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Denova-Gutiérrez E, Clark P, Capozza RF, Nocciolino LM, Ferretti JL, Velázquez-Cruz R, Rivera B, Cointry GR, Salmerón J. Differences in the relation between bone mineral content and lean body mass according to gender and reproductive status by age ranges. J Bone Miner Metab 2019; 37:749-758. [PMID: 30515578 DOI: 10.1007/s00774-018-0978-0] [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: 07/04/2018] [Accepted: 11/12/2018] [Indexed: 10/27/2022]
Abstract
The present study aims: (1) to explore the influence of lean mass (LM) on bone mineral content (BMC), (2) to investigate the pubertal influences on the BMC-LM relation, and (3) to perform Z-score charts of BMC-LM relation, stratified by gender and reproductive status categorized by age ranges. A cross-sectional analysis was conducted using 4001 healthy subjects between 7 and 90 years participating in the Health Workers Cohort Study. Of these, 720 participants were ≤ 19 years, 2417 were women ≥ 20 years, and 864 were men ≥ 20 years. Using Dual X-ray absorptiometry (DXA), we measured BMC and LM. Participants' pubertal development was assessed according to Tanner's stage scale. To describe BMC-LM relation, simple correlation coefficients were computed. To produce best-fit equations, an ANOVA test was conducted. Z-score graphs for the BMC-LM relation were obtained. In general, the BMC-LM correlations were linear and highly significant. For boys, curves were virtually parallel, with similar intercepts and a progressive displacement of values toward the upper-right region of the graph, for each Tanner subgroup. For girls, curves for Tanner 1-2 and 4-5 stages were parallel; but, in girls Tanner 4-5, the intercepts were significantly higher by about +300-400 g of BMC (P < 0.001). For postmenopausal women, the curve was parallel to that for the premenopausal but showed a lower intercept (P < 0.001). We provide DXA reference data on a well-characterized cohort of 4001 healthy subjects. These reference curves provide a reference value for the assessment and monitoring of bone health in all age groups included in the present study.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Patricia Clark
- Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Laura Marcela Nocciolino
- Centro de Estudios de Metabolismo Fosfocálcico, Universidad Nacional de Rosario, Rosario, Argentina
| | - Jose Luis Ferretti
- Centro de Estudios de Metabolismo Fosfocálcico, Universidad Nacional de Rosario, Rosario, Argentina
| | - Rafael Velázquez-Cruz
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Berenice Rivera
- Unidad Académica en Investigación Epidemiológica, Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Gustavo Roberto Cointry
- Centro de Estudios de Metabolismo Fosfocálcico, Universidad Nacional de Rosario, Rosario, Argentina.
| | - Jorge Salmerón
- Unidad Académica en Investigación Epidemiológica, Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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Duran I, Martakis K, Bossier C, Stark C, Rehberg M, Semler O, Schoenau E. Interaction of body fat percentage and height with appendicular functional muscle-bone unit. Arch Osteoporos 2019; 14:65. [PMID: 31222628 DOI: 10.1007/s11657-019-0610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/22/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The interaction of body fat percentage and height with appendicular BMC for LBM was analyzed. Only body fat had significant negative correlation with the appendicular BMC for LBM. PURPOSE/INTRODUCTION For the clinical evaluation of the functional muscle-bone unit, it was proposed to evaluate the adaptation of the bone to the acting forces. A frequently used parameter for this is the total body less head bone mineral content (TBLH-BMC) determined by dual-energy X-ray absorptiometry (DXA) in relation to the total body lean body mass (LBM). Body fat percentage seemed to correlate negatively and height positively with TBLH-BMC for LBM. It was supposed that appendicular BMC for LBM is a more accurate surrogate for the functional muscle-bone unit since appendicular LBM does not incorporate the mass of internal organs. The aim of this study was to analyze the interaction of body fat percentage and height with appendicular BMC for LBM. METHODS As part of the National Health and Nutrition Examination Survey (NHANES) study, between the years 1999 and 2004, whole-body DXA scans on randomly selected Americans from 8 years of age were carried out. From all eligible DXA scans, three major US ethnic groups were evaluated (non-Hispanic Whites, non-Hispanic Blacks, and Mexican Americans) for further statistical analysis. RESULTS For the statistical analysis, the DXA scans of 8190 non-Hispanic White children and adults (3903 female), of 4931 non-Hispanic Black children and adults (2250 female), and 5421 of Mexican American children and adults (2424 female) were eligible. Only body fat had a significant negative correlation with the appendicular BMC for LBM. CONCLUSIONS Only body fat had significant negative correlation with appendicular BMC for LBM, and thus, should be addressed when evaluating functional muscle-bone unit.
