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Li Z, Chen J, Yang J, Wang R, Wang W. Relationship between paraspinal muscle properties and bone mineral density based on QCT in patients with lumbar disc herniation. BMC Musculoskelet Disord 2024; 25:360. [PMID: 38714980 PMCID: PMC11075372 DOI: 10.1186/s12891-024-07484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE Increasing research suggests that paraspinal muscle fat infiltration may be a potential biological marker for the assessment of osteoporosis. Our aim was to investigate the relationship between lumbar paraspinal muscle properties on MRI and volumetric bone mineral density (vBMD) based on QCT in patients with lumbar disc herniation (LDH). METHODS A total of 383 patients (aged 24-76 years, 193 females) with clinically and radiologically diagnosed LDH were enrolled in this retrospective study. The muscle cross-sectional area (CSA) and the proton density fat fraction (PDFF) were measured for the multifidus (MF), erector spinae (ES) and psoas major (PS) at the central level of L3/4, L4/5 and L5/S1 on lumbar MRI. QCT was used to measure the vBMD of two vertebral bodies at L1 and L2 levels. Patients were divided into three groups based on their vBMD values: normal bone density group (> 120 mg/cm3), osteopenia group (80 to 120 mg/cm3) and osteoporosis group (< 80 mg/cm3). The differences in paraspinal muscle properties among three vBMD groups were tested by one-way ANOVA with post hoc analysis. The relationships between paraspinal muscle properties and vBMD were analyzed using Pearson correlation coefficients. Furthermore, the association between vBMD and paraspinal muscle properties was further evaluated using multiple linear regression analysis, with age and sex also included as predictors. RESULTS Among the 383 LDH patients, 191 had normal bone density, 129 had osteopenia and 63 had osteoporosis. In LDH patients, compared to normal and osteopenia group, paraspinal muscle PDFF was significantly greater in osteoporosis group, while paraspinal muscle CSA was lower (p < 0.001). After adjusting for age and sex, it was found that MF PDFF and PS CSA were found to be independent factors influencing vBMD (p < 0.05). CONCLUSION In patients with LDH, paraspinal muscle properties measured by IDEAL-IQ sequence and lumbar MR scan were found to be related to vBMD. There was a correlation between the degree of paraspinal muscle PDFF and decreasing vBMD, as well as a decrease paraspinal muscle CSA with decreasing vBMD. These findings suggest that clinical management should consider offering tailored treatment options for patients with LDH based on these associations.
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Affiliation(s)
- Ze Li
- School of Sports Medicine and Health, Chengdu Sport University, No.2, Tiyuan Road, Chengdu, Sichuan, China
- Department of radiology, Sichuan Province Orthopedic Hospital, No.132, West Section of 1st Ring Road, Chengdu, Sichuan, China
| | - Junrong Chen
- Department of radiology, Sichuan Province Orthopedic Hospital, No.132, West Section of 1st Ring Road, Chengdu, Sichuan, China.
| | - Jian Yang
- Department of radiology, Sichuan Province Orthopedic Hospital, No.132, West Section of 1st Ring Road, Chengdu, Sichuan, China
| | - Ran Wang
- Department of radiology, Sichuan Province Orthopedic Hospital, No.132, West Section of 1st Ring Road, Chengdu, Sichuan, China
| | - Wenbin Wang
- Department of radiology, Sichuan Province Orthopedic Hospital, No.132, West Section of 1st Ring Road, Chengdu, Sichuan, China
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Zhang G, Wang S, Ma P, Li S, Sun X, Zhao Y, Pan J. Increased regional body fat is associated with depressive symptoms: a cross-sectional analysis of NHANES data obtained during 2011-2018. BMC Psychiatry 2024; 24:336. [PMID: 38702637 PMCID: PMC11067210 DOI: 10.1186/s12888-024-05782-4] [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: 10/04/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
AIMS The findings from previous epidemiological studies of the association between regional body fat and depressive symptoms have been unclear. We aimed to determine the association between the body fat in different regions and depressive symptoms based on data from the National Health and Nutrition Examination Survey (NHANES). METHODS This study included 3393 participants aged ≥ 20 years from the NHANES performed during 2011-2018. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The fat mass (FM) was measured in different regions using dual-energy X-ray absorptiometry to determine the total FM, trunk FM, arm FM, and leg FM. The FM index (FMI) was obtained by dividing the FM in kilograms by the square of the body height in meters. Weighted data were calculated in accordance with analytical guidelines. Linear logistic regression models were used to quantify the association between regional FMI and depressive symptoms. Univariate and stratified analyses were also performed. RESULTS The participants in this study comprised 2066 males and 1327 females. There were 404 (11.91%) participants with depressive symptoms, who were aged 40.89 ± 11.74 years and had a body mass index of 30.07 ± 7.82 kg/m². A significant association was found between total FMI and depressive symptoms. In the fully adjusted multivariate regression model, a higher total FMI (odds ratio = 2.18, 95% confidence interval [CI] = 1.08-4.39) was related to a higher risk of depressive symptoms, while increased total FMI (β = 1.55, 95% CI = 0.65-2.44, p = 0.001), trunk FMI (β = 0.57, 95% CI = 0.04-1.10, p = 0.036), and arm FMI (β = 0.96, 95% CI = 0.33-1.59, p = 0.004) were significantly associated with PHQ-9 (Patient Health Questionnaire-9) scores, whereas the leg FMI was not (p = 0.102). The weighted association between total FMI and depressive symptoms did not differ significantly between most of the subpopulations (all p values for interaction > 0.05). The risk of having depression was higher in individuals who were non-Hispanic Whites, smokers, drinkers, obese, and had diabetes and thyroid problems (p < 0.05). CONCLUSION These findings suggest that the population with a higher regional FMI is more likely to have depressive symptoms, especially in those who also have an increased total FMI. The association is more pronounced in individuals who are smokers, drinkers, obese, and have diabetes and thyroid problems.
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Affiliation(s)
- GuiMei Zhang
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Sisi Wang
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Ping Ma
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Shuna Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510632, China
| | - Xizhe Sun
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Yang Zhao
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China
| | - Jiyang Pan
- Department of Psychiatry, Sleep Medicine Centre, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, 510632, P.R. China.
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Tzou SJ, Peng CH, Huang LY, Chen FY, Kuo CH, Wu CZ, Chu TW. Comparison between linear regression and four different machine learning methods in selecting risk factors for osteoporosis in a Chinese female aged cohort. J Chin Med Assoc 2023; 86:1028-1036. [PMID: 37729604 DOI: 10.1097/jcma.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Population aging is emerging as an increasingly acute challenge for countries around the world. One particular manifestation of this phenomenon is the impact of osteoporosis on individuals and national health systems. Previous studies of risk factors for osteoporosis were conducted using traditional statistical methods, but more recent efforts have turned to machine learning approaches. Most such efforts, however, treat the target variable (bone mineral density [BMD] or fracture rate) as a categorical one, which provides no quantitative information. The present study uses five different machine learning methods to analyze the risk factors for T-score of BMD, seeking to (1) compare the prediction accuracy between different machine learning methods and traditional multiple linear regression (MLR) and (2) rank the importance of 25 different risk factors. METHODS The study sample includes 24 412 women older than 55 years with 25 related variables, applying traditional MLR and five different machine learning methods: classification and regression tree, Naïve Bayes, random forest, stochastic gradient boosting, and eXtreme gradient boosting. The metrics used for model performance comparisons are the symmetric mean absolute percentage error, relative absolute error, root relative squared error, and root mean squared error. RESULTS Machine learning approaches outperformed MLR for all four prediction errors. The average importance ranking of each factor generated by the machine learning methods indicates that age is the most important factor determining T-score, followed by estimated glomerular filtration rate (eGFR), body mass index (BMI), uric acid (UA), and education level. CONCLUSION In a group of women older than 55 years, we demonstrated that machine learning methods provide superior performance in estimating T-Score, with age being the most important impact factor, followed by eGFR, BMI, UA, and education level.
