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Blythe CS, Reynolds MS, Gregory LS. Identifying Calcaneal Anatomical Regions of Interest (ROI) for Quantitative Ultrasound Application in Subadults. Calcif Tissue Int 2022; 111:559-570. [PMID: 36044069 PMCID: PMC9613548 DOI: 10.1007/s00223-022-01018-3] [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: 06/20/2022] [Accepted: 08/16/2022] [Indexed: 11/02/2022]
Abstract
Whilst quantitative ultrasound can be reliably used to assess bone health in adults, the fixed location of the transducers in current devices may result in inaccurate and unreliable measurements in bone assessment in children due to the variation in foot size during growth. To improve positioning for paediatric assessment, Jaworski et al. (1995) created an anatomical method to identify the region of interest (ROI), however, there have been no medical imaging studies to confirm that the Jaworski method results in consistent placement of the transducer on the centre of the calcaneal body to avoid edge artefacts. In this study, computed tomography scans of the tarsus were collected from 498 individuals (258 females; 240 males) aged 2 to 20 years and used to create three novel anatomical methods to identify ROI on the calcaneus using palpable landmarks. In addition, the established Jaworski method was applied to the same scans and compared to our novel methods. The maximum ROI significantly increased with age with males having significantly greater diameters, supporting the recommendation that ½ inch diameter transducers should be used on individuals younger than 7 years of age. We identified that 79% of the 'Jaworski points' lied anterosuperior to the ROI centre point identified in this study, with 10% of the points lying outside the ROI. Of the three novel methods, only the calcaneal insertion method demonstrated small measurement variance between individuals of the same age in each sex and is therefore the preferred method for ultrasound clinical application.
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Affiliation(s)
- Connor S Blythe
- Clinical Anatomy and Paediatric Imaging Research Laboratory, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Mikaela S Reynolds
- Clinical Anatomy and Paediatric Imaging Research Laboratory, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Laura S Gregory
- Clinical Anatomy and Paediatric Imaging Research Laboratory, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Wang L, Xu Z, Li N, Meng X, Wang S, Yu C, Leng J, Zhao M, Li W, Deng Y. The association between overweight and obesity on bone mineral density in 12 to 15 years old adolescents in China. Medicine (Baltimore) 2021; 100:e26872. [PMID: 34397903 PMCID: PMC8360441 DOI: 10.1097/md.0000000000026872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/14/2021] [Indexed: 01/04/2023] Open
Abstract
Overweight/obesity can influence bone mineral accretion, but the conclusions are not consistent. We aimed to examine the association between bone mineral density (BMD) levels and body mass index (BMI) in 12 to 15 years old adolescents.We performed a cross-sectional study including 8365 adolescents. BMD was evaluated using a quantitative ultrasound device. Z scores for BMI were evaluated using World Health Organization references. Logistic regression models were performed to evaluate the association between BMD levels and BMI.Totally 1866 (22.3%) adolescents had low /reduced BMD, and boys had a higher rate than girls (72.6% vs 27.4%, P < .001). The rates of thinness, normal weight, overweight, and obesity were 2.8%, 57.1%, 22.3%, and 17.8%, respectively. The multivariable-adjusted (age, sex, systolic blood pressure, and height Z score) ORs (95% CIs) of low/reduced BMD associated with BMI groups (thinness, normal [reference], overweight, and obesity) were 0.59 (0.39-0.89), 1.00, 1.61 (1.41-1.84), and 1.98 (1.69-2.30), respectively (Ptrend < .001). This positive association existed in boys and girls though the differences were not significant between normal weight and thin girls. The multivariable-adjusted ORs for each 1-unit increase in BMI Z score were 1.36 (1.24-1.49) for girls, and 1.23 (1.16-1.30) for boys, and 1.26 (1.20-1.32) for all participants.We observed a positive association between BMI and low/reduced BMD in 12 to 15 years old adolescents. More attention should be paid on overweight and obese adolescents to reduce the risk of low BMD. Further studies are needed to explore the mechanisms of this association.
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Affiliation(s)
- Leishen Wang
- Tianjin Women and Children's Health Center, No. 96, Guizhou Rd, Heping District, Tianjin, China
| | - Zhongxian Xu
- Health and Family Planning Service Center for Women and Children in Dongli District, No. 7, Xianfeng Rd, Dongli District, Tianjin, China
| | - Nan Li
- Tianjin Women and Children's Health Center, No. 96, Guizhou Rd, Heping District, Tianjin, China
| | - Xuemei Meng
- Health and Family Planning Service Center for Women and Children in Dongli District, No. 7, Xianfeng Rd, Dongli District, Tianjin, China
| | - Shuo Wang
- Tianjin Women and Children's Health Center, No. 96, Guizhou Rd, Heping District, Tianjin, China
| | - Chengshu Yu
- Health and Family Planning Service Center for Women and Children in Dongli District, No. 7, Xianfeng Rd, Dongli District, Tianjin, China
| | - Junhong Leng
- Tianjin Women and Children's Health Center, No. 96, Guizhou Rd, Heping District, Tianjin, China
| | - Ming Zhao
- Health and Family Planning Service Center for Women and Children in Dongli District, No. 7, Xianfeng Rd, Dongli District, Tianjin, China
| | - Weiqin Li
- Tianjin Women and Children's Health Center, No. 96, Guizhou Rd, Heping District, Tianjin, China
| | - Yanmei Deng
- Health and Family Planning Service Center for Women and Children in Dongli District, No. 7, Xianfeng Rd, Dongli District, Tianjin, China
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Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty. Nutrients 2021; 13:nu13072163. [PMID: 34202423 PMCID: PMC8308367 DOI: 10.3390/nu13072163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Bone mineral acquisition during adolescence is crucial for maximizing peak bone mass. Fat mass (FM) and bone mass are closely related. This study investigated the association of FM distribution with bone mass in Chinese male adolescents. Method: A total of 693 male adolescents aged 10–18 years were recruited from a secondary school in Jiangmen, China. Their bone mass and body composition were measured by quantitative ultrasound and bioelectrical impedance analysis, respectively. The associations of the measures of fat distribution with bone parameters, i.e., broadband ultrasound attenuation, speed of sound (SOS), and stiffness index (SI), were analyzed using multiple linear regression. Age, height, body mass index, stage of puberty, physical activity, sedentary behavior, dietary energy intake, and dietary calcium and vitamin D intake were adjusted in the model. Further subgroup analyses of prepubertal and pubertal participants were conducted. Results: The measures of fat distribution showed negative associations with SOS and SI in total subjects (p < 0.010). In prepubertal boys, the measures of fat distribution were only associated with SOS (β = −0.377 to −0.393, p < 0.050). In pubertal boys, the measures of fat distribution had associations with all bone parameters (β = −0.205 to −0.584, p < 0.050). The strongest association was between trunk FM and SOS (β = −0.584, p < 0.001). Conclusion: This study supported that the measures of fat distribution were negatively associated with bone parameters in Chinese male adolescents. Trunk FM had the strongest association with bone parameter. These associations appear to be stronger in pubertal boys than in prepubertal boys.
