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Johansson L, Litsne H, Axelsson KF, Lorentzon M. High physical activity is associated with greater cortical bone size, better physical function, and with lower risk of incident fractures independently of clinical risk factors in older women from the SUPERB study. J Bone Miner Res 2024; 39:1284-1295. [PMID: 38995943 PMCID: PMC11371905 DOI: 10.1093/jbmr/zjae114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/07/2024] [Accepted: 04/02/2024] [Indexed: 07/14/2024]
Abstract
The Physical Activity Scale for the Elderly (PASE) is a validated test to assess physical activity in older people. It has not been investigated if physical activity, according to PASE, is associated with fracture risk independently from the clinical risk factors (CRFs) in FRAX, bone mineral density (BMD), comorbidity, and if such an association is due to differences in physical performance or bone parameters. The purpose of this study was to evaluate if PASE score is associated with bone characteristics, physical function, and independently predicts incident fracture in 3014 75-80-yr-old women from the population-based cross-sectional SUPERB study. At baseline, participants answered questionnaires and underwent physical function tests, detailed bone phenotyping with DXA, and high-resolution peripheral quantitative CT. Incident fractures were X-ray verified. Cox regression models were used to assess the association between PASE score and incident fractures, with adjustments for CRFs, femoral neck (FN) BMD, and Charlson comorbidity index. Women were divided into quartiles according to PASE score. Quartile differences in bone parameters (1.56% for cortical volumetric BMD and 4.08% for cortical area, Q4 vs Q1, p = .007 and p = .022, respectively) were smaller than quartile differences in physical performance (27% shorter timed up and go test, 52% longer one leg standing time, Q4 vs Q1). During 8 yr (median, range 0.20-9.9) of follow-up, 1077 women had any fracture, 806 a major osteoporotic fracture (MOF; spine, hip, forearm, humerus), and 236 a hip fracture. Women in Q4 vs. Q1 had 30% lower risk of any fracture, 32% lower risk of MOF, and 54% lower risk of hip fracture. These associations remained in fully adjusted models. In conclusion, high physical activity was associated with substantially better physical function and a lower risk of any fracture, MOF and hip fracture, independently of risk factors used in FRAX, FN BMD, and comorbidity.
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Affiliation(s)
- Lisa Johansson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, 431 80 Mölndal, Sweden
- Region Västra Götaland, Department of Orthopedics, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden
| | - Henrik Litsne
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, 431 80 Mölndal, Sweden
| | - Kristian F Axelsson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, 431 80 Mölndal, Sweden
- Region Västra Götaland, Närhälsan Norrmalm Health Centre, 549 40 Skövde, Sweden
| | - Mattias Lorentzon
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, 431 80 Mölndal, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3065, Australia
- Geriatric Medicine, Institute of Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden
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Nissen FI, Esser VFC, Bui M, Li S, Hopper JL, Bjørnerem Å, Hansen AK. Is There a Causal Relationship between Physical Activity and Bone Microarchitecture? A Study of Adult Female Twin Pairs. J Bone Miner Res 2023; 38:951-957. [PMID: 37198881 PMCID: PMC10947270 DOI: 10.1002/jbmr.4826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 05/19/2023]
Abstract
The reasons for the association between physical activity (PA) and bone microarchitecture traits are unclear. We examined whether these associations were consistent with causation and/or with shared familial factors using a cross-sectional study of 47 dizygotic and 93 monozygotic female twin pairs aged 31-77 years. Images of the nondominant distal tibia were obtained using high-resolutionperipheral quantitative computed tomography. The bone microarchitecture was assessed using StrAx1.0 software. Based on a self-completed questionnaire, a PA index was calculated as a weighted sum of weekly hours of light (walking, light gardening), moderate (social tennis, golf, hiking), and vigorous activity (competitive active sports) = light + 2 * moderate + 3 * vigorous. We applied Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) to test whether cross-pair cross-trait associations changed after adjustment for within-individual associations. Within-individual distal tibia cortical cross-sectional area (CSA) and cortical thickness were positively associated with PA (regression coefficients [β] = 0.20 and 0.22), while the porosity of the inner transitional zone was negatively associated with PA (β = -0.17), all p < 0.05. Trabecular volumetric bone mineral density (vBMD) and trabecular thickness were positively associated with PA (β = 0.13 and 0.14), and medullary CSA was negatively associated with PA (β = -0.22), all p ≤ 0.01. Cross-pair cross-trait associations of cortical thickness, cortical CSA, and medullary CSA with PA attenuated after adjustment for the within-individual association (p = 0.048, p = 0.062, and p = 0.028 for changes). In conclusion, increasing PA was associated with thicker cortices, larger cortical area, lower porosity of the inner transitional zone, thicker trabeculae, and smaller medullary cavities. The attenuation of cross-pair cross-trait associations after accounting for the within-individual associations was consistent with PA having a causal effect on the improved cortical and trabecular microarchitecture of adult females, in addition to shared familial factors. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Frida Igland Nissen
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Orthopedic SurgeryUniversity Hospital of North NorwayTromsøNorway
- Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway
| | - Vivienne F. C. Esser
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
| | - Minh Bui
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
| | - Shuai Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
- Precision Medicine, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVICAustralia
- Murdoch Children's Research Institute, Royal Children's HospitalMelbourneVICAustralia
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
| | - Åshild Bjørnerem
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway
- Norwegian Research Center for Women's Health, OsloUniversity HospitalOsloNorway
| | - Ann Kristin Hansen
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Orthopedic SurgeryUniversity Hospital of North NorwayTromsøNorway
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3
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Cai Y, Song W, Li J, Jing Y, Liang C, Zhang L, Zhang X, Zhang W, Liu B, An Y, Li J, Tang B, Pei S, Wu X, Liu Y, Zhuang CL, Ying Y, Dou X, Chen Y, Xiao FH, Li D, Yang R, Zhao Y, Wang Y, Wang L, Li Y, Ma S, Wang S, Song X, Ren J, Zhang L, Wang J, Zhang W, Xie Z, Qu J, Wang J, Xiao Y, Tian Y, Wang G, Hu P, Ye J, Sun Y, Mao Z, Kong QP, Liu Q, Zou W, Tian XL, Xiao ZX, Liu Y, Liu JP, Song M, Han JDJ, Liu GH. The landscape of aging. SCIENCE CHINA. LIFE SCIENCES 2022; 65:2354-2454. [PMID: 36066811 PMCID: PMC9446657 DOI: 10.1007/s11427-022-2161-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/05/2022] [Indexed: 02/07/2023]
Abstract
Aging is characterized by a progressive deterioration of physiological integrity, leading to impaired functional ability and ultimately increased susceptibility to death. It is a major risk factor for chronic human diseases, including cardiovascular disease, diabetes, neurological degeneration, and cancer. Therefore, the growing emphasis on "healthy aging" raises a series of important questions in life and social sciences. In recent years, there has been unprecedented progress in aging research, particularly the discovery that the rate of aging is at least partly controlled by evolutionarily conserved genetic pathways and biological processes. In an attempt to bring full-fledged understanding to both the aging process and age-associated diseases, we review the descriptive, conceptual, and interventive aspects of the landscape of aging composed of a number of layers at the cellular, tissue, organ, organ system, and organismal levels.
