESULTS As expected, men had significantly greater levels of physical activity, lower adiposity, greater lean mass, higher leg extension power, and greater muscle quality compared with women (all P < 0.05). In linear regression analyses, muscle quality and physical activity were the strongest predictors of lower-extremity physical function in men and independently explained 42% and 29% of the variance, respectively. In women, muscle quality (16%) and percent body fat (12%) were independent predictors after adjustment for covariates. CONCLUSIONS Muscle quality is the strongest predictor of lower-extremity physical function in men and women, but sex impacts the importance of physical activity and adiposity. These findings suggest that older men and women may benefit from different intervention strategies for preventing physical disability and also highlight the importance of weight management for older women to preserve physical function.
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Nindl BC, Jaffin DP, Dretsch MN, Cheuvront SN, Wesensten NJ, Kent ML, Grunberg NE, Pierce JR, Barry ES, Scott JM, Young AJ, O'Connor FG, Deuster PA. Human Performance Optimization Metrics. J Strength Cond Res 2015; 29 Suppl 11:S221-45. [DOI: 10.1519/jsc.0000000000001114] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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165
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Association between accelerometer-measured physical activity and muscle capacity in middle-aged postmenopausal women. Menopause 2015; 22:1204-11. [DOI: 10.1097/gme.0000000000000447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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166
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Andrews JS, Trupin L, Schmajuk G, Barton J, Margaretten M, Yazdany J, Yelin EH, Katz PP. Muscle Strength and Changes in Physical Function in Women With Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2015; 67:1070-7. [PMID: 25623919 DOI: 10.1002/acr.22560] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/05/2015] [Accepted: 01/20/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Cross-sectional studies have observed that muscle weakness is associated with worse physical function among women with systemic lupus erythematosus (SLE). The present study examines whether reduced upper and lower extremity muscle strength predict declines in function over time among adult women with SLE. METHODS One hundred forty-six women from a longitudinal SLE cohort participated in the study. All measures were collected during in-person research visits approximately 2 years apart. Upper extremity muscle strength was assessed by grip strength. Lower extremity muscle strength was assessed by peak knee torque of extension and flexion. Physical function was assessed using the Short Physical Performance Battery (SPPB). Regression analyses modeled associations of baseline upper and lower extremity muscle strength with followup SPPB scores controlling for baseline SPPB, age, SLE duration, SLE disease activity (Systemic Lupus Activity Questionnaire), physical activity level, prednisone use, body composition, and depression. Secondary analyses tested whether associations of baseline muscle strength with followup in SPPB scores differed between intervals of varying baseline muscle strength. RESULTS Lower extremity muscle strength strongly predicted changes over 2 years in physical function even when controlling for covariates. The association of reduced lower extremity muscle strength with reduced physical function in the future was greatest among the weakest women. CONCLUSION Reduced lower extremity muscle strength predicted clinically significant declines in physical function, especially among the weakest women. Future studies should test whether therapies that promote preservation of lower extremity muscle strength may prevent declines in function among women with SLE.
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Affiliation(s)
| | | | - Gabriela Schmajuk
- University of California, San Francisco, and VA Medical Center, San Francisco, California
| | - Jennifer Barton
- Portland VA Medical Center and Oregon Health and Science University, Portland
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Randomized Phase II Study of the Anti-inflammatory Effect of Ghrelin During the Postoperative Period of Esophagectomy. Ann Surg 2015; 262:230-6. [PMID: 25361222 DOI: 10.1097/sla.0000000000000986] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A prospective randomized phase II trial was conducted to evaluate the efficacy of ghrelin administration in reducing systemic inflammatory response syndrome (SIRS) duration after esophagectomy. BACKGROUND Esophagectomy for esophageal cancer is highly invasive and leads to prolonged SIRS duration and postoperative complications. Ghrelin has multiple effects, including anti-inflammatory effects. METHODS Forty patients undergoing esophagectomy were randomly assigned to either the ghrelin group (n = 20), which received continuous infusion of ghrelin (0.5 μg/kg/h) for 5 days, or the placebo group (n = 20), which received pure saline for 5 days. The primary endpoint was SIRS duration. The secondary endpoints were the incidence of postoperative complications, time of a negative nitrogen balance, changes in body weight and composition, and levels of inflammatory markers, including C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS The ghrelin group had a shorter SIRS duration and lower CRP and IL-6 levels than did the placebo group. The incidence of pulmonary complications was lower in the ghrelin group than in the placebo group, whereas other complications did not differ between the groups. Although time of the negative nitrogen balance was shorter in the ghrelin group than in the placebo group, changes in total body weight and lean body weight did not differ significantly. CONCLUSIONS Postoperative ghrelin administration was effective for inhibiting inflammatory mediators and improving the postoperative clinical course of patients with esophageal cancer.
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168
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Schorr M, Lawson EA, Dichtel LE, Klibanski A, Miller KK. Cortisol Measures Across the Weight Spectrum. J Clin Endocrinol Metab 2015; 100:3313-21. [PMID: 26171799 PMCID: PMC4570173 DOI: 10.1210/jc.2015-2078] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 07/08/2015] [Indexed: 11/19/2022]
Abstract
CONTEXT There are conflicting reports of increased vs decreased hypothalamic-pituitary-adrenal (HPA) activation in obesity; the most consistent finding is an inverse relationship between body mass index (BMI) and morning cortisol. In anorexia nervosa (AN), a low-BMI state, cortisol measures are elevated. OBJECTIVE This study aimed to investigate cortisol measures across the weight spectrum. DESIGN AND SETTING This was a cross-sectional study at a clinical research center. PARTICIPANTS This study included 60 women, 18-45 years of age: overweight/obese (OB; N = 21); AN (N = 18); and normal-weight controls (HC; N = 21). MEASURES HPA dynamics were assessed by urinary free cortisol, mean overnight serum cortisol obtained by pooled frequent sampling every 20 minutes from 2000-0800 h, 0800 h serum cortisol and cortisol-binding globulin, morning and late-night salivary cortisol, and dexamethasone-CRH testing. Body composition and bone mineral density (BMD) were assessed by dual-energy x-ray absorptiometry. RESULTS Cortisol measures demonstrated a U-shaped relationship with BMI, nadiring in the overweight-class I obese range, and were similarly associated with visceral adipose tissue and total fat mass. Mean cortisol levels were higher in AN than OB. There were weak negative linear relationships between lean mass and some cortisol measures. Most cortisol measures were negatively associated with postero-anterior spine and total hip BMD. CONCLUSIONS Cortisol measures are lowest in overweight-class I obese women-lower than in lean women. With more significant obesity, cortisol levels increase, although not to as high as in AN. Therefore, extreme underweight and overweight states may activate the HPA axis, and hypercortisolemia may contribute to increased adiposity in the setting of caloric excess. Hypercortisolemia may also contribute to decreased BMD and muscle wasting in the setting of both caloric restriction and excess.
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Affiliation(s)
- Melanie Schorr
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Laura E Dichtel
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Anne Klibanski
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
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169
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Wells JCK, Haroun D, Williams JE, Nicholls D, Darch T, Eaton S, Fewtrell MS. Body composition in young female eating-disorder patients with severe weight loss and controls: evidence from the four-component model and evaluation of DXA. Eur J Clin Nutr 2015; 69:1330-5. [PMID: 26173868 PMCID: PMC4672328 DOI: 10.1038/ejcn.2015.111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/04/2015] [Accepted: 03/21/2015] [Indexed: 11/26/2022]
Abstract
Background/Objectives: Whether fat-free mass (FFM) and its components are depleted in eating-disorder (ED) patients is uncertain. Dual energy X-ray absorptiometry (DXA) is widely used to assess body composition in pediatric ED patients; however, its accuracy in underweight populations remains unknown. We aimed (1) to assess body composition of young females with ED involving substantial weight loss, relative to healthy controls using the four-component (4C) model, and (2) to explore the validity of DXA body composition assessment in ED patients. Subjects/Methods: Body composition of 13 females with ED and 117 controls, aged 10–18 years, was investigated using the 4C model. Accuracy of DXA for estimation of FFM and fat mass (FM) was tested using the approach of Bland and Altman. Results: Adjusting for age, height and pubertal stage, ED patients had significantly lower whole-body FM, FFM, protein mass (PM) and mineral mass (MM) compared with controls. Trunk and limb FM and limb lean soft tissue were significantly lower in ED patients. However, no significant difference in the hydration of FFM was detected. Compared with the 4C model, DXA overestimated FM by 5±36% and underestimated FFM by 1±9% in ED patients. Conclusion: Our study confirms that ED patients are depleted not only in FM but also in FFM, PM and MM. DXA has limitations for estimating body composition in individual young female ED patients.
