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Gendler PE, Coviak CP, Martin JT, Kim KK, Dankers JK, Barclay JM, Sanchez TA. Revision of the Osteoporosis Knowledge Test. West J Nurs Res 2014; 37:1623-43. [DOI: 10.1177/0193945914537565] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to revise the Osteoporosis Knowledge Test (OKT) and evaluate its reliability and validity. The original OKT, developed in the early 1990s, needed updating based on current research. A convenience sample of 105 adults completed the draft revised OKT. A subsample ( n = 27) completed the questionnaire 2 weeks later to determine stability. The sample was recruited from diverse sites in western and northern Michigan over a year. The 32-item Revised OKT (2012) demonstrated internal consistency (total scale Kuder–Richardson-20 = .85, Nutrition subscale = .83, and Exercise subscale = .81). Test–retest analysis resulted in a Pearson correlation coefficient of .87. Validity was evaluated by content validity. Questions were examined for difficulty, effectiveness of distracters, and discrimination. In addition, measures of point-biserial, internal consistency and stability were determined. The Revised OKT (2012) is a comprehensive instrument reflecting current research and assesses osteoporosis knowledge of adults.
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Affiliation(s)
| | | | | | | | - Jennifer K. Dankers
- Grand Valley State University, Grand Rapids, MI, USA
- Heart Failure Clinic at MidMichigan Physicians Group Cardiology, Midland, USA
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302
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Mantripragada VP, Jayasuriya AC. IGF-1 release kinetics from chitosan microparticles fabricated using environmentally benign conditions. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 42:506-16. [PMID: 25063148 DOI: 10.1016/j.msec.2014.05.068] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/05/2014] [Accepted: 05/30/2014] [Indexed: 01/23/2023]
Abstract
The main objective of this study is to maximize growth factor encapsulation efficiency into microparticles. The novelty of this study is to maximize the encapsulated growth factors into microparticles by minimizing the use of organic solvents and using relatively low temperatures. The microparticles were fabricated using chitosan biopolymer as a base polymer and cross-linked with tripolyphosphate (TPP). Insulin like-growth factor-1 (IGF-1) was encapsulated into microparticles to study release kinetics and bioactivity. In order to authenticate the harms of using organic solvents like hexane and acetone during microparticle preparation, IGF-1 encapsulated microparticles prepared by the emulsification and coacervation methods were compared. The microparticles fabricated by emulsification method have shown a significant decrease (p<0.05) in IGF-1 encapsulation efficiency, and cumulative release during the two-week period. The biocompatibility of chitosan microparticles and the bioactivity of the released IGF-1 were determined in vitro by live/dead viability assay. The mineralization data observed with von Kossa assay, was supported by mRNA expression levels of osterix and runx2, which are transcription factors necessary for osteoblasts differentiation. Real time RT-PCR data showed an increased expression of runx2 and a decreased expression of osterix over time, indicating differentiating osteoblasts. Chitosan microparticles prepared in optimum environmental conditions are a promising controlled delivery system for cells to attach, proliferate, differentiate and mineralize, thereby acting as a suitable bone repairing material.
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Affiliation(s)
| | - Ambalangodage C Jayasuriya
- Biomedical Engineering Program, The University of Toledo, Toledo, OH 43614-5807, USA; Department of Orthopaedic Surgery, The University of Toledo, Toledo, OH 43614-5807, USA.
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303
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Winther A, Dennison E, Ahmed LA, Furberg AS, Grimnes G, Jorde R, Gjesdal CG, Emaus N. The Tromsø Study: Fit Futures: a study of Norwegian adolescents' lifestyle and bone health. Arch Osteoporos 2014; 9:185. [PMID: 24893722 DOI: 10.1007/s11657-014-0185-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 05/21/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Bone mass achievement predicts later fracture risk. This population-based study describes bone mineral density (BMD) levels and associated factors in Norwegian adolescents. Compared with international reference ranges, BMD levels appear higher and physical activity levels are positively associated with BMD. PURPOSE Norway has one of the highest reported incidences of osteoporotic fractures. Maximisation of peak bone mass may prevent later fractures. This population-based study compared BMD levels of Norwegian adolescents with international reference ranges and explored associated factors. METHODS All first-year upper-secondary school students, aged 15-19 years in the Tromsø region were invited to the Fit Futures study in 2010-2011. Over 90 % of the invited participants attended, 508 girls and 530 boys. BMD was measured at total hip, femoral neck and total body by dual X-ray absorptiometry. Lifestyle variables were collected by self-administered questionnaires and interviews. All analyses were performed sex stratified, using linear regression models. RESULTS In girls, mean BMD (SD) was 1.060 g/cm(2) (0.124), 1.066 g/cm(2) (0.123) and 1.142 g/cm(2) (0.077) at the total hip, femoral neck and total body, respectively. In boys, corresponding values were 1.116 (0.147), 1.103 (0.150) and 1.182 (0.097), with significant higher values than the Lunar pediatric reference at 16 years of age. In girls, height and self-reported intensive physical activity of more than 4 h a week and early sexual maturation were positively associated with BMD at both femoral sites (p < 0.047). Among boys age, height, body mass index, physical activity and alcohol intake were positively (p < 0.038), whereas early stages of sexual maturation and smoking was negatively (p < 0.047) related to BMD. CONCLUSIONS Despite the heavy fracture burden, Norwegian adolescents' BMD levels are higher than age-matched Caucasians. Physical activity is associated with 1 SD increased BMD levels in those involved in competition or hard training.
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Affiliation(s)
- Anne Winther
- Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway,
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High bone density in adolescents with obesity is related to fat mass and serum leptin concentrations. J Pediatr Gastroenterol Nutr 2014; 58:723-8. [PMID: 24399210 DOI: 10.1097/mpg.0000000000000297] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Obesity has been associated with increased bone mass, but the mechanisms involved are still poorly understood. We aimed to explore the relation between bone mineral density and factors known to influence bone formation in obese and lean adolescents. METHODS We recruited 24 obese and 25 lean adolescents in a case-control study. Total body bone mineral density (TB-BMD) z scores and body composition were determined using dual-energy x-ray absorptiometry. We measured 25-hydroxyvitamin D (25-OH-D), glucose, insulin, and leptin concentrations. Physical activity (PA) level was quantified using accelerometer. RESULTS TB-BMD z score was higher, whereas 25-OH-D and PA levels were lower in obese compared with lean subjects (TB-BMD z score 1.06 ± 0.96 vs 0.26 ± 0.91, P = 0.004; 25-OH-D 9.9 ± 6.4 vs 18.5 ± 7.4 ng mL, P < 0.001; PA level 308.3 ± 22.1 vs 406.8 ± 29.2 count min, P = 0.01). TB-BMD z score was not related to 25-OH-D or PA levels, but was positively correlated with leptin concentration and fat mass (P < 0.05). Vitamin D concentration was negatively correlated with fat mass (P < 0.001). CONCLUSIONS Despite lower serum vitamin D and PA levels, BMD was higher in adolescents with obesity and associated with higher serum leptin concentrations. Furthermore, adolescents with obesity have lower vitamin D serum concentrations than lean controls, probably owing to its distribution in adipose tissue.
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306
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Abstract
Fracture risk is determined by bone mass, geometry, and microstructure, which result from peak bone mass (the amount attained at the end of pubertal growth) and from the amount of bone lost subsequently. Nutritional intakes are an important environmental factor that influence both bone mass accumulation during childhood and adolescence and bone loss that occurs in later life. Bone growth is influenced by dietary intake, particularly of calcium and protein. Adequate dietary calcium and protein are essential to achieve optimal peak bone mass during skeletal growth and to prevent bone loss in the elderly. Dairy products are rich in nutrients that are essential for good bone health, including calcium, protein, vitamin D, potassium, phosphorus, and other micronutrients and macronutrients. Studies supporting the beneficial effects of milk or dairy products on bone health show a significant inverse association between dairy food intake and bone turnover markers and a positive association with bone mineral content. Fortified dairy products induce more favorable changes in biochemical indexes of bone metabolism than does calcium supplementation alone. The associations between the consumption of dairy products and the risk of hip fracture are less well established, although yogurt intake shows a weakly positive protective trend for hip fracture. By consuming 3 servings of dairy products per day, the recommended daily intakes of nutrients essential for good bone health may be readily achieved. Dairy products could therefore improve bone health and reduce the risk of fractures in later life.
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Affiliation(s)
- René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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307
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Agahi N, Shaw BA, Fors S. Social and economic conditions in childhood and the progression of functional health problems from midlife into old age. J Epidemiol Community Health 2014; 68:734-40. [PMID: 24759781 PMCID: PMC4112427 DOI: 10.1136/jech-2013-203698] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood living conditions have been found to predict health and mortality in midlife and in old age. This study examines the associations between social and economic childhood conditions and the onset and progression of functional health problems from midlife into old age, and the extent to which potential associations are mediated by educational attainment and smoking. METHODS Data from the Level of Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old were merged to create a longitudinal data set with five repeated measures from 1968 to 2004 (n=1765, aged 30-50 years and free from functional health problems at baseline). Multilevel regression models were used to analyse retrospective reports of social and economic conditions in childhood (eg, conflicts or economic problems in the family) in relation to the progression of functional health problems over the 36-year period. RESULTS Results showed that social and economic disadvantages in childhood were associated with an earlier onset and a faster progression of functional health problems from midlife into old age. Subsequent models showed that differences in educational attainment, but not smoking, explained much of the association between childhood disadvantages and trajectories of functional health problems. CONCLUSIONS According to these results, adverse social and economic conditions in childhood affect the development of functional health problems from midlife into old age indirectly through less favourable life careers, including lower education. Creating equal opportunities for educational attainment may help reduce the long-term effects of disadvantaged childhood conditions and postpone functional health problems.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | - Benjamin A Shaw
- School of Public Health, University of Albany, State University of New York, New York, USA
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
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308
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Ishikawa S, Kim Y, Kang M, Morgan DW. Effects of weight-bearing exercise on bone health in girls: a meta-analysis. Sports Med 2014; 43:875-92. [PMID: 23754172 DOI: 10.1007/s40279-013-0060-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Because growing bone possesses a greater capacity to adapt to mechanical loading than does mature bone, it is important for girls to engage in weight-bearing activities, especially since the prevalence of osteoporosis among older women is considerably higher than that of older men. In recent years, the osteogenic potential of weight-bearing activities performed by children and adolescents has received increasing attention and accumulating evidence suggests that this type of activity may improve bone health prior to adulthood and help prevent osteoporosis later in life. OBJECTIVE Because previous interventions have varied with respect to the exercise parameters studied and sometimes produced conflicting findings, this meta-analysis was undertaken to evaluate the impact of weight-bearing exercise on the bone health of female children and adolescents and quantify the influence of key moderating variables (e.g. pubertal stage, exercise mode, intervention strategy, exercise duration, frequency of exercise, programme length and study design) on skeletal development in this cohort. METHODS A comprehensive literature search was conducted using databases such as PubMed, MEDLINE, CINAHL, Web of Science, Physical Education Index, Science Direct and ProQuest. Search terms included 'bone mass', 'bone mineral', 'bone health', 'exercise' and 'physical activity'. Randomized- and non-randomized controlled trials featuring healthy prepubertal, early-pubertal and pubertal girls and measurement of areal bone mineral density (aBMD) or bone mineral content (BMC) using dual energy x-ray absorptiometry were examined. Comprehensive Meta-Analysis software was used to determine weighted mean effect sizes (ES) and conduct moderator analyses for three different regions of interest [i.e. total body, lumbar spine (LS), and femoral neck]. RESULTS From 17 included studies, 72 ES values were retrieved. Our findings revealed a small, but significant influence of weight-bearing exercise on BMC and aBMD of the LS (overall ES 0.19; 95% confidence interval (CI) 0.05, 0.33 and overall ES 0.26, 95% CI 0.09, 0.43, respectively) and BMC of the femoral neck (ES 0.23; 95% CI 0.10, 0.36). For both aBMD and BMC, overall ES was not affected by any moderator variables except frequency of exercise, such that weight-bearing activity performed for more than 3 days per week resulted in a significantly greater ES value for LS aBMD compared with programmes lasting 3 or fewer days per week [Cochran's Q statistic (Qbetween) = 4.09; p < 0.05]. CONCLUSION The impact of weight-bearing activities seems to be site specific, and a greater frequency of weight-bearing activities is related to greater aBMD of LS in growing girls. Future investigations are warranted to better understand the dose-response relationship between weight-bearing activity and bone health in girls and explore the mediating role of pubertal status in promoting skeletal development among female youth.