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Affiliation(s)
- Yusheng Cai
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Wei Song
- Frontier Science Center for Immunology and Metabolism, Medical Research Institute, College of Life Sciences, Wuhan University, Wuhan, 430071, China
| | - Jiaming Li
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ying Jing
- University of Chinese Academy of Sciences, Beijing, 100049, China
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Chuqian Liang
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Liyuan Zhang
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, 100101, China
| | - Xia Zhang
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Wenhui Zhang
- University of Chinese Academy of Sciences, Beijing, 100049, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Beibei Liu
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, 100101, China
| | - Yongpan An
- Peking University International Cancer Institute, Peking University Health Science Center, Peking University, Beijing, 100191, China
| | - Jingyi Li
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Baixue Tang
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, 100084, China
| | - Siyu Pei
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Xueying Wu
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Yuxuan Liu
- School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, Ministry of Education Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology, Tsinghua University, Beijing, 100084, China
| | - Cheng-Le Zhuang
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, 200072, China
| | - Yilin Ying
- Department of Geriatrics, Medical Center on Aging of Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
- International Laboratory in Hematology and Cancer, Shanghai Jiaotong University School of Medicine/Ruijin Hospital, Shanghai, 200025, China
| | - Xuefeng Dou
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yu Chen
- Shanghai Key Laboratory of Maternal Fetal Medicine, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China
| | - Fu-Hui Xiao
- State Key Laboratory of Genetic Resources and Evolution/Key Laboratory of Healthy Aging Research of Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China
- CAS Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, 650223, China
| | - Dingfeng Li
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, China
| | - Ruici Yang
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, China
| | - Ya Zhao
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, 330031, China
| | - Yang Wang
- Center of Growth, Metabolism and Aging, Key Laboratory of Bio-Resource and Eco-Environment, Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, China
| | - Lihui Wang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medical Sciences, Hangzhou, 311121, China
| | - Yujing Li
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Shuai Ma
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
| | - Si Wang
- Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
- The Fifth People's Hospital of Chongqing, Chongqing, 400062, China.
| | - Xiaoyuan Song
- MOE Key Laboratory of Cellular Dynamics, Hefei National Research Center for Physical Sciences at the Microscale, CAS Key Laboratory of Brain Function and Disease, Neurodegenerative Disorder Research Center, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
| | - Jie Ren
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Liang Zhang
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Jun Wang
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Weiqi Zhang
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
| | - Zhengwei Xie
- Peking University International Cancer Institute, Peking University Health Science Center, Peking University, Beijing, 100191, China.
| | - Jing Qu
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jianwei Wang
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, 100084, China.
| | - Yichuan Xiao
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Ye Tian
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Gelin Wang
- School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, Ministry of Education Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology, Tsinghua University, Beijing, 100084, China.
| | - Ping Hu
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, 200072, China.
- Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, 510005, China.
| | - Jing Ye
- Department of Geriatrics, Medical Center on Aging of Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
- International Laboratory in Hematology and Cancer, Shanghai Jiaotong University School of Medicine/Ruijin Hospital, Shanghai, 200025, China.
| | - Yu Sun
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China.
- Department of Medicine and VAPSHCS, University of Washington, Seattle, 98195, USA.
| | - Zhiyong Mao
- Shanghai Key Laboratory of Maternal Fetal Medicine, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.
| | - Qing-Peng Kong
- State Key Laboratory of Genetic Resources and Evolution/Key Laboratory of Healthy Aging Research of Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650223, China.
- CAS Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, 650223, China.
| | - Qiang Liu
- CAS Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, 650223, China.
- Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230027, China.
| | - Weiguo Zou
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Xiao-Li Tian
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, 330031, China.
| | - Zhi-Xiong Xiao
- Center of Growth, Metabolism and Aging, Key Laboratory of Bio-Resource and Eco-Environment, Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, China.
| | - Yong Liu
- Frontier Science Center for Immunology and Metabolism, Medical Research Institute, College of Life Sciences, Wuhan University, Wuhan, 430071, China.
| | - Jun-Ping Liu
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medical Sciences, Hangzhou, 311121, China.
- Department of Immunology and Pathology, Monash University Faculty of Medicine, Prahran, Victoria, 3181, Australia.
- Hudson Institute of Medical Research, and Monash University Department of Molecular and Translational Science, Clayton, Victoria, 3168, Australia.
| | - Moshi Song
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Jing-Dong J Han
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Center for Quantitative Biology, Peking University, Beijing, 100871, China.
| | - Guang-Hui Liu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
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Junno JA, Keisu A, Niemelä M, Modarress Julin M, Korpelainen R, Jämsä T, Niinimäki J, Lehenkari P, Oura P. Accelerometer-measured physical activity is associated with knee breadth in middle-aged Finns - a population-based study. BMC Musculoskelet Disord 2022; 23:517. [PMID: 35642051 PMCID: PMC9153128 DOI: 10.1186/s12891-022-05475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Articular surface size is traditionally considered to be a relatively stable trait throughout adulthood. Increased joint size reduces bone and cartilage tissue strains. Although physical activity (PA) has a clear association with diaphyseal morphology, the association between PA and articular surface size is yet to be confirmed. This cross-sectional study aimed to clarify the role of moderate-to-vigorous PA (MVPA) in knee morphology in terms of tibiofemoral joint size. Methods A sample of 1508 individuals from the population-based Northern Finland Birth Cohort 1966 was used. At the age of 46, wrist-worn accelerometers were used to monitor MVPA (≥3.5 METs) during a period of two weeks, and knee radiographs were used to obtain three knee breadth measurements (femoral biepicondylar breadth, mediolateral breadth of femoral condyles, mediolateral breadth of the tibial plateau). The association between MVPA and knee breadth was analyzed using general linear models with adjustments for body mass index, smoking, education years, and accelerometer weartime. Results Of the sample, 54.8% were women. Most individuals were non-smokers (54.6%) and had 9—12 years of education (69.6%). Mean body mass index was 26.2 (standard deviation 4.3) kg/m2. MVPA was uniformly associated with all three knee breadth measurements among both women and men. For each 60 minutes/day of MVPA, the knee breadth dimensions were 1.8—2.0% (or 1.26—1.42 mm) larger among women (p < 0.001) and 1.4—1.6% (or 1.21—1.28 mm) larger among men (p < 0.001). Conclusions Higher MVPA is associated with larger tibiofemoral joint size. Our findings indicate that MVPA could potentially increase knee dimensions through similar biomechanical mechanisms it affects diaphyseal morphology, thus offering a potential target in reducing tissue strains and preventing knee problems. Further studies are needed to confirm and investigate the association between articulation area and musculoskeletal health. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05475-7.