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Affiliation(s)
- Ibrahim Duran
- Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.
| | - K Martakis
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany.,Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - C Bossier
- Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
| | - C Stark
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany.,Cologne Centre for Musculoskeletal Biomechanics, University of Cologne, Cologne, Germany
| | - M Rehberg
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany
| | - O Semler
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany.,Center for Rare Skeletal Diseases in Childhood, Medical Faculty and University Hospital, Cologne, Germany
| | - E Schoenau
- Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.,Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany
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Duran I, Martakis K, Hamacher S, Stark C, Semler O, Schoenau E. Are there effects of age, gender, height, and body fat on the functional muscle-bone unit in children and adults? Osteoporos Int 2018; 29:1069-1079. [PMID: 29455248 DOI: 10.1007/s00198-018-4401-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/17/2018] [Indexed: 01/20/2023]
Abstract
UNLABELLED The aim was to describe the effect of age, gender, height, different stages of human life, and body fat on the functional muscle-bone unit. All these factors had a significant effect on the functional muscle-bone unit and should be addressed when assessing functional muscle-bone unit in children and adults. INTRODUCTION For the clinical evaluation of the functional muscle-bone unit, it was proposed to evaluate the adaptation of the bone to the acting forces. A frequently used parameter for this is the total body less head bone mineral content (TBLH-BMC) determined by dual-energy X-ray absorptiometry (DXA) in relation to the lean body mass (LBM by DXA). LBM correlates highly with muscle mass. Therefore, LBM is a surrogate parameter for the muscular forces acting in everyday life. The aim of the study was to describe the effect of age and gender on the TBLH-BMC for LBM and to evaluate the impact of other factors, such as height, different stages of human life, and of body fat. METHODS As part of the National Health and Nutrition Examination Survey (NHANES) study, between the years 1999-2006 whole-body DXA scans on randomly selected Americans from 8 years of age were carried out. From all eligible DXA scans (1999-2004), three major US ethnic groups were evaluated (non-Hispanic Whites, non-Hispanic Blacks, and Mexican Americans) for further statistical analysis. RESULTS For the statistical analysis, the DXA scans of 8190 non-Hispanic White children and adults (3903 female), of 4931 non-Hispanic Black children and adults (2250 female) and 5421 of Mexican-American children and adults (2424 female) were eligible. Age, gender, body height, and especially body fat had a significant effect on the functional muscle-bone unit. CONCLUSIONS When assessing TBLH-BMC for LBM in children and adults, the effects of age, gender, body fat, and body height should be addressed. These effects were analyzed for the first time in such a large cohort.
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Affiliation(s)
- I Duran
- Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.