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Affiliation(s)
- J C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - D Haroun
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - J E Williams
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - D Nicholls
- Department of Psychological Medicine, Child and Adolescent Mental Health, Great Ormond Street Hospital, London, UK
| | - T Darch
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - S Eaton
- Developmental Biology and Cancer Programme, UCL Institute of Child Health, London, UK
| | - M S Fewtrell
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
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Seino S, Shinkai S, Iijima K, Obuchi S, Fujiwara Y, Yoshida H, Kawai H, Nishi M, Murayama H, Taniguchi Y, Amano H, Takahashi R. Reference Values and Age Differences in Body Composition of Community-Dwelling Older Japanese Men and Women: A Pooled Analysis of Four Cohort Studies. PLoS One 2015; 10:e0131975. [PMID: 26147341 PMCID: PMC4492501 DOI: 10.1371/journal.pone.0131975] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 06/10/2015] [Indexed: 12/21/2022] Open
Abstract
Objectives To determine age- and sex-specific body composition reference values and investigate age differences in these parameters for community-dwelling older Japanese men and women, using direct segmental multi-frequency bioelectrical impedance analysis. Methods We conducted a pooled analysis of data collected in four cohort studies between 2008 and 2012: Kusatsu Longitudinal Study, Hatoyama Cohort Study, Itabashi Cohort Study, and Kashiwa Cohort Study. The pooled analysis included cross-sectional data from 4478 nondisabled, community-dwelling adults aged 65-94 years (2145 men, 2333 women; mean age: 72.9 years in men and 72.6 years in women). Body weight, fat mass (FM), percentage FM, fat-free mass (FFM), and appendicular lean soft tissue mass were measured using the InBody 720 and 430 (Biospace Co. Ltd, Seoul, Korea). The values were then normalized by height in meters squared to determine body mass index (BMI), FM index (FMI), FFM index (FFMI), and skeletal muscle mass index (SMI). Results Simple means (standard deviation) of BMI, percentage FM, FMI, FFMI, and SMI were 23.4 (2.9) kg/m2, 24.9 (6.3)%, 5.96 (2.09) kg/m2, 17.4 (1.5) kg/m2, and 7.29 (0.76) kg/m2, respectively, in men and 22.7 (3.3) kg/m2, 31.7 (7.1)%, 7.40 (2.61) kg/m2, 15.3 (1.2) kg/m2, and 5.86 (0.67) kg/m2, respectively, in women. We then calculated quartiles and quintiles for these indices after stratifying for sex and 5-year age group. FFMI and SMI decreased significantly with age in both sexes (P < 0.001 for trends), but FFMI remained constant among the women with only a 1% decrease up to age 84 years. Percentage FM increased significantly, with age (P < 0.001 in men and P = 0.045 in women for trends), but FMI was unchanged in both sexes (P = 0.147 in men and P = 0.176 in women for trends). Conclusion The present data should be useful in the clinical evaluation of body composition of older Japanese and for international comparisons. The small age-related decrease in FFMI may be a noteworthy characteristic of body composition change in older Japanese women.
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Affiliation(s)
- Satoshi Seino
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
- * E-mail:
| | - Katsuya Iijima
- Institute OF Gerontology, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Hideyo Yoshida
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Mariko Nishi
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Hiroshi Murayama
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Yu Taniguchi
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Hidenori Amano
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
| | - Ryutaro Takahashi
- Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae, Itabashi, Tokyo, Japan
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Zanchetta MB, Costa F, Longobardi V, Longarini G, Mazure RM, Moreno ML, Vázquez H, Silveira F, Niveloni S, Smecuol E, Temprano MDLP, Hwang HJ, González A, Mauriño EC, Bogado C, Zanchetta JR, Bai JC. Significant bone microarchitecture impairment in premenopausal women with active celiac disease. Bone 2015; 76:149-57. [PMID: 25779933 DOI: 10.1016/j.bone.2015.03.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 01/23/2015] [Accepted: 03/05/2015] [Indexed: 02/07/2023]
Abstract
Patients with active celiac disease (CD) are more likely to have osteoporosis and increased risk of fractures. High-resolution peripheral quantitative computed tomography (HR-pQCT) permits three-dimensional exploration of bone microarchitectural characteristics measuring separately cortical and trabecular compartments, and giving a more profound insight into bone disease pathophysiology and fracture. We aimed to determine the volumetric and microarchitectural characteristics of peripheral bones-distal radius and tibia-in an adult premenopausal cohort with active CD assessed at diagnosis. We prospectively enrolled 31 consecutive premenopausal women with newly diagnosed CD (median age 29 years, range: 18-49) and 22 healthy women of similar age (median age 30 years, range 21-41) and body mass index. Compared with controls, peripheral bones of CD patients were significantly lower in terms of total volumetric density mg/cm(3) (mean ± SD: 274.7 ± 51.7 vs. 324.7 ± 45.8, p 0.0006 at the radius; 264.4 ± 48.7 vs. 307 ± 40.7, p 0.002 at the tibia), trabecular density mg/cm(3) (118.6 ± 31.5 vs. 161.9 ± 33.6, p<0.0001 at the radius; 127.9 ± 28.7 vs. 157.6 ± 15.6, p < 0.0001 at the tibia); bone volume/trabecular volume ratio % (9.9 ± 2.6 vs. 13.5 ± 2.8, p<0.0001 at the radius; 10.6 ± 2.4 vs. 13.1 ± 1.3, p < 0.0001 at the tibia); number of trabeculae 1/mm (1.69 ± 0.27 vs. 1.89 ± 0.26, p 0.009 at the radius; 1.53 ± 0.32 vs. 1.80 ± 0.26, p 0.002 at the tibia); and trabecular thickness mm (0.058 ± 0.010 vs. 0.071 ± 0.008, p < 0.0001 at the radius with no significant difference at the tibia). Cortical density was significantly lower in both regions (D comp mg/cm(3) 860 ± 57.2 vs. 893.9 ± 43, p 0.02; 902.7 ± 48.7 vs. 932.6 ± 32.6, p 0.01 in radius and tibia respectively). Although cortical thickness was lower in CD patients, it failed to show any significant inter-group difference (a-8% decay with p 0.11 in both bones). Patients with symptomatic CD (n = 22) had a greater bone microarchitectural deficit than those with subclinical CD. HR-pQCT was used to successfully identify significant deterioration in the microarchitecture of trabecular and cortical compartments of peripheral bones. Impairment was characterized by lower trabecular number and thickness-which increased trabecular network heterogeneity-and lower cortical density and thickness. In the prospective follow-up of this group of patients we expect to be able to assess whether bone microarchitecture recovers and to what extend after gluten-free diet.
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Affiliation(s)
- María Belén Zanchetta
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina; Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
| | - Florencia Costa
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Vanesa Longobardi
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Gabriela Longarini
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Roberto Martín Mazure
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - María Laura Moreno
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Horacio Vázquez
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Fernando Silveira
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Sonia Niveloni
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Edgardo Smecuol
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - María de la Paz Temprano
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Hui Jer Hwang
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Andrea González
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Eduardo César Mauriño
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina
| | - Cesar Bogado
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina; Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina
| | - Jose R Zanchetta
- IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina; Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina
| | - Julio César Bai
- Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina; Cátedra de Gastroenterología Facultad de Medicina, Universidad del Salvador, Buenos Aires, Argentina
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Shapiro BB, Bross R, Morrison G, Kalantar-Zadeh K, Kopple JD. Self-Reported Interview-Assisted Diet Records Underreport Energy Intake in Maintenance Hemodialysis Patients. J Ren Nutr 2015; 25:357-63. [PMID: 25682334 PMCID: PMC4469525 DOI: 10.1053/j.jrn.2014.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 12/11/2014] [Accepted: 12/18/2014] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Studies suggest that maintenance hemodialysis (MHD) patients report dietary energy intakes (EIs) that are lower than what is actually ingested. Data supporting this conclusion have several important limitations. The present study introduces a novel approach of assessing underreporting of EI in MHD patients. DESIGN Comparisons of EI of free-living MHD patients determined from food records to their measured energy needs. SETTING Metabolic research ward. SUBJECTS Thirteen clinically stable MHD patients with unchanging weights whose EI was assessed by dietitian interview-assisted 3-day food records. INTERVENTION EI was compared with (1) patients' resting energy expenditure (REE), measured by indirect calorimetry, and estimated total energy expenditure (TEE) and (2) patients' dietary energy requirements (DER) measured while patients underwent nitrogen balance studies and consumed a constant energy diet in a research ward for a mean duration of 89.5 days. DER was calculated as the actual EI during the research study corrected for changes in body fat and lean body mass measured by Dual X-Ray Absorptiometry. MAIN OUTCOME MEASURE Underreporting of EI was determined by an EI:REE ratio <1.27 and an EI:TEE ratio or EI:DEE ratio <1.0. RESULTS Seven of the 13 MHD patients studied were male. Patient's ages were 47.7 ± standard deviation 9.7 years; body mass index averaged 25.4 ± 2.8 kg/m2, and dialysis vintage was 53.3 ± 37.1 months. The EI:REE ratio (1.03 ± 0.23) was significantly less than the cutoff value for underreporting of 1.27 (P = .001); 12 of 13 patients had EI:REE ratios <1.27. The mean EI:TEE ratio was significantly less than the cutoff value of 1.0 (0.73 ± 0.17, P < .0001), and 12 MHD patients had EI:TEE ratios <1.0. The EI:DER ratio was also <1.0 (0.83 ± 0.25, P = .012), and 10 MHD had EI:DER ratios <1.0. CONCLUSIONS Dietitian interview-assisted diet records by MHD patients substantially underestimate the patient's dietary EI.