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Abstract
OBJECTIVES Long-term complications of HIV including low bone mineral density remain a concern. We studied the prevalence and predictors of low bone mineral density among South African perinatally HIV-infected adolescents (PHIVA) on antiretroviral therapy (ART). DESIGN Cross-sectional analysis. METHODS Bone health was evaluated by measuring the calcaneus stiffness index among PHIVA on ART. Low stiffness index was defined as z-score less than -2 SD compared with age-matched and sex-matched HIV-uninfected adolescents (HIV-). RESULT Overall, 407 PHIVA (median age: 14 years; 50.4% female; median age at ART initiation: 4.2 years) and 92 HIV- (median age: 13.7 years; 54.4% female) were included. Median duration on ART was 9.8 years (interquartile range 6.8-11.5) with 38% initiating ART at 2 years or less of age. Stiffness index was lower in PHIVA (-0.19 vs. 0.43, P ≤ 0.001), respectively. During puberty, mean stiffness index increased with Tanner Stage in both PHIVA and HIV- but these increases were larger among HIV-; Tanner Stage II-III (96 vs. 101, P = 0.009) and Tanner Stage IV-V (104 vs. 112, P = 0.001). Among PHIVA, 52 (13%) had low stiffness index. After adjusting for age, sex and Tanner Stage, use of lopinavir/ritonavir [odds ratio (OR) = 2.31, P = 0.012] and viral load more than 50 copies/ml (OR = 2.06, P = 0.023) were associated with increased risk of low stiffness index, while use of efavirenz (OR = 0.41, P = 0.009) was associated with decreased risk of low stiffness index. CONCLUSION Stiffness index was a significantly lower in PHIVA than in HIV-, especially during puberty. Among PHIVA, detectable viral load and use of lopinavir/ritonavir were risk factors for low stiffness index. Further longitudinal studies are important to determine the clinical implications.
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Li R, Wen ZG, Li HX, Yu Q, Xu Y, Xiao SM. Associations of Sex Steroids With Changes in Calcaneal Quantitative Ultrasound Measurements: A Longitudinal Study in Chinese Male Adolescents. J Clin Densitom 2020; 23:588-595. [PMID: 32037205 DOI: 10.1016/j.jocd.2020.01.001] [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: 11/05/2019] [Revised: 12/30/2019] [Accepted: 01/06/2020] [Indexed: 11/19/2022]
Abstract
This 2-year longitudinal study aimed to detect the associations of sex steroids, sex hormone-binding globulin with bone parameters and the changes thereof in Chinese male adolescents. A total of 642 male students aged 12-16 years from a secondary school in Jiangmen, China, were included. Total testosterone (T), total oestradiol (E2), and sex hormone-binding globulin were measured by chemiluminescence immunoassay. The bioavailable T (BioT) and E2 (BioE2) were calculated. The speed of sound, broadband ultrasound attenuation, and stiffness index of the right heel were measured by Sahara Clinical Bone Sonometer at both baseline and 2-year follow-up. The confounding effects of age, height, weight, pubertal stage, physical activity, energy-adjusted dietary calcium intake, and dietary vitamin D intake were adjusted. The baseline value of each bone parameter was also adjusted in the longitudinal analysis. Results showed that total T and BioT were positively associated with bone parameters and changes in them (β = 0.076-0.115, p < 0.05). A threshold effect of BioT on broadband ultrasound attenuation, stiffness index and their changes were also observed. Positive associations between BioT and bone mass gain were observed only in individuals with BioT levels <240.0 ng/dl (β = 0.088-0.131, p < 0.05). Moreover, total E2 or BioE2 were found to be inversely associated with speed of sound and its change (β = -0.109 to -0.077, p < 0.05). This study supported that in Chinese male adolescents, serum T was a positive predictor for bone formation with a threshold effect, and E2 could have influence on the changes in bone architecture during puberty. These findings may improve the understanding of the effects of sex steroids on the acceleration of bone formation in male adolescents and provide useful information for the prediction model establishment of peak bone mass.
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Affiliation(s)
- Ran Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhi-Gang Wen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Department of Endocrinology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong, China.
| | - Hai-Xia Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qing Yu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Department of Xiamen Cancer Prevention and Control, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China
| | - Yang Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Su-Mei Xiao
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Al-Mendalawi MD. A Study of Association of Premature Graying of Hair and Osteopenia in North Indian Population. Int J Trichology 2020; 12:137. [PMID: 33223743 PMCID: PMC7659733 DOI: 10.4103/ijt.ijt_72_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022] Open
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Cheng L, Pohlabeln H, Ahrens W, Lauria F, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, Michels N, Moreno LA, Page AS, Pitsiladis Y, Hebestreit A. Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents. Int J Behav Nutr Phys Act 2020; 17:54. [PMID: 32345301 PMCID: PMC7189536 DOI: 10.1186/s12966-020-00956-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods Calcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009, Zaragoza, Spain
| | - Angie S Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Brighton, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
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Di Nisio A, De Rocco Ponce M, Giadone A, Rocca MS, Guidolin D, Foresta C. Perfluoroalkyl substances and bone health in young men: a pilot study. Endocrine 2020; 67:678-684. [PMID: 31565782 DOI: 10.1007/s12020-019-02096-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Perfluoroalkyl substances (PFAS) are a class of endocrine-disrupting chemicals. Toxicological studies indicate that PFAS accumulate in bone tissue and could cause alterations in bone metabolism. The primary objective of this study was to examine the association between PFAS exposure and bone status in a cohort of young men resident in a well-defined area with high PFAS environmental pollution. METHODS Bone status was assessed in 117 subjects aged 18-21 by quantitative ultrasound (QUS) at the heel. Subjects underwent an accurate medical visit. Socio-demographic characteristics, lifestyle, and medical histories were collected. We also verified the interaction between PFAS and hydroxyapatite by computational modelling. The organic anion-transporting peptide (OATP), the putative transporter of PFAS, was evaluated by qPCR in bone biopsies from femoral heads discarded during arthroplasty in three male subjects. RESULTS Exposed subjects showed significantly lower stiffness index, which resulted in lower t-score and higher prevalence of subjects at medium-high risk of fracture (23.6%) compared with controls (9.7%). Data from computational modelling suggested that PFOA exhibits a high affinity for hydroxyapatite, since the estimated change in free energy is in the order of that exhibited by bisphosphonates. Finally, we observed consistent expression of OATP1A2 gene in primary human osteoblasts. CONCLUSIONS This is the first study reporting increased osteoporosis risk in young men exposed to PFAS and provide preliminary information on molecular mechanisms that could explain this observation, in agreement with previous studies on animal models and humans. However, these results must be interpreted with caution given the cross-sectional study design and the small number of cases.