| | - K Martakis
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - S Hamacher
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - C Stark
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
- Cologne Centre for Musculoskeletal Biomechanics, University of Cologne, Cologne, Germany
| | - O Semler
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
- Center for Rare Skeletal Diseases in Childhood, University of Cologne, Cologne, Germany
| | - E Schoenau
- Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
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Lifshitz F, Hecht JP, Bermúdez EF, Gamba CA, Reinoso JM, Casavalle PL, Friedman SM, Rodriguez PN. Body composition analysis by dual-energy X-ray absorptiometry in young preschool children. Eur J Clin Nutr 2016; 70:1203-1209. [DOI: 10.1038/ejcn.2016.38] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 02/03/2016] [Accepted: 02/09/2016] [Indexed: 02/06/2023]
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Võsoberg K, Tillmann V, Tamm AL, Jürimäe T, Maasalu K, Jürimäe J. Adipocytokine and ghrelin levels in relation to bone mineral density in prepubertal rhythmic gymnasts entering puberty: a 3-year follow-up study. Eur J Appl Physiol 2016; 116:831-9. [PMID: 26879077 DOI: 10.1007/s00421-016-3338-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/01/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate changes in bone mineral density (BMD) in rhythmic gymnasts (RG) entering puberty and their age-matched untrained controls (UC) over the 36-month period, and associations with leptin, adiponectin and ghrelin over this period. METHODS Whole body (WB), lumbar spine (LS) and femoral neck (FN) BMD, WB bone mineral content (BMC), and leptin, adiponectin and ghrelin were measured in 35 RG and 33 UC girls at baseline and at 12-month intervals over the next 3 years. The change over the 36 months was calculated (∆ score). RESULTS The pubertal development over the next 36 months was slower in RG compard to UC, while there was no difference in bone age development between the groups. BMD at all sites was higher in RG in comparison with UC at every measurement point. ∆LS BMD and ∆FN BMD, but not ∆WB BMD and ∆WB BMC, were higher in RG compared with UC. None of the measured hormones at baseline or their ∆ scores correlated with ∆BMD and ∆BMC in RG. Baseline fat free mass correlated with ∆WB BMD and ∆WB BMC in RG, while baseline leptin was related to ∆WB BMC, ∆WB BMD and ∆LS BMD in UC. CONCLUSIONS Measured baseline hormones and their ∆ scores did not correlate with increases in bone mineral values in RG entering puberty. Although the pubertal development in RG was slower than in UC, high-intensity training appeared to increase BMD growth and counterbalance negative effects of slow pubertal develpment, lower fat mass and leptin in RG.
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Affiliation(s)
- Kristel Võsoberg
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 18. Ülikooli St., 50090, Tartu, Estonia
| | - Vallo Tillmann
- Department of Pediatrics, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | | | - Toivo Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 18. Ülikooli St., 50090, Tartu, Estonia
| | - Katre Maasalu
- Clinics of Traumatology and Orthopaedics, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 18. Ülikooli St., 50090, Tartu, Estonia.
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Abstract
Muscle can be assessed by imaging techniques according to its size (as thickness, area, volume, or alternatively, as a mass) and architecture (fiber length and pennation angle), with values used as an anthropometric measure or a surrogate for force production. Similarly, the size of the bone (as area or volume) can be imaged using MRI or pQCT, although typically bone mineral mass is reported. Bone imaging measures of mineral density, size, and geometry can also be combined to calculate bone's structural strength-measures being highly predictive of bone's failure load ex vivo. Imaging of muscle-bone relationships can, hence, be accomplished through a number of approaches by adoption and comparison of these different muscle and bone parameters, dependent on the research question under investigation. These approaches have revealed evidence of direct, mechanical muscle-bone interactions independent of allometric associations. They have led to important information on bone mechanoadaptation and the influence of muscular action on bone, in addition to influences of age, gender, exercise, and disuse on muscle-bone relationships. Such analyses have also produced promising diagnostic tools for clinical use, such as identification of primary, disuse-induced, and secondary osteoporosis and estimation of bone safety factors. Standardization of muscle-bone imaging methods is required to permit more reliable comparisons between studies and differing imaging modes, and in particular to aid adoption of these methods into widespread clinical practice.