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Affiliation(s)
- Shiow-Jyu Tzou
- Teaching and Researching Center, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
| | - Chung-Hsin Peng
- Department of Urology, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Fang-Yu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Chun-Heng Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Chung-Ze Wu
- Department of Internal Medicine, Shuang Ho Hospital, New Taipei City, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- MJ Health Research Foundation, Taipei, Taiwan, ROC
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Fighera TM, dos Santos BR, Spritzer PM. Lean mass and associated factors in women with PCOS with different phenotypes. PLoS One 2023; 18:e0292623. [PMID: 37796920 PMCID: PMC10553224 DOI: 10.1371/journal.pone.0292623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
Although current evidence suggests increased risk of obesity, insulin resistance, and metabolic alterations in patients with polycystic ovary syndrome (PCOS), especially of a hyperandrogenic phenotype, the impact of each one of these variables on muscle mass remains uncertain. In this case-control study, we evaluated clinical and hormonal characteristics related to lean body mass according to the different PCOS phenotypes. We performed clinical, metabolic, and hormonal assessments and evaluated body compartments by dual-energy X-ray absorptiometry in 133 women of reproductive age. Creatinine served as an indirect marker of lean mass. Median age was 28 (range, 17-37) years. Women with phenotypes A and B (n = 59) had higher body mass index (BMI) and metabolic syndrome prevalence than those with phenotype C (n = 23) and controls (n = 51) (p<0.005). Women with phenotypes A and B also had higher Ferriman-Gallwey score (p<0.001), insulin levels (p = 0.006), HOMA-IR (p = 0.008), testosterone (p = 0.008), free androgen index (FAI) (p<0.001), fat mass index (FMI) (p = 0.015), android-to-gynoid fat ratio (p = 0.036), and bone mineral density (BMD) at lumbar spine (p = 0.027) and total femur (p = 0.013) than controls. Median appendicular lean mass index (ALMI) was higher in phenotypes A and B than in controls (7.01 [IQR, 6.33-8.02] vs. 6.69 [IQR, 5.94-7.09], p = 0.024), but it did not differ significantly from that in phenotype C (6.60 [IQR, 6.16-7.22], p = 0.222). Even after adjusting for BMI, ALMI correlated positively with creatinine in women with phenotypes A and B (rho = 0.319, p = 0.023) but not in those with phenotype C (p = 0.238) or controls (p = 0.097). In multivariate linear regression analyses, ALMI was positively associated with insulin, FAI, FMI, and total femur BMD. The present results suggest that fasting insulin, FAI, fat mass, and total femur BMD were positively associated with increased lean mass in women with PCOS phenotypes A and B.
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Affiliation(s)
- Tayane Muniz Fighera
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Betânia Rodrigues dos Santos
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Physiology and Postgraduate Program in Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Physiology and Postgraduate Program in Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Wang J, Zheng Y, Wang Y, Zhang C, Jiang Y, Suo C, Cui M, Zhang T, Chen X, Xu K. BMI trajectory of rapid and excessive weight gain during adulthood is associated with bone loss: a cross-sectional study from NHANES 2005-2018. J Transl Med 2023; 21:536. [PMID: 37573305 PMCID: PMC10422827 DOI: 10.1186/s12967-023-04397-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Studies have examined the effect of weight change on osteoporosis, but the results were controversial. Among them, few had looked at weight change over the life span. This study aimed to fill this gap and investigate the association between lifetime body mass index (BMI) trajectories and bone loss. METHODS In this cross-sectional study, participants at age 50 and above were selected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Dual-energy X-ray Absorptiometry was used to measure the bone mineral density at the femoral neck and lumbar spine. Standard BMI criteria were used, with < 25 kg/m2 for normal, 25-29.9 kg/m2 for overweight, and ≥ 30 kg/m2 for obesity. The latent class trajectory model (LCTM) was used to identify BMI trajectories. Multinomial logistic regression models were fitted to evaluate the association between different BMI trajectories and osteoporosis or osteopenia. RESULTS For the 9,706 eligible participants, we identified four BMI trajectories, including stable (n = 7,681, 70.14%), slight increase (n = 1253, 12.91%), increase to decrease (n = 195, 2.01%), and rapid increase (n = 577, 5.94%). Compared with individuals in the stable trajectory, individuals in the rapid increase trajectory had higher odds of osteoporosis (OR = 2.25, 95% CI 1.19-4.23) and osteopenia (OR = 1.49, 95% CI 1.02-2.17). This association was only found in the lumbar spine (OR = 2.11, 95% CI 1.06-4.2) but not in the femoral neck. In early-stage (age 25-10 years ago) weight change, staying an obesity and stable weight seemed to have protective effects on osteoporosis (OR = 0.26, 95% CI 0.08-0.77) and osteopenia (OR = 0.46, 95% CI 0.25-0.84). Meanwhile, keeping an early-stage stable and overweight was related to lower odds of osteopenia (OR = 0.53, 95% CI 0.34-0.83). No statistically significant association between recent (10 years ago to baseline) weight change and osteoporosis was found. CONCLUSIONS Rapid and excess weight gain during adulthood is associated with a higher risk of osteoporosis. But this association varies by skeletal sites. Maintaining stable overweight and obesity at an early stage may have potentially beneficial effects on bone health.
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Affiliation(s)
- Jiacheng Wang
- School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China
| | - Yi Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, 200000, China
| | - Yawen Wang
- School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China
| | - Chengjun Zhang
- School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, 200000, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Chen Suo
- School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Mei Cui
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Tiejun Zhang
- School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, 200000, China.
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China.
| | - Kelin Xu
- School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China.
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
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Shieh A, Karlamangla AS, Karvonen-Guttierez C, Greendale GA. Menopause-Related Changes in Body Composition Are Associated With Subsequent Bone Mineral Density and Fractures: Study of Women's Health Across the Nation. J Bone Miner Res 2023; 38:395-402. [PMID: 36542065 PMCID: PMC10023299 DOI: 10.1002/jbmr.4759] [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: 08/22/2022] [Revised: 12/01/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
During the menopause transition (MT), lean mass decreases and fat mass increases. We examined the associations of these body composition changes during the MT (2 years before to 2 years after the final menstrual period) with bone mineral density (BMD) at the end of the MT and fracture after the MT. We included 539 participants from the Study of Women's Health Across the Nation who were not taking bone-beneficial or bone-detrimental medications before or during the MT. Using multivariable linear regression, we assessed the independent associations of % lean mass loss and % fat mass gain during the MT (mutually adjusted) with femoral neck (FN) and lumbar spine (LS) BMD at the end of the MT, adjusted for pre-MT BMD, pre-MT lean and fat mass, race/ethnicity, Study of Women's Health Across the Nation (SWAN) study site, age, and cigarette use. We used Cox proportional hazards regression to quantify the relations of % lean loss and % fat gain during the MT with fracture after the MT. The Cox model was adjusted for the covariates above plus post-MT use of bone-detrimental medications, and censored at the first use of bone-beneficial medications; we further controlled for FN or LS BMD at the end of the MT. Adjusted for covariates, each standard deviation (SD) (6.9%) increment in lean mass loss was associated with 0.010 g/cm2 lower FN BMD (p < 0.0001); each SD (19.9%) increment in fat mass gain was related to 0.026 g/cm2 greater FN (p = 0.009) and LS (p = 0.03) BMD. Each SD increment in lean mass loss and fat mass gain was associated with 63% (p = 0.001) and 28% (p = 0.05) greater fracture hazard after the MT; associations were essentially unchanged by BMD adjustment. MT-related lean mass loss and fat mass gain were associated differentially with BMD; both were independently related to more fractures. Mitigating MT-related body composition changes may reduce fracture risk. © 2022 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)
- Albert Shieh
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles
| | - Arun S. Karlamangla
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles
| | | | - Gail A. Greendale
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles
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Zhou S, Chen S, Zhu X, You T, Li P, Shen H, Gao H, He Y, Zhang K. Associations between paraspinal muscles fatty infiltration and lumbar vertebral bone mineral density - An investigation by fast kVp switching dual-energy CT and QCT. Eur J Radiol Open 2022; 9:100447. [PMID: 36277658 PMCID: PMC9579482 DOI: 10.1016/j.ejro.2022.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 10/27/2022] Open
Abstract
Purpose To investigate the relationship between paraspinal muscles fat content and lumbar bone mineral density (BMD). Methods A total of 119 participants were enrolled in our study (60 males, age: 50.88 ± 17.79 years, BMI: 22.80 ± 3.80 kg·m-2; 59 females, age: 49.41 ± 17.69 years, BMI: 22.22 ± 3.12 kg·m-2). Fat content of paraspinal muscles (erector spinae (ES), multifidus (MS), and psoas (PS)) were measured at (ES L1/2-L4/5; MS L2/3-L5/S1; PS L2/3-L5/S1) levels using dual-energy computed tomography (DECT). Quantitative computed tomography (QCT) was used to assess BMD of L1 and L2. Linear regression analysis was used to assess the relationship between BMD of the lumbar spine and paraspinal muscles fat content with age, sex, and BMI. The variance inflation factor (VIF) was used to detect the degree of multicollinearity among the variables. P < .05 was considered to indicate a statistically significant difference. Results The paraspinal muscles fat content had a fairly significant inverse association with lumbar BMD after controlling for age, sex, and BMI (adjusted R 2 = 0.584-0.630, all P < .05). Conclusion Paraspinal muscles fat content was negatively associated with BMD.Paraspinal muscles fatty infiltration may be considered as a potential marker to identify BMD loss.