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Affiliation(s)
- A Di Nisio
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - M De Rocco Ponce
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - A Giadone
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - M S Rocca
- Istituto di Ricerca Pediatrica (IRP)-Fondazione Città della Speranza, Haematology-Oncology Lab, Padova, Italy
| | - D Guidolin
- Department of Neurosciences, University of Padova, via Gabelli 65, 35128, Padova, Italy
| | - C Foresta
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
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The Impact of Mother-Child Dyad Dietary Intervention Using the Transtheoretical Model on Bone Mineral Density in Japanese Female Adolescents. J Pediatr Nurs 2020; 50:e39-e47. [PMID: 31669496 DOI: 10.1016/j.pedn.2019.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Peak bone mass, an important determinant of osteoporosis risk, is reached during adolescence. We evaluated the impact of mother-child dyad dietary intervention using the transtheoretical model (TTM) on bone mineral density in Japanese female adolescents. DESIGN AND METHODS The participants were dyads of female adolescents aged 15-16 years and their mothers (who are generally responsible for cooking). We enrolled 92 dyads, with 56 assigned to the intervention group and 36 to the control group. Bone mineral density was measured using quantitative ultrasound parameters (QUS). Nutrient intake and stage of behavioral change were collected via questionnaires. Evaluations were conducted at baseline and seven months later. The intervention group underwent the TTM-based dietary education program for six months. RESULTS After the intervention program, the ratio of change of the quantitative ultrasound parameter-speed of sound (SOS)-was significantly higher in the intervention than the control group (p < 0.001). Finally, we demonstrated that the intervention was found to significantly affect post-test outcomes in terms of SOS according to the result of analysis of covariance (p < 0.05). CONCLUSIONS Dietary intervention for female adolescents and their mothers using the TTM may enhance the bone mineral density in female adolescents. PRACTICE IMPLICATIONS We suggest that dietary intervention for female adolescents and their mothers using the transtheoretical model may enhance the bone mineral density in female adolescents.
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Jafri L, Majid H, Ahmed S, Naureen G, Khan AH. Calcaneal Ultrasound and Its Relation to Dietary and Lifestyle Factors, Anthropometry, and Vitamin D Deficiency in Young Medical Students. Front Endocrinol (Lausanne) 2020; 11:601562. [PMID: 33551995 PMCID: PMC7859491 DOI: 10.3389/fendo.2020.601562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/26/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Bone quality and peak bone mass are greatly affected by lifestyle factors. The objective of the study was to investigate the relationships between anthropometry, dietary and caloric intake, body composition measurements, physical activity, and vitamin D status with quantitative ultrasound-based bone parameters among medical students. METHODS Both male and female medical college students were included in this study. A detailed questionnaire was administered, collecting clinical, dietary, physical activity information, physical examination details, including body mass index (BMI). Body composition (total body fat, total body water, muscle mass, mean visceral fat mass, basal metabolic rate, bone mass using a bioelectrical impedance analyzer) and calcaneal heel ultrasound parameters were measured using an Osteosys Sonost-3000, Ultrasound Bone Densitometer were measured, respectively. RESULTS In this cross-sectional study, 211 healthy students with a mean age of 20.1 ± 1.1 years, 51.7% (n = 109) were males. Majority (79.4%) of the young adults had vitamin D deficiency. The mean BMI, calcium intake, and vitamin D levels were 22.35 ± 3.43 kg/m2, 788.7 ± 364.8 mg/day, and 15.02 ± 8.63 ng/ml, respectively. Female subjects compared to males had statistically significantly lower daily energy intake, muscle mass, visceral fat mass, calcium intake, and vitamin D levels. In addition the median Z-scores in females [-1.40 (-0.57 to -1.82)] was significantly poorer than the male [-0.50 (0.20 to -1.3)] counterparts, p-value <0.001. Multiple regression analysis showed that overall body fat percent (p-value 0.016) and visceral fat percent (p-value 0.029) were the only significant negative predictors to the calcaneal bone quality index (BQI) values. CONCLUSION Adolescent lifestyle patterns can influence young adult bone strength. The young Pakistani females exhibited significantly lower dietary intakes and more inadequate bone parameters compared to males. Our data suggest that total body and visceral fat percent are the predominant negatively associated determinant of bone strength for this cohort. Calcaneal ultrasound can be utilized for mass screening of young adults for identification of low BMD.
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Affiliation(s)
- Lena Jafri
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
- *Correspondence: Lena Jafri,
| | - Hafsa Majid
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Sibtain Ahmed
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Ghazala Naureen
- Department of Medicine - Western Health, The University of Melbourne and Australian Institute for Musculoskeletal Science, The University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Aysha Habib Khan
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
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İnan-Erdoğan I, Akgül S, Işgın-Atıcı K, Tuğrul-Yücel T, Boduroğlu K, Derman O, Kanbur N. Effects of vitamin D and estrogen receptor polymorphisms on bone mineral density in adolescents with anorexia nervosa. J Pediatr Endocrinol Metab 2019; 32:1377-1384. [PMID: 31714887 DOI: 10.1515/jpem-2019-0240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/02/2019] [Indexed: 11/15/2022]
Abstract
Background Anorexia nervosa (AN) is a serious eating disorder that is associated with decreased bone mineral density (BMD) and greater lifetime risk for fractures. The aim of this study was to determine the correlation between BMD and genetic polymorphisms in AN. Methods This case-control study analyzed vitamin D receptor (VDR) (VDRBsml, VDRFokl) and estrogen receptor (ESR) (ESR1Xbal, ESR1Pvull) polymorphisms in 45 adolescents diagnosed with AN and 46 age-matched healthy controls. BMD values of the AN group were classified as low or normal, and polymorphisms were compared between cases and controls. The effects of body mass index (BMI), duration of disease and amenorrhea on BMD were also evaluated. Results In girls with AN, a positive effect of the bb genotype of VDRBsmI polymorphism on femur Z-scores (p = 0.103) and of the Ff genotype of VDRFokI polymorphism on vertebra Z-scores (p = 0.097) was observed. In boys with AN, a positive effect of the Ff genotype of VDRFokI polymorphism on vertebra BMD (g/cm2) was detected (p = 0.061). No association was detected between ESR polymorphisms. An inverse relationship was observed between BMD and duration of illness and amenorrhea. A direct relationship was detected between BMD and BMI. Conclusions Specific VDR gene polymorphism genotypes may have positive effects on BMD in patients with AN. Additionally, the lack of association between ESR gene polymorphisms on BMD could be attributed to the low estrogen status of the patient.