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Affiliation(s)
- Saori Ishikawa
- Department of Health and Human Performance, Middle Tennessee State University, P.O. Box 96, Murfreesboro, TN 37132, USA.
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309
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del Pozo E, Janner M, Mackenzie AR, Arampatzis S, Dixon AK, Perrelet R, Ruch W, Lippuner K, Zapf J, Lamberts SW, Mullis PE. Radiometrical, hormonal and biological correlates of skeletal growth in the female rat from birth to senescence. Growth Horm IGF Res 2014; 24:83-88. [PMID: 24735836 DOI: 10.1016/j.ghir.2014.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 02/22/2014] [Accepted: 03/18/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We investigated the skeletal growth profile of female rats from birth to senescence (100weeks) on the basis of sequential radiometrical, hormonal and biochemical parameters. DESIGN Weaning rats entered the study which was divided into two sections: a) sequential measurements of vertebral and tibial growths and bone mineral density (BMD), estimation of mineral content of the entire skeleton (BMC) and chemical analysis of vertebral Ca; and b) determination of basal and pulsatile growth hormone (rGH), insulin-like growth hormone (IGF-I), estradiol (E2), parathyroid hormone (PTH), osteocalcin (OC) and urinary d-pyridinoline (dp) throughout the experimental period. RESULTS Vertebral and tibial growths ceased at week 25 whereas BMD and BMC as well as total vertebral Ca exhibited a peak bone mass at week 40. rGH pulsatile profiles were significantly higher in younger animals coinciding with the period of active growth and IGF-I peaked at 7weeks, slowly declining thereafter and stabilizing after week 60. OC and dp closely paralleled IGF-I coinciding with the period of enhanced skeletal growth, remaining thereafter in the low range indicative of reduced bone turnover. E2 increased during reproductive life but the lower values subsequently recorded were still in the physiological range, strongly suggesting a protective role of this steroid on bone remodeling. PTH followed a similar profile to E2, but the significance of this after completion of growth remains unclear. CONCLUSIONS Mechanisms governing skeletal growth in the female rat appear similar to those in humans. Bone progression and attainment of peak bone mass are under simultaneous control of rGH, IGF-I and calciotropic hormones and are modulated by E2. This steroid seems to protect the skeleton from resorption before senescence whereas the role of PTH in this context remains uncertain.
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Affiliation(s)
- Emilio del Pozo
- Department of Osteoporosis, University Hospital, Bern, Switzerland.
| | - Marco Janner
- Division of Pediatric Endocrinology, Diabetes and Metabolism; University Children's Hospital, Bern, Switzerland
| | | | | | - Arnold K Dixon
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Romain Perrelet
- Department of Osteoporosis, University Hospital, Bern, Switzerland
| | - Walter Ruch
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Kurt Lippuner
- Department of Osteoporosis, University Hospital, Bern, Switzerland
| | - Juergen Zapf
- Department of Internal Medicine, University Hospital, Zürich, Switzerland
| | | | - Primus E Mullis
- Division of Pediatric Endocrinology, Diabetes and Metabolism; University Children's Hospital, Bern, Switzerland
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310
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Abstract
PURPOSE OF REVIEW To review the recent publications describing the link between pediatric nephrolithiasis and bone metabolism. RECENT FINDINGS Nephrolithiasis incidence is increasing in children and is associated with low bone mineral density (BMD). Affected children are conceptually at risk for fractures and osteoporosis. In addition to abnormal calcium metabolism, inflammation, genetic makeup and dietary habits are being recognized as important factors in the pathophysiology of nephrolithiasis and low bone density. Findings from retrospective reviews suggest that low BMD in children may be improved with citrate or thiazide treatment. SUMMARY The healthcare burden from low BMD with subsequent osteoporosis and fracture risk is immense with potential far-reaching effects in patient quality of life and healthcare expense. Bone mass is acquired in the pediatric age range, thus it is important to identify and treat at-risk children. Retrospective reviews in pediatric patients indicate that citrate or thiazide diuretic treatment may improve BMD. We now understand that a relationship exists between nephrolithiasis and low BMD. To improve healthcare for our current patients as well as protect their future health it is important to identify low BMD and initiate strategies to improve BMD in 'at-risk' children.
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311
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Kalkwarf HJ, Abrams SA, DiMeglio LA, Koo WWK, Specker BL, Weiler H. Bone densitometry in infants and young children: the 2013 ISCD Pediatric Official Positions. J Clin Densitom 2014; 17:243-57. [PMID: 24674638 DOI: 10.1016/j.jocd.2014.01.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 01/08/2014] [Indexed: 11/19/2022]
Abstract
Infants and children <5 yr were not included in the 2007 International Society for Clinical Densitometry Official Positions regarding Skeletal Health Assessment of Children and Adolescents. To advance clinical care of very young children, the International Society for Clinical Densitometry 2013 Position Development Conference reviewed the literature addressing appropriate methods and skeletal sites for clinical dual-energy X-ray absorptiometry (DXA) measurements in infants and young children and how results should be reported. DXA whole-body bone mineral content and bone mineral density for children ≥3 yr and DXA lumbar spine measurements for infants and young children 0-5 yr were identified as feasible and reproducible. There was insufficient information regarding methodology, reproducibility, and reference data to recommended forearm and femur measurements at this time. Appropriate methods to account for growth delay when interpreting DXA results for children <5 yr are currently unknown. Reference data for children 0-5 yr at multiple skeletal sites are insufficient and are needed to enable interpretation of DXA measurements. Given the current scarcity of evidence in many areas, it is likely that these positions will change over time as new data become available.
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Affiliation(s)
- Heidi J Kalkwarf
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Steven A Abrams
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Linda A DiMeglio
- Department of Pediatrics, Section of Pediatric Endocrinology and Diabetology, Indiana University, Indianapolis, IN, USA
| | - Winston W K Koo
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Bonny L Specker
- Ethel Austin Martin Program in Human Nutrition, South Dakota State University, Brookings, SD, USA
| | - Hope Weiler
- School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada
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312
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El Hage R, Zakhem E, Theunynck D, Zunquin G, Bedran F, Sebaaly A, Bachour F, Maalouf G. Maximal oxygen consumption and bone mineral density in a group of young Lebanese adults. J Clin Densitom 2014; 17:320-4. [PMID: 24674639 DOI: 10.1016/j.jocd.2014.01.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 12/23/2013] [Accepted: 01/17/2014] [Indexed: 11/27/2022]
Abstract
The aim of this study was to explore the relationship between maximal oxygen consumption (VO2 max) and bone mineral density (BMD) in a group of young Lebanese adults. Twenty women and 37 men whose ages range from 18 to 32 yr participated in this study. Informed written consent was obtained from the participants. Body weight and height were measured, and body mass index was calculated. VO2 max was determined by direct measurement while exercising on a bicycle ergometer (Siemens-Elema RE 820; Rodby Elektronik AB, Enhorna, Sweden). Whole body bone mineral content (WB BMC), whole body bone mineral density (WB BMD), lumbar spine BMD (L1-L4 BMD), total hip BMD (TH BMD), and femoral neck BMD (FN BMD) were measured by dual-energy X-ray absorptiometry. In women, VO2 max (expressed as L/mn) was positively correlated to WB BMC (r = 0.82; p < 0.001), WB BMD (r = 0.80; p < 0.001), L1-L4 BMD (r = 0.73; p < 0.001), TH BMD (r = 0.80; p < 0.001), and FN BMD (r = 0.85; p < 0.001). In men, VO2 max (expressed as L/mn) was positively correlated to WB BMC (r = 0.57; p < 0.001), WB BMD (r = 0.53; p < 0.001), L1-L4 BMD (r = 0.50; p < 0.001), TH BMD (r = 0.38; p < 0.01), and FN BMD (r = 0.30; p < 0.05). In both sexes, the positive associations between VO2 max and bone variables (BMC and BMD) remained significant after adjustment for age (p < 0.001). This study suggests that VO2 max (L/mn) is a positive determinant of BMC and BMD in young adults. Aerobic power seems to be a determinant of BMC and BMD in young adults.