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Key Words
- ASiR-V, Adaptive statistical iterative reconstruction-Veo
- BIA, Bioimpedance analysis
- BMD, Bone mineral density
- Bone density
- CNR, Contrast-to-noise ratio
- DECT, Dual-energy computed tomography
- DXA, Dual-energy x-ray absorptiometry
- EMCL, extramyocellular lipids
- ES, Erector spinae
- FF, fat fraction
- FI %, Fatty infiltration ratio
- FM, Fat mass
- GSI, Gemstone spectral imaging
- IMCL, intramyocellular lipids
- LM, Lean mass
- MD, Material decomposition
- MRI, Magnetic resonance imaging
- MS, Multifidus
- MSK, Musculoskeletal
- Osteoporosis
- PDFF, Proton density fat fractions
- PS, Psoas
- Paraspinal muscles
- QCT, Quantitative computed tomography
- Tomography
- VIF, Variance inflation factor
- X-Ray computed
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Affiliation(s)
- Shuwei Zhou
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China,The College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, 300 Xueshi Road, Yuelu District, Changsha 410208, PR China
| | - Suping Chen
- GE Healthcare (Shanghai) Co., Ltd., Shanghai 201203, PR China
| | - Xu Zhu
- The College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, 300 Xueshi Road, Yuelu District, Changsha 410208, PR China
| | - Tian You
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China
| | - Ping Li
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China
| | - Hongrong Shen
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China
| | - Hui Gao
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China
| | - Yewen He
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China
| | - Kun Zhang
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007, PR China,The College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, 300 Xueshi Road, Yuelu District, Changsha 410208, PR China,Corresponding author at: Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha 410007 PR China.
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Noroozzadeh M, Amiri M, Farhadi-Azar M, Ramezani Tehrani F. Bone Health in Women With Polycystic Ovary Syndrome: A Narrative Review. J Clin Densitom 2022; 25:606-614. [PMID: 35430131 DOI: 10.1016/j.jocd.2022.02.005] [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: 09/29/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Abstract
Bone as an active connective and endocrine tissue is influenced by hormones, physical activity, inflammatory factors, minerals, dietary components, and body weight. Bone fractures are a major cause of decreased quality of life and mortality in humans. Polycystic ovary syndrome (PCOS), is one of the most common endocrine disorders in women of reproductive age worldwide. PCOS is associated with disturbances in androgen and estrogen levels, insulin resistance (IR), obesity, as well as low-grade chronic inflammation, and gut microbiota (GM) dysbiosis, all of which may negatively or positively affect bone metabolism. However, it has not yet been well clarified whether PCOS is bone-protective or bone-destructive. This study aimed to review the association between bone health and PCOS, and summarize its related factors. PubMed, Scopus, and Web of Science databases were searched to retrieve relevant English publications investigating the relationship between bone health and PCOS. Several disorders associated with PCOS can negatively or positively affect bone metabolism. Despite some positive effects of insulin, androgens, estrogens, and obesity on bone, IR, estrogen deficiency, low-grade chronic inflammation, and GM dysbiosis may adversely affect the bone metabolism in PCOS women. Studies comparing bone mineral density or bone metabolism and the risk of bone fractures in women with PCOS have controversial results. Further studies are required to understand the mechanisms underlying bone metabolism in PCOS subjects. Moreover, prospective studies are needed to estimate the risk of bone fractures and osteoporosis in PCOS subjects.
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Affiliation(s)
- Mahsa Noroozzadeh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahbanoo Farhadi-Azar
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Godbole AM, Moonie S, Coughenour C, Zhang C, Chen A, Vuong AM. Exploratory analysis of the associations between neonicotinoids and measures of adiposity among US adults: NHANES 2015-2016. CHEMOSPHERE 2022; 300:134450. [PMID: 35367485 PMCID: PMC9167792 DOI: 10.1016/j.chemosphere.2022.134450] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Toxicology studies suggest that neonicotinoids may be associated with adiposity development via thyroid hormone disruption and increased oxidative stress. Prior epidemiological studies report mixed results for the association between neonicotinoids and adiposity measures. OBJECTIVE To examine the association between detectable concentrations of parent neonicotinoids (imidacloprid, acetamiprid, clothianidin) and neonicotinoid metabolites (5-hydroxy-imidacloprid, N-desmethyl-acetamiprid) with adiposity measures among US adults, and whether sex modifies the associations for neonicotinoid metabolites with adiposity. METHODS National Health and Nutrition Examination Survey (NHANES) 2015-2016 data was utilized to estimate covariate-adjusted associations between detectable neonicotinoids and fat mass index (FMI), lean mass index (LMI), waist circumference, body fat percentage, and body mass index (BMI) using multiple linear regression. We estimated incidence rate ratios (IRRs) for overweight or obese status with detectable neonicotinoid concentrations using Poisson's modified regression. Sampling strategies were accounted for in the regression models. RESULTS Detectable levels of acetamiprid were associated with a decrease in FMI (β = -3.17 kg/m2, 95% CI [-4.79, -1.54]), LMI (β = -3.17 kg/m2, 95% CI [-5.17, -1.17]), body fat percentage (β = -4.41, 95% CI [-8.20, -0.62]), waist circumference (β = -9.80 cm, 95% CI [-19.08, -0.51]), and BMI (β = -3.88kg/m2, 95% CI [-7.25, -0.51]) among adults. In contrast, detectable levels of 5-hydroxy-imidacloprid were associated with greater rates of being overweight/obese (IRR = 1.11, 95% CI [1.04, 1.18)) and increased LMI (β = 0.67 kg/m2, 95% CI [0.04, 1.29]). Sex modified the association between N-desmethyl-acetamiprid and LMI (pint = 0.075) with a positive association among males (β = 1.14 kg/m2, 95% CI [0.38, 1.90]), and an insignificant inverse association in females. Sex also modified the association for N-desmethyl-acetamiprid with FMI (pint = 0.095) and body fat percentage (pint = 0.072), with suggestive evidence showing positive associations for males and inverse associations for females. CONCLUSION Detectable concentrations of acetamiprid were inversely associated with adiposity, while there were mixed findings for 5-hydroxy-imidacloprid. Findings suggest sex differences, though results are not clear with regard to the directionality of the association by sex.
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Affiliation(s)
- Amruta M Godbole
- Department of Epidemiology and Biostatistics, University of Nevada Las Vegas, School of Public Health, Las Vegas, NV, United States
| | - Sheniz Moonie
- Department of Epidemiology and Biostatistics, University of Nevada Las Vegas, School of Public Health, Las Vegas, NV, United States
| | - Courtney Coughenour
- Department of Environmental and Occupational Health, University of Nevada Las Vegas, School of Public Health, Las Vegas, NV, United States
| | - Cai Zhang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ann M Vuong
- Department of Epidemiology and Biostatistics, University of Nevada Las Vegas, School of Public Health, Las Vegas, NV, United States.
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10
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Li Y. Association between obesity and bone mineral density in middle-aged adults. J Orthop Surg Res 2022; 17:268. [PMID: 35568921 PMCID: PMC9107258 DOI: 10.1186/s13018-022-03161-x] [Citation(s) in RCA: 12] [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: 02/07/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between obesity and bone mineral density (BMD) varies in different studies. Our aim in this study was to explore the association between obesity (body mass index ≥ 30) and BMD among adults 40-59 years of age. METHODS This study was conducted on a sample of 2218 participants (986 men and 1232 women) aged 40 to 59 years from the National Health and Nutrition Examination Survey 2011-2018. The independent variable was body mass index (BMI). The outcome variable was lumbar BMD. The associations of BMI with lumbar BMD were examined using multivariable linear regression models. RESULTS BMI was positively associated with lumbar BMD after adjusting for other covariates [β 0.006; 95% confidence interval (CI) 0.003-0.008]. An inverted U-shaped association between BMI and lumbar BMD was further identified, with the point of infection at approximately 50 kg/m2. In the subgroup analyses, the relationship between BMI and lumbar BMD in women and blacks was an inverted U-shape. CONCLUSION Based on the results, it may be beneficial to appropriately increase BMI to promote BMD. However, considering the inverted U-shaped association, excessive BMI may be harmful to bone health in women and blacks.