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Affiliation(s)
- Işıl İnan-Erdoğan
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Ankara, Turkey
| | - Sinem Akgül
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Kübra Işgın-Atıcı
- Hacettepe University, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Tuğba Tuğrul-Yücel
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Pediatric Genetics, Ankara, Turkey
| | - Koray Boduroğlu
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Pediatric Genetics, Ankara, Turkey
| | - Orhan Derman
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Hacettepe University Faculty of Medicine, İhsan Doğramacı Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey
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12
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The impact of height on low/reduced bone mineral density in Chinese adolescents aged 12-14 years old: gender differences. Arch Osteoporos 2019; 14:78. [PMID: 31286269 DOI: 10.1007/s11657-019-0606-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 05/09/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Low/reduced bone mineral density (BMD) is an important predictor of childhood fracture. In this article, we presented the prevalence of BMD in Chinese adolescents and, for the first time, demonstrated the gender disparities in the impact of height on BMD. PURPOSE To analyze the gender disparities in the association of low/reduced BMD with height in Chinese adolescents at the stage of growth spurt. METHODS A total of 8152 adolescents aged 12-14 years old were included based on a cross-sectional study in Tianjin, China. Height and weight were measured with standard equipment. BMD was measured using the method of quantitative ultrasound. Adolescents with Z ≤ - 2.0 or - 2.0 < Z ≤ - 1.0 were defined as "low BMD" or "reduced BMD". RESULTS The total low/reduced BMD rate was 22.0% in Chinese adolescents aged 12-14 years old, and boys were more likely to have low/reduced BMD than girls (30.1% vs. 12.9%, P < 0.001). The rate of low/reduced BMD significantly increased with age in boys (Ptrend = 0.019), whereas decreased with age in girls (Ptrend = 0.018). We found significant interaction effect between gender and height standard deviation score (height-Z) in the association with low/reduced BMD (Pinteraction < 0.001). There was a positive association of height-Z among boys (OR = 1.30, 95%CI 1.21-1.39, P < 0.001), meanwhile low/reduced BMD was inversely associated with height-Z among girls (OR = 0.85, 95%CI 0.78-0.94, P < 0.001). CONCLUSIONS Our study suggested strong gender disparities in the impact of height on BMD in Chinese adolescents aged 12-14 years old, where the association between low/reduced BMD and height was positive among boys but inverse among girls. The study provides evidence on the early prevention and the risk factor identification of low/reduced BMD and childhood fractures.
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Alghadir AH, Gabr SA, Rizk AA. Physical Fitness, Adiposity, and Diets as Surrogate Measures of Bone Health in Schoolchildren: A Biochemical and Cross-Sectional Survey Analysis. J Clin Densitom 2018; 21:406-419. [PMID: 29657025 DOI: 10.1016/j.jocd.2017.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 12/19/2017] [Indexed: 01/19/2023]
Abstract
This study aimed to investigate the associations between adiposity, muscular fitness (MF), diet, sun exposure, and physical activity profiles as surrogate measures with bone health status in a sample of schoolchildren aged 8-18 yr old. A total of 250 Egyptian schoolchildren aged 8-18 yr were randomly invited to participate in these cross-sectional survey analyses. Calcaneal broadband ultrasound attenuation (c-BUA), bone mineral density (BMD), and bone formation markers (total calcium, serum bone alkaline phosphatase, and osteocalcin) were measured as markers of bone health. Adiposity profile, MF, physical activity (PA), sun exposure, Ca, and vitamin D dietary intake as related cofactors of bone health were measured by using prevalidated questionnaires and standard analytical techniques. A total of 85% (n = 213) of the study population showed normal bone health and 14.8% (n = 37) had abnormal bone health; most of them are girls (67.6%) classified according to BMD and c-BUA Z-scores into osteopenia (9.6%) and osteoporosis (5.2%). Compared with boys, higher correlations between c-BUA, bone mineral content, and BMD measures in the femoral neck, lumbar spine, whole body, and bone markers were reported in girls with lower bone mass. There was a positive significant correlation between body mass index, adiposity, sun exposure, MF, PA status, Ca and vitamin D intake, and c-BUA and BMD score analyses. These parameters were shown to be associated with about ~57.3%-88.4% of bone health characteristics of children and adolescents with osteopenia and osteoporosis. In children and adolescents, sun exposure, Ca and vitamin D diets, adiposity, PA, and changes in the levels of Ca, osteocalcin, and serum bone alkaline phosphatase were shown to be associated with bone health. Also, a significant correlation was reported between c-BUA score, dual-energy X-ray absorptiometry-BMD measures, and bone markers at clinically important bone sites of girls and boys. However, further clinical trials should be studied to consider c-BUA and bone markers as the benchmark estimates of bone mass for diagnostic purposes in young ages.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sami A Gabr
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ashraf A Rizk
- Department of Health Science, College of Health Science and physical activity, King Saud University, Riyadh, Saudi Arabia
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Amanzholkyzy A, Nurgalieva RE, Dosimov AZ, Stankevicius E, Kaldybaeva AT. Ethnic Manifestations of Gene Polymorphisms of Vitamin D Receptor (VDR) in Adolescents of Western Kazakhstan Region. J Natl Med Assoc 2018; 110:78-83. [PMID: 29510848 DOI: 10.1016/j.jnma.2017.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/04/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND (OBJECTIVES) The objective of the article is studying the connection of VDR gene polymorphisms with bone tissue mineral density and biochemical marker of 25-PO vitamin D in adolescents of both ethnic groups, living in Western Kazakhstan Region. METHODS The study included 110 relatively healthy children aged 13-18 years of Aktobe, the representatives of Kazakh ethnic group e 66 (Kazakh children) and Slavonic e 44 (Russian children). The groups were formed according to BTMD data, ethnic affiliation and according to content of vitamin D and gene polymorphism of vitamin D (VDR). RESULTS Genotype SS is negative marker in Kazakh adolescents of Western Kazakhstan Region for BTMD and 25-PO vitamin D; in children of Kazakh nationality with osteopathy sign, genotype SS occurs at almost twice the rate in comparison with Slavonic ethnic group and respectively by a factor of 2 less 25-PO vitamin D content. CONCLUSION Disorders of bone mineralization and metabolism depend on ethnic affiliation and presence of defined polymorphic genotypes of VDR gene molecular markers. Genotype Tt is a normal variant of gene polymorphism and is characterized by significantly less 25-PO vitamin D content in adolescents of Kazakh ethnic group, in comparison with their age mates of Slavonic ethnic group.
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Affiliation(s)
- Aynur Amanzholkyzy
- West Kazakhstan Marat Ospanov State Medical University, 030000, Maresiev Street 68, Aktobe, Kazakhstan.