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Affiliation(s)
- Alex Ireland
- Cognitive Motor Function Research Group, Manchester Metropolitan University, Manchester, England
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Feldman S, Capozza RF, Mortarino PA, Reina PS, Ferretti JL, Rittweger J, Cointry GR. Site and sex effects on tibia structure in distance runners and untrained people. Med Sci Sports Exerc 2013; 44:1580-8. [PMID: 22330024 DOI: 10.1249/mss.0b013e31824e10b6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose was to study the relationship between mechanical environment and bone structure by comparing the tibia in people with different physical activities. MATERIALS AND METHODS Indicators of bone mass (bone mineral content), bone material "quality" (cortical volumetric mineral density (vBMD)), and diaphyseal design (endocortical and periosteal perimeters (EcPm and PoPm, respectively), cortical thickness (CtTh), circularity, and bending and torsion cross-sectional moments of inertia (CSMIs)) were determined in serial peripheral quantitative computed tomography scans taken at 5% steps of the tibia in 40 voluntary men and women age 25-40 yr who were either physically inactive or experienced distance runners (n = 10-12 per group). RESULTS Bone mass and design indicators were higher in runner than in nonrunner men, with a variable effect size along the tibia. In the distal tibia, runners had enhanced bone mineral content and CtTh (resistance to compression), but EcPm, PoPm, circularity, and CSMI were unaffected. In the midshaft, CSMIs (resistance to bending/torsion) were enhanced in runners, whereas bone mass was unaffected. In the proximal third, effects were observed for CtTh, EcPm, and PoPm. In female runners, these benefits were restricted to CSMIs only. Cortical vBMD, naturally lower in men than in women, was reduced in runners of either sex. DISCUSSION Results are coherent with previous findings in physically inactive people and with Frost's mechanostat theory. The observed group differences in cortical vBMD could reflect an increase in intracortical porosity (enhanced remodeling for damage repair), eventually compensated biomechanically by CSMI improvements. The sex specificity of exercise effects may suggest the interference by the endocrine environment. Results confirm that the mechanical environment is a strong determinant of regional tibia structure and suggest that the endocrine environment may reduce the effects of physical interventions on bone health in fertile women.
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Affiliation(s)
- Sara Feldman
- Laboratory of Osteoarticular Biology, Tissue Engineering and Emergent Therapies, Faculty of Medical Sciences, National University of Rosario, Rosario, Argentina
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Dolan E, McGoldrick A, Davenport C, Kelleher G, Byrne B, Tormey W, Smith D, Warrington GD. An altered hormonal profile and elevated rate of bone loss are associated with low bone mass in professional horse-racing jockeys. J Bone Miner Metab 2012; 30:534-42. [PMID: 22491874 DOI: 10.1007/s00774-012-0354-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 03/04/2012] [Indexed: 10/28/2022]
Abstract
Horse-racing jockeys are a group of weight-restricted athletes, who have been suggested as undertaking rapid and extreme weight cycling practices in order to comply with stipulated body-mass standards. The aim of this study was to examine bone mass, turnover and endocrine function in jockeys and to compare this group with age, gender and body mass index matched controls. Twenty male professional jockeys and 20 healthy male controls participated. Dual energy X-ray absorptiometry scans and early morning fasting blood and urine samples were used to measure bone mass, turnover and a hormonal profile. Total body bone mineral density (BMD) was significantly lower in jockeys (1.143 ± 0.05 vs. 1.27 ± 0.06 g cm(-3), p < 0.01). Bone resorptive activity was elevated in the jockey group as indicated by significantly higher urinary NTx/creatinine (76.94 ± 29.52 vs. 55.9 ± 13.9 nmol mmol(-1), p < 0.01), resulting in a significantly negative uncoupling index between bone resorption and formation. Sex hormone binding globulin (SHBG) levels were significantly higher in jockeys (41.21 ± 9.77 vs. 28.24 ± 9.98 nmol L(-1), p < 0.01) with a lower percentage of bioavailable testosterone (48.89 ± 7.38 vs. 59.18 ± 6.74 %, p < 0.01). SHBG and insulin-like growth factor-1 were independent predictors of total body and femoral neck BMD, respectively (p < 0.05). In conclusion, it appears that professional jockeys have an elevated rate of bone loss and reduced bone mass that appears to be associated with disrupted hormonal activity. It is likely that this may have occurred in response to the chronic weight cycling habitually experienced by this group.
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Affiliation(s)
- Eimear Dolan
- School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen, AB10 7QG, Scotland, UK.