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Affiliation(s)
- Yue Li
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.
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11
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Hilton C, Vasan SK, Neville MJ, Christodoulides C, Karpe F. The associations between body fat distribution and bone mineral density in the Oxford Biobank: a cross sectional study. Expert Rev Endocrinol Metab 2022; 17:75-81. [PMID: 34859739 PMCID: PMC8944227 DOI: 10.1080/17446651.2022.2008238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Body composition is associated with bone mineral density (BMD), but the precise associations between body fat distribution and BMD remain unclear. The regional adipose tissue depots have different metabolic profiles. We hypothesized that they would have independent associations with BMD. RESEARCH DESIGN AND METHODS We used data from 4,900 healthy individuals aged 30-50 years old from the Oxford Biobank to analyze associations between regional fat mass, lean mass and total BMD. RESULTS Total lean mass was strongly positively associated with BMD. An increase in total BMD was observed with increasing mass of all the fat depots, as measured either by anthropometry or DXA, when accounting for lean mass. However, on adjustment for both total fat mass and lean mass, fat depot specific associations emerged. Increased android and visceral adipose tissue mass in men, and increased visceral adipose tissue mass in women, were associated with lower BMD. CONCLUSIONS Fat distribution alters the association between adiposity and BMD.
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Affiliation(s)
- Catriona Hilton
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - Matt J Neville
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Trust, Oxford, UK
| | - Constantinos Christodoulides
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Trust, Oxford, UK
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12
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Yoon BH, Kim DY. Discordance between Hip and Spine Bone Mineral Density: A Point of Care. J Bone Metab 2021; 28:249-251. [PMID: 34905672 PMCID: PMC8671031 DOI: 10.11005/jbm.2021.28.4.249] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Byung-Ho Yoon
- Department of Orthopedic Surgery, Ewha Womans University, College of Medicine, Mokdong Hospital, Seoul, Korea
| | - Deog-Yoon Kim
- Department of Nuclear Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
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13
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Schacter GI, Leslie WD. Diabetes and Osteoporosis: Part I, Epidemiology and Pathophysiology. Endocrinol Metab Clin North Am 2021; 50:275-285. [PMID: 34023043 DOI: 10.1016/j.ecl.2021.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Both diabetes and osteoporosis are increasingly prevalent diseases, in part owing to aging populations worldwide. Epidemiologic data have shown that other organs may be adversely affected by diabetes, including the skeleton, in what has become known as diabetes-induced osteoporosis, which represents the combined impact of conventional osteoporosis with the additional fracture burden attributed to diabetes. There is an increased risk of fracture in patients with Type 1 and Type 2 diabetes, and some antidiabetic medications also may contribute to increased risk of fracture in diabetes.
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Affiliation(s)
- G Isanne Schacter
- Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, GF-335, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
| | - William D Leslie
- Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, C5121, 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada.
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14
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Balogun SA, Aitken D, Wu F, Scott D, Jones G, Winzenberg T. Linear and non-linear associations between physical activity, body composition and multimorbidity over 10 years among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2021; 76:2015-2020. [PMID: 33780541 DOI: 10.1093/gerona/glab086] [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: 09/02/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND This study aims to describe the relationships between physical activity (PA), body composition and multimorbidity over 10 years. METHODS Participants (N=373; 49% women; average age 61.3±6.7 years) were followed for 10 years. Multimorbidity was defined by self-report as the presence of two or more of 12 listed chronic conditions. PA (steps-per-day) at baseline was assessed by pedometer, handgrip strength (HGS) by dynamometer and appendicular lean mass (ALM) and total body fat mass by dual x-ray absorptiometry . Relative HGS and ALM were calculated by dividing each body mass index (BMI). Regression cubic splines were used to assess evidence for a non-linear relationship. RESULTS After 10 years, 45% participants had multimorbidity. There was a non-linear relationship between PA and multimorbidity - PA was associated with lower multimorbidity risk among individuals who engaged in <10,000 steps-per-day (RR=0.91, 95% CI: 0.85, 0.97, per 1000 steps-per-day), but not among those who participated in ≥10,000 steps-per-day (RR=1.04, 95% CI: 0.93, 1.09, per 1000 steps-per-day). Higher BMI (RR=1.05, 95% CI: 1.02, 1.08, per kg/m 2) and fat mass (RR=1.03, 95% CI: 1.01, 1.04, per kg), and lower relative HGS (RR=0.85, 95% CI: 0.77, 0.94, per 0.1 psi/kg/m 2) and ALM (RR=0.93, 95% CI: 0.88, 0.98, per 0.1 kg/kg/m 2) were linearly associated with a higher risk of multimorbidity. Absolute HGS and ALM were not significantly associated with multimorbidity. DISCUSSION These findings highlight the potential clinical importance of maintaining adequate levels of PA and of reducing adiposity and maintaining muscle function for minimising the risk of multimorbidity in older adults.
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Affiliation(s)
- Saliu A Balogun
- Menzies Institute for Medical Research, University of Tasmania, Australia.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - David Scott
- Menzies Institute for Medical Research, University of Tasmania, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Victoria, Australia.,School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Australia.,Faculty of Health, University of Tasmania, Australia
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15
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Wong JC, O’Neill S, Beck BR, Forwood MR, Khoo SK. Comparison of obesity and metabolic syndrome prevalence using fat mass index, body mass index and percentage body fat. PLoS One 2021; 16:e0245436. [PMID: 33444369 PMCID: PMC7808627 DOI: 10.1371/journal.pone.0245436] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/03/2021] [Indexed: 12/01/2022] Open
Abstract
Background Accurate obesity classification is important so that appropriate intervention can be instituted to modify metabolic risk factors. Commonly utilized body mass index (BMI) and percentage body fat (PBF) are influenced by lean mass whereas fat mass index (FMI) measures only body fat. This study compares the prevalence of obesity and metabolic risk factors with FMI, BMI and PBF using DXA (dual-energy x-ray absorptiometry). Methods 489 women randomly recruited from the electoral roll were stratified into 4 age groups; 40–49, 50–59, 60–69 and 70–79 years from 2000 to 2001. Clinical data and DXA body composition were obtained. Statistical analyses were performed using Medcalc v15 (Ostend, Belgium) with significance level at p = 0.05 (two-tailed). Results There was higher prevalence of obesity using PBF compared to BMI and FMI (p<0.001). This difference was greater from age 50–59 (p<0.05) which may be explained by age-related lean mass loss. PBF over-classified obesity in over 35% of normal and 95% of overweight categories compared to FMI and BMI. BMI has a sensitivity of 78.9% and specificity of 98.3% for obesity using FMI as the standard. BMI under-classified obesity in the overweight category by 14.9% compared to FMI. There was no difference in diabetes, dyslipidemia, hypertension and metabolic syndrome prevalence within the BMI-obesity and FMI-obesity categories (p>0.05). Conclusion PBF classified more obesity than BMI and FMI because of its low pre-determined threshold. The greater difference with PBF compared to BMI and FMI from the 50–59 decade onwards can be attributed to age-related lean mass loss. BMI had the lowest sensitivity for obesity diagnosis. BMI under-classified obesity in the overweight category compared to FMI due to its inability to differentiate lean mass. However, there was no significant difference in the prevalence of metabolic risk factors between BMI and FMI-obesity categories indicating that fat location may influence metabolic dysregulation.