| | - Rose E Nurgalieva
- West Kazakhstan State Medical University named after Marat Ospanov, 030000, Maresiev Street 68, Aktobe, Kazakhstan
| | - Arystan Zh Dosimov
- West Kazakhstan State Medical University named after Marat Ospanov, 030000, Maresiev Street 68, Aktobe, Kazakhstan
| | - Edgaras Stankevicius
- Lithuanian University of Health Sciences, LT-44307, A. Micreviciaus Street 9, Kaunas, Lithuania
| | - Ayman T Kaldybaeva
- West Kazakhstan State Medical University named after Marat Ospanov, 030000, Maresiev Street 68, Aktobe, Kazakhstan
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15
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Lageweg CMT, van der Putten ME, van Goudoever JB, Feuth T, Gotthardt M, van Heijst AFJ, Christmann V. Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry. Bone Rep 2018; 8:38-45. [PMID: 29955621 PMCID: PMC6019963 DOI: 10.1016/j.bonr.2018.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/09/2018] [Accepted: 01/17/2018] [Indexed: 01/09/2023] Open
Abstract
Background Preterm infants are at risk of impaired bone health in later life. Dual-energy X-ray absorptiometry-scan (DXA) is the gold standard to determine bone mineralization. Phalangeal quantitative ultrasound (pQUS) is an alternative technique that is inexpensive, easy to use and radiation-free. The aim of this study was to investigate whether both techniques reveal equivalent results. Materials and methods Sixty former preterm infants (31 boys; 29 girls) received a DXA and pQUS at age 9 to 10 years. DXA measured bone mineral content (BMC) and bone mineral density (BMD) for total body and lumbar spine (L1-4), while pQUS measured the amplitude dependent speed of sound (AD-SoS) and bone transit time (BTT) at metacarpals II-IV providing continuous values and Z-scores based on age and sex. Four statistical methods evaluated the association between both techniques: Pearson's correlation coefficients, partial correlation coefficients adjusted for gestational age, height and BMI, Bland-Altman analysis and cross tabulation. Results Both techniques showed a statistically significant weak correlation for continuous values as well as Z-scores (0.291–0.462, p < 0.05). Boys had significant and relatively high correlations (0.468–0.585, p < 0.05). In comparison, the correlations for girls were not significant. Correlation coefficients further decreased while calculating the partial correlations. The Bland-Altman plots showed poor agreement. Sensitivity ranged from 33% to 92% and specificity from 16% to 68%. Positive and negative predictive values ranged from 4% to 38% and 82% to 97%, respectively. Conclusions We found statistically significant weak correlations and poor agreement between DXA and pQUS measurements. DXA is not equivalent to pQUS and therefore not replaceable by this technique in former preterm born children at the age of 9 to 10 years. DXA is the golden standard to determine bone mineralization, while Quantitative ultrasound is a radiation-free alternative. Four statistical tests were used to investigate the equivalence of both methods. Comparison of results of 60 preterm born children at age 9 to 10 years found poor agreement between both methods. There was a discrepancy in differentiating the same children with normal or reduced bone mineralization. Quantitative ultrasound cannot replace the DXA scan for determination of bone mineralization in preterm born children.
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Affiliation(s)
- Carmen M T Lageweg
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mayke E van der Putten
- Department of Pediatrics, Subdivision of Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.,Departement of Pediatrics, Emma Children's Hospital - AMC Amsterdam, Amsterdam, The Netherlands
| | - Ton Feuth
- Department for Health Evidence, Radboud Institute for Health Science, Subdivision of Biostatistics, Radboud university medical center, Nijmegen, The Netherlands
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, The Netherlands
| | - Arno F J van Heijst
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Viola Christmann
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
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Khalil N, Ebert JR, Honda M, Lee M, Nahhas RW, Koskela A, Hangartner T, Kannan K. Perfluoroalkyl substances, bone density, and cardio-metabolic risk factors in obese 8-12 year old children: A pilot study. ENVIRONMENTAL RESEARCH 2018; 160:314-321. [PMID: 29040951 DOI: 10.1016/j.envres.2017.10.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/12/2017] [Accepted: 10/07/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Perfluoroalkyl substances (PFASs), including perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA), have been associated with adverse bone, and metabolic changes in adults. However association of PFASs with bone health in children is understudied. Considering their role as endocrine disruptors, we examined relationships of four PFASs with bone health in children. METHODS In a cross sectional pilot study, 48 obese children aged 8-12 years were enrolled from Dayton's Children Hospital, Ohio. Anthropometric, clinical and biochemical assessments of serum were completed. Serum PFASs were measured by UPLC-ESI-MS/MS. In a subset of 23 children, bone health parameters were measured using calcaneal quantitative ultrasound (QUS). RESULTS While PFASs exposure was associated with a consistent negative relationship with bone health parameters, among four PFASs tested, only PFNA showed a significant negative relationship with bone parameter (β [95% CI], = - 72.7 [- 126.0, - 19.6], p = .010). PFNA was also associated with raised systolic blood pressure (p = .008), low density lipoprotein cholesterol (LDL-C; p < .001), and total cholesterol (TC; p = .014). In addition, both PFOA and PFOS predicted elevation in LDL-C, and PFOA predicted increased TC, as well. In this analysis, PFASs were not strongly related to thyroid hormones, 25-hydroxy vitamin D, liver enzymes, or glucose homeostasis. CONCLUSION PFASs exposure in obese children may play a role in adverse skeletal and cardiovascular risk profiles.
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Affiliation(s)
- Naila Khalil
- Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, 3123 Research Blvd, Suite #200, Dayton, OH 45420, USA.
| | - James R Ebert
- The Pediatric Lipid Clinic, Dayton's Children Hospital, One Children's Plaza, Dayton, OH 45404, USA.
| | - Masato Honda
- Wadsworth Center, New York State Department of Health, Albany, NY 12201-0509, USA.
| | - Miryoung Lee
- Department of Epidemiology, Human Genetics & Environmental Sciences, The Universit y of Texas Health Science Center School of Public Health, One West University Blvd, SPH Building N1.102B, Brownsville, TX 78520, USA.
| | - Ramzi W Nahhas
- Department of Population and Public Health Sciences, and Department of Psychiatry, Boonshoft School of Medicine, Wright State University, 3123, Research Blvd, Suite #200, Dayton, OH 45420, USA.
| | - Antti Koskela
- Cancer Research and Translational Medicine Research Unit and MRC Oulu, Faculty of Medicine, University of Oulu, P.O.Box 5000, FIN-90014 Oulu, Finland.
| | | | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, State University of New York, Albany, NY 12201-0509, USA.
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17
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Szmodis M, Zsákai A, Bosnyák E, Protzner A, Trájer E, Farkas A, Szőts G, Tóth M. Reference data for ultrasound bone characteristics in Hungarian children aged 7-19 years. Ann Hum Biol 2017; 44:704-714. [PMID: 29037074 DOI: 10.1080/03014460.2017.1390152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Backround: Osteoporosis is a common disease and physical activity (PA) has a favourable influence on bone status. AIM To establish normative data for calcaneal quantitative ultrasound (QUS) bone characteristics in children and to analyse the relationships between PA, anthropometric and bone parameters. SUBJECTS AND METHODS Hungarian children aged 7-19 (n = 2674; 1325 girls, 1349 boys) provided PA, anthropometric and bone data. QUS parameters were registered with Sonost3000 densitometer (speed of sound: SOS, m/s; broadband ultrasound attenuation: BUA, dB/MHz; bone quantity index (BQI = αSOS + βBUA). Reference centiles of QUS parameters were constructed by LMS method. Multivariate linear regression models were used to analyse the relationships. RESULTS QUS bone parameters increased with age. There were no gender differences, except in 11- and 19-year-old children, where boys showed higher values. SOS (1497.15 ± 15.72 vs 1494.05 ± 14.81 m/s) and BQI (65.31 ± 16.71 vs 62.26 ± 15.78) were higher in athletic children. The regression model revealed significant relations between SOS and age, relative muscle mass and PA; BUA correlated with gender, morphological age, BMI, relative muscle mass and PA. CONCLUSIONS Changes in the bone parameters among 7-19-year-old Hungarian children depended on age, anthropometric dimensions and the level of PA. The normative data could be used for monitoring QUS bone parameters in children, leading to more effective interventions for healthy bones.