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Dolan E, Crabtree N, McGoldrick A, Ashley DT, McCaffrey N, Warrington GD. Weight regulation and bone mass: a comparison between professional jockeys, elite amateur boxers, and age, gender and BMI matched controls. J Bone Miner Metab 2012; 30:164-70. [PMID: 21773703 DOI: 10.1007/s00774-011-0297-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 06/20/2011] [Indexed: 11/28/2022]
Abstract
The aim of this study was to compare bone mass between two groups of jockeys (flat: n = 14; national hunt: n = 16); boxers (n = 14) and age, gender and BMI matched controls (n = 14). All subjects underwent dual energy X-ray absorptiometry (DXA) scanning for assessment of bone mass, with measurements made of the total body, vertebra L2-4 and femoral neck. Body composition and the relative contribution of fat and lean mass were extrapolated from the results. Data were analysed in accordance with differences in body composition, in particular, height, lean mass, fat mass and age. Both jockey groups were shown to display lower bone mass than either the boxers or control group at a number of sites including total body bone mineral density (BMD) (1.019 ± 0.06 and 1.17 ± 1.05 vs. 1.26 ± 0.01 and 1.26 ± 0.06 g cm(-2) for flat, national hunt, boxer and control, respectively), total body bone mineral content (BMC) less head, L2-4 BMD and femoral neck BMD and BMC (p < 0.05). Regression analysis revealed that lean mass and height were the primary predictors of total body BMC, although additional group-specific influences were present which reduced bone mass in the flat jockey group and enhanced it in the boxers (R (2) = 0.814). Reduced bone mass in jockeys may be a consequence of reduced energy availability in response to chronic weight restriction and could have particular implications for these athletes in light of the high risk nature of the sport. In contrast, the high intensity, high impact training associated with boxing may have conveyed an osteogenic stimulus on these athletes.
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Affiliation(s)
- Eimear Dolan
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, Ireland.
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Andreoli A, Bazzocchi A, Celi M, Lauro D, Sorge R, Tarantino U, Guglielmi G. Relationship between body composition, body mass index and bone mineral density in a large population of normal, osteopenic and osteoporotic women. Radiol Med 2011; 116:1115-23. [PMID: 21643640 DOI: 10.1007/s11547-011-0689-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 02/17/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE The knowledge of factors modulating the behaviour of bone mass is crucial for preventing and treating osteoporotic disease; among these factors, body weight (BW) has been shown to be of primary importance in postmenopausal women. Nevertheless, the relative effects of body composition indices are still being debated. Our aim was to analyze the relationship between body mass index (BMI), fat and lean mass and bone mineral density (BMD) in a large population of women. Moreover, this study represents a first important report on reference standard values for body composition in Italian women. MATERIALS AND METHODS Between 2005 and 2008, weight and height of 6,249 Italian women (aged 30-80 years) were measured and BMI was calculated; furthermore BMD, bone mineral content, fat and lean mass were measured by dual-energy X-ray absorptiometry. Individuals were divided into five groups by decades (group 1, 30.0-39.9; group 2, 40.0-49.9; group 3, 50.0-59.9; group 4, 60.0-69.9; group 5, 70.0-79.9). Differences among decades for all variables were calculated using a one-way analysis of variance (ANOVA) and Bonferroni test by the SPSS programme. RESULTS Mean BW was 66.8±12.1 kg, mean height 159.1±6.3 cm and mean BMI 26.4±4.7 kg/m(2). According to BW and BMI, there was an increase of obesity with age, especially in women older than 50 years (p<0.001). Lean mass increased until 50 years of age but significantly decreased after this age (p<0.001). The percentage of osteopenia and osteoporosis in the examined population was 43.0% and 16.7%, respectively. CONCLUSIONS Our data show that obesity significantly decreased the risk for osteoporosis but did not decrease the risk for osteopenia. It is strongly recommended that a strong policy regarding prevention of osteopenia and osteoporosis be commenced. An overall examination of our results suggests that both fat and lean body mass can influence bone mass and that their relative effect on bone could be modulated by their absolute amount and ratio to total BW.