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Affiliation(s)
- Juho-Antti Junno
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Archaeology, Faculty of Humanities, University of Oulu, Oulu, Finland.,Archaeology, Faculty of Arts, University of Helsinki, Helsinki, Finland
| | - Asla Keisu
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maisa Niemelä
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Marella Modarress Julin
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
| | - Timo Jämsä
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Petri Lehenkari
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Petteri Oura
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland. .,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Forensic Medicine Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
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5
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Flores LE, Nelson S, Waltman N, Kupzyk K, Lappe J, Mack L, Bilek LD. Examining effects of habitual physical activity and body composition on bone structure in early post-menopausal women: a pQCT analysis. Osteoporos Int 2022; 33:425-433. [PMID: 34510230 DOI: 10.1007/s00198-021-06146-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
UNLABELLED After menopause, bones decline in structure and can break more easily. Physical activity can strengthen bones. This study investigated how activity and body composition can impact bone structure in post-menopausal women. Higher levels of physical activity were positively associated with bone structure at the lower leg. PURPOSE The menopausal transition is characterized by dramatic bone loss, leading to an increased risk of fracture. Few studies have examined how modifiable risk factors influence bone structure. Thus, the objective of this cross-sectional study was to examine the relationship between habitual physical activity (PA), body composition, and bone structure in post-menopausal women with low bone mass. METHODS Data was analyzed from 276 post-menopausal women with low bone mass enrolled in the Heartland Osteoporosis Prevention Study. Body composition and bone structure measures were collected using dual X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) at the tibia. Habitual PA was collected using the Human Activity Profile questionnaire. Multiple regression analysis was used to determine the relative impact of habitual PA and body composition on bone structure measures (density, area, and strength). Direct and/or indirect effects of PA on bone outcomes were assessed by path analysis. RESULTS Mean (± SD) age of participants was 54.5 (± 3.2) years and average BMI was 25.7 (± 4.7). Mean T-score of the total lumber spine and hip were - 1.5 (± .6) and - 0.8 (± .59), respectively, with all women classified with low bone mass. Habitual PA had a significant positive effect on bone area and strength measures at the 66% site, and trend effects at the 4% site. Lean mass had a significant positive effect on area and strength at the 66% site and 4% site. Fat mass showed no effect at the 66% site, with a positive effect on density and strength at the 4% site. CONCLUSION Increased habitual activity was related to improved bone structure of the tibia. Our results in post-menopausal women emphasize that PA and lean mass preservation are important for maintaining bone structure in the years following menopause.
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Affiliation(s)
- L E Flores
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA.
| | - S Nelson
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
| | - N Waltman
- Lincoln Division, University of Nebraska Medical Center College of Nursing, Lincoln, NE, USA
| | - K Kupzyk
- Center for Nursing Science, University of Nebraska Medical Center, Omaha, NE, USA
| | - J Lappe
- Creighton Osteoporosis Research Center, Omaha, NE, USA
| | - L Mack
- Diabetes, Endocrinology, & Metabolism, Nebraska Medicine, Omaha, NE, USA
| | - L D Bilek
- College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA
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6
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Swindall R, Roden-Forman JW, Conflitti J, Cook A, Wadle C, Boyle J, Ward J, Gross B, Rogers F, Le TD, Norwood S. Elderly trauma associated with high-risk recreational activity: A population-based study, United States, 2010 through 2016. Surgery 2021; 171:1677-1686. [PMID: 34955287 DOI: 10.1016/j.surg.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding trends in prevalence and etiology is critical to public health strategies for prevention and management of injury related to high-risk recreation in elderly Americans. METHODS The National Emergency Department Sample from 2010 through 2016 was queried for patients with a principal diagnosis of trauma (ICD-9 codes 800.0-959.9) and who were 55 years and older. High-risk recreation was determined from e-codes a priori. Primary outcome measures were mortality and total hospital charges. RESULTS Of the 29,491,352 patient cohort, 458,599 (1.56%) engaged in high-risk activity, including those age 85 and older. High-risk cases were younger (median age 61 vs 70) and majority male (71.87% vs 39.24%). The most frequent activities were pedal cycling (45.81%), motorcycling (29.08%), and off-road vehicles (9.13%). Brain injuries (8.82% vs 3.88%), rib/sternal fractures (13.35% vs 3.53%), and cardiopulmonary injury (5.25% vs 0.57%) were more common among high-risk cases. Mortality (0.75% vs 0.40%) and total median hospital charges ($3,360 vs $2,312) were also higher for high-risk admissions, where the odds of mortality increased exponentially per year of age (odds ratio, 1.06; 99.5% CI, 1.05-1.08). High-risk recreation was associated with more than $1 billion in total hospital charges and more than 100 deaths among elderly Americans per year. CONCLUSION Morbidity, mortality, and resource utilization due to high-risk recreation extend into the ninth decade of life. The patterns of injury described here offer opportunities for targeted injury prevention education to minimize risk among this growing segment of the United States population.
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Affiliation(s)
- Rebecca Swindall
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center Tyler, TX.
| | - Jacob W Roden-Forman
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center Tyler, TX
| | - Joseph Conflitti
- Department of Surgery, Trauma Program, UT Health East Texas, Tyler, TX
| | - Alan Cook
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center Tyler, TX
| | - Carly Wadle
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center Tyler, TX
| | - Julianna Boyle
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center Tyler, TX
| | - Jeanette Ward
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Brian Gross
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Fred Rogers
- Department of Surgery, University of Vermont College of Medicine, Burlington, VT
| | - Tuan D Le
- United States Army Institute of Surgical Research, Fort Sam Houston, TX
| | - Scott Norwood
- Department of Surgery, Trauma Program, UT Health East Texas, Tyler, TX
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7
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Gondim Teixeira PA, Villani N, Ait Idir M, Germain E, Lombard C, Gillet R, Blum A. Ultra-high resolution computed tomography of joints: practical recommendations for acquisition protocol optimization. Quant Imaging Med Surg 2021; 11:4287-4298. [PMID: 34603984 DOI: 10.21037/qims-21-217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/19/2021] [Indexed: 12/21/2022]
Abstract
Background To assess the influence on the spatial resolution of various Ultra-high-resolution computed tomography (CT) parameters and provide practical recommendations for acquisition protocol optimization in musculoskeletal imaging. Methods All acquisitions were performed with an Ultra-high resolution scanner, and variations of the following parameters were evaluated: field-of-view (150-300 mm), potential (80-140 KVp), current (25-250 mAs), focal spot size (0.4×0.5 to 0.8×1.3 mm2), slice thickness (0.25-0.5 mm), reconstruction matrix (512×512 to 2048×2048), and iso-centering (up to 85 mm off-center). Two different image reconstruction algorithms were evaluated: hybrid iterative reconstruction (HIR) and model-based iterative reconstruction (MBIR). CATPHAN 600 phantom images were analyzed to calculate the number of visible line pairs per centimeter (lp/cm). Task transfer function (TTF) curves were calculated to quantitatively evaluate spatial resolution. Cadaveric knee acquisitions were also performed. Results Under the conditions studied, the factor that most intensely influenced spatial resolution was the matrix size (additional visualization of up to 8 lp/cm). Increasing the matrix from 512×512 to 2048×2048 led to a 28.2% increase in TTF10% values with a high-dose protocol and a 5.6% increase with a low-dose protocol with no change in the number of visually distinguishable line pairs. The second most important factor affecting spatial resolution was the tube output (29.6% TTF10% gain and 5 additional lp/cm visualized), followed by the reconstruction algorithm choice and lateral displacement (both with a 4 lp/cm gain). Decreasing the slice thickness from 0.5 to 0.25 mm, led to an increase of 3 lp/cm (from 17 to 20 lp/cm) and a 17.3% increase in TTF10% values with no change in the "in-plane" spatial resolution. Conclusions This study provides practical recommendations for spatial resolution optimization using Ultra-high-resolution CT.