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Affiliation(s)
- Bryan B Shapiro
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Rachelle Bross
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; UCLA Clinical and Translational Science Institute, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Gillian Morrison
- UCLA Clinical and Translational Science Institute, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; UCLA Fielding School of Public Health, Los Angeles, California; Division of Nephrology and Hypertension, University of California at Irvine, Orange, California
| | - Joel D Kopple
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; UCLA Fielding School of Public Health, Los Angeles, California; David Geffen School of Medicine at UCLA, Los Angeles, California.
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174
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von Düring ME, Jenssen T, Bollerslev J, Åsberg A, Godang K, Eide IA, Dahle DO, Hartmann A. Visceral fat is better related to impaired glucose metabolism than body mass index after kidney transplantation. Transpl Int 2015; 28:1162-71. [PMID: 25970153 DOI: 10.1111/tri.12606] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/31/2015] [Accepted: 05/07/2015] [Indexed: 12/30/2022]
Abstract
The role of visceral adipose tissue (VAT) in post-transplant hyperglycaemia is not known. We evaluated 167 patients without diabetes 8-10 weeks after kidney transplantation, performing oral glucose tolerance tests and measuring VAT content from dual-energy X-ray absorptiometry scans. Median VAT weight in normal glucose tolerance patients was 0.9 kg, impaired fasting glucose patients 1.0 kg, impaired glucose tolerance patients 1.3 kg and patients with post-transplant diabetes (PTDM) 2.1 kg (P = 0.004, indicating a difference between groups). Percentage VAT of total body fat was associated with fasting (R(2) = 0.094, P < 0.001) and 2-h glucose concentration (R(2) = 0.062, P = 0.001), while BMI was only associated with 2-h glucose concentration (R(2) = 0.029, P = 0.028). An association between BMI and 2-h glucose concentration was lost in adjusted models, as opposed to the associations between VAT as percentage of total body fat and glucose concentrations (R(2) = 0.132, P < 0.001 and R(2) = 0.097, P = 0.001, respectively for fasting and 2-h glucose concentration). In conclusion, VAT is more closely related to impaired glucose metabolism than BMI after kidney transplantation. The association with central obesity should encourage additional studies on lifestyle interventions to prevent PTDM.
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Affiliation(s)
- Marit Elizabeth von Düring
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trond Jenssen
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jens Bollerslev
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Endocrinology, Section of Specialized Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anders Åsberg
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,School of Pharmacy, University of Oslo, Oslo, Norway
| | - Kristin Godang
- Department of Endocrinology, Section of Specialized Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ivar Anders Eide
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dag Olav Dahle
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anders Hartmann
- Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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175
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Lees MJ, Bansil K, Hind K. Total, regional and unilateral body composition of professional English first-class cricket fast bowlers. J Sports Sci 2015; 34:252-8. [DOI: 10.1080/02640414.2015.1048274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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176
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Strasser B, Arvandi M, Pasha EP, Haley AP, Stanforth P, Tanaka H. Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 2015; 25:495-502. [PMID: 25770757 DOI: 10.1016/j.numecd.2015.01.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/26/2014] [Accepted: 01/18/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The relation between adiposity and arterial stiffness remains controversial. We determined whether abdominal and visceral adipose tissue may be a better predictor of arterial stiffness than general obesity in middle-aged adults. METHODS AND RESULTS A total of 146 participants (76 men, 70 women; 50 years) were studied. The automatic vascular screening device (Omron VP-1000plus) was used to measure blood pressure simultaneously in the arms and ankles and to determine arterial stiffness by pulse wave velocity (PWV). Using multiple linear regressions, the relations between indicators of obesity and arterial stiffness were examined after adjustment for confounders. Both carotid-femoral PWV and brachial-ankle PWV were significantly associated with BMI (both P < 0.05) but not with body fat percentage. Measures of abdominal obesity, including waist circumference and visceral fat mass (via DXA), were strongly associated with PWV and remained positively associated with arterial stiffness after adjustment for age and gender. Cardiovascular fitness as assessed by maximal oxygen consumption was related to body fat percentage but not with visceral fat. More favorable cardiovascular health profile was associated with both lower visceral fat mass and PWV (both P < 0.001). CONCLUSION Abdominal obesity and visceral fat are associated with large artery stiffness. These findings support the importance of adiposity measures as a risk factor for arterial stiffening in middle-aged adults.
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Affiliation(s)
- B Strasser
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA; Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria.
| | - M Arvandi
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - E P Pasha
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - A P Haley
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - P Stanforth
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - H Tanaka
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
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177
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Lee JJ, Freeland-Graves JH, Pepper MR, Stanforth PR, Xu B. Prediction of Android and Gynoid Body Adiposity via a Three-dimensional Stereovision Body Imaging System and Dual-Energy X-ray Absorptiometry. J Am Coll Nutr 2015; 34:367-77. [PMID: 25915106 PMCID: PMC5690984 DOI: 10.1080/07315724.2014.966396] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Current methods for measuring regional body fat are expensive and inconvenient compared to the relative cost-effectiveness and ease of use of a stereovision body imaging (SBI) system. The primary goal of this research is to develop prediction models for android and gynoid fat by body measurements assessed via SBI and dual-energy x-ray absorptiometry (DXA). Subsequently, mathematical equations for prediction of total and regional (trunk, leg) body adiposity were established via parameters measured by SBI and DXA. METHODS A total of 121 participants were randomly assigned into primary and cross-validation groups. Body measurements were obtained via traditional anthropometrics, SBI, and DXA. Multiple regression analysis was conducted to develop mathematical equations by demographics and SBI assessed body measurements as independent variables and body adiposity (fat mass and percentage fat) as dependent variables. The validity of the prediction models was evaluated by a split sample method and Bland-Altman analysis. RESULTS The R(2) of the prediction equations for fat mass and percentage body fat were 93.2% and 76.4% for android and 91.4% and 66.5% for gynoid, respectively. The limits of agreement for the fat mass and percentage fat were -0.06 ± 0.87 kg and -0.11% ± 1.97% for android and -0.04 ± 1.58 kg and -0.19% ± 4.27% for gynoid. Prediction values for fat mass and percentage fat were 94.6% and 88.9% for total body, 93.9% and 71.0% for trunk, and 92.4% and 64.1% for leg, respectively. CONCLUSIONS The three-dimensional (3D) SBI produces reliable parameters that can predict android and gynoid as well as total and regional (trunk, leg) fat mass.
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Affiliation(s)
- Jane J. Lee
- Department of Nutritional Sciences, The University of Texas at Austin, Texas
| | | | - M. Reese Pepper
- Department of Nutritional Sciences, The University of Texas at Austin, Texas
| | - Philip R. Stanforth
- Department of Kinesiology and Healthy Education, The University of Texas at Austin, Texas
| | - Bugao Xu
- School of Human Ecology, The University of Texas at Austin, Texas
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178
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Andrews JS, Trupin L, Schmajuk G, Barton J, Margaretten M, Yazdany J, Yelin EH, Katz PP. Muscle strength, muscle mass, and physical disability in women with systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2015; 67:120-7. [PMID: 25049114 DOI: 10.1002/acr.22399] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 07/01/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Data describing relationships between muscle strength, muscle mass, and physical disability among individuals with systemic lupus erythematosus (SLE) are limited. The present study examines the relationship of muscle strength and muscle mass with physical disability among adult women with SLE. METHODS A total of 146 women from a longitudinal SLE cohort participated in the study. All measures were collected during an in-person research visit. Lower extremity muscle strength was assessed by peak knee torque of extension and flexion and by chair-stand time. Total lean body mass, appendicular lean mass, and fat mass (kg/m(2) ) were measured by whole-body dual x-ray absorptiometry. Self-reported physical disability was assessed using the Short Form 36 health survey (SF-36) physical functioning subscale, and the Valued Life Activities (VLA) disability scale. Spearman's rank correlation coefficients tested the correlations between muscle strength, muscle mass, and disability scores. Regression analyses modeled the effect of lower extremity muscle strength and mass on SF-36 and VLA disability scores controlling for age, SLE duration, SLE disease activity measured with the Systemic Lupus Activity Questionnaire, physical activity level, prednisone use, body composition, and depression. RESULTS On all measures, reduced lower extremity muscle strength was associated with poorer SF-36 and VLA disability scores. Trends persisted after adjustment for covariates. Muscle mass was moderately correlated with muscle strength, but did not contribute significantly to adjusted regression models. CONCLUSION Lower extremity muscle strength, but not muscle mass, was strongly associated with physical disability scores. While further studies are needed, these findings suggest that improving muscle strength may reduce physical disability among women with SLE.