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Affiliation(s)
- Rawad El Hage
- Department of Physical Education, University of Balamand, El-Koura, Lebanon.
| | - Eddy Zakhem
- Department of Physical Education, University of Balamand, El-Koura, Lebanon
| | - Denis Theunynck
- Département STAPS, URePSSS-EA 4110/EA448, ULCO, Dunkerque, France
| | - Gautier Zunquin
- Département STAPS, URePSSS-EA 4110/EA448, ULCO, Dunkerque, France
| | - Farid Bedran
- Musculoskeletal Department, Bellevue Medical Center, Faculty of Medicine of Saint Joseph University, Mansourieh, Lebanon
| | - Amer Sebaaly
- Musculoskeletal Department, Bellevue Medical Center, Faculty of Medicine of Saint Joseph University, Mansourieh, Lebanon
| | - Falah Bachour
- Musculoskeletal Department, Bellevue Medical Center, Faculty of Medicine of Saint Joseph University, Mansourieh, Lebanon
| | - Ghassan Maalouf
- Musculoskeletal Department, Bellevue Medical Center, Faculty of Medicine of Saint Joseph University, Mansourieh, Lebanon
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313
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Physical activity when young provides lifelong benefits to cortical bone size and strength in men. Proc Natl Acad Sci U S A 2014; 111:5337-42. [PMID: 24706816 DOI: 10.1073/pnas.1321605111] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The skeleton shows greatest plasticity to physical activity-related mechanical loads during youth but is more at risk for failure during aging. Do the skeletal benefits of physical activity during youth persist with aging? To address this question, we used a uniquely controlled cross-sectional study design in which we compared the throwing-to-nonthrowing arm differences in humeral diaphysis bone properties in professional baseball players at different stages of their careers (n = 103) with dominant-to-nondominant arm differences in controls (n = 94). Throwing-related physical activity introduced extreme loading to the humeral diaphysis and nearly doubled its strength. Once throwing activities ceased, the cortical bone mass, area, and thickness benefits of physical activity during youth were gradually lost because of greater medullary expansion and cortical trabecularization. However, half of the bone size (total cross-sectional area) and one-third of the bone strength (polar moment of inertia) benefits of throwing-related physical activity during youth were maintained lifelong. In players who continued throwing during aging, some cortical bone mass and more strength benefits of the physical activity during youth were maintained as a result of less medullary expansion and cortical trabecularization. These data indicate that the old adage of "use it or lose it" is not entirely applicable to the skeleton and that physical activity during youth should be encouraged for lifelong bone health, with the focus being optimization of bone size and strength rather than the current paradigm of increasing mass. The data also indicate that physical activity should be encouraged during aging to reduce skeletal structural decay.
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314
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Rouy E, Vico L, Laroche N, Benoit V, Rousseau B, Blachier F, Tomé D, Blais A. Protein quality affects bone status during moderate protein restriction in growing mice. Bone 2014; 59:7-13. [PMID: 24495359 DOI: 10.1016/j.bone.2013.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 10/16/2013] [Accepted: 10/16/2013] [Indexed: 01/16/2023]
Abstract
Adequate protein intake during development is critical to ensure optimal bone gain and to attain a higher peak bone mass later on. We hypothesized that the quality of the dietary protein is of prime importance for bone physiology during moderate protein restriction. The target population was growing Balb/C mice. We compared two protein restricted diets (6% of total energy as protein), one based on soy (LP-SOY) and one based on casein (LP-CAS). For comparison, a normal protein soy-based control group (NP-SOY) and a low protein group receiving an anabolic daily parathyroid hormone (PTH) 1-34 injection (LP-SOY+PTH) were included in the protocol. After 8weeks, LP-SOY mice had reduced body weights related to a lower lean mass whereas LP-CAS mice were not different from the NP-SOY group. LP-SOY mice were characterized by lower femoral cortical thickness, bone volume, trabecular number and thickness and increased medullar adiposity when compared to both the LP-CAS and NP-SOY groups. However, the dietary intervention had no effect on the vertebral parameters. The negative effect of the LP-SOY diet was correlated to an impaired bone formation as shown by the reduced P1NP serum level as well as the reduced osteoid surfaces and bone formation rate in the femur. PTH injection in LP-SOY mice had no effect on total weight or lean mass, but improved all bone parameters at both femoral and vertebral sites, suggesting that amino acid deficiency was not the primary reason for degraded bone status in mice consuming soy protein. In conclusion, our study showed that under the same protein restriction (6% of energy), a soy diet leads to impaired bone health whereas a casein diet has little effect when compared to a normal protein control.
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Affiliation(s)
- Emilien Rouy
- UMR 914 INRA-AgroParisTech, Nutrition Physiology and Ingestive Behavior, 75005 Paris, France; Yoplait France, 92641 Boulogne-Billancourt, France.
| | - Laurence Vico
- INSERM U1059/LBTO, Université Jean Monnet, Université de Lyon, 42023 Saint-Étienne, France
| | - Norbert Laroche
- INSERM U1059/LBTO, Université Jean Monnet, Université de Lyon, 42023 Saint-Étienne, France
| | | | | | - François Blachier
- UMR 914 INRA-AgroParisTech, Nutrition Physiology and Ingestive Behavior, 75005 Paris, France
| | - Daniel Tomé
- UMR 914 INRA-AgroParisTech, Nutrition Physiology and Ingestive Behavior, 75005 Paris, France
| | - Anne Blais
- UMR 914 INRA-AgroParisTech, Nutrition Physiology and Ingestive Behavior, 75005 Paris, France
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315
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Takeda E, Yamamoto H, Yamanaka-Okumura H, Taketani Y. Increasing dietary phosphorus intake from food additives: potential for negative impact on bone health. Adv Nutr 2014; 5:92-7. [PMID: 24425727 PMCID: PMC3884105 DOI: 10.3945/an.113.004002] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
It is important to consider whether habitual high phosphorus intake adversely affects bone health, because phosphorus intake has been increasing, whereas calcium intake has been decreasing in dietary patterns. A higher total habitual dietary phosphorus intake has been associated with higher serum parathyroid hormone (PTH) and lower serum calcium concentrations in healthy individuals. Higher serum PTH concentrations have been shown in those who consume foods with phosphorus additives. These findings suggest that long-term dietary phosphorus loads and long-term hyperphosphatemia may have important negative effects on bone health. In contrast, PTH concentrations did not increase as a result of high dietary phosphorus intake when phosphorus was provided with adequate amounts of calcium. Intake of foods with a ratio of calcium to phosphorus close to that found in dairy products led to positive effects on bone health. Several randomized controlled trials have shown positive relations between dairy intake and bone mineral density. In our loading test with a low-calcium, high-phosphorus lunch provided to healthy young men, serum PTH concentrations showed peaks at 1 and 6 h, and serum fibroblast growth factor 23 (FGF23) concentrations increased significantly at 8 h after the meal. In contrast, the high-calcium, high-phosphorus meal suppressed the second PTH and FGF23 elevations until 8 h after the meal. This implies that adequate dietary calcium intake is needed to overcome the interfering effects of high phosphorus intake on PTH and FGF23 secretion. FGF23 acts on the parathyroid gland to decrease PTH mRNA and PTH secretion in rats with normal kidney function. However, increased serum FGF23 is an early alteration of mineral metabolism in chronic kidney disease, causing secondary hyperthyroidism, and implying resistance of the parathyroid gland to the action of FGF23 in chronic kidney disease. These findings suggest that long-term high-phosphorus diets may impair bone health mediated by FGF23 resistance both in chronic kidney disease patients and in the healthy population.
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Affiliation(s)
- Eiji Takeda
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima City, Tokushima, Japan; and,To whom correspondence should be addressed. E-mail:
| | - Hironori Yamamoto
- Department of Health and Nutrition, Faculty of Human Life, Jin-ai University, Echizen City, Fukui, Japan
| | - Hisami Yamanaka-Okumura
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima City, Tokushima, Japan; and
| | - Yutaka Taketani
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima City, Tokushima, Japan; and
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316
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Rizzoli R, Abraham C, Brandi ML. Nutrition and bone health: turning knowledge and beliefs into healthy behaviour. Curr Med Res Opin 2014; 30:131-41. [PMID: 24059908 DOI: 10.1185/03007995.2013.847410] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Primary osteoporosis prevention requires healthy behaviours, such as regular physical exercise and adequate dietary intakes of calcium, vitamin D and protein. Calcium and vitamin D can decrease postmenopausal bone loss and prevent fracture risk. However, there is still a high prevalence of calcium and vitamin D insufficiency in women aged 50+ years. Dietary sources of these nutrients are the preferred choice, and dairy products represent a valuable dietary source of calcium due to the high content, high absorptive rate and relatively low cost. Furthermore, dairy products also contain other key nutrients including vitamin D, phosphorus and protein that contribute to bone health. Studies of women's beliefs and behaviours with respect to osteoporosis highlight poor knowledge of the importance of dietary nutrient intakes and low concern regarding bone health. Osteoporosis educational programmes exist to help women change behaviours relevant to bone health. Such programmes can have positive influences on women's knowledge, attitudes, perceived norms, motivation and behaviours. Increased awareness of the consequences of low calcium and vitamin D intakes may promote women's attitudes towards dietary sources, in particular dairy products, and lead to better adherence to health recommendations. Increasing dietary nutrient intakes through educational initiatives should be further developed to aid the prevention of osteoporosis and the efficacy of osteoporosis management.
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Affiliation(s)
- R Rizzoli
- Geneva University Hospitals and Faculty of Medicine , Geneva , Switzerland
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317
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Feskanich D, Bischoff-Ferrari HA, Frazier L, Willett WC. Milk consumption during teenage years and risk of hip fractures in older adults. JAMA Pediatr 2014; 168:54-60. [PMID: 24247817 PMCID: PMC3983667 DOI: 10.1001/jamapediatrics.2013.3821] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Milk consumption during adolescence is recommended to promote peak bone mass and thereby reduce fracture risk in later life. However, its role in hip fracture prevention is not established and high consumption may adversely influence risk by increasing height. OBJECTIVES To determine whether milk consumption during teenage years influences risk of hip fracture in older adults and to investigate the role of attained height in this association. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study over 22 years of follow-up in more than 96,000 white postmenopausal women from the Nurses' Health Study and men aged 50 years and older from the Health Professionals Follow-up Study in the United States. EXPOSURES Frequency of consumption of milk and other foods during ages 13 to 18 years and attained height were reported at baseline. Current diet, weight, smoking, physical activity, medication use, and other risk factors for hip fractures were reported on biennial questionnaires. MAIN OUTCOMES AND MEASURES Cox proportional hazards models were used to calculate relative risks (RRs) of first incidence of hip fracture from low-trauma events per glass (8 fl oz or 240 mL) of milk consumed per day during teenage years. RESULTS During follow-up, 1226 hip fractures were identified in women and 490 in men. After controlling for known risk factors and current milk consumption, each additional glass of milk per day during teenage years was associated with a significant 9% higher risk of hip fracture in men (RR = 1.09; 95% CI, 1.01-1.17). The association was attenuated when height was added to the model (RR = 1.06; 95% CI, 0.98-1.14). Teenage milk consumption was not associated with hip fractures in women (RR = 1.00 per glass per day; 95% CI, 0.95-1.05). CONCLUSIONS AND RELEVANCE Greater milk consumption during teenage years was not associated with a lower risk of hip fracture in older adults. The positive association observed in men was partially mediated through attained height.