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Affiliation(s)
- Joseph C. Wong
- Department of Nuclear Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
- * E-mail:
| | - Sheila O’Neill
- Betty Byrne Henderson Women's Health Research Centre, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Belinda R. Beck
- School of Allied Health Sciences & Menzies Health Institute Queensland, Griffith University Gold Coast campus, Gold Coast, Queensland, Australia
- The Bone Clinic, Brisbane, Queensland, Australia
| | - Mark R. Forwood
- School of Medical Science & Menzies Health Institute Queensland, Griffith University Gold Coast campus, Gold Coast, Queensland, Australia
| | - Soo Keat Khoo
- Betty Byrne Henderson Women's Health Research Centre, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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16
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Lee JH, Kim YJ, Kim SW, Kim H, Han W, Ku SY. Correlation between bone mineral density and endometrial thickness over time in women with breast cancer history. Sci Prog 2021; 104:368504211000515. [PMID: 33733929 PMCID: PMC10358553 DOI: 10.1177/00368504211000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As the efficacy of chemotherapy and adjuvant endocrine therapy for breast cancer increase, the quality-of-life to cancer survivors could be more important issue in strategies of breast cancer treatment. Bone health has become more compelling in care of breast cancer survivor than ever before. This retrospective study was aimed to evaluate factors relating to the change in BMD and to ascertain the correlation between changes in BMD and EMT of women with breast cancer in follow-up. Records of 164 women who underwent surgery for breast cancer were reviewed in this study. The basal characteristics included parity, menopausal state, medication with vitamin D, bisphosphonate, selective estrogen modulator (SERM), aromatase inhibitor (AI), gonadotrophin releasing hormone agonist (GnRHa), chemotherapy, radiotherapy, cancer type including positivity of estrogen receptor, progesterone receptor and HER2, combined the other gynecologic disease or the other origin cancer. At initial and follow-up visit, all subjective were checked with BMD, endometrial thickness (EMT). The mean age was 52.1 ± 8.5 years old and overall interval between initial and follow-up visits were 17.6 ± 7.5 month in this study. The BMDs of L1-4 (1.040 ± 0.166 g/cm2 vs 1.070 ± 0.181 g/cm2, p < 0.001), femur neck (0.850 ± 0.121 g/cm2 vs 0.870 ± 0.136 g/cm2, p < 0.001), and femur total (0.902 ± 0.132 g/cm2 vs 0.915 ± 0.138 g/cm2, p < 0.001) at follow-up visit were significantly lower than those at initial visit. The change in BMDs of L1-4 (ΔBMDL1-4, r = 0.353, p < 0.001, and r = 0.228, p = 0.003), femur neck (ΔBMDNeck, r = 0.198, p = 0.011, and r = 0.282, p < 0.001), femur total (ΔBMDTotal, r = 0.294, p < 0.001, and r = 0.327, p < 0.001) had positive correlation with age and the change in EMT (ΔEMT). After age correction, ΔEMT had positive correlation with ΔBMDNeck (r = 0.245, p = 0.002) and ΔBMDTotal (r = 0.273, p < 0.001). ΔBMDL1-4 and ΔBMDNeck differed according to menopausal state (p < 0.001 and p = 0.035), bisphosphonate (p < 0.001 and p < 0.001), and GnRHa (p < 0.001 and p < 0.001). In follow-up of women with history of breast cancer, ΔEMT could be an alternative screening marker for BMD decrease.
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Affiliation(s)
- Ji Han Lee
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea
| | - Sung Woo Kim
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Hoon Kim
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
- Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Wonshik Han
- Department of Breast and Endocrine Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Seung-Yup Ku
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
- Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, South Korea
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17
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Zhu K, Hunter M, James A, Lim EM, Cooke BR, Walsh JP. Relationship between visceral adipose tissue and bone mineral density in Australian baby boomers. Osteoporos Int 2020; 31:2439-2448. [PMID: 32719992 DOI: 10.1007/s00198-020-05556-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/21/2020] [Indexed: 02/01/2023]
Abstract
UNLABELLED Adiposity has a complex relationship with bone health. In 4865 Australian baby boomers (2642 females) aged 45-70 years, we found that higher visceral adipose tissue mass is associated with reduced bone density adjusting for body mass and lifestyle factors, suggesting that excess visceral fat may be deleterious to bone. INTRODUCTION Increased body mass is associated with higher bone mineral density (BMD), but higher visceral adipose tissue (VAT) may have a negative impact on bone health. In the Busselton Healthy Ageing Study, we examined associations between VAT mass and BMD in 4865 participants (2642 females) aged 45-70 years. METHODS VAT mass and BMD of whole body, total hip, femoral neck and lumbar spine were measured using DXA. VAT mass was examined as a continuous variable and in quartiles using sex-specific cut-offs. RESULTS The mean age was 58.0 ± 5.8 years. Males had significantly higher BMI (28.3 ± 3.7 vs 27.5 ± 4.9 kg/m2) and VAT mass (1675 ± 878 vs 882 ± 600 g) than females (both P < 0.001). In males, after adjustment for age, body mass, height and lifestyle factors, VAT mass negatively associated with total body, total hip and femoral neck BMD (β = - 0.153 to - 0.293, all P < 0.001). Males in the highest quartile of VAT mass (> 2200 g) had significantly lower BMD at all three sites than those in lower quartiles, with estimated BMD differences of 2.3-5.7% (all P < 0.05). In females, VAT mass negatively associated with total body, femoral neck and lumbar spine BMD (β = - 0.067 to - 0.178, all P < 0.05) and those in the highest quartile (> 1250 g) had significantly lower total body BMD than other quartiles (by 1.7-3.7%, all P < 0.05). CONCLUSION In middle-aged Australians, after covariate adjustment, higher DXA-derived VAT mass is associated with reduced bone density, suggesting that excess visceral fat may be deleterious to bone, especially in males.
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Affiliation(s)
- K Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia.
- Medical School, University of Western Australia, Crawley, Western Australia, Australia.
| | - M Hunter
- Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - A James
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - E M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - B R Cooke
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
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18
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Bai J, Gao Q, Wang C, Dai J. Diabetes mellitus and risk of low-energy fracture: a meta-analysis. Aging Clin Exp Res 2020; 32:2173-2186. [PMID: 31768878 DOI: 10.1007/s40520-019-01417-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Low-energy fracture risk is significantly increased in diabetes mellitus, the purpose of this article is to systematically evaluate the association between diabetes mellitus and risk for low-energy fracture. METHODS We conducted a systematic literature search of Medline, Embase, Science Citation Index, Wiley Online Library database through January 2019. Pooled relative risks (RR) with corresponding 95% confidence intervals (95% CI) were calculated with random-effects model to assess the strength of association. RESULTS Thirty-seven studies met the inclusion criteria, which included 3,123,382 participants. The pooled RR of any fracture in people with diabetes mellitus was 1.5 (95% CI 1.3-1.8; P < 0.05). The significant association not found in subgroup analysis of prospective design, follow-up period ≥ 10 year (all P > 0.05). The pooled RR of hip fracture in people with diabetes mellitus was 2.0 (95% CI 1.8-2.3; P < 0.05). In addition, subgroup analysis shown higher risk of hip fracture in type 1 diabetes (RR: 5.3). The pooled RR of vertebral fracture with diabetes mellitus was 1.4 (95% CI 0.9-2.2; P = 0.196). Subgroup analysis by type of diabetes showed that the RR of vertebral fracture for patients with unknown-type diabetes was 2.4 (95% CI 1.4-4.0; P < 0.05). Diabetes mellitus was associated with fractures at other sites, and effect estimates was statically significant. CONCLUSIONS Diabetes mellitus is an independent risk factor for low-energy fracture, and this relationship is more pronounced in hip fracture.
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Affiliation(s)
- Jing Bai
- Department of Endocrinology, Cangzhou People's Hospital, No. 7 Qingchi North Avenue, Cangzhou, 061001, China
| | - Qian Gao
- Department of Endocrinology, Cangzhou People's Hospital, No. 7 Qingchi North Avenue, Cangzhou, 061001, China
| | - Chen Wang
- Department of Orthopedics, Cangzhou People's Hospital, No. 7 Qingchi North Avenue, Cangzhou, 061001, China
| | - Jia Dai
- Department of Orthopedics, Cangzhou People's Hospital, No. 7 Qingchi North Avenue, Cangzhou, 061001, China.
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Zhao Y, Qin R, Ma X, Qin Z, Yang Z, Hong H, Lv H, Ye K, Wei Y, Zheng W, Qi H, Ni Y, Zhang L, Yan J, Liu G, Wu A. Adiposity is not beneficial to bone mineral density in 0-5 year old Chinese children: The Jiangsu bone health study. Obes Res Clin Pract 2019; 14:39-46. [PMID: 31879074 DOI: 10.1016/j.orcp.2019.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 10/07/2019] [Accepted: 10/30/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Data on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD. SUBJECTS AND METHODS This was a large population-based multicenter study in which the representative children aged 0-5 years were recruited from 13 Children's Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson's correlation and further tested using partial correlation in the additive model. RESULTS A total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r=0.711, P<0.001; r=0.727, P<0.001; r=-0.318, P<0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2kg, but started to gain slowlyand even decreased when the weight was over 21.2kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P<0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (β=-47.45, 95%CI=-85.07, -9.83, P=0.013). CONCLUSIONS Adiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.