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179
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Pedlow K, McDonough S, Lennon S, Kerr C, Bradbury I. Assisted standing for Duchenne muscular dystrophy. Hippokratia 2015. [DOI: 10.1002/14651858.cd011550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Katy Pedlow
- University of Ulster; Centre for Health and Rehabilitation Technologies; Room 1f126 Shore Road Newtownabbey County Antrim UK BT37 OQB
| | - Suzanne McDonough
- University of Ulster; Health and Rehabilitation Sciences; School of Health Sciences Room 14J15 Newtownabbey Co Antrim UK BT37 0QB
| | - Sheila Lennon
- Flinders University; Faculty of Health Sciences, School of Medicine; Adelaide Australia SA 5041
| | - Claire Kerr
- Queen's University Belfast; School of Nursing & Midwifery; Belfast Northern Ireland UK BT9 7BL
| | - Ian Bradbury
- University of Ulster; CHART; Shore Road Jordanstown UK
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180
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Gibby JT, Njeru DK, Cvetko ST, Merrill RM, Bikman BT, Gibby WA. Volumetric analysis of central body fat accurately predicts incidence of diabetes and hypertension in adults. BMC OBESITY 2015; 2:10. [PMID: 26217525 PMCID: PMC4511444 DOI: 10.1186/s40608-015-0039-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 02/05/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Central adipose tissue is appreciated as a risk factor for cardiometabolic disorders. The purpose of this study was to determine the efficacy of a volumetric 3D analysis of central adipose tissue in predicting disease. Full body computerized tomography (CT) scans were obtained from 1225 female (518) and male (707) subjects, aged 18-88. Percent central body fat (%cBF) was determined by quantifying the adipose tissue volume from the dome of the liver to the pubic symphysis. Calcium score was determined from the calcium content of coronary arteries. Relationships between %cBF, BMI, and several cardiometabolic disorders were assessed controlling for age, sex, and race. RESULTS Higher %cBF was significantly greater for those with type 2 diabetes and hypertension, but not stroke or hypercholesterolemia. Simple anthropometric determination of BMI equally correlated with diabetes and hypertension as central body fat. Calcium scoring significantly correlated with all measurements of cardiovascular health, including hypertension, hypercholesterolemia, and heart disease. CONCLUSIONS Central body fat and BMI equally and highly predict incidence of hypertension and type 2 diabetes.
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Affiliation(s)
- Jacob T Gibby
- />Departments of Physiology and Developmental Biology, Provo, UT USA
| | | | | | - Ray M Merrill
- />Health Science, Brigham Young University, Provo, UT USA
| | - Benjamin T Bikman
- />Departments of Physiology and Developmental Biology, Provo, UT USA
| | - Wendell A Gibby
- />Accuscan Health Imaging Center, Salt Lake City, UT 84101 USA
- />Novarad, American Fork, UT 84003 USA
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Abstract
Modeling for cold stress has generated a rich history of innovation, has exerted a catalytic influence on cold physiology research, and continues to impact human activity in cold environments. This overview begins with a brief summation of cold thermoregulatory model development followed by key principles that will continue to guide current and future model development. Different representations of the human body are discussed relative to the level of detail and prediction accuracy required. In addition to predictions of shivering and vasomotor responses to cold exposure, algorithms are presented for thermoregulatory mechanisms. Various avenues of heat exchange between the human body and a cold environment are reviewed. Applications of cold thermoregulatory modeling range from investigative interpretation of physiological observations to forecasting skin freezing times and hypothermia survival times. While these advances have been remarkable, the future of cold stress modeling is still faced with significant challenges that are summarized at the end of this overview.
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Affiliation(s)
- Xiaojiang Xu
- Biophysics and Biomedical Modeling Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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182
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Hamarneh SR, Murphy CA, Shih CW, Frontera W, Torriani M, Irazoqui JE, Makimura H. Relationship between serum IGF-1 and skeletal muscle IGF-1 mRNA expression to phosphocreatine recovery after exercise in obese men with reduced GH. J Clin Endocrinol Metab 2015; 100:617-25. [PMID: 25375982 PMCID: PMC4318910 DOI: 10.1210/jc.2014-2711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT GH and IGF-1 are believed to be physiological regulators of skeletal muscle mitochondria. OBJECTIVE The objective of this study was to examine the relationship between GH/IGF-1 and skeletal muscle mitochondria in obese subjects with reduced GH secretion in more detail. DESIGN Fifteen abdominally obese men with reduced GH secretion were treated for 12 weeks with recombinant human GH. Subjects underwent (31)P-magnetic resonance spectroscopy to assess phosphocreatine (PCr) recovery as an in vivo measure of skeletal muscle mitochondrial function and percutaneous muscle biopsies to assess mRNA expression of IGF-1 and mitochondrial-related genes at baseline and 12 weeks. RESULTS At baseline, skeletal muscle IGF-1 mRNA expression was significantly associated with PCr recovery (r = 0.79; P = .01) and nuclear respiratory factor-1 (r = 0.87; P = .001), mitochondrial transcription factor A (r = 0.86; P = .001), peroxisome proliferator-activated receptor (PPAR)γ (r = 0.72; P = .02), and PPARα (r = 0.75; P = .01) mRNA expression, and trended to an association with PPARγ coactivator 1-α (r = 0.59; P = .07) mRNA expression. However, serum IGF-1 concentration was not associated with PCr recovery or any mitochondrial gene expression (all P > .10). Administration of recombinant human GH increased both serum IGF-1 (change, 218 ± 29 μg/L; P < .0001) and IGF-1 mRNA in muscle (fold change, 2.1 ± 0.3; P = .002). Increases in serum IGF-1 were associated with improvements in total body fat (r = -0.53; P = .04), trunk fat (r = -0.55; P = .03), and lean mass (r = 0.58; P = .02), but not with PCr recovery (P > .10). Conversely, increase in muscle IGF-1 mRNA was associated with improvements in PCr recovery (r = 0.74; P = .02), but not with body composition parameters (P > .10). CONCLUSION These data demonstrate a novel association of skeletal muscle mitochondria with muscle IGF-1 mRNA expression, but independent of serum IGF-1 concentrations.
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Affiliation(s)
- Sulaiman R Hamarneh
- Department of Surgery (S.R.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114; Program in Nutritional Metabolism (C.A.M., C.W.S., H.M.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard College (C.W.S.), Boston, Massachusetts 02138; Department of Physical Medicine and Rehabilitation (W.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; and Department of Radiology (M.T.), Laboratory of Comparative Immunology, Center for the Study of Inflammatory Bowel Disease (J.E.I.), and Neuroendocrine Unit (H.M.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
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183
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Kostovski E, Hjeltnes N, Eriksen EF, Kolset SO, Iversen PO. Differences in bone mineral density, markers of bone turnover and extracellular matrix and daily life muscular activity among patients with recent motor-incomplete versus motor-complete spinal cord injury. Calcif Tissue Int 2015; 96:145-54. [PMID: 25539858 DOI: 10.1007/s00223-014-9947-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/17/2014] [Indexed: 01/10/2023]
Abstract
Spinal cord injury (SCI) leads to severe bone loss, but the associated mechanisms are poorly described in incomplete SCI individuals. The purpose of the study is to compare alterations in bone mineral density (BMD) and serum biomarkers of bone turnover in recent motor-incomplete to -complete SCI men, as well as to describe their physical activity and spasticity. We studied 31 men with acute SCI. Whole-body DXA scans, serum biomarkers and self-reported activity and spasticity were examined 1 and/or 3 and 12 months after the injury. We observed a decrease in proximal femur BMD (p < 0.02) in both the groups. Serum phosphate and carboxy-terminal-collagen crosslinks were significantly lower in motor-incomplete versus complete SCI men, whereas albumin-corrected Ca(2+) (p = 0.02) were lower only 3 months after injury. When data from all 31 SCI participants were pooled, we observed increased serum matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of MMP-2 (TIMP-2) (p < 0.02) whereas TIMP-1 decreased (p = 0.03). BMD correlated positively with self-reported activity (r = 0.59, p = 0.04) and negatively with spasticity (r = 0.74, p = 0.02) 12 months after injury. As a summary, men with motor-incomplete SCI developed significant proximal femur bone loss 12 months after injury and exhibited increased bone resorption throughout the first year after the injury. Compared with complete SCI men, incomplete SCI men show attenuated bone resorption. Our pooled data show increased turnover of extracellular matrix after injury and that increased exercise before and after injury correlated with reduced bone loss.