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Affiliation(s)
- Diane Feskanich
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University of Zurich, Switzerland,Department of Rheumatology and Institute for Physical Medicine and Rehabilitation, University Hospital Zurich, Switzerland
| | - Lindsay Frazier
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Walter C. Willett
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Nutrition Department, Harvard School of Public Health, Boston, MA,Epidemiology Department, Harvard School of Public Health, Boston, MA
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318
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El Hage R. Composite indices of femoral neck strength in adult female soccer players. J Clin Densitom 2014; 17:212-3. [PMID: 23541717 DOI: 10.1016/j.jocd.2013.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 03/05/2013] [Indexed: 11/21/2022]
Affiliation(s)
- Rawad El Hage
- Laboratoire de physiologie et de biomécanique de la performance motrice, Université de Balamand, Al Koura, Liban
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319
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El Hage R. Adult male professional soccer players have higher lumbar spine and hip bone mineral density than age- and body weight-matched controls. J Clin Densitom 2014; 17:214-5. [PMID: 23871218 DOI: 10.1016/j.jocd.2013.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 06/19/2013] [Indexed: 11/25/2022]
Affiliation(s)
- Rawad El Hage
- Department of Physical Education, Faculty of Arts and Social Sciences, University of Balamand, El-Koura, Lebanon
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320
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Warden SJ, Galley MR, Hurd AL, Richard JS, George LA, Guildenbecher EA, Barker RG, Fuchs RK. Cortical and trabecular bone benefits of mechanical loading are maintained long term in mice independent of ovariectomy. J Bone Miner Res 2014; 29:1131-40. [PMID: 24436083 PMCID: PMC3999300 DOI: 10.1002/jbmr.2143] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/17/2013] [Accepted: 10/21/2013] [Indexed: 11/10/2022]
Abstract
Skeletal loading enhances cortical and trabecular bone properties. How long these benefits last after loading cessation remains an unresolved, clinically relevant question. This study investigated long-term maintenance of loading-induced cortical and trabecular bone benefits in female C57BL/6 mice and the influence of a surgically induced menopause on the maintenance. Sixteen-week-old animals had their right tibia extrinsically loaded 3 days/week for 4 weeks using the mouse tibial axial compression loading model. Left tibias were not loaded and served as internal controls. Animals were subsequently detrained (restricted to cage activities) for 0, 4, 8, 26, or 52 weeks, with ovariectomy (OVX) or sham-OVX surgery being performed at 0 weeks detraining. Loading increased midshaft tibia cortical bone mass, size, and strength, and proximal tibia bone volume fraction. The cortical bone mass, area, and thickness benefits of loading were lost by 26 weeks of detraining because of heightened medullary expansion. However, loading-induced benefits on bone total area and strength were maintained at each detraining time point. Similarly, the benefits of loading on bone volume fraction persisted at all detraining time points. The long-term benefits of loading on both cortical and trabecular bone were not influenced by a surgically induced menopause because there were no interactions between loading and surgery. However, OVX had independent effects on cortical bone properties at early (4 and 8 weeks) detraining time points and trabecular bone properties at all detraining time points. These cumulative data indicate loading has long-term benefits on cortical bone size and strength (but not mass) and trabecular bone morphology, which are not influenced by a surgically induced menopause. This suggests skeletal loading associated with physical activity may provide long-term benefits by preparing the skeleton to offset both the cortical and trabecular bone changes associated with aging and menopause.
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Affiliation(s)
- Stuart J Warden
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA; Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA
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321
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El Hage R, Zakhem E, Zunquin G, Theunynck D, Moussa E, Maalouf G. Does soccer practice influence compressive strength, bending strength, and impact strength indices of the femoral neck in young men? J Clin Densitom 2014; 17:213-4. [PMID: 23567091 DOI: 10.1016/j.jocd.2013.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 03/12/2013] [Indexed: 01/06/2023]
Affiliation(s)
| | - Eddy Zakhem
- Division of Physical Education, University of Balamand, Al Koura, Lebanon
| | | | - Denis Theunynck
- EA 4110, Laboratoire RELACS, Département STAPS, Université du Littoral Côte d'Opale, Dunkerque, France
| | - Elie Moussa
- Division of Physical Education, University of Balamand, Al Koura, Lebanon
| | - Ghassan Maalouf
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Beirut, Lebanon
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322
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Lai CL, Tseng SY, Chen CN, Liao WC, Wang CH, Lee MC, Hsu PS. Effect of 6 months of whole body vibration on lumbar spine bone density in postmenopausal women: a randomized controlled trial. Clin Interv Aging 2013; 8:1603-9. [PMID: 24348029 PMCID: PMC3857009 DOI: 10.2147/cia.s53591] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background The issue of osteoporosis-induced fractures has attracted the world’s attention. Postmenopausal women are particularly at risk for this type of fracture. The nonmedicinal intervention for postmenopausal women is mainly exercise. Whole body vibration (WBV) is a simple and convenient exercise. There have been some studies investigating the effect of WBV on osteoporosis; however, the intervention models and results are different. This study mainly investigated the effect of high-frequency and high-magnitude WBV on the bone mineral density (BMD) of the lumbar spine in postmenopausal women. Methods This study randomized 28 postmenopausal women into either the WBV group or the control group for a 6-month trial. The WBV group received an intervention of high-frequency (30 Hz) and high-magnitude (3.2 g) WBV in a natural full-standing posture for 5 minutes, three times per week, at a sports center. Dual-energy X-ray absorptiometry was used to measure the lumbar BMD of the two groups before and after the intervention. Results Six months later, the BMD of the WBV group had significantly increased by 2.032% (P=0.047), while that of the control group had decreased by 0.046% (P=0.188). The comparison between the two groups showed that the BMD of the WBV group had increased significantly (P=0.016). Conclusion This study found that 6 months of high-frequency and high-magnitude WBV yielded significant benefits to the BMD of the lumbar spine in postmenopausal women, and could therefore be provided as an alternative exercise.
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Affiliation(s)
- Chung-Liang Lai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan ; Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Shiuan-Yu Tseng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan ; Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chung-Nan Chen
- Department of Radiology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Wan-Chun Liao
- Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chun-Hou Wang
- School of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Meng-Chih Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan ; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Pi-Shan Hsu
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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323
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Reza SM, Rasool H, Mansour S, Abdollah H. Effects of calcium and training on the development of bone density in children with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4304-4309. [PMID: 24157403 DOI: 10.1016/j.ridd.2013.08.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/24/2013] [Accepted: 08/26/2013] [Indexed: 06/02/2023]
Abstract
In this study we examined the effects of physical training and calcium intake on the development of bone mineral density (BMD) in children with Down syndrome (DS). A total of 48 children with DS (age 7-12 years old) matched for age and BMD were assigned to four groups exercise and calcium intake (Ex(+)Ca(+)), calcium intake-no-exercise (Ex(-)Ca(+)), exercise no-calcium intake (Ex(+)Ca(-)) and non-exercise-no-calcium intake (Ex(-)Ca(-)). The training protocol included 45 min of weight bearing exercise performed 3 sessions per week in addition to dietary calcium rich food intake of enriched cow milk with vitamin D containing 200 mg calcium per serving or no enriched dietary supplement for a duration of 4 months. Data analysis was performed on data by using t-test, one-way ANOVA analysis and Tukey post hoc tests to determine the main and combined effects of training and calcium regiment on BMD. All groups showed greater femoral neck BMD after 4 months. The increase in femoral neck BMD in the Ex(+)Ca(+) group was 5.96% greater than the Ex(+)Ca(-) group (p<0.01). The effect of training was greater than calcium intake alone. The Ex(+)Ca(-) group achieved 3.52% greater BMD than Ex(-)Ca(+) group (p<0.01). In this study, all the experimental groups had greater BMD than the no-calcium-no-exercise group that served as the control group (p<0.01). It was concluded that additional weight bearing exercise and calcium supplementation resulted in a greater increase in BMD in children with DS.
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324
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Buenzli PR, Thomas CDL, Clement JG, Pivonka P. Endocortical bone loss in osteoporosis: the role of bone surface availability. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2013; 29:1307-1322. [PMID: 23818461 DOI: 10.1002/cnm.2567] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 05/08/2013] [Accepted: 05/12/2013] [Indexed: 06/02/2023]
Abstract
Age-related bone loss and postmenopausal osteoporosis are due to a dysregulation of bone remodelling in which less bone is reformed than resorbed. This dysregulation of bone remodelling does not occur with equal strength in all bone regions. Loss of bone is more pronounced near the endocortical surface. This leads to thinning of the cortical wall proceeding from the endosteum, a process sometimes called 'trabecularisation'. In this paper, we investigate the influence of the nonuniform distribution of bone surface within bone tissue for osteoporotic bone losses. We use a spatio-temporal computational model of bone remodelling in which microstructural changes of bone tissue are represented by a phenomenological relationship between bone specific surface and bone porosity. The simulation of an osteoporotic condition by our model shows that the evolution of bone porosity within a bone cross section is significantly influenced by the nonuniform availability of bone surface. Greater bone loss occurs near the endocortical wall, leading to cortical wall thinning and to an expansion of the medullary cavity similar to cross-sectional observations from human femur midshafts. Our model suggests that the rate of cortical wall thinning is fast/slow in the presence/absence of an adjacent trabecular or trabecularised bone compartment.
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Affiliation(s)
- Pascal R Buenzli
- School of Mathematical Sciences, Monash University, VIC 3800, Australia; Engineering Computational Biology Group, The University of Western Australia, WA 6009, Australia
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325
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DiVasta AD, Gordon CM. Exercise and bone: where do we stand? Metabolism 2013; 62:1714-7. [PMID: 24140089 DOI: 10.1016/j.metabol.2013.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Amy D DiVasta
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, USA; Division of Pediatric and Adolescent Gynecology, Boston Children's Hospital, Boston, MA 02115, USA.