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MESH Headings
- Absorptiometry, Photon
- Adiposity
- Adult
- Aged
- Aged, 80 and over
- Analysis of Variance
- Body Composition
- Body Mass Index
- Body Weight
- Bone Density
- Bone Diseases, Metabolic/diagnosis
- Bone Diseases, Metabolic/diagnostic imaging
- Bone Diseases, Metabolic/epidemiology
- Bone Diseases, Metabolic/prevention & control
- Female
- Humans
- Incidence
- Italy/epidemiology
- Middle Aged
- Obesity/epidemiology
- Osteoporosis, Postmenopausal/diagnosis
- Osteoporosis, Postmenopausal/diagnostic imaging
- Osteoporosis, Postmenopausal/epidemiology
- Osteoporosis, Postmenopausal/prevention & control
- Predictive Value of Tests
- Reference Values
- Retrospective Studies
- Sensitivity and Specificity
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Affiliation(s)
- A Andreoli
- Human Nutrition and Physiology Unit, University of Rome "Tor Vergata", Via Montpellier 1, 00173 Rome, Italy.
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Schulze UME, Schuler S, Schlamp D, Schneider P, Mehler-Wex C. Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation. Child Adolesc Psychiatry Ment Health 2010; 4:20. [PMID: 20615217 PMCID: PMC2914652 DOI: 10.1186/1753-2000-4-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 07/08/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS There still is a lack of prospective studies on bone mineral development in patients with a history of early onset Anorexia nervosa (AN). Therefore we assessed associations between bone mass accrual and clinical outcomes in a former clinical sample. In addition to an expected influence of regular physical activity and hormone replacement therapy, we explored correlations with nutritionally dependent hormones. METHODS 3-9 years (mean 5.2 +/- 1.7) after hospital discharge, we re-investigated 52 female subjects with a history of early onset AN. By means of a standardized approach, we evaluated the general outcome of AN. Moreover, bone mineral content (BMC) and bone mineral density (BMD) as well as lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). In a substudy, we measured the serum concentrations of leptin and insulin-like growth factor-I (IGF-I). RESULTS The general outcome of anorexia nervosa was good in 50% of the subjects (BMI >/= 17.5 kg/m2, resumption of menses). Clinical improvement was correlated with BMC and BMD accrual (chi2 = 5.62/chi2 = 6.65, p = 0.06 / p = 0.036). The duration of amenorrhea had a negative correlation with BMD (r = -.362; p < 0.01), but not with BMC. Regular physical activity tended to show a positive effect on bone recovery, but the effect of hormone replacement therapy was not significant. Using age-related standards, the post-discharge sample for the substudy presented IGF-I levels below the 5th percentile. IGF-I serum concentrations corresponded to the general outcome of AN. By contrast, leptin serum concentrations showed great variability. They correlated with BMC and current body composition parameters. CONCLUSIONS Our results from the main study indicate a certain adaptability of bone mineral accrual which is dependent on a speedy and ongoing recovery. While leptin levels in the substudy tended to respond immediately to current nutritional status, IGF-I serum concentrations corresponded to the individual's age and general outcome of AN.