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Affiliation(s)
- Pedro Augusto Gondim Teixeira
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France.,Lorraine University, Inserm, IADI, Nancy, France
| | - Nicolas Villani
- Radioprotection Unit, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Malik Ait Idir
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Edouard Germain
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Charles Lombard
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Romain Gillet
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
| | - Alain Blum
- Guilloz Imaging department, Central Hospital, University Hospital Center of Nancy, Nancy, France
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8
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Sheng B, Li X, Nussler AK, Zhu S. The relationship between healthy lifestyles and bone health: A narrative review. Medicine (Baltimore) 2021; 100:e24684. [PMID: 33663079 PMCID: PMC7909112 DOI: 10.1097/md.0000000000024684] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Bone health, especially osteoporosis among ageing populations, has become an important topic for both clinical and basic researchers. The relationship between bone health and healthy lifestyles has been frequently discussed. The present study focuses on the relationship between bone health and healthy lifestyles among older adults, based on a global comparison. METHODS This narrative review was performed by collecting clinical trials, basic research and reviews on lifestyle and bone health in PubMed database. RESULTS Positive effects of physical activity and negative effects of malnutrition, alcohol abuse, and cigarette smoking on bone health were revealed. The relationship between bone health and drinking coffee and tea is still inconclusive. Moreover, the diversity of each region should be aware when considering healthy lifestyles to improve bone health. CONCLUSION Healthy lifestyles are highly related to bone health, and different lifestyles may have different influences on regions with a high risk of bone diseases. It is practical to acknowledge the diversity of economic, religious, environmental and geological conditions in each region when providing suitable and effective recommendations for healthy lifestyles that can improve overall bone health.
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Affiliation(s)
- Bin Sheng
- The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, PR China
| | - Xin Li
- The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, PR China
| | - Andreas K. Nussler
- Siegfried Weller Institute for Trauma Research, Eberhard Karls University Tuebingen, Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
| | - Sheng Zhu
- Siegfried Weller Institute for Trauma Research, Eberhard Karls University Tuebingen, Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
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9
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Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity. J Clin Med 2020; 9:jcm9123797. [PMID: 33255351 PMCID: PMC7760316 DOI: 10.3390/jcm9123797] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/23/2022] Open
Abstract
This study aimed to investigate the associations of competitive sport participation in adolescence and age at menarche (AAM) with body composition, femoral neck bone mineral density (BMD), physical performance, and physical activity (PA) in middle-aged women. 1098 women aged 47–55 years formed the sample of this retrospective study. Participants self-reported their PA level at age 13–16 years and AAM. The protocol also included dual-energy X-ray absorptiometry, physical performance tests, and accelerometer-measured PA. Participants were divided into three groups according to their PA level at the age of 13–16 (no exercise, regular PA, and competitive sport) and according to their AAM (≤12, 13, and ≥14 years). After adjusting for potential confounding factors, participation in competitive sport at age 13–16 was associated with higher midlife lean mass and BMD, and better physical performance compared to groups with no exercise or regular PA. Individuals with AAM ≥ 14 years had lower midlife BMI and fat mass than participants in the other AAM groups and pre- and perimenopausal women with AAM ≥ 14 years had lower BMD than those with AAM ≤ 12. The findings indicate that participation in competitive sport in adolescence is associated with healthier body composition, higher BMD, and better physical performance in midlife, but BMD might be impaired if menarche occurs late.
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10
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Kolbasi EN, Demirdag F, Yildiz K, Murat S, Balkaya G. Determinants of Bone Health in Older Adults. Medeni Med J 2020; 35:23-28. [PMID: 32733746 PMCID: PMC7384495 DOI: 10.5222/mmj.2020.50133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/06/2020] [Indexed: 11/12/2022] Open
Abstract
Objective: The objective of this study was to determine the predictors of bone health in older adults. Methods: A total of 313 subjects older than 65 years (mean age 74.2±6.4 years, 70.6% female) were included in the study. Demographic characteristics of participants such as gait speed, handgrip strength, level of physical activity (using Rapid Assessment of Physical Activity-RAPA scale), vitamin D levels, T scores of femur neck (FN) and lumbar spine (LS) were recorded. Results: Based on FN, 40.7% of participants had normal T scores whereas 46.2% and 13.1% of them were osteopenic and osteoporotic, respectively. FN was correlated with age (r:-0.184, p<0.001), BMI (r:0.269, p<0.001), and handgrip strength (r:0.149, p:0.009) in addition to the aerobic subscale of RAPA (RAPA-aerobic) (r:-0.133, p:0.02). Similarly, the LS was correlated with female gender (r:-0.207, p<0.001), age (r:0.136, p:0.016), body mass index (BMI) (r:0.246, p<0.001) and handgrip strength (r:0.217, p<0.001). The predictors of bone health were decided upon using multiple logistic regression analysis. The deterministic model consisted of age, gender, BMI, height, weight, handgrip strength, gait speed, RAPA-aerobic and vitamin D. For LS dependent variable, the overall model was significant (F:10.149, p<0.001). However, only two variables were significant predictors in the model ie. weight (β:0.389, p<0.001) and handgrip strength (β=0.186, p<0.001). Similarly for independent variable of FN, the overall model was significant (F:6.525, p<0.001) and only two variables were significant predictors: weight (β:0.371, p<0.001) and RAPA-Aerobic (β:0.148, p:0.009). Conclusion: Lower levels of body weight, participation in aerobic activity and handgrip strength might be risk factors for deterioration of bone health in older adults.
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Affiliation(s)
- Esma Nur Kolbasi
- Istanbul Medeniyet University, Department of Physiotherapy and Rehabilitation, Istanbul - Turkey
| | - Filiz Demirdag
- Istanbul Medeniyet University Göztepe Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | - Kubra Yildiz
- Istanbul Medeniyet University, Department of Nutrition and Dietetics, Istanbul, Turkey
| | - Sadiye Murat
- Istanbul Medeniyet University Göztepe Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Gozde Balkaya
- Istanbul Medeniyet University Göztepe Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
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11
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Nandiraju D, Ahmed I. Human skeletal physiology and factors affecting its modeling and remodeling. Fertil Steril 2020; 112:775-781. [PMID: 31731931 DOI: 10.1016/j.fertnstert.2019.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 12/21/2022]
Abstract
Human skeleton is a living tissue that performs structural and metabolic functions. It is not only the largest storehouse for calcium and other essential ions but also a depot for toxic chemicals faced by human body throughout life. Skeletal modeling starts at conception and then throughout life undergoes constant remodeling to adopt its shape and strength according to human needs. With the passage of time, like other tissues in the body, bones also bear the brunt of life and in this life long process loses its strength and vitality. Multiple genetic and environmental factors play an integral part in its formation, strength, and decline.