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Affiliation(s)
- Márta Szmodis
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Annamária Zsákai
- b Department of Biological Anthropology , Eötvös Loránd University , Budapest , Hungary
| | - Edit Bosnyák
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Anna Protzner
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Emese Trájer
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Anna Farkas
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Gábor Szőts
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Miklós Tóth
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary.,c Department of Medical Chemistry , Semmmelweis University , Budapest , Hungary.,d Faculty of Health Sciences , University of Pécs , Pécs , Hungary
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Ramteke SM, Kaufman JJ, Arpadi SM, Shiau S, Strehlau R, Patel F, Mbete N, Coovadia A, Yin MT. Unusually High Calcaneal Speed of Sound Measurements in Children with Small Foot Size. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:357-361. [PMID: 27692859 PMCID: PMC5300769 DOI: 10.1016/j.ultrasmedbio.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/28/2016] [Accepted: 08/16/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this clinical note is to describe the performance of the Lunar Achilles Insight device in assessing bone quality at the calcaneus in 142 children between the ages of 5 and 11 y accessing healthcare in Johannesburg, South Africa. We observed an asymmetric bimodal distribution in speed of sound (SOS). The minor mode consisted of unusually high SOS values (≥1625 m/s), which were primarily observed among children with foot size <19 cm and height <119 cm. Cortical regions of the bone may have been inadvertently included in the region of interest for smaller feet, causing unusually high SOS values. The unusually high SOS values indicate that the validity of SOS in this device, as it is currently used for measuring bone quality in young children, is questionable. Future studies using this device in young children should develop new methodology to account for smaller foot size.
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Affiliation(s)
- Sarah M Ramteke
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
| | - Jonathan J Kaufman
- CyberLogic, Inc., New York, NY, USA; Department of Orthopedics, The Mount Sinai Medical Center, New York, NY, USA
| | - Stephen M Arpadi
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA; Department of Pediatrics, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Stephanie Shiau
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Renate Strehlau
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ndileka Mbete
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ashraf Coovadia
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michael T Yin
- Department of Medicine, Division of Infectious Disease, Columbia University Medical Center, New York, NY, USA.
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Weeks BK, Hirsch R, Nogueira RC, Beck BR. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children? Bone Joint Res 2016; 5:538-543. [PMID: 27827803 PMCID: PMC5131090 DOI: 10.1302/2046-3758.511.bjr-2016-0116.r1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/07/2016] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of the current study was to assess whether calcaneal broadband ultrasound attenuation (BUA) can predict whole body and regional dual-energy x-ray absorptiometry (DXA)-derived bone mass in healthy, Australian children and adolescents at different stages of maturity. Methods A total of 389 boys and girls across a wide age range (four to 18 years) volunteered to participate. The estimated age of peak height velocity (APHV) was used to classify children into pre-, peri-, and post-APHV groups. BUA was measured at the non-dominant heel with quantitative ultrasonometry (QUS) (Lunar Achilles Insight, GE), while bone mineral density (BMD) and bone mineral content (BMC) were examined at the femoral neck, lumbar spine and whole body (DXA, XR-800, Norland). Associations between BUA and DXA-derived measures were examined with Pearson correlations and linear regression. Participants were additionally ranked in quartiles for QUS and DXA measures in order to determine agreement in rankings. Results For the whole sample, BUA predicted 29% of the study population variance in whole body BMC and BMD, 23% to 24% of the study population variance in lumbar spine BMC and BMD, and 21% to 24% of the variance in femoral neck BMC and BMD (p < 0.001). BUA predictions were strongest for the most mature participants (pre-APHV R2 = 0.03 to 0.19; peri-APHV R2 = 0.05 to 0.17; post-APHV R2 = 0.18 to 0.28) and marginally stronger for girls (R2 = 0.25-0.32, p < 0.001) than for boys (R2 = 0.21-0.27, p < 0.001). Agreement in quartile rankings between QUS and DXA measures of bone mass was generally poor (27.3% to 38.2%). Conclusion Calcaneal BUA has a weak to moderate relationship with DXA measurements of bone mass in children, and has a tendency to misclassify children on the basis of quartile rankings. Cite this article: B. K. Weeks, R. Hirsch, R. C. Nogueira, B. R. Beck. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children? Bone Joint Res 2016;5:538–543. DOI: 10.1302/2046-3758.511.BJR-2016-0116.R1.
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Affiliation(s)
- B K Weeks
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - R Hirsch
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - R C Nogueira
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - B R Beck
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Sandström L, McGuigan FEA, Callréus M, Akesson KE. Peak Bone Mass and Quantitative Ultrasound Bone Properties in Young Adulthood: A Study in the PEAK-25 Cohort of Women. J Clin Densitom 2016; 19:477-484. [PMID: 27067746 DOI: 10.1016/j.jocd.2016.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/25/2016] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
Abstract
Peak bone mass is normally reached in the third decade of life. Previously, in the population-based PEAK-25 cohort (n = 1061, age 25.5 ± 0.2), we demonstrated that bone mineral density in the population-based PEAK-25 cohort is comparatively high; therefore, this study aimed to determine if the calcaneus microarchitecture mirrored this. In the process, we describe normative quantitative ultrasound (QUS) values for 25-yr-old women and the relationship between QUS values and extremes of body weight. QUS variables speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index were measured. Young adult values were based on the manufacturer-supplied QUS reference values. Analyses were performed in the cohort as a whole, and additionally, to understand the relationship between body weight and QUS values in young women, the variables were categorized into octiles for weight or body mass index (BMI) and the lowest and highest octiles were compared. In the cohort, SOS values, reflecting bone density, were higher (108 ± 18%), whereas BUA values, reflecting bone complexity, were lower (90 ± 14%) compared to the young adult reference population. SOS did not correlate with body weight or BMI. In the cohort, overall correlations between BUA weight, and BMI were small and positive (Pearson's r coefficients 0.261 and 0.197, respectively; p < 0.001), although in the low-weight group, r coefficients were higher (r = 0.313 and 0.268; p < 0.05). In contrast, in the high-weight group, correlation with BUA values tended to be small, negative, and nonsignificant. Correlation between QUS and dual-energy X-ray absorptiometry-measured bone mineral density was low to moderate and significant at all skeletal sites (r = 0.37-0.52). Whereas coefficients tended to be higher in the low-weight group, the reverse was apparent for the low-BMI group. In these 25-yr-old women, a comparatively high dual-energy X-ray absorptiometry-measured bone mass is offset by less complex bone structures assessed by QUS. This may have implications for later osteoporosis assessment and future fracture risk.