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326
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Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol 2013; 2:1143-211. [PMID: 23798298 DOI: 10.1002/cphy.c110025] [Citation(s) in RCA: 1239] [Impact Index Per Article: 112.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life.
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Affiliation(s)
- Frank W Booth
- Departments of Biomedical Sciences, Medical Pharmacology and Physiology, and Nutrition and Exercise Physiology, Dalton Cardiovascular Institute, University of Missouri, Columbia, Missouri, USA.
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327
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May A, Pettifor JM, Norris SA, Ramsay M, Lombard Z. Genetic factors influencing bone mineral content in a black South African population. J Bone Miner Metab 2013; 31:708-16. [PMID: 23475190 PMCID: PMC3825635 DOI: 10.1007/s00774-013-0431-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 01/24/2013] [Indexed: 11/30/2022]
Abstract
Bone mass differs according to ethnic classification, with individuals of African ancestry attaining the highest measurements across numerous skeletal sites. Elevated bone mass is even maintained in those individuals exposed to adverse environmental factors, suggesting a prominent genetic effect that may have clinical or therapeutic value. Using a candidate gene approach, we investigated associations of six candidate genes (ESR1, TNFRSF11A, TNFRSF11B, TNFSF11, SOST and SPP1) with bone mass at the hip and lumbar spine amongst pre-pubertal black South African children (mean age 10.6 years) who formed part of the longitudinal Birth to Twenty cohort. 151 black children were genotyped at 366 polymorphic loci, including 112 previously associated and 254 tagging single nucleotide polymorphisms (SNPs). Linear regression was used to highlight significant associations whilst adjusting for height, weight, sex and bone area. Twenty-seven markers (8 previously associated and 19 tag SNPs; P < 0.05) were found to be associated with either femoral neck (18) or lumbar spine (9) bone mineral content. These signals were derived from three genes, namely ESR1 (17), TNFRSF11B (9) and SPP1 (1). One marker (rs2485209) maintained its association with the femoral neck after correction for multiple testing (P = 0.038). When compared to results amongst Caucasian adults, we detected differences with respect to associated skeletal sites. Allele frequencies and linkage disequilibrium patterns were also significantly different between populations. Hence, our results support the existence of a strong genetic effect acting at the femoral neck in black South African children, whilst simultaneously highlighting possible causes that account for inter-ethnic bone mass diversity.
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Affiliation(s)
- Andrew May
- />Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service, University of the Witwatersrand, Watkins-Pitchford Building, Room 109, Cnr Hospital and De Korte Street, Braamfontein, 2000 Johannesburg South Africa
| | - John M. Pettifor
- />MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2000 South Africa
| | - Shane A. Norris
- />MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2000 South Africa
| | - Michèle Ramsay
- />Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service, University of the Witwatersrand, Watkins-Pitchford Building, Room 109, Cnr Hospital and De Korte Street, Braamfontein, 2000 Johannesburg South Africa
| | - Zané Lombard
- />Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service, University of the Witwatersrand, Watkins-Pitchford Building, Room 109, Cnr Hospital and De Korte Street, Braamfontein, 2000 Johannesburg South Africa
- />Wits Bioinformatics, University of the Witwatersrand, Private Bag 3, Wits, 2050 Johannesburg South Africa
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328
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Tang M, O'Connor LE, Campbell WW. Diet-induced weight loss: the effect of dietary protein on bone. J Acad Nutr Diet 2013; 114:72-85. [PMID: 24183993 DOI: 10.1016/j.jand.2013.08.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 08/06/2013] [Indexed: 01/28/2023]
Abstract
High-protein (>30% of energy from protein or >1.2 g/kg/day) and moderately high-protein (22% to 29% of energy from protein or 1.0 to 1.2 g/kg/day) diets are popular for weight loss, but the effect of dietary protein on bone during weight loss is not well understood. Protein may help preserve bone mass during weight loss by stimulating insulin-like growth factor 1, a potent bone anabolism stimulator, and increasing intestinal calcium absorption. Protein-induced acidity is considered to have minimal effect on bone resorption in adults with normal kidney function. Both the quantity and predominant source of protein influence changes in bone with diet-induced weight loss. Higher-protein, high-dairy diets may help attenuate bone loss during weight loss.
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329
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Pereira PC. Milk nutritional composition and its role in human health. Nutrition 2013; 30:619-27. [PMID: 24800664 DOI: 10.1016/j.nut.2013.10.011] [Citation(s) in RCA: 327] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/13/2013] [Accepted: 10/21/2013] [Indexed: 12/14/2022]
Abstract
Dairy and milk consumption are frequently included as important elements in a healthy and balanced diet. It is the first food for mammals and provides all the necessary energy and nutrients to ensure proper growth and development, being crucial in respect to bone mass formation. However, several controversies arise from consumption of dairy and milk products during adulthood, especially because it refers to milk from other species. Despite these controversies, epidemiologic studies confirm the nutritional importance of milk in the human diet and reinforce the possible role of its consumption in preventing several chronic conditions like cardiovascular diseases (CVDs), some forms of cancer, obesity, and diabetes. Lactose malabsorption symptoms and cow milk protein allergy are generally considered to be the adverse reactions to milk consumption. The present article reviews the main aspects of milk nutritional composition and establishes several associations between its nutritious role, health promotion, and disease prevention.
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Affiliation(s)
- Paula C Pereira
- Laboratório de Bioquímica, CiiEm - Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz, Cooperativa de Ensino Superior, C.R.L. Quinta da Granja, Monte de Caparica, Caparica, Portugal.
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330
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Al-Shaar L, Nabulsi M, Maalouf J, El-Rassi R, Vieth R, Beck TJ, El-Hajj Fuleihan G. Effect of vitamin D replacement on hip structural geometry in adolescents: a randomized controlled trial. Bone 2013; 56:296-303. [PMID: 23810841 DOI: 10.1016/j.bone.2013.06.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 06/12/2013] [Accepted: 06/18/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND We have shown in a randomized controlled trial that vitamin D increases bone mass, lean mass and bone area in adolescent girls, but not boys. These increments may translate into improvements in bone geometry and therefore bone strength. This study investigated the impact of vitamin D on hip geometric dimensions from DXA-derived hip structural analyses in adolescents who participated in the trial. METHODS 167 girls (mean age 13.1 years) and 171 boys (mean age 12.7 years) were randomly assigned to receive weekly placebo oil or vitamin D3, at doses of 1400 IU or 14,000 IU, in a double blind placebo-controlled 1-year trial. DXA images were obtained at baseline and one year, and hip images were analyzed using the hip structural analysis (HSA) software to derive parameters of bone geometry. These include outer diameter (OD), cross sectional area (CSA), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and shaft (S) regions. Analysis of Covariance (ANCOVA) was used to examine group differences for changes of bone structural parameters. RESULTS In the overall group of girls, vitamin D supplementation increased aBMD (7.9% and 6.8% in low and high doses, versus 4.2% in placebo) and reduced the BR of NN (6.1% and 2.4% in low and high doses, versus 1.9% in placebo). It also improved aBMD (7.9% and 5.2% versus 3.6%) and CSA (7.5% and 5.1% versus 4.1%) of the IT and OD of the S (2.4% and 2.5% versus 0.8% respectively). Significant changes in the OD and BR of the NN, in the overall group of girls remained, after adjusting for lean mass, and were unaffected with further adjustments for lifestyle, pubertal status, and height measures. Conversely, boys did not exhibit any significant changes in any parameters of interest. A dose effect was not detected and subgroup analyses revealed no beneficial effect of vitamin D by pubertal stage. CONCLUSIONS Vitamin D supplementation improved bone mass and several DXA-derived structural bone parameters, in adolescent girls, but not boys. This occurred at a critical site, the femoral neck, and if maintained through adulthood could improve bone strength and lower the risk of hip fractures.
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Affiliation(s)
- Laila Al-Shaar
- Calcium Metabolism and Osteoporosis Program, Department of Medicine, Lebanon
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331
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Thomas T, Briot K. Effets osseux et musculaires de la vitamine D. Presse Med 2013; 42:1351-7. [DOI: 10.1016/j.lpm.2013.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/01/2013] [Indexed: 12/31/2022] Open
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Crane JL, Cao X. Function of matrix IGF-1 in coupling bone resorption and formation. J Mol Med (Berl) 2013; 92:107-15. [PMID: 24068256 DOI: 10.1007/s00109-013-1084-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 08/16/2013] [Accepted: 09/01/2013] [Indexed: 12/13/2022]
Abstract
Balancing bone resorption and formation is the quintessential component for the prevention of osteoporosis. Signals that determine the recruitment, replication, differentiation, function, and apoptosis of osteoblasts and osteoclasts direct bone remodeling and determine whether bone tissue is gained, lost, or balanced. Therefore, understanding the signaling pathways involved in the coupling process will help develop further targets for osteoporosis therapy, by blocking bone resorption or enhancing bone formation in a space- and time-dependent manner. Insulin-like growth factor type 1 (IGF-1) has long been known to play a role in bone strength. It is one of the most abundant substances in the bone matrix, circulates systemically and is secreted locally, and has a direct relationship with bone mineral density. Recent data has helped further our understanding of the direct role of IGF-1 signaling in coupling bone remodeling which will be discussed in this review. The bone marrow microenvironment plays a critical role in the fate of mesenchymal stem cells and hematopoietic stem cells and thus how IGF-1 interacts with other factors in the microenvironment are equally important. While previous clinical trials with IGF-1 administration have been unsuccessful at enhancing bone formation, advances in basic science studies have provided insight into further mechanisms that should be considered for future trials. Additional basic science studies dissecting the regulation and the function of matrix IGF-1 in modeling and remodeling will continue to provide further insight for future directions for anabolic therapies for osteoporosis.