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Affiliation(s)
- Yan Zhao
- Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Rui Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China.
| | - Xianghua Ma
- Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China.
| | - Zhenying Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Zi Yang
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Hong Hong
- Department of Child Health Care, Drum Tower Maternity and Child Health Care Institute, Nanjing, 210009, China
| | - Heyu Lv
- Department of Child Health Care, Jiangning Maternity and Child Health Care Institute, Nanjing, 211100, China
| | - Kan Ye
- Department of Child Health Care, Suzhou Municipal Hospital, Suzhou, 215000, China
| | - Yarong Wei
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, 214000, China
| | - Wen Zheng
- Department of Child Health Care, Yancheng Maternity and Child Health Care Institute, Yancheng, 224000, China
| | - Hongxia Qi
- Department of Child Health Care, Xuzhou Children's Hospital, Xuzhou, 221000, China
| | - Yufei Ni
- Department of Child Health Care, Nantong Maternity and Child Health Care Hospital, Nantong, 226000, China
| | - Li Zhang
- Department of Child Health Care, Huai'an Maternity and Child Health Care Hospital, Huai'an, 223001, China
| | - Juhua Yan
- Department of Child Health Care, Kunshan Maternity and Child Health Care Institute, Kunshan, 215300, China
| | - Guoqin Liu
- Department of Child Health Care, Dafeng Maternity and Child Health Care Hospital, Dafeng, 224100, China
| | - Aiping Wu
- Department of Child Health Care, Xinghua Maternity and Child Health Care Hospital, Xinghua, 225700, China
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Fatty infiltration of paraspinal muscles is associated with bone mineral density of the lumbar spine. Arch Osteoporos 2019; 14:99. [PMID: 31617017 DOI: 10.1007/s11657-019-0639-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/31/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED A total of 88 subjects were enrolled to investigate the relationship between paraspinal muscle fatty infiltration and lumbar bone mineral density (BMD) using chemical shift encoding-based water-fat MRI and quantitative computed tomography (QCT), respectively. A moderate inverse correlation between paraspinal muscle proton density fat fraction and lumbar QCT-BMD was found with age, sex, and BMI controlled. PURPOSE To investigate the relationship between paraspinal muscle fatty infiltration and lumbar bone mineral density (BMD). METHODS A total of 88 subjects were enrolled in this study (52 females, 36 males; age, 46.6 ± 14.2 years old; BMI, 23.2 ± 3.49 kg/m2). Proton density fat fractions (PDFF) of paraspinal muscles (erector spinae, multifidus, and psoas) were measured at L2/3, L3/4, and L4/5 levels using chemical shift encoding-based water-fat MRI. Quantitative computed tomography (QCT) was used to assess BMD of L1, L2, and L3. The differences in paraspinal muscle PDFF among subjects with normal bone density, osteopenia, and osteoporosis were tested using one-way ANOVA. The relationship between paraspinal muscle PDFF and QCT-BMD was analyzed using linear regression with age, sex, and BMI variables. RESULTS PDFF of the erector spinae, multifidus, and psoas of subjects with normal bone density were all significantly less than those with osteopenia and those with osteoporosis (all p < 0.001). There was an inverse correlation between paraspinal muscle PDFF and BMD after controlling for age, sex, and BMI (standardized beta coefficient, - 0.21~- 0.29; all p < 0.05). CONCLUSIONS Paraspinal muscle fatty infiltration increased while lumbar BMD decreased after adjusting for age, sex, and BMI. Paraspinal muscles and vertebrae are interacting tissues. Paraspinal muscle fatty infiltration may be a marker of low lumbar BMD. Chemical shift imaging is an efficient and fast quantitative method and can be easily added to the clinical protocol to measure paraspinal muscle PDFF when the patient underwent the routine lumbar MRI with low-back pain.
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Interactions between Sedentary and Physical Activity Patterns, Lean Mass, and Bone Density in Arab Men. DISEASE MARKERS 2019; 2019:5917573. [PMID: 31737128 PMCID: PMC6815560 DOI: 10.1155/2019/5917573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/25/2019] [Accepted: 09/12/2019] [Indexed: 12/27/2022]
Abstract
The study examined the associations between physical activity and appendicular lean mass (ALM), fat mass, and bone mineral density (BMD) and examined the role of physical activity on these variables. The participants included 497 men (age: 32.2 ± 10.4 years and body mass index: 28.2 ± 5.4 kg/m2). The study was cross-sectional, and measurements included body composition measured on dual-energy X-ray absorptiometry and self-reported physical activity assessed using the International Physical Activity Questionnaire. Physical activity, including light physical activity, was associated with increased ALM (P ≤ 0.05). Fat indicators, including waist circumference, were positively associated with ALM (P ≤ 0.05), but not with BMD. Physical activity, including moderate-to-vigorous physical activity, was not associated with BMD, whereas ALM and handgrip strength were significantly associated with BMD (P ≤ 0.05). Physical activity independent of exercise intensity was directly associated with ALM and indirectly associated with BMD through increased muscle mass and strength.
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Lespessailles E, Paccou J, Javier RM, Thomas T, Cortet B. Obesity, Bariatric Surgery, and Fractures. J Clin Endocrinol Metab 2019; 104:4756-4768. [PMID: 30901056 DOI: 10.1210/jc.2018-02084] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/13/2019] [Indexed: 12/14/2022]
Abstract
CONTEXT Obesity and its associated comorbidities are a recognized and growing public health problem. For a long time, obesity-associated effects on bone were considered to strengthen the bone, mainly because of the known relationship between body weight and bone mass and the long-term weight-bearing load effect on bone. However, recent epidemiologic studies have shown that obesity may not have a fully protective effect on the occurrence of fragility fractures. The goal of this article is to review updated information on the link between obesity, bariatric surgery, and fractures. METHODS The primary source literature for this review was acquired by searching a published database for reviews and articles up to January 2018. Additional references were selected through the in-depth analysis of the relevant studies. RESULTS We present data showing that overweight and obesity are often encountered in fracture cases. We also analyzed possible reasons and risk factors for fractures associated with overweight and patients with obesity. In addition, this review focuses on the complex effects of dramatic changes in body composition when interpreting dual-energy X-ray absorptiometry readings and findings. Finally, we review the data on the effects and consequences of bariatric surgery on bone metabolism and the risk of fractures in patients undergoing these procedures. CONCLUSION Because of various adiposity-induced effects, patients with obesity are at risk for fracture in certain sites. Bariatric surgery increases the risk of fractures in patients undergoing malabsorptive procedures.
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Affiliation(s)
- Eric Lespessailles
- Department of Rheumatology, Regional Hospital of Orleans, University of Orleans, Orleans, France
| | - Julien Paccou
- Department of Rheumatology, University Hospital of Lille, University of Lille, Lille, France
| | - Rose-Marie Javier
- Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Thierry Thomas
- Department of Rheumatology, Nord Hospital, University Hospital of St-Etienne, University of Lyon, Saint-Etienne, France
| | - Bernard Cortet
- Department of Rheumatology, University Hospital of Lille, University of Lille, Lille, France
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Akhlaghi M, Ghasemi Nasab M, Riasatian M, Sadeghi F. Soy isoflavones prevent bone resorption and loss, a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2019; 60:2327-2341. [PMID: 31290343 DOI: 10.1080/10408398.2019.1635078] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Osteoporosis is a common bone disease characterized by reduced bone mass resulting from continuous bone resorption. METHODS PubMed, Scopus, and Embase were searched to find published trials on the effect of soy isoflavones on bone mineral density (BMD) and bone turnover markers (bone-specific alkaline phosphatase, osteocalcin, osteoprotegerin, pyridinoline, deoxypyridinoline, C-telopeptide, and N-telopeptide). Random-effects inverse-variance model was used to calculate the pooled effects. RESULTS A total of 5313 articles were found, screened, and assessed for eligibility, and finally 52 trials were included in the meta-analysis. Consumption of soy isoflavones caused significant improvement in BMD of lumbar spine (mean difference (MD) = 0.76%; 95% CI: 0.09, 1.42%; p = 0.03), hip (MD = 0.22%; 95% CI: 0.02, 0.42%; p = 0.04), and femoral neck (MD = 2.27%; 95% CI: 1.22, 3.31%; p < 0.001). Subgroup analysis showed that in all 3 sites, the improvement was significant in normal weight subjects and interventions longer than a year, although trial location and dosage were also factors influencing isoflavones' impact on BMD. Among markers of bone turnover, osteoprotegerin (MD = 5.79; 95% CI: 3.08, 8.51 pg/ml; p < 0.001), pyridinoline (MD = -5.13; 95% CI: -7.76, -2.50 nmol/mmol; p < 0.001), and C-telopeptides (MD = -0.08; 95% CI: -0.16, -0.00 ng/ml; p = 0.04) were favorably affected by isoflavones while osteocalcin and bone alkaline phosphatase did not change. Subgroup analysis of bone markers showed that in overweight/obese individuals and dosages <90 mg/day, isoflavones are more effective. CONCLUSIONS Soy isoflavones prevent osteoporosis-related bone loss in any weight status or treatment duration. They increase BMD in normal weight subjects and diminish bone resorption in overweight/obese individuals. Although bone resorption may be decelerated over short-term isoflavone consumption, periods longer than a year are probably needed to affect BMD. Isoflavones also appear benefits on bone in any dose or subjects' ethnicity.