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Affiliation(s)
- E Kostovski
- Department of Science, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway,
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184
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Body composition indices and predicted cardiovascular disease risk profile among urban dwellers in Malaysia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:174821. [PMID: 25710002 PMCID: PMC4326033 DOI: 10.1155/2015/174821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 01/13/2015] [Accepted: 01/13/2015] [Indexed: 02/03/2023]
Abstract
Objectives. This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. Methods. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Results. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. Conclusions. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.
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185
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Zemski AJ, Slater GJ, Broad EM. Body composition characteristics of elite Australian rugby union athletes according to playing position and ethnicity. J Sports Sci 2015; 33:970-8. [PMID: 25553727 DOI: 10.1080/02640414.2014.977937] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study describes the body composition traits of modern-day elite rugby union athletes according to playing position and ethnicity. Thirty-seven international Australian rugby athletes of Caucasian and Polynesian descent undertook body composition assessment using dual-energy X-ray absorptiometry and surface anthropometry. Forwards were significantly taller, heavier and had a greater total fat mass and lean mass than backs. Backs displayed a higher percentage lean mass and lower sum of seven skinfolds and percentage fat mass. While no whole body composition differences were seen between ethnicities, significant regional differences were observed. In the periphery (arm and leg) regions, Polynesians had a greater proportion of fat mass (53.1% vs. 51.3%, P = 0.052, d = 0.5) and lean mass (49.7% vs. 48.6%, P = 0.040, d = 0.9), while in the trunk region a lower proportion of fat mass (37.2% vs. 39.5%, P = 0.019, d = 0.7) and lean mass (45.6% vs. 46.8%, P = 0.020, d = 1.1). Significant differences were also seen between Caucasian and Polynesian forwards in leg lean mass (31.4 kg vs. 35.9 kg, P = 0.014, d = 2.4) and periphery lean mass (43.8 kg vs. 49.6 kg, P = 0.022, d = 2.4). Elite Polynesian rugby athletes have different distribution patterns of fat mass and lean mass compared to Caucasians, which may influence their suitability for particular positions.
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Affiliation(s)
- Adam J Zemski
- a School of Health and Sport Sciences , University of the Sunshine Coast , Maroochydore , Australia
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186
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Kalyani RR, Metter EJ, Egan J, Golden SH, Ferrucci L. Hyperglycemia predicts persistently lower muscle strength with aging. Diabetes Care 2015; 38:82-90. [PMID: 25392294 PMCID: PMC4274779 DOI: 10.2337/dc14-1166] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Persons with diabetes have accelerated muscle loss compared with their counterparts. The relationship of hyperglycemia per se to declines in muscle function has not been explored yet has implications for developing appropriate intervention strategies to prevent muscle loss. RESEARCH DESIGN AND METHODS We examined 984 participants aged 25-96 years in the Baltimore Longitudinal Study of Aging (2003-2011) with HbA1c, knee extensor strength (isokinetic dynamometer), and lean body mass (DEXA) measured at baseline. Participants had repeated measurements up to 7.5 years later. Muscle quality was defined as knee extensor strength/leg lean mass. Participants were categorized by HbA1c quartile (<5.5, 5.5-5.79, 5.8-6.09, and ≥6.1% or <37, 37-40, 40-43, and ≥43 mmol/mol). Mixed-effects regression models were used to examine the regression of muscle outcomes on HbA1c. RESULTS Muscle strength and quality were significantly lower across HbA1c quartiles (both P < 0.001), without differences in muscle mass at baseline. Comparing highest versus lowest HbA1c quartiles and adjusting for age, race, sex, weight, and height, strength was significantly lower (-4.70 ± 2.30 N · m; P value trend = 0.02) and results were unchanged after adjustment for physical activity (P value trend = 0.045) but of borderline significance after additional adjustment for peripheral neuropathy (P value trend = 0.05). Adjusting for demographics, muscle quality was significantly lower (-0.32 ± 0.15 N · m/kg; P value trend = 0.02) in the highest versus lowest HbA1c quartiles, but differences were attenuated after adjusting for weight and height (-0.25 ± 0.15 N · m/kg; P value trend = 0.07). Muscle mass measures were similar across HbA1c quartiles. CONCLUSIONS Hyperglycemia is associated with persistently lower muscle strength with aging, but this effect may be mediated, at least in part, by peripheral neuropathy. Future studies should explore if better glycemic control can preserve muscle function in diabetes.
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Affiliation(s)
- Rita Rastogi Kalyani
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - E Jeffrey Metter
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Josephine Egan
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Sherita H Golden
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
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187
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Tapolyai M, Faludi M, Dossabhoy NR, Barna I, Lengvárszky Z, Szarvas T, Berta K, Fülöp T. Diuretics and bioimpedance-measured fluid spaces in hypertensive patients. J Clin Hypertens (Greenwich) 2014; 16:895-9. [PMID: 25329360 PMCID: PMC8032123 DOI: 10.1111/jch.12428] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/03/2014] [Accepted: 09/04/2014] [Indexed: 09/20/2023]
Abstract
The authors examined the relationship between thiazide-type diuretics and fluid spaces in a cohort of hypertensive patients in a retrospective study of 60 stable hypertensive patients without renal abnormalities who underwent whole-body bioimpedance analysis. Overhydration was greater in the diuretic group, but only to a nonsignificant degree (5.9 vs. 2.9%; P=.21). The total body water did not differ in the two groups (41.8 L vs. 40.5 L; P=.64). Extracellular fluid volume (ECV) (19.7 L vs. 18.5 L; P=.35) and intracellular fluid volume (ICV) spaces (20.8 L vs. 21.3 L; P=.75) were also not significantly different in the two groups. The ratio of ICV:ECV, however, appeared different: 1.05 vs 1.15 (P=.017) and the effect was maintained in the linear regression-adjusted model (β coefficient: -0.143; P=.001). The diuretic-related distortion of ICV:ECV ratio indicates potential fluid redistribution in hypertensive patients, with ICV participating in the process.
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Affiliation(s)
- Mihály Tapolyai
- Fresenius Medical Care HungarySemmelweis UniversityBudapestHungary
- Carolinas CampusEdward Via Osteopathic College of MedicineSpartanburgSC
| | - Mária Faludi
- Fresenius Medical Care HungarySemmelweis UniversityBudapestHungary
| | | | | | | | - Tibor Szarvas
- Department of MathematicsLouisiana State UniversityShreveportLA
| | - Klára Berta
- Fresenius Medical Care HungarySemmelweis UniversityBudapestHungary
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188
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Hoffseth K, Randall C, Hansma P, Yang HTY. Study of indentation of a sample equine bone using finite element simulation and single cycle reference point indentation. J Mech Behav Biomed Mater 2014; 42:282-91. [PMID: 25528690 DOI: 10.1016/j.jmbbm.2014.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 11/17/2014] [Accepted: 11/22/2014] [Indexed: 11/30/2022]
Abstract
In an attempt to study the mechanical behavior of bone under indentation, methods of analyses and experimental validations have been developed, with a selected test material. The test material chosen is from an equine cortical bone. Stress-strain relationships are first obtained from conventional mechanical property tests. A finite element simulation procedure is developed for indentation analyses. The simulation results are experimentally validated by determining (1) the maximum depth of indentation with a single cycle type of reference point indentation, and (2) the profile and depth of the unloaded, permanent indentation with atomic force microscopy. The advantage of incorporating in the simulation a yield criterion calibrated by tested mechanical properties, with different values in tension and compression, is demonstrated. In addition, the benefit of including damage through a reduction in Young's modulus is shown in predicting the permanent indentation after unloading and recovery. The expected differences in response between two indenter tips with different sharpness are predicted and experimentally observed. Results show predicted indentation depths agree with experimental data. Thus, finite element simulation methods with experimental validation, and with damage approximation by a reduction of Young's modulus, may provide a good approach for analysis of indentation of cortical bone. These methods reveal that multiple factors affect measured indentation depth and that the shape of the permanent indentation contains useful information about bone material properties. Only further work can determine if these methods or extensions to these methods can give useful insights into bone pathology, for example the bone fragility of thoroughbred racehorses.