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Affiliation(s)
- Linnéa Sandström
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Malmö, Sweden; Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
| | - Fiona E A McGuigan
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Malmö, Sweden; Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden.
| | - Mattias Callréus
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Malmö, Sweden; Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
| | - Kristina E Akesson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Malmö, Sweden; Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
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Inamori-Kawamoto O, Ishikawa T, Michiue T, Mustafa AMH, Sogawa N, Kanou T, Oritani S, Maeda H. Possible application of CT morphometry of the calcaneus and talus in forensic anthropological identification. Int J Legal Med 2015; 130:575-85. [PMID: 26362306 DOI: 10.1007/s00414-015-1258-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
Computed tomography (CT) data provide information for volumetric and radiographic density analysis. The present study investigated the application of virtual CT volumetry of the tarsal bones to estimation of the sex, stature, and body weight using postmortem CT (PMCT) data of forensic autopsy cases. Three-dimensional (3D) images of the bilateral foot bones of intact Japanese subjects after adolescence (age ≥ 15 years, n = 179, 100 males and 79 females) were reconstructed on an automated CT image analyzer system. Measured parameters were mass volume, mean CT value (HU), and total CT value of the talus and calcaneus. Mean CT values of these bones showed age-dependent decreases in elderly subjects over 60 years of age for both sexes, with significant sex-related differences especially in the elderly. The mass volumes and total CT values of the talus and calcaneus showed significant sex-related differences, and also moderate correlations with body height and weight for bilateral bones in all cases (r = 0.58-0.78, p < 0.0001); however, the correlations of these parameters of the female talus with body weight were insufficient (r = 0.41-0.61, p < 0.0001). These observations indicate the applicability of virtual CT morphometry of the talus and calcaneus using an automated analyzer to estimate the sex and stature in forensic identification; however, greater variations should be considered in body weight estimations of females.
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Affiliation(s)
- Osamu Inamori-Kawamoto
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan.,Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan
| | - Takaki Ishikawa
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan. .,Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan. .,Division of Legal Medicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan.
| | - Tomomi Michiue
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan.,Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan
| | | | - Nozomi Sogawa
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan.,Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan
| | - Tetsuya Kanou
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan
| | - Shigeki Oritani
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan
| | - Hitoshi Maeda
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan.,Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan
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Williams KD, Blangero J, Mahaney MC, Subedi J, Jha B, Williams-Blangero S, Towne B. Axial quantitative ultrasound assessment of pediatric bone quality in eastern Nepal. Osteoporos Int 2015; 26:2319-28. [PMID: 25862355 DOI: 10.1007/s00198-015-3115-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 03/18/2015] [Indexed: 12/29/2022]
Abstract
UNLABELLED This study presents quantitative ultrasonography (QUS) bone quality data for an underrepresented, south Asian pediatric population from Nepal. Data were collected as part of a longitudinal study of growth and development. This study offers normative data and documents the effect of stunting, wasting, and underweight on the bone properties measured by QUS. INTRODUCTION The purpose of this study was to (1) examine the bone quality of a rural, non-Western pediatric population using QUS, (2) explore variation in the trajectory of bone quality development between males and females, and (3) examine the impact of growth disruption(s) on bone quality. METHODS A cross-sectional study of 860 children and adolescents aged 5-18 years from the Jirel ethnic group in eastern Nepal was performed. The Sunlight Omnisense 7000P was used to assess bone quality of the distal 1/3 radius and midshaft tibia. WHO reference standards were used to assess growth disruptions of height, weight, and BMI. RESULTS QUS bone quality data for an underrepresented, non-Western pediatric population are presented for the radius and tibia. A sizable portion of the study participants were classified as stunted, wasted, and/or underweight. Despite this prevalence of growth disruption in the study sample, bone quality data conform to other documented populations with less growth disruption. Thus, this study offers normative data and documents the minimal effect of stunting, wasting, and underweight on the bone properties measured by QUS. CONCLUSIONS Non-Western pediatric populations are significantly underserved with regard to simple, non-invasive screening tools that may help identify developmental disorders and assess bone health. The children and adolescents examined here represent normal growth and development for an underrepresented south Asian population. While this work demonstrates that stunting, wasting, or underweight status at time of QUS assessment is not associated with poor bone quality, we do suggest that further study is needed to examine possible cumulative effects of persistent disruptions that may lead to compromised bone quality in later adolescence.
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Affiliation(s)
- K D Williams
- Department of Anthropology, Temple University, 1115 Polett Walk, 210 Gladfelter Hall, Philadelphia, PA, 19120, USA,
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Xu Y, Guo B, Gong J, Xu H, Bai Z. The correlation between calcaneus stiffness index calculated by QUS and total body BMD assessed by DXA in Chinese children and adolescents. J Bone Miner Metab 2014; 32:159-66. [PMID: 23695447 DOI: 10.1007/s00774-013-0474-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/14/2013] [Indexed: 12/31/2022]
Abstract
Few studies have shown comparison data between calcaneus stiffness index (SI) calculated by quantitative ultrasound (QUS) and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) in the Chinese population. This study was aimed to examine the correlations between calcaneus SI calculated by QUS and total body BMD and bone mineral content (BMC) measured by DXA in Chinese children and adolescents. We measured the total body BMD and BMC using Lunar Prodigy (GE Healthcare), and speed of sound (SOS), broadband ultrasound attenuation (BUA), and a calculated SI of the left os calcis using Lunar Achilles Express (GE Healthcare) in 392 healthy Chinese schoolchildren and adolescents aged 5-19 years. The short-term precision for DXA was 0.5 % for total body BMD. The precision for QUS was 1.8 % for SI, 2.9 % for BUA, and 0.4 % for SOS. Pearson's correlation coefficients (r) were calculated to assess the possible correlations between the total body BMC by DXA and SI calculated by QUS. There were significantly positive correlations between SI of the left os calcis and total body BMD (r = 0.693, p < 0.001, n = 392) and BMC (r = 0.690, p < 0.001, n = 392). For all the subjects, significant positive correlations were observed between the calcaneal SI and the age, weight, height, BMI, total body BMD, total body BMC, total body lean mass, and total body fat mass, with r ranging from 0.310 (total body fat mass) to 0.693 (total body BMD) (p < 0.001, n = 392). In conclusion, QUS bone densitometry is a useful measuring method showing the physiological bone development in childhood and adolescence.
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Affiliation(s)
- Yi Xu
- Department of Clinical Medicine, Medical College, Jinan University, No. 601 West Huangpu Road, Guangzhou, 510632, China
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Gavris M, Courteix D, Serbanoiu S, Hantiu I, Tifrea C, Ferry B. Bone Tissue in Down Syndrome Patients Deteriorates Following Aging: A Study Based on Bone Ultrasound Analysis. J Med Ultrasound 2014. [DOI: 10.1016/j.jmu.2013.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Gianfagna F, Cugino D, Ahrens W, Bailey MES, Bammann K, Herrmann D, Koni AC, Kourides Y, Marild S, Molnár D, Moreno LA, Pitsiladis YP, Russo P, Siani A, Sieri S, Sioen I, Veidebaum T, Iacoviello L. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children. PLoS One 2013; 8:e70632. [PMID: 23936460 PMCID: PMC3731254 DOI: 10.1371/journal.pone.0070632] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/20/2013] [Indexed: 01/08/2023] Open
Abstract
Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs) and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2±1.8 years) from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet) and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714), was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ = −1.8, p = 0.006). Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0–43.9%), the CCT haplotype (frequency = 39.7%) was associated with lower SI values (dominant model, Δ = −1.0, p = 0.04) as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4%) showed much lower SI than non-carriers (Δ = −3.9, p<0.0001; p for interaction = 0.025). The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p = 0.01). This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls.