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Affiliation(s)
- Janet L Crane
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Ross Building, Room 229, 720 Rutland Ave, Baltimore, MD, 21205, USA,
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333
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Machado M, Fernandes P, Cardadeiro G, Baptista F. Femoral neck bone adaptation to weight-bearing physical activity by computational analysis. J Biomech 2013; 46:2179-85. [DOI: 10.1016/j.jbiomech.2013.06.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 06/28/2013] [Accepted: 06/30/2013] [Indexed: 11/25/2022]
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Baroncelli GI, Vierucci F, Bertelloni S, Erba P, Zampollo E, Giuca MR. Pamidronate treatment stimulates the onset of recovery phase reducing fracture rate and skeletal deformities in patients with idiopathic juvenile osteoporosis: comparison with untreated patients. J Bone Miner Metab 2013; 31:533-43. [PMID: 23549954 DOI: 10.1007/s00774-013-0438-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 02/07/2013] [Indexed: 11/26/2022]
Abstract
Although spontaneous remission occurs in patients with idiopathic juvenile osteoporosis (IJO), permanent bone deformities may occur. The effects of long-term pamidronate treatment on clinical findings, bone mineral status, and fracture rate were evaluated. Nine patients (age 9.8 ± 1.1 years, 7 males) with IJO were randomized to intravenous pamidronate (0.8 ± 0.1 mg/kg per day for 3 days; cycles per year 2.0 ± 0.1; duration 7.3 ± 1.1 years; n = 5) or no treatment (n = 4). Fracture rate, phalangeal quantitative ultrasound, and lumbar bone mineral density (BMD) by dual energy X-ray absorptiometry at entry and during follow-up (range 6.3-9.4 years) were assessed. Bone pain improved in treated patients. Difficulty walking continued for 3-5 years in untreated patients, and vertebral collapses occurred in three of them. During follow-up, phalangeal amplitude-dependent speed of sound (AD-SoS), bone transmission time (BTT), and lumbar BMDarea and BMDvolume progressively increased in treated patients (P < 0.05-P < 0.0001). In untreated patients AD-SoS and BTT decreased during the first 2-4 years of follow-up (P < 0.05-P < 0.01); lumbar BMDarea increased after 6 years (P < 0.001) whereas BTT and lumbar BMDvolume increased after 7 years of follow-up (P < 0.05 and P < 0.001, respectively). At the end of follow-up, AD-SoS, BTT, lumbar BMDarea, and BMDvolume Z-scores were lower in untreated patients than in treated patients (-2.2 ± 0.3 and -0.5 ± 0.2; -1.9 ± 0.2 and -0.6 ± 0.2; -2.3 ± 0.3 and -0.7 ± 0.3; -2.4 ± 0.2 and -0.7 ± 0.3, P < 0.0001, respectively). Fracture rate was higher in untreated patients than in treated patients during the first 3 years of follow-up (P < 0.02). Our study showed that spontaneous recovery of bone mineral status is unsatisfactory in patients with IJO. Pamidronate treatment stimulated the onset of recovery phase reducing fracture rate and permanent disabilities without evidence of side-effects.
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Affiliation(s)
- Giampiero I Baroncelli
- Pediatric Unit I, Department of Obstetrics, Gynecology and Pediatrics, University-Hospital, Via Roma 67, 56126, Pisa, Italy,
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Warden SJ, Galley MR, Hurd AL, Wallace JM, Gallant MA, Richard JS, George LA. Elevated mechanical loading when young provides lifelong benefits to cortical bone properties in female rats independent of a surgically induced menopause. Endocrinology 2013; 154:3178-87. [PMID: 23782938 PMCID: PMC3749484 DOI: 10.1210/en.2013-1227] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 06/07/2013] [Indexed: 11/19/2022]
Abstract
Exercise that mechanically loads the skeleton is advocated when young to enhance lifelong bone health. Whether the skeletal benefits of elevated loading when young persist into adulthood and after menopause are important questions. This study investigated the influence of a surgically induced menopause in female Sprague-Dawley rats on the lifelong maintenance of the cortical bone benefits of skeletal loading when young. Animals had their right forearm extrinsically loaded 3 d/wk between 4 and 10 weeks of age using the forearm axial compression loading model. Left forearms were internal controls and not loaded. Animals were subsequently detrained (restricted to cage activities) for 94 weeks (until age 2 years), with ovariectomy (OVX) or sham-OVX surgery being performed at 24 weeks of age. Loading enhanced midshaft ulna cortical bone mass, structure, and estimated strength. These benefits persisted lifelong and contributed to loaded ulnas having greater strength after detraining. Loading also had effects on cortical bone quality. The benefits of loading when young were not influenced by a surgically induced menopause because there were no interactions between loading and surgery. However, OVX had independent effects on cortical bone mass, structure, and estimated strength at early postsurgery time points (up to age 58 weeks) and bone quality measures. These data indicate skeletal loading when young had lifelong benefits on cortical bone properties that persisted independent of a surgically induced menopause. This suggests that skeletal loading associated with exercise when young may provide lifelong antifracture benefits by priming the skeleton to offset the cortical bone changes associated with aging and menopause.
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Affiliation(s)
- Stuart J Warden
- Center for Translational Musculoskeletal Research, School of Medicine, Indiana University, Indianapolis, Indiana 46202, USA.
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336
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Slawson DL, Fitzgerald N, Morgan KT. Position of the Academy of Nutrition and Dietetics: the role of nutrition in health promotion and chronic disease prevention. J Acad Nutr Diet 2013; 113:972-9. [PMID: 23790411 DOI: 10.1016/j.jand.2013.05.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Indexed: 01/15/2023]
Abstract
It is the position of the Academy of Nutrition and Dietetics that primary prevention is the most effective and affordable method to prevent chronic disease, and that dietary intervention positively impacts health outcomes across the life span. Registered dietitians and dietetic technicians, registered are critical members of health care teams and are essential to delivering nutrition-focused preventive services in clinical and community settings, advocating for policy and programmatic initiatives, and leading research in disease prevention and health promotion. Health-promotion and disease-prevention strategies are effective at reducing morbidity and mortality and improving quality of life, and have a significant impact on the leading causes of disease. By applying these principles within a social ecological theoretical framework, positive influence can be applied across the spectrum of engagement: at intrapersonal, interpersonal, institutional, community, and public policy levels. Through the application of efficacious and cost-effective interventions, registered dietitians and dietetic technicians, registered, can positively impact public health as well as health outcomes for the individuals that they counsel. This position paper supports the "Practice Paper of the Academy of Nutrition and Dietetics: The Role of Nutrition in Health Promotion and Chronic Disease Prevention" published on the Academy's website at: www.eatright.org/positions.
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Gianfagna F, Cugino D, Ahrens W, Bailey MES, Bammann K, Herrmann D, Koni AC, Kourides Y, Marild S, Molnár D, Moreno LA, Pitsiladis YP, Russo P, Siani A, Sieri S, Sioen I, Veidebaum T, Iacoviello L. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children. PLoS One 2013; 8:e70632. [PMID: 23936460 PMCID: PMC3731254 DOI: 10.1371/journal.pone.0070632] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/20/2013] [Indexed: 01/08/2023] Open
Abstract
Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs) and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2±1.8 years) from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet) and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714), was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ = −1.8, p = 0.006). Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0–43.9%), the CCT haplotype (frequency = 39.7%) was associated with lower SI values (dominant model, Δ = −1.0, p = 0.04) as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4%) showed much lower SI than non-carriers (Δ = −3.9, p<0.0001; p for interaction = 0.025). The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p = 0.01). This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls.
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Affiliation(s)
- Francesco Gianfagna
- Research Laboratories, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso, Italy
| | | | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Department of Mathematics and Computer Sciences, University of Bremen, Bremen, Germany
| | - Mark E. S. Bailey
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karin Bammann
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Diana Herrmann
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - Anna C. Koni
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Yiannis Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Staffan Marild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Dénes Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Luis A. Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis P. Pitsiladis
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paola Russo
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - Alfonso Siani
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - Sabina Sieri
- Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Isabelle Sioen
- Department of Public Health, Ghent University, Ghent, Belgium
- FWO, Research Foundation Flanders, Brussels, Belgium
| | - Toomas Veidebaum
- Center of Health and Behavioral Science, National Institute for Health Development, Tallinn, Estonia
| | - Licia Iacoviello
- Casa di Cura Montevergine, Mercogliano (AV), Italy
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy
- * E-mail:
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Laine CM, Laine T. Diagnosis of Osteoporosis in Children and Adolescents. EUROPEAN ENDOCRINOLOGY 2013; 9:141-144. [PMID: 29922371 PMCID: PMC6003589 DOI: 10.17925/ee.2013.09.02.141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/24/2013] [Indexed: 11/24/2022]
Abstract
Osteoporosis is traditionally regarded as a disease of elderly women. However, this bone disorder occurs in patients of both sexes and of all ages and is also increasingly recognised in the paediatric setting. In particular, patients, including young children, with other chronic diseases are at risk of developing bone fragility. There are also several forms of hereditary osteoporosis, which should be identified at an early stage to ensure adequate treatment. The diagnosis of osteoporosis in children is challenging, since their bone mineral density (BMD) is affected by growth and pubertal development. In addition to low BMD, a child must also exhibit a significant proneness to fractures before the osteoporosis diagnosis can be made. Through early diagnosis and treatment for paediatric bone fragility, we can also ameliorate bone health in adulthood. In this article we review the aetiology, known risk factors and the diagnostic criteria of osteoporosis in the young.
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Affiliation(s)
- Christine M Laine
- Consultant in Endocrinology, Institute of Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Tero Laine
- Senior Consultant in Paediatric Orthopaedics, Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
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339
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Schnitzler CM, Mesquita JM. Cortical porosity in children is determined by age-dependent osteonal morphology. Bone 2013; 55:476-86. [PMID: 23579288 DOI: 10.1016/j.bone.2013.03.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 03/28/2013] [Accepted: 03/29/2013] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Fracture rates in children are high. Cortical bone makes a major contribution to bone strength, determined by cortical geometry, mineralization and porosity. Of these, porosity remains least well explored. Since most cortical canals are part of an osteon, we examined osteons and their canals for age-related changes in numbers, size and shape in 87 iliac crest bone samples of subjects aged 0-25 years, using histomorphometry. RESULTS Three types of secondary osteons were identified: drifting, eccentric and concentric. 1. Drifting osteons predominated to the mid-teens, were large, asymmetrical, and had giant canals (remodeling space) with the resorption front drifting towards the marrow. The cause of drift remains unclear. Onset of formation appeared delayed, and commenced on the periosteum-facing surface. From the mid-teens numerical density of drifting osteons decreased, and so did porosity. 2. Eccentric osteons were smaller, more circular and had a small excentric canal; their numerical density gradually increased with age. 3. Concentric osteons (adult bone) were the smallest, most symmetrical osteons, had a small central canal, and markedly increased in numerical density from the mid-teens. Boys showed greater overall porosity and greater numerical density of drifting osteons, and later change to concentric osteons than girls. Whites had greater numerical density and greater areal density of resorption cavities than blacks. CONCLUSIONS Structure of osteons and canals varied during growth. Large asymmetrical drifting osteons with giant active canals (remodeling space) predominated until the mid-teens and accounted for > 70% of childhood cortical porosity. Thereafter smaller concentric (adult type) osteons increasingly predominated. Gender differences may relate to greater fracture rates in boys, and race differences to greater fracture rates in whites. The role of osteocyte-mediated mechanotransduction in osteonal structure and cortical porosity during growth warrants further exploration.