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Affiliation(s)
- Masoumeh Akhlaghi
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ghasemi Nasab
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Riasatian
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Sadeghi
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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24
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Bailey RL, Sahni S, Chocano-Bedoya P, Daly RM, Welch AA, Bischoff-Ferrari H, Weaver CM. Best Practices for Conducting Observational Research to Assess the Relation between Nutrition and Bone: An International Working Group Summary. Adv Nutr 2019; 10:391-409. [PMID: 30926984 PMCID: PMC6520043 DOI: 10.1093/advances/nmy111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/30/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022] Open
Abstract
Diet is a modifiable factor that can affect bone strength and integrity, and the risk of fractures. Currently, a hierarchy of scientific evidence contributes to our understanding of the role of diet on bone health and fracture risk. The strength of evidence is generally based on the type of study conducted, the quality of the methodology employed, the rigor and integrity of the data collected and analysis plan, and the transparency and completeness of the results. Randomized controlled trials (RCTs) are considered to be the gold standard from a clinical research paradigm, but there is a dearth of high-quality diet-related intervention trials with bone as the primary outcome, forcing the use of observational research to inform research and clinical practices. However, for observational research to be of the most utility, standardization and optimization of the study design, accurate and reliable measurement of key variables, and appropriate data analysis and data reporting are paramount. Although there have been recommendations made in relation to RCTs in the field of nutrition, no clear rubric exists for best practices in conducting observational research with regard to nutrition and bone health. Therefore, the purpose of this paper is to describe the best practices and considerations for designing, conducting, analyzing, interpreting, and reporting observational research specifically for understanding the role of nutrition in bone health, amassed by a global panel of scientific experts with strengths in bone, nutrition epidemiology, physical activity, public health, clinical and translational trials, and observational study methods. The global panel of scientific experts represents the leadership and selected participants from the 10th annual International Symposium for the Nutritional Aspects of Osteoporosis. The topics selected and best practices presented reflect expert opinion and areas of scientific expertise of the authors rather than a systematic or comprehensive literature review or professional reporting guidelines.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN,Address correspondence to RLB (e-mail: )
| | - Shivani Sahni
- Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School
| | | | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Melbourne, Australia
| | - Ailsa A Welch
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | | | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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Kelly OJ, Gilman JC, Boschiero D, Ilich JZ. Osteosarcopenic Obesity: Current Knowledge, Revised Identification Criteria and Treatment Principles. Nutrients 2019; 11:E747. [PMID: 30935031 PMCID: PMC6520721 DOI: 10.3390/nu11040747] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 02/06/2023] Open
Abstract
Osteosarcopenic obesity (OSO) syndrome describes the simultaneous deterioration of bone, muscle and excess fat, resulting in reduced functionality and systemic metabolic dysregulation. The key component contributing to this may be ectopic fat in the viscera, bone and muscle. OSO research to date is summarized, and the revised criteria for its identification for research purposes are reviewed and proposed, including new criteria to assess visceral fat in males and females. Finally, nutritional and physical activity recommendations are consolidated into a treatment algorithm, which can be validated in future studies and which may also be applied to preventative management.
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Affiliation(s)
| | | | | | - Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32306, USA.
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26
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Zhu K, Oddy WH, Holt P, Ping-Delfos WCS, McVeigh J, Straker L, Mori TA, Lye S, Pennell C, Walsh JP. Relationship Between Vitamin D Status From Childhood to Early Adulthood With Body Composition in Young Australian Adults. J Endocr Soc 2019; 3:563-576. [PMID: 30805568 PMCID: PMC6382407 DOI: 10.1210/js.2018-00349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/16/2019] [Indexed: 02/08/2023] Open
Abstract
Context Vitamin D plays a role in the differentiation and metabolism of skeletal muscle and, possibly, adipose tissue; however, the relationship between vitamin D status during growth and body composition in early adulthood is unclear. Objective We examined associations between vitamin D status in childhood, adolescence, and early adulthood with body composition at age 20 years. Design, Setting, Participants We studied 821 offspring (385 females) of the Western Australian Pregnancy Cohort Study who had ≥3 serum 25-hydroxyvitamin D [25(OH)D] at age 6, 14, 17, and 20 years and body composition assessed at age 20 using dual-energy x-ray absorptiometry. The participants were grouped into four vitamin D status trajectories: consistently lower, decreasing, increasing, and consistently higher. Results The mean serum 25(OH)D at the study visits was 72.7 to 86.8 nmol/L. In males, serum 25(OH)D at 17 and 20 years was positively associated with lean body mass (LBM), and 25(OH)D at age 20 correlated negatively with fat body mass (FBM). Males with a consistently higher 25(OH)D trajectory had a 2.3- to 3.7-kg greater LBM and 4.1- to 6.0-kg lower FBM at 20 years compared with those with consistently lower or decreasing trajectories (P < 0.05 for all). In females, 25(OH)D at 14, 17, and 20 years was negatively associated with FBM. Females with increasing or consistently higher 25(OH)D trajectories had a 5.2- to 6.8-kg lower FBM at age 20 compared with those with a consistently lower trajectory (P < 0.05 for all). Conclusions In the present predominantly white, relatively vitamin D-replete cohort, a higher vitamin D status trajectory from childhood to early adulthood was associated with a greater LBM in males and lower FBM in both sexes at age 20.
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Affiliation(s)
- Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Patrick Holt
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Wendy Chan She Ping-Delfos
- General Practice and Primary Health Care Research Unit, School of Medicine (Fremantle), University of Notre Dame, Perth, Western Australia, Australia
| | - Joanne McVeigh
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Trevor A Mori
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Stephen Lye
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Craig Pennell
- School of Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Medical School, University of Western Australia, Perth, Western Australia, Australia
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Nadeem B, Bacha R, Gilani SA. Correlation of Subcutaneous Fat Measured on Ultrasound with Body Mass Index. J Med Ultrasound 2018; 26:205-209. [PMID: 30662152 PMCID: PMC6314101 DOI: 10.4103/jmu.jmu_34_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/27/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Body mass index (BMI) is used for the assessment of obesity and overweight worldwide. When body fat is increased BMI is also increased. Ultrasound is a reliable method to assess body fat. We have selected only one suprapubic region for the assessment of fat which is very easy to measure even in routine pelvic and abdominal ultrasound examination. During our routine examination, we can measure abdominal fat and inform the patient about his/her health state regarding obesity. It was a hypothesis that increases in abdominal subcutaneous fat will increase in BMI. OBJECTIVE The objective is to correlate subcutaneous fats measured on ultrasound with BMI. MATERIALS AND METHODS It was a cross-sectional study, which was performed in Gilani ultrasound center, Lahore, Pakistan. A total of 384 participants were included with simple random sampling technique. Individuals of 16-60 years age of both genders were included in that study. Pregnant ladies, athletes, children, and elderly participants were not included in that study. Toshiba (Xario) and Mindray (Z5) ultrasound machine were used for subcutaneous fats measurement. Participants were scanned in the supine position. Subcutaneous fats were measured on the suprapubic region in three different trials. Compression was avoided. Compression artifacts were avoided by applying more quantity of gel between transducer and skin. Stadiometer was used for the measurement of weight and height. To calculate BMI, Quetelet index was used. BMI was calculated with that formula BMI = weight (kg) divided by height (m2). RESULTS The result was made by calculation of mean and standard deviation. We calculated Pearson correlation between BMI and subcutaneous fats measured on ultrasound at the suprapubic region. It showed a significant high correlation between BMI and subcutaneous fat (P = 0.0000 which is < 0.001). CONCLUSION There is a significantly high correlation between BMI and subcutaneous fat measured on ultrasound. Ultrasound is a reliable method to assess subcutaneous fat. It can be a predictor of obesity like BMI.