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Affiliation(s)
- Deepika Nandiraju
- Division of Endocrinology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Intekhab Ahmed
- Division of Endocrinology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
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12
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Foreman SC, Wu PH, Kuang R, John MD, Tien PC, Link TM, Krug R, Kazakia GJ. Factors associated with bone microstructural alterations assessed by HR-pQCT in long-term HIV-infected individuals. Bone 2020; 133:115210. [PMID: 31874226 DOI: 10.1016/j.bone.2019.115210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE In adults with long-term HIV infection, low bone density and increased fracture risk have emerged as significant comorbidities. Our aim was to assess the association of exercise, nutrition, and medications with bone quality in adults with long-term HIV infection. METHODS Forty-three adults with HIV infection were enrolled (median BMI 25.7, range 18.2-35.6 kg/m2; median age 57, range 50-69 years). Participants underwent ultradistal radius and tibia high-resolution peripheral quantitative CT (HR-pQCT). Questionnaires included the revised Community Healthy Activities Model Program for Seniors (CHAMPS), the Mini Nutritional Assessment (MNA) as well as medication assessments. Multivariable linear regression models were used to evaluate the association of exercise, nutritional status, tenofovir disoproxil fumarate (TDF) and protease inhibitor (PI) use with bone density and microstructure, adjusting for demographic risk factors. RESULTS In regression models, higher nutrition scores were associated with higher tibia cortical thickness (R2 = 0.23; β = 0.03; p = 0.044) and higher radius cortical BMD (R2 = 0.43; β = 8.4; p = 0.026). Higher weekly frequency of all physical activities was significantly associated with higher radius trabecular BMD (R2 = 0.38; β = 0.96; p = 0.050), higher radius trabecular number (R2 = 0.31; β = 0.01; p = 0.026), lower tibia and radius trabecular separation (tibia: R2 = 0.30; β = -0.003; p = 0.038; radius: R2 = 0.35; β = -0.003; p = 0.021), and higher radius bone stiffness (R2 = 0.45; β = 0.38; p = 0.047). Higher frequency of bone loading physical activities was significantly associated with higher tibia trabecular density (R2 = 0.44; β = 4.06; p = 0.036), higher tibia bone stiffness (R2 = 0.46; β = 3.06; p = 0.050), and higher tibia estimated failure load (R2 = 0.46; β = 0.17; p = 0.049). TDF used in combination with a PI was associated with lower radius trabecular BMD (R2 = 0.39; β = -41.2; p = 0.042), lower radius trabecular number (R2 = 0.34; β = -0.44; p = 0.009) and greater radius trabecular separation (R2 = 0.42; β = 0.16; p = 0.002), while TDF use without a PI was not associated with reduced bone quality. CONCLUSIONS In adults with HIV infection, malnutrition is associated with poor cortical bone quality, while reduced frequency of physical activities and specifically reduced frequency of mechanical loading activities are associated with deficient trabecular bone structure and reduced estimates of bone strength. TDF use in combination with a PI is associated with deleterious effects on trabecular bone structure.
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Affiliation(s)
- Sarah C Foreman
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA; Department of Radiology, Technical University of Munich, Germany
| | - Po Hung Wu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA
| | - Ruby Kuang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA
| | - Malcolm D John
- Department of Medicine, University of California, San Francisco, 4150 Clement St, Rm 111W, San Francisco, CA 94121, USA
| | - Phyllis C Tien
- Department of Medicine, University of California, San Francisco, 4150 Clement St, Rm 111W, San Francisco, CA 94121, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA
| | - Galateia J Kazakia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107, USA.
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13
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Langsetmo L, Burghardt AJ, Schousboe JT, Cawthon PM, Cauley JA, Lane NE, Orwoll ES, Ensrud KE. Objective measures of moderate to vigorous physical activity are associated with higher distal limb bone strength among elderly men. Bone 2020; 132:115198. [PMID: 31866494 PMCID: PMC6993955 DOI: 10.1016/j.bone.2019.115198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 11/25/2022]
Abstract
Our aim was to determine the association between objectively measured physical activity (PA) and bone strength of the distal limbs among older men. We studied 994 men from the MrOS cohort study (mean age 83.9) who had repeat (Year 7 and 14) 5-day activity assessment with at least 90% wear time (SenseWearPro3 Armband) and Year 14 measures using high resolution peripheral quantitative tomography (HR-pQCT) (Scanco). Total energy expenditure (TEE), total steps per day, peak cadence (mean of top 30 steps/min over 24 h) and time spent in a given level of activity: sedentary (reference, <1.5 metabolic equivalents of task [METs]), light (1.5 to <3 METs), or moderate to vigorous physical activity(MVPA: ≥3 METs) were calculated as mean over the two time points. Estimated failure load was determined from HR-pQCT data using finite element analysis. We used standardized variables and adjusted for potential confounders using linear regression. The means ±SDs for daily activity were: 2338 ± 356 kcal/d [TEE]; 5739 ± 2696 steps/day [step count], 60 ± 20 cpm [peak cadence], 67 ± 28 min/d [light activity], and 85 ± 52 min/d [MVPA]. Higher TEE, step count, and peak cadence were each associated with higher failure load of the distal radius (effect sizes respectively: 0.13 [95% CI: 0.05, 0.20], 0.11 [95% CI: 0.04, 0.18], and 0.08 [95% CI: 0.01, 0.15]) and higher failure load of the distal tibia (effect sizes respectively 0.21 [95% CI: 0.13, 0.28], 0.19 [95% CI: 0.13, 0.26], 0.19 [95% CI, 0.13, 0.25]). Time spent in MVPA vs. time sedentary was related to bone strength at both sites after adjustment, whereas time spent in light activity vs. time sedentary was not. TEE was associated with compartmental area and BMD parameters at distal tibia, but only area parameters at the distal radius. In summary, MVPA over a 7-year period of time may have a modest association with bone strength and geometry among older men.
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Affiliation(s)
- Lisa Langsetmo
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, United States of America.
| | - Andrew J Burghardt
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States of America
| | - John T Schousboe
- HealthPartners Institute, Bloomington, MN, United States of America; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States of America
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Nancy E Lane
- Department of Internal Medicine, University of California, Davis, CA, United States of America
| | - Eric S Orwoll
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, United States of America
| | - Kristine E Ensrud
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, United States of America; Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America; Center for Care Delivery & Outcomes Research, VA Health Care System, Minneapolis, MN, United States of America
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Pagnotti GM, Styner M, Uzer G, Patel VS, Wright LE, Ness KK, Guise TA, Rubin J, Rubin CT. Combating osteoporosis and obesity with exercise: leveraging cell mechanosensitivity. Nat Rev Endocrinol 2019; 15:339-355. [PMID: 30814687 PMCID: PMC6520125 DOI: 10.1038/s41574-019-0170-1] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis, a condition of skeletal decline that undermines quality of life, is treated with pharmacological interventions that are associated with poor adherence and adverse effects. Complicating efforts to improve clinical outcomes, the incidence of obesity is increasing, predisposing the population to a range of musculoskeletal complications and metabolic disorders. Pharmacological management of obesity has yet to deliver notable reductions in weight and debilitating complications are rarely avoided. By contrast, exercise shows promise as a non-invasive and non-pharmacological method of regulating both osteoporosis and obesity. The principal components of exercise - mechanical signals - promote bone and muscle anabolism while limiting formation and expansion of fat mass. Mechanical regulation of bone and marrow fat might be achieved by regulating functions of differentiated cells in the skeletal tissue while biasing lineage selection of their common progenitors - mesenchymal stem cells. An inverse relationship between adipocyte versus osteoblast fate selection from stem cells is implicated in clinical conditions such as childhood obesity and increased marrow adiposity in type 2 diabetes mellitus, as well as contributing to skeletal frailty. Understanding how exercise-induced mechanical signals can be used to improve bone quality while decreasing fat mass and metabolic dysfunction should lead to new strategies to treat chronic diseases such as osteoporosis and obesity.
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Affiliation(s)
- Gabriel M Pagnotti
- School of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
| | - Maya Styner
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Gunes Uzer
- College of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, USA
| | - Vihitaben S Patel
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Laura E Wright
- School of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Theresa A Guise
- School of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
| | - Janet Rubin
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Clinton T Rubin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.