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Affiliation(s)
- Ulrike ME Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany
| | - Simone Schuler
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Germany
| | - Dieter Schlamp
- Heckscher Clinic for Child and Adolescent Psychiatry, Munich, Germany
| | - Peter Schneider
- Clinic for Nuclear Medicine, University of Würzburg, Germany
| | - Claudia Mehler-Wex
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Germany
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Capozza RF, Feldman S, Mortarino P, Reina PS, Schiessl H, Rittweger J, Ferretti JL, Cointry GR. Structural analysis of the human tibia by tomographic (pQCT) serial scans. J Anat 2010; 216:470-81. [PMID: 20136670 DOI: 10.1111/j.1469-7580.2009.01201.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study analyses the evaluation of tomographic indicators of tibia structure, assuming that the usual loading pattern shifts from uniaxial compression close to the heel to a combined compression, torsion and bending scheme towards the knee. To this end, pQCT scans were obtained at 5% intervals of the tibia length (S5-S95 sites from heel to knee) in healthy men and women (10/10) aged 20-40 years. Indicators of bone mass [cortical area, cortical/total bone mineral content (BMC)], diaphyseal design (peri/endosteal perimeters, cortical thickness, circularity, bending/torsion moments of inertia - CSMIs), and material quality [(cortical vBMD (bone mineral density)] were determined. The longitudinal patterns of variation of these measures were similar between genders, but male values were always higher except for cortical vBMD. Expression of BMC data as percentages of the minimal values obtained along the bone eliminated those differences. The correlative variations in cortical area, BMC and thickness, periosteal perimeter and CSMIs along the bone showed that cortical bone mass was predominantly associated with cortical thickness toward the mid-diaphysis, and with bone diameter and CSMIs moving more proximally. Positive relationships between CSMIs (y) and total BMC (x) showed men's values shifting to the upper-right region of the graph and women's values shifting to the lower-left region. Total BMC decayed about 33% from S5 to S15 (where minimum total BMC and CSMI values and variances and maximum circularity were observed) and increased until S45, reaching the original S5 value at S40. The observed gender-related differences reflected the natural allometric relationships. However, the data also suggested that men distribute their available cortical mass more efficiently than women. The minimum amount and variance of mass indicators and CSMIs, and the largest circularity observed at S15 reflected the assumed adaptation to compression pattern at that level. The increase in CSMIs (successively for torsion, A-P bending, and lateral bending), the decrease in circularity values and the changes in cortical thickness and periosteal perimeter toward the knee described the progressive adaptation to increasing torsion and bending stresses. In agreement with the biomechanical background, the described relationships: (i) identify the sites at which some changes in tibial stresses and diaphyseal structure take place, possibly associated with fracture incidence; (ii) allow prediction of mass indicators at any site from single determinations; (iii) establish the proportionality between the total bone mass at regions with highly predominant trabecular and cortical bone of the same individual, suitable for a specific evaluation of changes in trabecular mass; and (iv) evaluate the ability of bone tissue to self-distribute the available cortical bone according to specific stress patterns, avoiding many anthropometric and gender-derived influences.
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Vescovi JD, Scheid JL, Hontscharuk R, De Souza MJ. Cognitive dietary restraint: Impact on bone, menstrual and metabolic status in young women. Physiol Behav 2008; 95:48-55. [DOI: 10.1016/j.physbeh.2008.04.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2007] [Revised: 02/27/2008] [Accepted: 04/03/2008] [Indexed: 11/16/2022]
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Mauro M, Armstrong D. Evaluation of densitometric bone-muscle relationships in Crohn's disease. Bone 2007; 40:1610-4. [PMID: 17433801 DOI: 10.1016/j.bone.2007.02.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 02/16/2007] [Accepted: 02/26/2007] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with Crohn's disease (CD) are 1.4 to 2.5 times more likely than the normal population to sustain a fracture but the factors involved in the pathogenesis are not clearly understood. Bone mass is affected both by nutrition and by muscular activity. Trauma excepted, the largest voluntary loads on bones come from muscle contraction, not body weight. AIM To assess the relationship between bone mass (bone mineral content) and muscle mass (lean mass) in CD patients. METHODS Adult CD patients who had had a whole body, lumbar and hip densitometric evaluation were selected. Information regarding age, gender, weight, duration of CD, age at diagnosis, use of glucocorticoids and disease activity during the year before densitometric evaluation and laboratory parameters were collected. RESULTS Data from 65 patients (28.8+/-10.6 years, F=44, M=21) were analyzed. Lumbar bone mineral content (BMC), BMC in both hips, total and regional BMC significantly correlated with body weight and total and regional lean mass (LM). In multiple regression analysis, only total LM was shown to be independently associated with lumbar BMC, BMC in both hips and total BMC. LM in upper and lower limbs was shown to be independently associated with BMC in upper and lower limbs, respectively. CONCLUSIONS These results suggest that muscular mass and activity, rather than overall body weight, are important determinants of bone mass and, hence of bone strength in Crohn's disease. Thus, the management of bone loss in inflammatory bowel disease should address the effects of both nutrition and exercise on muscle mass.
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Affiliation(s)
- Marina Mauro
- Intestinal Disease Research Program and Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada
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