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Affiliation(s)
- Christine M Schnitzler
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Wits, Johannesburg 2050, South Africa.
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340
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Matute-Llorente Á, González-Agüero A, Gómez-Cabello A, Vicente-Rodríguez G, Casajús JA. Decreased levels of physical activity in adolescents with down syndrome are related with low bone mineral density: a cross-sectional study. BMC Endocr Disord 2013; 13:22. [PMID: 23826810 PMCID: PMC3750373 DOI: 10.1186/1472-6823-13-22] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 07/01/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Down syndrome (DS) has been described as one of the main contributors for low bone mineral density (BMD). Physical activity (PA) is a key factor in skeletal health and thus, PA levels might be associated to the risk of developing osteoporosis. Therefore, the aims were (1) to describe PA patterns in adolescents with DS compared to their counterparts and (2) to determine the relationships between PA and the risk of having low bone mass in adolescents with DS. METHODS Nineteen adolescents (10 girls) with DS and 14 without disabilities (7 girls) participated in the study. Minutes in different PA intensities were objectively assessed with accelerometers (ActiTrainer). Moreover adolescents with DS were classified into PA tertiles taking into account the amount of total minutes of PA at any intensity, resulting in those performing low, medium or high of PA (lowPA, medPA and highPA). BMD was measured at the whole body, hip and lumbar spine with dual-energy X-ray absorptiometry and the BMD Z-score was calculated for each region taking into account age- and sex-matched reference data. Student's unpaired t-tests and analysis of covariance were used to compare variables between different conditions (DS vs. control) and PA levels (low, medium and high). RESULTS None of the adolescents with DS achieved the minimum of 60 min of daily moderate to vigorous PA (VPA) intensity recommended by PA guidelines; adolescents with DS group spent less time in sedentary and in VPA and more time in light PA than those without DS (p < 0.05). Adolescents with DS showed lower BMD Z-score values than those without (p < 0.05). Those adolescents with DS allocated in the lowPA tertile showed significant lower BMD Z-score at the hip and a general tendency towards lower BMD Z-score was found at whole body and lumbar spine compared to those in highPA tertile and (p < 0.05). CONCLUSIONS Adolescents with DS in the highPA tertile showed lower risk of developing future osteoporosis by having higher BMD Z-score at the hip. This data provides an idea regarding the importance of accumulated minutes of PA, and not only moderate or vigorous in the bone health in adolescents with DS.
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Affiliation(s)
- Ángel Matute-Llorente
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Ed. Cervantes Corona de Aragón St 42, 2nd floor, Zaragoza 50009, Spain
- Faculty of Health and Sport Science, Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, Huesca 22001, Spain
| | - Alejandro González-Agüero
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Ed. Cervantes Corona de Aragón St 42, 2nd floor, Zaragoza 50009, Spain
- Department of Sport and Exercise Science, Aberystwyth University, Ceredigion, United Kingdom
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Ed. Cervantes Corona de Aragón St 42, 2nd floor, Zaragoza 50009, Spain
- Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Ed. Cervantes Corona de Aragón St 42, 2nd floor, Zaragoza 50009, Spain
- Faculty of Health and Sport Science, Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, Huesca 22001, Spain
| | - José Antonio Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Ed. Cervantes Corona de Aragón St 42, 2nd floor, Zaragoza 50009, Spain
- Faculty of Health and Sport Science, Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, Huesca 22001, Spain
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Meyer U, Ernst D, Zahner L, Schindler C, Puder JJ, Kraenzlin M, Rizzoli R, Kriemler S. 3-Year follow-up results of bone mineral content and density after a school-based physical activity randomized intervention trial. Bone 2013; 55:16-22. [PMID: 23510752 DOI: 10.1016/j.bone.2013.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 03/07/2013] [Accepted: 03/09/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND As an important modifiable lifestyle factor in osteoporosis prevention, physical activity has been shown to positively influence bone mass accrual during growth. We have previously shown that a nine month general school based physical activity intervention increased bone mineral content (BMC) and density (aBMD) in primary school children. From a public health perspective, a major key issue is whether these effects persist during adolescence. We therefore measured BMC and aBMD three years after cessation of the intervention to investigate whether the beneficial short-term effects persisted. METHODS All children from 28 randomly selected first and fifth grade classes (intervention group (INT): 16 classes, n=297; control group (CON): 12 classes, n=205) who had participated in KISS (Kinder-und Jugendsportstudie) were contacted three years after cessation of the intervention program. The intervention included daily physical education with daily impact loading activities over nine months. Measurements included anthropometry, vigorous physical activity (VPA) by accelerometers, and BMC/aBMD for total body, femoral neck, total hip, and lumbar spine by dual-energy X-ray absorptiometry (DXA). Sex- and age-adjusted Z-scores of BMC or aBMD at follow-up were regressed on intervention (1 vs. 0), the respective Z-score at baseline, gender, follow-up height and weight, pubertal stage at follow-up, previous and current VPA, adjusting for clustering within schools. RESULTS 377 of 502 (75%) children participated in baseline DXA measurements and of those, 214 (57%) participated to follow-up. At follow-up INT showed significantly higher Z-scores of BMC at total body (adjusted group difference: 0.157 units (0.031-0.283); p=0.015), femoral neck (0.205 (0.007-0.402); p=0.042) and at total hip (0.195 (0.036 to 0.353); p=0.016) and higher Z-scores of aBMD for total body (0.167 (0.016 to 0.317); p=0.030) compared to CON, representing 6-8% higher values for children in the INT. No differences could be found for the remaining bone parameters. For the subpopulation with baseline VPA (n=163), effect sizes became stronger after baseline VPA adjustment. After adjustment for baseline and current VPA (n=101), intervention effects were no longer significant, while effect sizes remained the same as without adjustment for VPA. CONCLUSION Beneficial effects on BMC of a nine month general physical activity intervention appeared to persist over three years. Part of the maintained effects may be explained by current physical activity.
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Affiliation(s)
- Ursina Meyer
- Swiss Tropical and Public Health Institute, 4053 Basel, Switzerland.
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Umaretiya PJ, Thacher TD, Fischer PR, Cha SS, Pettifor JM. Bone mineral density in Nigerian children after discontinuation of calcium supplementation. Bone 2013; 55:64-8. [PMID: 23567161 DOI: 10.1016/j.bone.2013.03.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 03/12/2013] [Accepted: 03/21/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Nigerian toddlers with low dietary calcium intakes increased forearm bone mineral density (BMD) after 18 months of calcium supplementation compared with placebo. However, it is not known if this bone mineral accretion is sustained after calcium supplement withdrawal. We therefore investigated the influence of prior calcium supplementation on forearm BMD 12 months after withdrawal of the supplement. METHODS Nigerian toddlers aged 12-18 months from three urban communities were enrolled in a controlled trial of calcium supplementation. Two communities received daily calcium supplements, one as calcium carbonate (400mg), and the other as ground fish (529±109 mg), for a duration of 18 months, and all three communities received vitamin A (2500 IU daily) as placebo. Forearm BMD was measured 5 times during 18 months of calcium supplementation and at 12 months after supplement withdrawal. RESULTS Of 647 children enrolled, 390 completed the trial of calcium supplementation and 261 of these returned for the final follow-up 12 months after discontinuation of supplementation. During the 18 months of supplementation, an adjusted model demonstrated that the increase in both distal and proximal forearm BMD over time was significantly greater in the calcium supplemented groups than in the placebo group (P<0.04). However, after supplement withdrawal, the increase in BMD over time was largely attenuated and only remained significant at the proximal forearm in the ground fish group (P=0.03). CONCLUSION The benefit of calcium supplementation on forearm BMD in young Nigerian children is not sustained after supplement withdrawal.
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343
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Crane JL, Zhao L, Frye JS, Xian L, Qiu T, Cao X. IGF-1 Signaling is Essential for Differentiation of Mesenchymal Stem Cells for Peak Bone Mass. Bone Res 2013; 1:186-94. [PMID: 26273502 DOI: 10.4248/br201302007] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 04/23/2013] [Indexed: 01/27/2023] Open
Abstract
Survival of children with chronic medical illnesses is leading to an increase in secondary osteoporosis due to impaired peak bone mass (PBM). Insulin-like growth factor type 1 (IGF-1) levels correlate with the pattern of bone mass accrual and many chronic illnesses are associated with low IGF-1 levels. Reduced serum levels of IGF-1 minimally affect the integrity of the skeleton, whereas recent studies suggest that skeletal IGF-I regulates PBM. To determine the role of IGF-1 in postnatal bone mass accrual regardless of source, we established an inducible type 1 Igf receptor Cre/lox knockout mouse model, in which the type 1 Igf receptor was deleted inducibely in the mesenchymal stem cells (MSCs) from 3-7 weeks of age. The size of the mouse was not affected as knockout and wild type mice had similar body weights and nasoanal and femoral lengths. However, bone volume and trabecular bone thickness were decreased in the secondary spongiosa of female knockout mice relative to wild type controls, indicating that IGF-1 is critical for bone mass. IGF-1 signaling in MSCs in vitro has been implicated to be involved in both migration to the bone surface and differentiation into bone forming osteoblasts. To clarify the exact role of IGF-1 in bone, we found by immunohistochemical analysis that a similar number of Osterix-positive osteoprogenitors were on the bone perimeter, indicating migration of MSCs was not affected. Most importantly, 56% fewer osteocalcin-positive mature osteoblasts were present on the bone perimeter in the secondary spongiosa in knockout mice versus wild type littermates. These in vivo data demonstrate that the primary role of skeletal IGF-1 is for the terminal differentiation of osteoprogenitors, but refute the role of IGF-1 in MSC migration in vivo. Additionally, these findings confirm that impaired IGF-1 signaling in bone MSCs is sufficient to impair bone mass acquisition.
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Affiliation(s)
- Janet L Crane
- Department of Pediatrics, Johns Hopkins University School of Medicine , Baltimore, MD 21205, USA ; Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine , Baltimore. MD 21205, USA
| | - Luo Zhao
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing. 100730, P.R. China
| | - Joseph S Frye
- University of Missouri School of Medicine , Columbia, MO, 65211, USA
| | - Lingling Xian
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine , Baltimore. MD 21205, USA
| | - Tao Qiu
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine , Baltimore. MD 21205, USA
| | - Xu Cao
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine , Baltimore. MD 21205, USA
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344
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Puthanakit T, Siberry GK. Bone health in children and adolescents with perinatal HIV infection. J Int AIDS Soc 2013; 16:18575. [PMID: 23782476 PMCID: PMC3687077 DOI: 10.7448/ias.16.1.18575] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/10/2013] [Accepted: 04/16/2013] [Indexed: 01/02/2023] Open
Abstract
The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD) appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood.