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MODARRESS-SADEGHI MAHSA, OURA PETTERI, JUNNO JUHOANTTI, NIEMELÄ MAISA, NIINIMÄKI JAAKKO, JÄMSÄ TIMO, KORPELAINEN RAIJA, KARPPINEN JARO. Objectively Measured Physical Activity Is Associated with Vertebral Size in Midlife. Med Sci Sports Exerc 2019; 51:1606-1612. [DOI: 10.1249/mss.0000000000001962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Morse LR, Troy KL, Fang Y, Nguyen N, Battaglino R, Goldstein RF, Gupta R, Taylor JA. Combination Therapy With Zoledronic Acid and FES-Row Training Mitigates Bone Loss in Paralyzed Legs: Results of a Randomized Comparative Clinical Trial. JBMR Plus 2019; 3:e10167. [PMID: 31131346 PMCID: PMC6524678 DOI: 10.1002/jbm4.10167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 12/11/2022] Open
Abstract
Spinal cord injury (SCI) results in rapid, severe osteoporosis and an increased risk of lower extremity fractures. Despite the medical complications associated with these fractures, there is no standard of care to prevent osteoporotic fractures following SCI. Functional electrical stimulation- (FES-) assisted rowing is a promising intervention to improve bone health in SCI because of its ability to generate a muscular contraction in conjunction with mechanical loading of the lower extremity long bones. Combination therapy consisting of FES-rowing plus zoledronic acid (ZA) may be a superior treatment via inhibition of bone resorption and stimulation of new bone formation. We studied participants enrolled in a randomized clinical trial comparing FES-rowing alone with FES-rowing plus ZA to improve bone health in SCI. Volumetric CT scans at the distal femur and proximal tibial metaphyses were performed. Bone geometric properties (cortical thickness index [CTI], cortical compressive strength index [CSI], buckling ratio [BR], bending strength index) and mineral (cortical bone volume [CBV], cortical bone mineral density, cortical bone mineral content) indices were determined. In models adjusting for baseline values, we found that the CBV (p = 0.05 to 0.006), the CTI (p = 0.009), and the BR (p = 0.001) at both the distal femoral and proximal tibial metaphyses were greater in the ZA plus rowing group compared with the rowing-only group. Similarly, there was a significant positive association between the total rowing work completed and the BR at the proximal tibia (p = 0.05). A subgroup analysis of the rowing-only arm showed that gains in the CSI at the tibial metaphysis varied in a dose-dependent fashion based on the total amount of exercise performed (p = 0.009). These findings demonstrate that the osteogenic response to FES-rowing is dose-dependent. Combination therapy with ZA and FES-row training has therapeutic potential to improve bone quality, and perhaps reduce fracture risk at the most common fracture site following SCI. © 2019 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
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Affiliation(s)
- L R Morse
- Rocky Mountain Regional Spinal Injury System Craig Rehabilitation Hospital Englewood CO USA.,Department of PMR University of Colorado School of Medicine Aurora CO USA
| | - K L Troy
- Department of Biomedical Engineering Worcester Polytechnic Institute Worcester MA USA
| | - Y Fang
- Department of Biomedical Engineering Worcester Polytechnic Institute Worcester MA USA
| | - N Nguyen
- Rocky Mountain Regional Spinal Injury System Craig Rehabilitation Hospital Englewood CO USA
| | - R Battaglino
- Department of PMR University of Colorado School of Medicine Aurora CO USA
| | - R F Goldstein
- Rocky Mountain Regional Spinal Injury System Craig Rehabilitation Hospital Englewood CO USA
| | - R Gupta
- Department of Radiology Massachusetts General Hospital Boston MA USA
| | - J A Taylor
- Spaulding Rehabilitation Hospital Boston MA USA.,Department of Physical Medicine and Rehabilitation Harvard Medical School Boston MA USA
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17
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Muthuri SG, Ward KA, Kuh D, Elhakeem A, Adams JE, Cooper R. Physical Activity Across Adulthood and Bone Health in Later Life: The 1946 British Birth Cohort. J Bone Miner Res 2019; 34:252-261. [PMID: 30347128 PMCID: PMC6392181 DOI: 10.1002/jbmr.3607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/11/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022]
Abstract
Leisure-time physical activity (LTPA) is widely recommended for the prevention of osteoporosis and fractures in older populations. However, whether the beneficial effects of LTPA on bone accumulate across life and are maintained even after reduction or cessation of regular PA in later life is unknown. We examined whether LTPA across adulthood was cumulatively associated with volumetric and areal bone mineral density (vBMD, aBMD) at ages 60 to 64 and whether associations were mediated by lean mass. Up to 1498 participants from the Medical Research Council National Survey of Health and Development were included in analyses. LTPA was self-reported at ages 36, 43, 53, and 60 to 64, and responses summed to generate a cumulative score (range 0 = inactive at all four ages to 8 = most active at all four ages). Total and trabecular vBMD were measured at the distal radius using pQCT and aBMD at the total hip and lumbar spine (L1 to L4) using DXA. Linear regression was used to test associations of the cumulative LTPA score with each bone outcome. After adjustment for height and weight, a 1-unit increase in LTPA score (95% CI) in men was associated with differences of 1.55% (0.78% to 2.31%) in radial trabecular vBMD, 0.83% (0.41% to 1.25%) in total hip aBMD, and 0.97% (0.44% to 1.49%) in spine aBMD. Among women, positive associations were seen for radial trabecular vBMD and total hip aBMD, but only among those of greater weight (LTPA × weight interaction p ≤ 0.01). In men, there was evidence to suggest that lean mass index may partly mediate these associations. These findings suggest that there are cumulative benefits of LTPA across adulthood on BMD in early old age, especially among men. The finding of weaker associations among women suggests that promotion of specifıc types of LTPA may be needed to benefit bone health in women. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
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Affiliation(s)
| | - Kate A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, UK
| | - Judith E Adams
- Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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18
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Larsson BAM, Sundh D, Mellström D, Axelsson KF, Nilsson AG, Lorentzon M. Association Between Cortical Bone Microstructure and Statin Use in Older Women. J Clin Endocrinol Metab 2019; 104:250-257. [PMID: 30423123 DOI: 10.1210/jc.2018-02054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 11/08/2018] [Indexed: 12/19/2022]
Abstract
CONTEXT Treatment with statins has been associated with increased bone mineral density, but whether this association depends on differences in cortical or trabecular volumetric bone microstructure is unknown. OBJECTIVE The aim of this study was to investigate if treatment with statins is associated with bone microstructure and geometry in older women. DESIGN SETTING AND PARTICIPANTS Older women were included in a population-based study of 3028 women (mean age ± SD, 77.8 ± 1.6 years) from the greater Gothenburg area in Sweden. Information regarding medical history, medication, and lifestyle factors was obtained from validated questionnaires. MAIN OUTCOME Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography. RESULTS The 803 women in the cohort who used statins had higher body weight, worse physical function, and more frequent cardiovascular disease and diabetes than nonusers (P < 0.05). Statin users had lower cortical porosity (radius, 2.2 ± 1.9 vs 2.5 ± 2.0%; tibia, 5.2 ± 2.4 vs 5.4 ± 2.5; P = 0.01), higher cortical bone density (radius, 1008 ± 39.1 vs 1001 ± 38.4 mg/cm3; tibia, 919 ± 42.6 vs 914 ± 41.5; P < 0.01), and greater cortical area (radius, 60.5 ± 9.6 vs 58.6 ± 9.7 mm2; tibia, 150.0 ± 23.6 vs 146.7 ± 23.8; P < 0.01) than nonusers after adjustment for a large number of confounders, including age, weight, smoking, other medications, and prevalent diseases. CONCLUSIONS Use of statins was associated with better cortical bone characteristics in older women.