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Affiliation(s)
- Kevin Hoffseth
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.
| | - Connor Randall
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Paul Hansma
- Department of Physics, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
| | - Henry T Y Yang
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, CA 93106, USA
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189
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Di Renzo L, Marsella LT, Sarlo F, Soldati L, Gratteri S, Abenavoli L, De Lorenzo A. C677T gene polymorphism of MTHFR and metabolic syndrome: response to dietary intervention. J Transl Med 2014; 12:329. [PMID: 25432492 PMCID: PMC4260200 DOI: 10.1186/s12967-014-0329-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms were found associated with body mass index (BMI)-defined obesity and lean mass. The aim of our study was to examine the role of the C677T MTHFR gene polymorphism in the response to diet in the management of metabolic syndrome. We investigated the body composition and metabolic factor changes after an hysocaloric balanced diet (HBD), in Italian obese women affected by metabolic syndrome (MS). METHODS Forty four obese women affected by MS were eligible for the study. A HBD for 12 weeks was assigned. Study participation included a complete screening for dietary habits, anthropometry, body composition, blood biochemical markers and C677T MTHFR polymorphism genotyping. The study has been registrated by ClinicalTrials.gov Id: NCT01890070. RESULTS The highest number of responders to HBD nutritional intervention were T(-) carriers (p ≤ 0.05). In the 81% of the total population a loss of Total Body Lean was observed. A significative loss (p ≤ 0.05) of Total Body Lean was observed in the 47% of T(-) carriers and in the 53% of T(+) carriers. Diastolic and systolic blood pressure, and waist circumference were reduced (p ≤ 0.05). The prevalence of MS parameters decreased by 84% for systolic and diastolic blood pressure; 79,5% for HDL cholesterol, 82% for fasting glucose and 77% for triglycerides. CONCLUSIONS MTHFR genetic variations analysis would be an innovative tool for the nutritional assessment. Our data provide the basis for personalized dietary recommendations based on the individual's genetic makeup and nutritional status. TRIAL REGISTRATION The study has been registrated by ClinicalTrials.gov Id: NCT01890070.
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Affiliation(s)
- Laura Di Renzo
- Division of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, 00133, Italy.
| | - Luigi Tonino Marsella
- Division of Legal Medicine and Social Security, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, 00133, Italy.
| | - Francesca Sarlo
- Department of Agriculture, University of Naples "Federico II", Portici, 80055 (Na), Italy.
| | - Laura Soldati
- Department of Health Sciences, University of Milan, Milan, Italy.
| | - Santo Gratteri
- Department of Surgery and Medical Science, University "Magna Græcia", Germaneto, (CZ), 88100, Italy.
| | - Ludovico Abenavoli
- Department of Health Science, University "Magna Græcia", Germaneto, (CZ), 88100, Italy.
| | - Antonino De Lorenzo
- Division of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, 00133, Italy.
- Clinic "Nuova Annunziatella", Rome, 00147, Italy.
- I.N.Di.M, National Institute for Mediterranean Diet and Nutrigenomic, Amantea, (CS), 87032, Italy.
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190
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Marzolini S, McIlroy W, Tang A, Corbett D, Craven BC, Oh PI, Brooks D. Predictors of low bone mineral density of the stroke-affected hip among ambulatory individuals with chronic stroke. Osteoporos Int 2014; 25:2631-8. [PMID: 25001986 DOI: 10.1007/s00198-014-2793-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Risk of hip fracture is greater poststroke than in an age-matched healthy population, in part because of declining hip BMD. We found that individuals may be at risk of loss of hip BMD from muscle atrophy, asymmetrical gait, and poor affected-side ankle dorsiflexor strength. These impairments may be targeted during rehabilitation. INTRODUCTION This study aimed to determine predictors of low hip BMD on the stroke-affected side in people living in the community. METHODS Forty-three participants (female; 27.9%), mean age 62.4 ± 13.5 and 17.9 ± 32.8 months, poststroke with motor impairments underwent dual energy X-ray absorptiometry scans. Gait characteristics, isometric strength, body composition, and fasting plasma lipids were measured. RESULTS At entry, 34.9% (15/43) of the participants had low total hip BMD on the stroke-affected side. Of those with low BMD, 93.3% (14/15) had a step length symmetry ratio >1, indicating greater reliance on the non-paretic leg for weight bearing. Logistic regression analysis revealed that lower affected-side ankle dorsiflexor strength (ß = 0.700, p = 0.02), lower total body fat-free mass index (ß = 0.437, p = 0.02), and greater step length symmetry ratio during walking (ß = 1.135 × 10(3), p = 0.03) were predictors of low hip BMD. CONCLUSION Low BMD of the stroke-affected side hip is prevalent in over a third of individuals with lower limb motor impairments. These individuals may be at particular risk of accelerated loss of BMD at the hip from asymmetrical gait pattern and poor affected-side ankle dorsiflexor strength. These impairments are intervention targets that may be addressed during rehabilitation which includes resistance training and addresses gait impairments.
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Affiliation(s)
- S Marzolini
- University Health Network, Toronto Rehabilitation Institute, Toronto, Canada,
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191
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Broers NJH, Martens RJH, Cornelis T, Diederen NMP, Wabel P, van der Sande FM, Leunissen KML, Kooman JP. Body composition in dialysis patients: a functional assessment of bioimpedance using different prediction models. J Ren Nutr 2014; 25:121-8. [PMID: 25443694 DOI: 10.1053/j.jrn.2014.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 08/21/2014] [Accepted: 08/25/2014] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The assessment of body composition (BC) in dialysis patients is of clinical importance given its role in the diagnosis of malnutrition and sarcopenia. Bioimpedance techniques routinely express BC as a 2-compartment (2-C) model distinguishing fat mass (FM) and fat-free mass (FFM), which may be influenced by the hydration of adipose tissue and fluid overload (OH). Recently, the BC monitor was introduced which applies a 3-compartment (3-C) model, distinguishing OH, adipose tissue mass, and lean tissue mass. The aim of this study was to compare BC between the 2-C and 3-C models and assess their relation with markers of functional performance (handgrip strength [HGS] and 4-m walking test), as well as with biochemical markers of nutrition. METHODS Forty-seven dialysis patients (30 males and 17 females) (35 hemodialysis, 12 peritoneal dialysis) with a mean age of 64.8 ± 16.5 years were studied. 3-C BC was assessed by BC monitor, whereas the obtained resistivity values were used to calculate FM and FFM according to the Xitron Hydra 4200 formulas, which are based on a 2-C model. RESULTS FFM (3-C) was 0.99 kg (95% confidence interval [CI], 0.27 to 1.71, P = .008) higher than FFM (2-C). FM (3-C) was 2.43 kg (95% CI, 1.70-3.15, P < .001) lower than FM (2-C). OH was 1.4 ± 1.8 L. OH correlated significantly with ΔFFM (FFM 3-C - FFM 2-C) (r = 0.361; P < .05) and ΔFM (FM 3-C - FM 2-C) (r = 0.387; P = .009). HGS correlated significantly with FFM (2-C) (r = 0.713; P < .001), FFM (3-C) (r = 0.711; P < .001), body cell mass (2-C) (r = 0.733; P < .001), and body cell mass (3-C) (r = 0.767; P < .001). Both physical activity (r = 0.456; P = .004) and HGS (r = 0.488; P = .002), but not BC, were significantly related to walking speed. CONCLUSIONS Significant differences between 2-C and 3-C models were observed, which are partly explained by the presence of OH. OH, which was related to ΔFFM and ΔFM of the 2-C and 3-C models, is therefore an important parameter for the differences in estimation of BC parameters of the 2-C and 3-C models. Both FFM (3-C) and FFM (2-C) were significantly related to HGS. Bioimpedance, HGS, and the 4-m walking test may all be valuable tools in the multidimensional nutritional assessment of both hemodialysis and peritoneal dialysis patients.
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Affiliation(s)
- Natascha J H Broers
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
| | - Remy J H Martens
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
| | - Tom Cornelis
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
| | - Nanda M P Diederen
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
| | - Peter Wabel
- Fresenius Medical Care D GmbH, Research and Development, Bad Homburg, Germany
| | - Frank M van der Sande
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
| | - Karel M L Leunissen
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
| | - Jeroen P Kooman
- Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands.