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Affiliation(s)
- Baby Nadeem
- University Institute of Radiological Sciences and Medical Imaging Technologies, Lahore, Pakistan
| | - Raham Bacha
- University Institute of Radiological Sciences and Medical Imaging Technologies, Lahore, Pakistan
| | - Syed Amir Gilani
- University Institute of Radiological Sciences and Medical Imaging Technologies, Lahore, Pakistan
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28
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Yamanaka JS, Yanagihara GR, Carlos BL, Ramos J, Brancaleon BB, Macedo AP, Issa JPM, Shimano AC. A high-fat diet can affect bone healing in growing rats. J Bone Miner Metab 2018; 36:255-263. [PMID: 28516218 DOI: 10.1007/s00774-017-0837-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/24/2017] [Indexed: 12/11/2022]
Abstract
A high-fat diet (HFD) can have a negative effect on bone quality in young and old people. Although bone healing in children is normally efficient, there is no evidence that children who have a diet rich in fat have compromised bone fracture regeneration compared with children with recommended dietary fat levels. The purpose of the present study was to evaluate the effects of an HFD on bone healing in growing female rats. Twenty-six postweaning female Wistar rats were divided into two groups (13 animals per group): a standard diet (SD) group and an HFD (with 60% of energy from fat) group. The rats received the assigned diets for 5 weeks, and in the third week they were submitted to an osteotomy procedure of the left tibia. Body mass and feed intake were recorded during the experiment. One day before euthanasia, an insulin tolerance test was performed. After euthanasia, the tibiae were removed and analyzed by densitometry, mechanical testing, histomorphometry, stereology and immunohistochemistry. An HFD caused an adaptive response to maintain energetic balance by decreasing feed intake and causing insulin insensitivity. There was no change in bone mineral density, collagen amount and immunostaining for bone formation, but maximal load and stiffness were decreased in the HFD group. In addition, bone volume had a tendency to be higher in the SD group than in the HFD group. Compared with rats receiving an SD, growing rats receiving an HFD for 5 weeks had similar bone mineral density but altered mechanical properties at the osteotomy defect site.
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Affiliation(s)
- Jéssica Suzuki Yamanaka
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Rezende Yanagihara
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Bruna Leonel Carlos
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Júnia Ramos
- Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Brígida Batista Brancaleon
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Ana Paula Macedo
- Departamento de Materiais Dentários e Próteses, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João Paulo Mardegan Issa
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
- Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Carlos Shimano
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil.
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JafariNasabian P, Inglis JE, Kelly OJ, Ilich JZ. Osteosarcopenic obesity in women: impact, prevalence, and management challenges. Int J Womens Health 2017; 9:33-42. [PMID: 28144165 PMCID: PMC5245917 DOI: 10.2147/ijwh.s106107] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Osteosarcopenic obesity syndrome (OSO) has recently been identified as a condition encompassing osteopenia/osteoporosis, sarcopenia and obesity. OSO is especially deleterious in older adults (even if they are not obese by conventional measures), due to age-related redistribution of fat and its infiltration into bone and muscle. Osteoporosis and bone fractures in elderly increase the risk of sarcopenia, which, through decreased mobility, increases the risk of more falls and fractures, creating a vicious cycle. Obesity plays a dual role: to a certain extent, it promotes bone and muscle gains through mechanical loading; in contrast, increased adiposity is also a source of pro-inflammatory cytokines and other endocrine factors that impair bone and muscle. As the elderly population increases, changes in lifestyle to delay the onset of OSO, or prevent OSO, are warranted. Among these changes, dietary patterns and physical activity modifications are the first ones to be implemented. The typical Western diet (and lifestyle) promotes several chronic diseases including OSO, by facilitating a pro-inflammatory state, largely via the imbalance in omega-6/omega-3 fatty acid ratio and low-fiber and high-processed food consumption. Nutritional modifications to prevent and/or alleviate the OSO syndrome include adequate intake of protein, calcium, magnesium and vitamin D and increasing consumptions of foods containing omega-3 polyunsaturated fatty acids and fiber. Certain types of physical activity, often decreased in overweight/obese women and in elderly, might preserve bone and muscle, as well as help in reducing body fat accrual and fat infiltration. Habitual daily activities and some alternative modes of exercise may be more appropriate for older adults and play a crucial role in preventing bone and muscle loss and maintaining optimal weight. In conclusion, older adults who suffer from OSO syndrome may benefit from combined efforts to improve diet and physical activity, and such recommendations should be fostered as part of public health programs.
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Affiliation(s)
- Pegah JafariNasabian
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL
| | - Julia E Inglis
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL
| | | | - Jasminka Z Ilich
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL
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30
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Kuźnar-Kamińska B, Grabicki M, Trafas T, Szulińska M, Cofta S, Piorunek T, Brajer-Luftmann B, Nowicka A, Bromińska B, Batura-Gabryel H. Body Composition, Anthropometric Indices and Hydration Status of Obstructive Sleep Apnea Patients: Can Cachexia Coexist with Obesity? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1020:43-51. [PMID: 28255913 DOI: 10.1007/5584_2017_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim of this study was to elucidate body composition, anthropometric indices, and hydration status in obstructive sleep apnea (OSA) patients, taking into account different disease stages, gender, and the possibility of the presence of cachexia. There were 98 OSA patients and 23 control subjects enrolled into the study. All study participants underwent polysomnography examination. Body mass index (BMI), fat mass index (FMI), fat free mass, muscle mass, body cell mass, total body water, and extracellular and intracellular water were evaluated. The neck, abdominal, and waist circumference was measured. We found that overweight and obesity were present in 96% of patients. Cachexia was present in one OSA individual with comorbidities. Apnea-hypopnea index correlated with the neck and waist circumference, and with BMI in OSA patients. All muscle indices and water contents above outlined were significantly higher in severe OSA compared with control subjects. BMI, FMI, neck circumference, and extracellular water were greater in a subset of severe OSA compared with a moderate OSA stage. The female OSA patients had a higher FMI than that present in males at a comparable BMI. We conclude that the most body composition indices differed significantly between severe OSA patients and control subjects. A higher FMI in females at a comparable BMI could be due to a discordance between BMI and FMI. Cachexia occurs rarely in OSA and seems to coexist with comorbidities.
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Affiliation(s)
- Barbara Kuźnar-Kamińska
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland.
| | - Marcin Grabicki
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
| | - Tomasz Trafas
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
| | - Monika Szulińska
- Department of Internal Diseases, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Szczepan Cofta
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
| | - Tomasz Piorunek
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
| | - Beata Brajer-Luftmann
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
| | - Agata Nowicka
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
| | - Barbara Bromińska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Halina Batura-Gabryel
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland
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Jang DG, Kwon JY, Choi SK, Ko HS, Shin JC, Park IY. Prevalence of Low Bone Mineral Density and Associated Risk Factors in Korean Puerperal Women. J Korean Med Sci 2016; 31:1790-1796. [PMID: 27709858 PMCID: PMC5056212 DOI: 10.3346/jkms.2016.31.11.1790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 08/05/2016] [Indexed: 11/30/2022] Open
Abstract
Although pregnancy is a medical condition that contributes to bone loss, little information is available regarding bone mineral density (BMD) in puerperal women. This cross sectional study aimed to evaluate the prevalence of low BMD in puerperal women and to identify associated risk factors. We surveyed all puerperal women who had BMD measurements taken 4-6 weeks after delivery in a tertiary university hospital, and did not have any bone loss-related comorbidities. Among the 1,561 Korean puerperal women, 566 (36.3%) had low BMD at the lumbar spine, total hip, femoral neck, and/or trochanter. Multivariate analysis revealed that underweight women had a significantly higher risk of low BMD compared with obese women at pre-pregnancy (adjusted odds ratio [aOR], 3.21; 95% confidence interval [CI], 1.83-5.63). Also, women with inadequate gestational weight gain (GWG) were 1.4 times more likely to have low BMD than women with excessive GWG (aOR, 1.42; 95% CI, 1.04-1.94). One-way ANOVA showed that BMDs at the lumbar spine and total hip were significantly different between the 4 BMI groups (both P < 0.001) and also between the 3 GWG groups (both P < 0.001). In conclusion, this study identifies a high prevalence of low BMD in puerperal women and thus suggests the need for further evaluation about the change of BMD in pregnancy and postpartum period.
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Affiliation(s)
- Dong Gyu Jang
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - Ji Young Kwon
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - Sae Kyung Choi
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - Hyun Sun Ko
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - Jong Chul Shin
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
| | - In Yang Park
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea.
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