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Affiliation(s)
- Berit A M Larsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg Gothenburg, Sweden
| | - Daniel Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg Gothenburg, Sweden
| | - Dan Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital, Mölndal Mölndal, Sweden
| | - Kristian F Axelsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg Gothenburg, Sweden
- Department of Orthopaedic Surgery, Skaraborg Hospital, Göteborg Skövde, Sweden
| | - Anna G Nilsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg Gothenburg, Sweden
- Department of Endocrinology, Sahlgrenska University Hospital, Göteborg Gothenburg, Sweden
| | - Mattias Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital, Mölndal Mölndal, Sweden
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19
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Lionikaite V, Henning P, Drevinge C, Shah FA, Palmquist A, Wikström P, Windahl SH, Lerner UH. Vitamin A decreases the anabolic bone response to mechanical loading by suppressing bone formation. FASEB J 2019; 33:5237-5247. [PMID: 30668919 PMCID: PMC6436664 DOI: 10.1096/fj.201802040r] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Increased vitamin A consumption is associated with decreased cortical bone mass and increased fracture risk in humans. Rodent studies have demonstrated that hypervitaminosis A increases cortical bone resorption, whereas the importance of the effects on bone formation is less well defined. We used an experimental model of increased bone formation by loading of the tibiae to investigate the effect of vitamin A on bone formation. Control [retinol activity equivalents (RAE) 4.5 µg/g chow] or vitamin A (RAE 60 µg/g chow) diets were given to female C57BL/6N mice for 4 wk, after which the tibiae were subjected to axial loading on alternate days for 2 wk, while the diets were continued. Vitamin A inhibited the loading-induced increase in trabecular and cortical bone volume. This was attributed to inhibition of loading-induced increase in osteoblast number and activity, and expression of osteoblastic genes Sp7, Alpl, and Col1a1 in cortical bone. Vitamin A, loading, and combination thereof also resulted in site-specific effects on bone composition measured by Raman spectroscopy. In summary, a clinically relevant dose of vitamin A suppresses the loading-induced gain of bone mass by decreasing bone formation. These observations may have implications for regulation of bone mass caused by physical activity and the risk of osteoporosis in humans.-Lionikaite, V., Henning, P., Drevinge, C., Shah, F. A., Palmquist, A., Wikström, P., Windahl, S. H., Lerner, U. H. Vitamin A decreases the anabolic bone response to mechanical loading by suppressing bone formation.
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Affiliation(s)
- Vikte Lionikaite
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Petra Henning
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christina Drevinge
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Furqan A Shah
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; and
| | - Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; and
| | - Pernilla Wikström
- Department of Medical Bioscience, Pathology, Umeå University, Umeå, Sweden
| | - Sara H Windahl
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ulf H Lerner
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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20
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Larsson B, Mellström D, Johansson L, Nilsson AG, Lorentzon M, Sundh D. Normal Bone Microstructure and Density But Worse Physical Function in Older Women Treated with Selective Serotonin Reuptake Inhibitors, a Cross-Sectional Population-Based Study. Calcif Tissue Int 2018; 103:278-288. [PMID: 29730704 PMCID: PMC6105159 DOI: 10.1007/s00223-018-0427-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/28/2018] [Indexed: 01/27/2023]
Abstract
Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women. From an ongoing population-based study, 1057 women (77.7 ± 1.5 years) were included. Validated questionnaires were used to assess information regarding medical history, medications, smoking, mental and physical health, and physical activity. Physical function was measured using clinically used tests: timed up and go, walking speed, grip strength, chair stand test, and one leg standing. Bone mineral density (BMD) was measured at the hip and spine with dual-energy X-ray absorptiometry (Hologic Discovery A). Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT). Treatment with SSRIs was associated with higher BMD at the femoral neck, total hip, and lumbar spine, whereas no associations were found for any HR-pQCT-derived measurements. The use of SSRIs was associated with lower grip strength, walking speed, and fewer chair stand rises. These associations were valid also after adjustments for known risk factors for falls. Treatment with SSRIs was, independently of covariates, associated with worse physical function without any signs of inferior bone geometry and microstructure.
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Affiliation(s)
- Berit Larsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Dan Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital, Building K, 6th floor, 431 80, Mölndal, Sweden
| | - Lisa Johansson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna G Nilsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital, Building K, 6th floor, 431 80, Mölndal, Sweden
| | - Daniel Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
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21
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Biver E, Durosier-Izart C, Merminod F, Chevalley T, van Rietbergen B, Ferrari SL, Rizzoli R. Fermented dairy products consumption is associated with attenuated cortical bone loss independently of total calcium, protein, and energy intakes in healthy postmenopausal women. Osteoporos Int 2018; 29:1771-1782. [PMID: 29725715 DOI: 10.1007/s00198-018-4535-4] [Citation(s) in RCA: 31] [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: 12/13/2017] [Accepted: 04/13/2018] [Indexed: 02/07/2023]
Abstract
UNLABELLED A longitudinal analysis of bone microstructure in postmenopausal women of the Geneva Retirees Cohort indicates that age-related cortical bone loss is attenuated at non-bearing bone sites in fermented dairy products consumers, not in milk or ripened cheese consumers, independently of total energy, calcium, or protein intakes. INTRODUCTION Fermented dairy products (FDP), including yogurts, provide calcium, phosphorus, and proteins together with prebiotics and probiotics, all being potentially beneficial for bone. In this prospective cohort study, we investigated whether FDP, milk, or ripened cheese consumptions influence age-related changes of bone mineral density (BMD) and microstructure. METHODS Dietary intakes were assessed at baseline and after 3.0 ± 0.5 years with a food frequency questionnaire in 482 postmenopausal women enrolled in the Geneva Retirees Cohort. Cortical (Ct) and trabecular (Tb) volumetric (v) BMD and microstructure at the distal radius and tibia were assessed by high-resolution peripheral quantitative computerized tomography, in addition to areal (a) BMD and body composition by dual-energy X-ray absorptiometry, at the same time points. RESULTS At baseline, FDP consumers had lower abdominal fat mass and larger bone size at the radius and tibia. Parathyroid hormone and β-carboxyterminal cross-linked telopeptide of type I collagen levels were inversely correlated with FDP consumption. In the longitudinal analysis, FDP consumption (mean of the two assessments) was associated with attenuated loss of radius total vBMD and of Ct vBMD, area, and thickness. There was no difference in aBMD and at the tibia. These associations were independent of total energy, calcium, or protein intakes. For other dairy products categories, only milk consumption was associated with lower decrease of aBMD and of failure load at the radius. CONCLUSION In this prospective cohort of healthy postmenopausal women, age-related Ct bone loss was attenuated at non-bearing bone sites in FDP consumers, not in milk or ripened cheese consumers, independently of total energy, calcium, or protein intakes. STUDY REGISTRATION ISRCTN11865958 ( http://www.isrctn.com ).