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192
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Six-month intragastric balloon treatment for obesity improves lung function, body composition, and metabolic syndrome. Obes Surg 2014; 24:232-40. [PMID: 23949905 DOI: 10.1007/s11695-013-1061-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The purpose of this study is to establish whether the use of an intragastric balloon (IGB) for 6 months improves lung function, metabolic parameters, and body fat distribution in patients with overweight/obesity and metabolic syndrome (MS). METHODS This is a longitudinal and interventional study on 40 adults, whose anthropometric, laboratory, and lung function parameters were assessed and who underwent dual-energy X-ray absorptiometry (DXA) before implantation and after removal of IGB. RESULTS The total lung capacity (TLC) (p = 0.0001), functional residual capacity (FRC) (p = 0.0001), residual volume (p = 0.0005), and expiratory reserve volume (ERV) (p = 0.0001) were significantly reduced by IGB. The body mass index (BMI) significantly decreased from a median of 39.1 kg/m(2) at the beginning of the study to 34.5 kg/m(2) at the end of the 6-month period (p = 0.0001). At the end of the study, 31 participants (77.5%) no longer met the diagnostic criteria of MS. The percentage of truncal, android, gynoid, and total fat investigated by DXA exhibited significant reductions (p = 0.0001). Significant correlations were found between delta TLC and delta waist circumference (ρ = -0.34; p = 0.03), delta FRC and delta IMC (ρ = -0.39; p = 0.01), delta ERV and delta BMI (ρ = -0.44; p = 0.005), and delta ERV and delta high-density lipoprotein (HDL) (ρ = -0.37; p = 0.02). Significant correlations were also found between delta ERV and delta truncal (ρ = -0.51; p = 0.004), android (ρ = -0.46; p = 0.01), gynoid (ρ = -0.55; p = 0.001), and total fat (ρ = -0.59; p = 0.0005). CONCLUSIONS IGB efficiently induced weight loss and promoted the improvement of lung function parameters, with a reduction of the restrictive ventilatory defect. It also promoted improvements of MS and the pattern of body fat distribution.
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Lee LC, Hsieh KC, Wu CS, Chen YJ, Chiang J, Chen YY. Validity of Standing Posture Eight-electrode Bioelectrical Impedance to Estimate Body Composition in Taiwanese Elderly. INT J GERONTOL 2014. [DOI: 10.1016/j.ijge.2013.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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194
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Germain N, Galusca B, Caron-Dorval D, Martin JF, Pujos-Guillot E, Boirie Y, Khalfallah Y, Ling Y, Minnion JS, Bloom SR, Epelbaum J, Estour B. Specific appetite, energetic and metabolomics responses to fat overfeeding in resistant-to-bodyweight-gain constitutional thinness. Nutr Diabetes 2014; 4:e126. [PMID: 25027794 PMCID: PMC5189928 DOI: 10.1038/nutd.2014.17] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 05/18/2014] [Indexed: 02/05/2023] Open
Abstract
Background: Contrasting with obesity, constitutional thinness (CT) is a rare condition of natural low bodyweight. CT exhibits preserved menstruation in females, no biological marker of undernutrition, no eating disorders but a bodyweight gain desire. Anorexigenic hormonal profile with high peptide tyrosine tyrosine (PYY) was shown in circadian profile. CT could be considered as the opposite of obesity, where some patients appear to resist diet-induced bodyweight loss. Objective: The objective of this study was to evaluate appetite regulatory hormones in CTs in an inverse paradigm of diet-induced weight loss. Methods: A 4-week fat overfeeding (2640 kJ excess) was performed to compare eight CT women (body mass index (BMI)<17.5 kg m−2) to eight female controls (BMI 18.5–25 kg m−2). Appetite regulatory hormones profile after test meal, food intake, bodyweight, body composition, energy expenditure and urine metabolomics profiles were monitored before and after overfeeding. Results: After overfeeding, fasting total and acylated ghrelin were significantly lower in CTs than in controls (P=0.01 and 0.03, respectively). After overfeeding, peptide tyrosine tyrosine (PYY) and glucagon-like-peptide 1 both presented earlier (T15 min vs T30 min) and higher post-meal responses (incremental area under the curve) in CTs compared with controls. CTs failed to increase bodyweight (+0.22±0.18 kg, P=0.26 vs baseline), contrasting with controls (+0.72±0.26 kg, P=0.03 vs baseline, P=0.01 vs CTs). Resting energy expenditure increased in CTs only (P=0.031 vs baseline). After overfeeding, a significant negative difference between total energy expenditure and food intake was noticed in CTs only (−2754±720 kJ, P=0.01). Conclusion: CTs showed specific adaptation to fat overfeeding: overall increase in anorexigenic hormonal profile, enhanced post prandial GLP-1 and PYY and inverse to controls changes in urine metabolomics. Overfeeding revealed a paradoxical positive energy balance contemporary to a lack of bodyweight gain, suggesting yet unknown specific energy expenditure pathways in CTs.
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Affiliation(s)
- N Germain
- 1] Division of Endocrinology, Diabetes, Metabolism and Eating disorders, CHU Saint-Etienne, Saint-Etienne Cedex, France [2] Laboratory of Exercise Physiology (LPE EA 4338), University of Lyon, Saint-Etienne Cedex 2, France
| | - B Galusca
- 1] Division of Endocrinology, Diabetes, Metabolism and Eating disorders, CHU Saint-Etienne, Saint-Etienne Cedex, France [2] Laboratory of Exercise Physiology (LPE EA 4338), University of Lyon, Saint-Etienne Cedex 2, France
| | - D Caron-Dorval
- 1] Division of Endocrinology, Diabetes, Metabolism and Eating disorders, CHU Saint-Etienne, Saint-Etienne Cedex, France [2] Laboratory of Exercise Physiology (LPE EA 4338), University of Lyon, Saint-Etienne Cedex 2, France
| | - J-F Martin
- UMR 1019, Human Nutrition Unit, INRA, Research Center Clermont-Ferrand, Clermont-Ferrand, France
| | - E Pujos-Guillot
- UMR 1019, Human Nutrition Unit, INRA, Research Center Clermont-Ferrand, Clermont-Ferrand, France
| | - Y Boirie
- UMR 1019, Human Nutrition Unit, INRA, Research Center Clermont-Ferrand, Clermont-Ferrand, France
| | - Y Khalfallah
- Division of Endocrinology, Diabetes, Metabolism and Eating disorders, CHU Saint-Etienne, Saint-Etienne Cedex, France
| | - Y Ling
- 1] Division of Endocrinology, Diabetes, Metabolism and Eating disorders, CHU Saint-Etienne, Saint-Etienne Cedex, France [2] Laboratory of Exercise Physiology (LPE EA 4338), University of Lyon, Saint-Etienne Cedex 2, France
| | - J S Minnion
- Division of Diabetes, Endocrinology and Metabolism, Imperial College, London, UK
| | - S R Bloom
- Division of Diabetes, Endocrinology and Metabolism, Imperial College, London, UK
| | - J Epelbaum
- UMR 894, INSERM, Psychiatry and Neurosciences Center, Paris Descartes University, Paris, France
| | - B Estour
- 1] Division of Endocrinology, Diabetes, Metabolism and Eating disorders, CHU Saint-Etienne, Saint-Etienne Cedex, France [2] Laboratory of Exercise Physiology (LPE EA 4338), University of Lyon, Saint-Etienne Cedex 2, France
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195
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Payne F, Lim K, Girousse A, Brown RJ, Kory N, Robbins A, Xue Y, Sleigh A, Cochran E, Adams C, Dev Borman A, Russel-Jones D, Gorden P, Semple RK, Saudek V, O'Rahilly S, Walther TC, Barroso I, Savage DB. Mutations disrupting the Kennedy phosphatidylcholine pathway in humans with congenital lipodystrophy and fatty liver disease. Proc Natl Acad Sci U S A 2014; 111:8901-6. [PMID: 24889630 PMCID: PMC4066527 DOI: 10.1073/pnas.1408523111] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Phosphatidylcholine (PC) is the major glycerophospholipid in eukaryotic cells and is an essential component in all cellular membranes. The biochemistry of de novo PC synthesis by the Kennedy pathway is well established, but less is known about the physiological functions of PC. We identified two unrelated patients with defects in the Kennedy pathway due to biallellic loss-of-function mutations in phosphate cytidylyltransferase 1 alpha (PCYT1A), the rate-limiting enzyme in this pathway. The mutations lead to a marked reduction in PCYT1A expression and PC synthesis. The phenotypic consequences include some features, such as severe fatty liver and low HDL cholesterol levels, that are predicted by the results of previously reported liver-specific deletion of murine Pcyt1a. Both patients also had lipodystrophy, severe insulin resistance, and diabetes, providing evidence for an additional and essential role for PCYT1A-generated PC in the normal function of white adipose tissue and insulin action.