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Affiliation(s)
- Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- HIVNAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - George K Siberry
- Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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345
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Warden SJ, Hill KM, Ferira AJ, Laing EM, Martin BR, Hausman DB, Weaver CM, Peacock M, Lewis RD. Racial differences in cortical bone and their relationship to biochemical variables in Black and White children in the early stages of puberty. Osteoporos Int 2013; 24:1869-79. [PMID: 23093348 PMCID: PMC4163020 DOI: 10.1007/s00198-012-2174-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 09/12/2012] [Indexed: 12/21/2022]
Abstract
UNLABELLED Osteoporotic fracture rates differ according to race with Blacks having up to half the rate of Whites. The current study demonstrates that racial divergence in cortical bone properties develops in early childhood despite lower serum 25-hydroxyvitamin D in Blacks. INTRODUCTION Racial differences in bone structure likely have roots in childhood as bone size develops predominantly during growth. This study aimed to compare cortical bone health within the tibial diaphysis of Black and White children in the early stages of puberty and explore the contributions of biochemical variables in explaining racial variation in cortical bone properties. METHODS A cross-sectional study was performed comparing peripheral quantitative computed tomography-derived cortical bone measures of the tibial diaphysis and biochemical variables in 314 participants (n = 155 males; n = 164 Blacks) in the early stages of puberty. RESULTS Blacks had greater cortical volumetric bone mineral density, mass, and size compared to Whites (all p < 0.01), contributing to Blacks having 17.0 % greater tibial strength (polar strength-strain index (SSIP)) (p < 0.001). Turnover markers indicated that Blacks had higher bone formation (osteocalcin (OC) and bone-specific alkaline phosphatase) and lower bone resorption (N-terminal telopeptide) than Whites (all p < 0.01). Blacks also had lower 25-hydroxyvitamin D (25(OH)D) and higher 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) (all p < 0.05). There were no correlations between tibial bone properties and 25(OH)D and PTH in Whites (all p ≥ 0.10); however, SSIP was negatively and positively correlated with 25(OH)D and PTH in Blacks, respectively (all p ≤ 0.02). Variation in bone cross-sectional area and SSIP attributable to race was partially explained by tibial length, 25(OH)D/PTH, and OC. CONCLUSIONS Divergence in tibial cortical bone properties between Blacks and Whites is established by the early stages of puberty with the enhanced cortical bone properties in Black children possibly being explained by higher PTH and OC.
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Affiliation(s)
- S J Warden
- Center for Translational Musculoskeletal Research and Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St., CF-326, Indianapolis, IN 46202, USA.
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346
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Zakhem E, El Hage R, Bassil S, Moussa E, Zunquin G, Theunynck D. Standing long jump performance is a positive determinant of bone mineral density in young adult women. J Clin Densitom 2013; 16:129-30. [PMID: 23523286 DOI: 10.1016/j.jocd.2013.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 02/28/2013] [Indexed: 11/18/2022]
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347
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Kang MJ, Lim JS. Bone mineral density deficits in childhood cancer survivors: Pathophysiology, prevalence, screening, and management. KOREAN JOURNAL OF PEDIATRICS 2013; 56:60-7. [PMID: 23482662 PMCID: PMC3589592 DOI: 10.3345/kjp.2013.56.2.60] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/09/2012] [Indexed: 11/29/2022]
Abstract
As chemotherapy and other sophisticated treatment strategies evolve and the number of survivors of long-term childhood cancer grows, the long-term complications of treatment and the cancer itself are becoming ever more important. One of the most important but often neglected complications is osteoporosis and increased risk of fracture during and after cancer treatment. Acquisition of optimal peak bone mass and strength during childhood and adolescence is critical to preventing osteoporosis later in life. However, most childhood cancer patients have multiple risk factors for bone mineral loss. Cancer itself, malnutrition, decreased physical activity during treatment, chemotherapeutic agents such as steroids, and radiotherapy cause bone mineral deficit. Furthermore, complications such as growth hormone deficiency and musculoskeletal deformity have negative effects on bone metabolism. Low bone mineral density is associated with fractures, skeletal deformity, pain, and substantial financial burden not only for childhood cancer survivors but also for public health care systems. Thus, it is important to monitor bone health in these patients and minimize their risk of developing osteoporosis and fragility fractures later in life.
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Affiliation(s)
- Min Jae Kang
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
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348
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Effect of calcitriol on bone turnover and osteocalcin in recent-onset type 1 diabetes. PLoS One 2013; 8:e56488. [PMID: 23437144 PMCID: PMC3577896 DOI: 10.1371/journal.pone.0056488] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/10/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Vitamin D supplementation in childhood improves the achievement of peak bone mass. We investigated the effect of supplementation with calcitriol on bone turnover in recent-onset type 1 diabetes (T1D). Moreover, the association between osteocalcin and parameters of β-cell function and metabolic control was examined. METHODOLOGY/PRINCIPAL FINDINGS We conducted a post-hoc analysis of a double-blind, placebo-controlled study of calcitriol supplementation to preserve β-cell function. 27 recent-onset T1D subjects, mean age 22 years, were randomized to 0.25 µg calcitriol per day or placebo (1:1) and followed up for one year. Changes in bone formation (osteoclacin) and resorption (beta-CrossLaps) markers, and differences between placebo and calcitriol-treated group were evaluated. At baseline, osteocalcin levels were significantly lower in female than in male patients (P<0.01) while no other metabolic parameters as HbA1c and C-peptide differed between gender. No significant correlations were found in relation to HbA1c, insulin requirement and C-peptide. At 1 year follow-up, no significant differences were observed between calcitriol and placebo groups for osteocalcin and β-CrossLaps. In the placebo group osteocalcin levels were unrelated with parameters of metabolic control, such as C-peptide, insulin requirement or HbA1c. Changes of C-peptide, insulin requirement and HbA1c were not related to osteocalcin levels. CONCLUSIONS Supplementation with 0.25 µg calcitriol per day to patients with new-onset T1D does not affect circulating markers of bone turnover. OC levels were unrelated to β-cell function and other metabolic parameters suggesting that OC is ineffective to control pancreatic function in presence of aggressive autoimmune destruction.
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349
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Mouratidou T, Vicente-Rodriguez G, Gracia-Marco L, Huybrechts I, Sioen I, Widhalm K, Valtueña J, González-Gross M, Moreno LA. Associations of dietary calcium, vitamin D, milk intakes, and 25-hydroxyvitamin D with bone mass in Spanish adolescents: the HELENA study. J Clin Densitom 2013; 16:110-7. [PMID: 22901550 DOI: 10.1016/j.jocd.2012.07.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/17/2012] [Accepted: 07/19/2012] [Indexed: 11/17/2022]
Abstract
Adequate nutrition is needed for the accrual of bone mass during the pre- and postpubertal growth periods. This study aimed to examine the associations between dietary calcium, vitamin D (calciferol), and milk intakes and 25-hydroxyvitamin D [25(OH)D] status and bone mineral content (BMC) and bone mineral density (BMD) in Spanish adolescents, aged 12.5-17.5 years, participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS). Bone mass was measured with dual-energy X-ray absorptiometry and diet via 2 nonconsecutive 24-h dietary recalls (n=227; 48% males). A random subsample of 101 adolescents (46% males) had available measures of 25(OH)D. Multiple linear regression was applied. Significant adjusted associations were observed in males, among milk intakes and BMC and BMD. Also in males, whole-body, head, and right arm BMD were positively related to calcium intakes. In females, 25(OH)D was positively related among others to whole-body, subtotal, and left and right arm BMC and BMD. It could be speculated that diet is not a limiting factor of bone mass development in this group of healthy adolescents, and further research on the effect of other factors in addition to diet in a larger sample should be undertaken.
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Affiliation(s)
- Theodora Mouratidou
- Nutrition and Development Research Group, University of Zaragoza, C/Corona de Aragon, Zaragoza, Spain.
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350
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Lötters FJB, Lenoir-Wijnkoop I, Fardellone P, Rizzoli R, Rocher E, Poley MJ. Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products. Osteoporos Int 2013; 24:139-50. [PMID: 22707061 PMCID: PMC3536961 DOI: 10.1007/s00198-012-1998-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 04/03/2012] [Indexed: 12/16/2022]
Abstract
UNLABELLED Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture, taking a health economics perspective. INTRODUCTION This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and costs, and, second, to contribute to a generic methodology for assessing the health-economic outcomes of food products. METHODS We constructed a model that generated the number of hip fractures that potentially can be prevented with dairy foods intakes, and then calculated costs avoided, considering the healthcare costs of hip fractures and the costs of additional dairy foods, as well as the number of disability-adjusted life years (DALYs) lost due to hip fractures associated with low nutritional calcium intake. Separate analyses were done for The Netherlands, France, and Sweden, three countries with different levels of dairy products consumption. RESULTS The number of hip fractures that may potentially be prevented each year with additional dairy products was highest in France (2,023), followed by Sweden (455) and The Netherlands (132). The yearly number of DALYs lost was 6,263 for France, 1,246 for Sweden, and 374 for The Netherlands. The corresponding total costs that might potentially be avoided are about 129 million, 34 million, and 6 million Euros, in these countries, respectively. CONCLUSIONS This study quantified the potential nutrition economic impact of increased dairy consumption on osteoporotic fractures, building connections between the fields of nutrition and health economics. Future research should further collect longitudinal population data for documenting the net benefits of increasing dairy consumption on bone health and on the related utilization of healthcare resources.
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Affiliation(s)
- F. J. B. Lötters
- Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - I. Lenoir-Wijnkoop
- Departement of Pharmaceutical Sciences, University of Utrecht, Sorbonnelaan 16, 3508TB Utrecht, The Netherlands
- Danone Research, Route Départementale 128, 91767 Palaiseau, France
| | - P. Fardellone
- Service de Rhumatologie, Centre Hospitalier Universitaire Amiens, INSERM ERI 12, Amiens, France
| | - R. Rizzoli
- University Hospital Geneva, Bone Diseases, Geneva, Switzerland
| | - E. Rocher
- Danone Research, Route Départementale 128, 91767 Palaiseau, France
| | - M. J. Poley
- Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, The Netherlands
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