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Affiliation(s)
- E Biver
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.
| | - C Durosier-Izart
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
| | - F Merminod
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
| | - T Chevalley
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
| | - B van Rietbergen
- Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB, Eindhoven, The Netherlands
| | - S L Ferrari
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
| | - R Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
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22
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Nakamura M, Inaba M, Yamada S, Ozaki E, Maruo S, Okuno S, Imanishi Y, Kuriyama N, Watanabe Y, Emoto M, Motoyama K. Association of Decreased Handgrip Strength with Reduced Cortical Thickness in Japanese Female Patients with Type 2 Diabetes Mellitus. Sci Rep 2018; 8:10767. [PMID: 30018407 PMCID: PMC6050319 DOI: 10.1038/s41598-018-29061-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 06/29/2018] [Indexed: 12/25/2022] Open
Abstract
LD-100, a quantitative ultrasonic device, allows us to measure cortical thickness (CoTh). Patients with type 2 diabetes mellitus (T2DM) show high prevalence of sarcopenia. This study aimed to clarify the association of handgrip strength (HGS) with cortical porosis, a major risk for fracture of DM. CoTh and trabecular bone mineral density (TrBMD) at the 5.5% distal radius were assessed in T2DM female patients (n = 122) and non-DM female controls (n = 704) by LD-100. T2DM patients aged older 40 years showed significantly lower HGS and CoTh, but not TrBMD, than non-DM counterparts. Although HGS was significantly and positively correlated with CoTh and TrBMD in T2DM patients, multivariate analysis revealed HGS as an independent factor positively associated with CoTh, but not TrBMD, in T2DM patients, suggesting the preferential association of HGS with cortical, but not trabecular, bone component in T2DM female patients. In conclusion, the present study demonstrated an early decline of HGS in T2DM female patients as compared with non-DM healthy controls after the age of 40 years, which is independently associated with thinner CoTh, but not TrBMD in T2DM patients, and thus suggested that reduced muscle strength associated with DM might be a major factor for cortical porosis development in DM patients.
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Affiliation(s)
- Miyuki Nakamura
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Shinsuke Yamada
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Saori Maruo
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Senji Okuno
- Department of Nephrology, Shirasagi Hosiptal, Osaka, Japan
| | - Yasuo Imanishi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Koka Motoyama
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
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23
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Sundh D, Nilsson M, Zoulakis M, Pasco C, Yilmaz M, Kazakia GJ, Hellgren M, Lorentzon M. High-Impact Mechanical Loading Increases Bone Material Strength in Postmenopausal Women-A 3-Month Intervention Study. J Bone Miner Res 2018; 33:1242-1251. [PMID: 29578618 PMCID: PMC6055617 DOI: 10.1002/jbmr.3431] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/13/2018] [Accepted: 03/19/2018] [Indexed: 01/23/2023]
Abstract
Bone adapts to loading in several ways, including redistributing bone mass and altered geometry and microarchitecture. Because of previous methodological limitations, it is not known how the bone material strength is affected by mechanical loading in humans. The aim of this study was to investigate the effect of a 3-month unilateral high-impact exercise program on bone material properties and microarchitecture in healthy postmenopausal women. A total of 20 healthy and inactive postmenopausal women (aged 55.6 ± 2.3 years [mean ± SD]) were included and asked to perform an exercise program of daily one-legged jumps (with incremental number, from 3×10 to 4×20 jumps/d) during 3 months. All participants were asked to register their performed jumps in a structured daily diary. The participants chose one leg as the intervention leg and the other leg was used as control. The operators were blinded to the participant's choice of leg for intervention. The predefined primary outcome was change in bone material strength index (BMSi), measured at the mid tibia with a handheld reference probe indentation instrument (OsteoProbe). Bone microstructure, geometry, and density were measured with high-resolution peripheral quantitative computed tomography (XtremeCT) at the ultradistal and at 14% of the tibia bone length (distal). Differences were analyzed by related samples Wilcoxon signed rank test. The overall compliance to the jumping program was 93.6%. Relative to the control leg, BMSi of the intervention leg increased 7% or 0.89 SD (p = 0.046), but no differences were found for any of the XtremeCT-derived bone parameters. In conclusion, a unilateral high-impact loading program increased BMSi in postmenopausal women rapidly without affecting bone microstructure, geometry, or density, indicating that intense mechanical loading has the ability to rapidly improve bone material properties before changes in bone mass or structure. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.
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Affiliation(s)
- Daniel Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Martin Nilsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,City District Administration of Örgryte-Härlanda, Gothenburg, Sweden
| | - Michail Zoulakis
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Courtney Pasco
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Melis Yilmaz
- Department of Molecular and Cell Biology, University of California, Berkeley, CA, USA
| | - Galateia J Kazakia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Martin Hellgren
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
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24
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Cárdenas Fuentes G, Bawaked RA, Martínez González MÁ, Corella D, Subirana Cachinero I, Salas-Salvadó J, Estruch R, Serra-Majem L, Ros E, Lapetra Peralta J, Fiol M, Rekondo J, Gómez-Gracia E, Tur Marí JA, Pinto Sala X, Babio N, Ortega C, Martínez JA, Schröder H. Association of physical activity with body mass index, waist circumference and incidence of obesity in older adults. Eur J Public Health 2018; 28:944-950. [PMID: 29554269 DOI: 10.1093/eurpub/cky030] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Gabriela Cárdenas Fuentes
- Cardiovascular Risk and Nutrition Research Group (CARIN), Epidemiology and Public Health Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Programme in Biomedicine, Department of Experimental and Health Sciences, Universidad Pompeu Fabra, Barcelona, Spain
| | - Rowaedh Ahmed Bawaked
- Cardiovascular Risk and Nutrition Research Group (CARIN), Epidemiology and Public Health Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Programme in Biomedicine, Department of Experimental and Health Sciences, Universidad Pompeu Fabra, Barcelona, Spain
| | - Miguel Ángel Martínez González
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine and IdiSNA (Institute for Health Research), University of Navarra, Pamplona, Spain
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dolores Corella
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Epidemiology, Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
| | - Isaac Subirana Cachinero
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular Epidemiology and Genetics Research Group, Epidemiology and Public Health Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), Madrid, Spain
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, Reus, Spain
| | - Ramón Estruch
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), Madrid, Spain
- Department of Internal Medicine, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Lluis Serra-Majem
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Food Sciences and Gastronomy, University of Barcelona, Barcelona, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Emilio Ros
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - José Lapetra Peralta
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud San Pablo, Sevilla, Spain
| | - Miguel Fiol
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain
| | - Javier Rekondo
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, University Hospital Araba, Vitoria, Spain
| | - Enrique Gómez-Gracia
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), Madrid, Spain
- Department of Preventive Medicine, University of Malaga, Malaga, Spain
| | - Josep Antoni Tur Marí
- Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears & CIBERobn, Palma de Mallorca, Spain
| | - Xavier Pinto Sala
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), Madrid, Spain
- Lipids and Vascular Risk Units, Internal Medicine, University Hospital of Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Nancy Babio
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, Reus, Spain
| | - Carolina Ortega
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Epidemiology, Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
| | - José Alfredo Martínez
- CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition and Food Sciences, Physiology and Toxicology, University of Navarra, Pamplona, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), Epidemiology and Public Health Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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