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Affiliation(s)
- Felicity Payne
- Metabolic Disease Group, The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, United Kingdom
| | - Koini Lim
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom
| | - Amandine Girousse
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom
| | - Rebecca J Brown
- Diabetes Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Nora Kory
- Department of Cell Biology, School of Medicine, Yale University, New Haven, CT 06520
| | - Ann Robbins
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom
| | - Yali Xue
- Metabolic Disease Group, The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, United Kingdom
| | - Alison Sleigh
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Elaine Cochran
- Diabetes Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Claire Adams
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom
| | - Arundhati Dev Borman
- Moorfields Eye Hospital National Health Service Trust, London EC1V 2PD, United Kingdom; and
| | - David Russel-Jones
- Centre for Endocrinology, Diabetes and Research, Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom
| | - Phillip Gorden
- Diabetes Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Robert K Semple
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom
| | - Vladimir Saudek
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom
| | - Stephen O'Rahilly
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom;
| | - Tobias C Walther
- Department of Cell Biology, School of Medicine, Yale University, New Haven, CT 06520
| | - Inês Barroso
- Metabolic Disease Group, The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, United Kingdom;University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom;
| | - David B Savage
- University of Cambridge, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, United Kingdom;
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196
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Covey MK, Collins EG, Reynertson SI, Dilling DF. Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD. Respir Med 2014; 108:1141-52. [PMID: 24958605 DOI: 10.1016/j.rmed.2014.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Aerobic exercise training is a recognized approach for improving functional capacity in COPD. People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity. The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training. METHODS Patients were randomized to: 1) sequential resistance then aerobic training (RT-then-AT) (8 weeks resistance training followed by 8 weeks aerobic exercise training), 2) control group (CE-then-AT + RT) (8 weeks of 'sham' training followed by 8 weeks concurrent aerobic and resistance training), 3) control group (CE-then-AT) (8 weeks 'sham' training followed by 8 weeks aerobic training). Outcomes were assessed at study entry, after week 8, and after week 16: aerobic exercise performance; muscle strength and endurance. RESULTS 75 patients completed training: FEV1 %pred 40 ± 10, V˙O(2peak) %predicted, 71 ± 22, fat-free mass index 19.5 ± 3.1. RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT + RT and CE-then-AT, but improvements in aerobic exercise performance were similar. Improvements in muscle strength were similar between RT-then-AT and CE-then-AT + RT. Sarcopenia was associated with poorer attendance, and lower aerobic and resistance training volumes. CONCLUSION Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training, other training outcomes were similar between the two groups, thus the sequential approach is not clearly superior to the concurrent approach in severe COPD. ClinicalTrials.gov Identifier: NCT01058213.
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Affiliation(s)
- Margaret K Covey
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, United States.
| | - Eileen G Collins
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, United States; Department of Research and Development, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Sandra I Reynertson
- Medicine Service Line at Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States; Department of Medicine, Division of Clinical Cardiology, Loyola University, Stritch School of Medicine, Maywood, IL, United States
| | - Daniel F Dilling
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Loyola University, Stritch School of Medicine, Maywood, IL, United States
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197
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De Lorenzo A, Nardi A, Iacopino L, Domino E, Murdolo G, Gavrila C, Minella D, Scapagnini G, Di Renzo L. A new predictive equation for evaluating women body fat percentage and obesity-related cardiovascular disease risk. J Endocrinol Invest 2014; 37:511-24. [PMID: 24458830 DOI: 10.1007/s40618-013-0048-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 12/17/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obesity represents a global public health problem due to its association with cardiovascular diseases and reduced lifespan. The most widely used classification of obesity is expressed as Body Mass Index (BMI); however, this formula is an imprecise adiposity measurement that ignores several important factors involved. Body Adiposity Index (BAI) was more recently proposed as an indirect evaluation of percentage body fat (PBF). PBF is a direct measure of person's relative body fat and a better predictor of obesity-related risk diseases than BMI and BAI. Since obesity and consequent diseases are considered epidemic, new accurate formulas for epidemiological studies are of interest to the scientific community. Because direct measurement of body composition could be quite expensive, the aims of our work were to analyse the distributions of PBF by Dual X-ray absorptiometry, and the creation of new predictive equation using only anthropometric measures that could be helpful to clinicians to assess easily body fat of female patients. METHODS/RESULTS A sample of 1,031 Caucasian Italian women was recruited and BMI, BAI and PBF were evaluated. With the aim of developing a predictive model of PBF a multivariate regression model was fitted to observed data. CONCLUSIONS The definition of universally recognized PBF by gender and age could have public health implications. In this study, we developed a new predictive PBF equation that does not require the use of medical instruments or skilled measurement techniques and that may be easily applicable to Italian women.
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Affiliation(s)
- A De Lorenzo
- Division of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133, Rome, Italy,
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198
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Nakavachara P, Pooliam J, Weerakulwattana L, Kiattisakthavee P, Chaichanwattanakul K, Manorompatarasarn R, Chokephaibulkit K, Viprakasit V. A normal reference of bone mineral density (BMD) measured by dual energy X-ray absorptiometry in healthy thai children and adolescents aged 5-18 years: a new reference for Southeast Asian Populations. PLoS One 2014; 9:e97218. [PMID: 24847716 PMCID: PMC4029563 DOI: 10.1371/journal.pone.0097218] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 04/16/2014] [Indexed: 11/19/2022] Open
Abstract
Ethnic-specific normative data of bone mineral density (BMD) is essential for the accurate interpretation of BMD measurement. There have been previous reports of normative BMD data for Caucasian and Asian children including Japanese, Chinese, Korean and Indian. However, the normative BMD data for Southeast Asian including Thai children and adolescents are not currently available. The goals of our study were 1) to establish normative data of BMD, bone mineral content (BMC), bone area (BA) and lean body mass (LBM) for healthy Thai children and adolescents; aged 5–18 years measured by dual energy X-ray absorptiometry (DXA, Lunar Prodigy) and 2) to evaluate the relationships between BMD vs. age, sex, puberty, weight, height, calcium intake and the age of menarche in our population. Gender and age-specific BMD (L2-4; LS and total body; TB), BMADLS (apparent BMD of the lumbar spine), BMC (L2-4 and total body), BA (L2-4 and total body) and LBM were evaluated in 367 children (174 boys and 193 girls). All parameters increased progressively with age. A rapid increase in BMD, BMC and BMADLS was observed at earlier ages in girls. Gender and Tanner stage-specific BMD normative data were also generated. The dynamic changes of BMD values from childhood to early and late puberty of Thai children appeared to be consistent with those of Caucasian and Asian populations. Using a multiple-regression, weight and Tanner stage significantly affected BMDLS, BMDTB and BMADLS in both genders. Only in girls, height was found to have significant influence on BMDTB and BMADLS. The positive correlation between BMD and several demographic parameters, except the calcium intake, was observed. In summary, we established a normal BMD reference for Thai children and adolescents and this will be of useful for clinicians and researchers to appropriately assess BMD in Thais and other Southeast Asian children.
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Affiliation(s)
- Pairunyar Nakavachara
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
- * E-mail:
| | - Julaporn Pooliam
- Clinical Epidemiological Unit, Office for Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Linda Weerakulwattana
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pornpimol Kiattisakthavee
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Katharee Chaichanwattanakul
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Racahnee Manorompatarasarn
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vip Viprakasit
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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199
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In-depth metabolic phenotyping of genetically engineered mouse models in obesity and diabetes. Mamm Genome 2014; 25:508-21. [PMID: 24792749 DOI: 10.1007/s00335-014-9520-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/10/2014] [Indexed: 01/09/2023]
Abstract
The world-wide prevalence of obesity and diabetes has increased sharply during the last two decades. Accordingly, the metabolic phenotyping of genetically engineered mouse models is critical for evaluating the functional roles of target genes in obesity and diabetes, and for developing new therapeutic targets. In this review, we discuss the practical meaning of metabolic phenotyping, the strategy of choosing appropriate tests, and considerations when designing and performing metabolic phenotyping in mice.
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200
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Khare M, Gold JA, Wencel M, Billimek J, Surampalli A, Duarte B, Pontello A, Galassetti P, Cassidy S, Kimonis VE. Effect of genetic subtypes and growth hormone treatment on bone mineral density in Prader-Willi syndrome. J Pediatr Endocrinol Metab 2014; 27:511-8. [PMID: 24515997 DOI: 10.1515/jpem-2013-0180] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 08/26/2013] [Indexed: 11/15/2022]
Abstract
UNLABELLED Abstract Background: Currently, there is limited information on the effects of growth hormone and of the different genetic subtypes on bone mineral density (BMD) in Prader-Willi syndrome (PWS). METHODS We evaluated BMD in 79 individuals with the common subtypes of PWS (48 with deletion and 27 with UPD) and the effect of growth hormone treatment (n=46) vs. no growth hormone treatment. RESULTS Forty-four percent of the individuals studied had whole body, hip, or spine BMD <-1 standard deviation (SD) and 10% had a BMD <-2 SD. BMD Z-scores and total BMD (g/cm2) of the spine were significantly higher in the growth hormone group. With each year of growth hormone treatment, these values increased by a factor of 0.207 and 0.011 (p=0.006 and 0.032), respectively. Individuals with uniparental disomy revealed higher spine BMD compared with deletion subclass; however, the differences were not significant. CONCLUSION This study emphasizes the importance of evaluating bone mineralization in individuals with PWS and the beneficial effects of prolonged treatment with growth hormone. There was a trend for a higher BMD in individuals with uniparental disomy.
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