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Affiliation(s)
- Francesco Gianfagna
- Research Laboratories, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso, Italy
| | | | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Department of Mathematics and Computer Sciences, University of Bremen, Bremen, Germany
| | - Mark E. S. Bailey
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karin Bammann
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Diana Herrmann
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - Anna C. Koni
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Yiannis Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Staffan Marild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Dénes Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Luis A. Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis P. Pitsiladis
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paola Russo
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - Alfonso Siani
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - Sabina Sieri
- Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Isabelle Sioen
- Department of Public Health, Ghent University, Ghent, Belgium
- FWO, Research Foundation Flanders, Brussels, Belgium
| | - Toomas Veidebaum
- Center of Health and Behavioral Science, National Institute for Health Development, Tallinn, Estonia
| | - Licia Iacoviello
- Casa di Cura Montevergine, Mercogliano (AV), Italy
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy
- * E-mail:
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Yesil P, Durmaz B, Atamaz FC. Normative data for quantitative calcaneal ultrasonometry in Turkish children aged 6 to 14 years: relationship of the stiffness index with age, pubertal stage, physical characteristics, and lifestyle. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:1191-1197. [PMID: 23804341 DOI: 10.7863/ultra.32.7.1191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Quantitative ultrasonometry is commonly used to assess bone health. The aim of this study was to define normative data for the stiffness index of the calcaneus in healthy Turkish children. METHODS Quantitative ultrasonometric measurements of the calcaneus were obtained in 1617 healthy schoolchildren (811 boys and 806 girls) aged 6 to 14 years. RESULTS The stiffness index increased by 19.3% and 12% in boys and girls, respectively. The greatest increases were seen in the age groups of 12 to 13 and 13 to 14 years in boys (3.9%) and 11 to 12 and 12 to 13 years in girls (4.1%). There was a significant increase in stiffness index values among all Tanner stages except stage 4 (P < .05). Although the stiffness index was related to age, weight, and height, no correlation was seen between the stiffness index and calcium intake or physical activity. CONCLUSIONS This study provides stiffness index data by age group and Tanner stage that may be useful for assessment of the bone status of Turkish children and can serve as comparative data for other patient groups.
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Affiliation(s)
- Pinar Yesil
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, Bornova, 35040 Izmir, Turkey
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Alcohol consumption and body composition in a population-based sample of elderly Australian men. Aging Clin Exp Res 2013; 25:183-92. [PMID: 23739904 DOI: 10.1007/s40520-013-0026-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 07/24/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Alcohol is calorie dense, and impacts activity, appetite and lipid processing. The aim of this study was to therefore investigate the association between alcohol consumption and components of body composition including bone, fat and lean tissue. METHODS Participants were recruited from a randomly selected, population-based sample of 534 men aged 65 years and older enrolled in the Geelong Osteoporosis Study. Alcohol intake was ascertained using a food frequency questionnaire and the sample categorised as non-drinkers or alcohol users who consumed ≤2, 3-4 or ≥5 standard drinks on a usual drinking day. Bone mineral density (BMD), lean body mass and body fat mass were measured using dual energy X-ray absorptiometry; overall adiposity (%body fat), central adiposity (%truncal fat) and body mass index (BMI) were calculated. Bone quality was determined by quantitative heel ultrasound (QUS). RESULTS There were 90 current non-drinkers (16.9 %), 266 (49.8 %) consumed 1-2 drinks/day, 104 (19.5 %) 3-4 drinks/day and 74 (13.8 %) ≥5 drinks/day. Those consuming ≥5 drinks/day had greater BMI (+4.8 %), fat mass index (+20.1 %), waist circumference (+5.0 %), %body fat (+15.2 %) and proportion of trunk fat (+5.3 %) and lower lean mass (-5.0 %) than non-drinkers after adjustment for demographic and lifestyle factors. Furthermore, they were more likely to be obese than non-drinkers according to criteria based on BMI (OR = 2.83, 95 %CI 1.10-7.29) or waist circumference (OR = 3.36, 95 %CI 1.32-8.54). There was an inverse relationship between alcohol consumption and QUS parameters and BMD at the mid forearm site; no differences were detected for BMD at other skeletal sites. CONCLUSION Higher alcohol intake was associated with greater total and central adiposity and reduced bone quality.
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Van den Bussche K, Michels N, Gracia-Marco L, Herrmann D, Eiben G, De Henauw S, Sioen I. Influence of birth weight on calcaneal bone stiffness in Belgian preadolescent children. Calcif Tissue Int 2012; 91:267-75. [PMID: 22911000 DOI: 10.1007/s00223-012-9636-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 07/03/2012] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the relation between birth weight and calcaneal bone stiffness in a large sample of Belgian, healthy, preadolescent children. Participants were 827 children (3.6-11.2 years, 51.6 % boys) from the Belgian cohort of the IDEFICS study. Birth weight was obtained using a parental questionnaire, and quantitative ultrasound (QUS) measurements were performed to determine calcaneal broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) using the Lunar Achilles device. Average birth weights were 3435.7 ± 512.0 g for boys and 3256.9 ± 471.1 g for girls. Average calcaneal QUS measurements were 89.6 ± 24.0 (23.3-153.9) dB/MHz for BUA, 1621.4 ± 49.6 (1516.3-1776.5) m/s for SOS, and 92.8 ± 15.6 (49.0-163.0) for SI. Birth weight was positively associated with BUA (r = 0.13, p = 0.002) and SOS (r = -0.16, p < 0.001). The associations remained after correcting for age and sex in multiple regression analyses but disappeared after correcting for anthropometric covariates. Our findings suggest that birth weight, as a rough proxy indicator for genetic and environmental influences during intrauterine life, is associated with BUA and SOS in preadolescent children and may therefore influence the risk of osteoporosis later in life. Further studies using QUS are needed to investigate the consistency of the results of this study.
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Sioen I, Mouratidou T, Herrmann D, De Henauw S, Kaufman JM, Molnár D, Moreno LA, Marild S, Barba G, Siani A, Gianfagna F, Tornaritis M, Veidebaum T, Ahrens W. Relationship between markers of body fat and calcaneal bone stiffness differs between preschool and primary school children: results from the IDEFICS baseline survey. Calcif Tissue Int 2012; 91:276-85. [PMID: 22907129 DOI: 10.1007/s00223-012-9640-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 07/27/2012] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the relationship between markers of body fat and bone status assessed as calcaneal bone stiffness in a large sample of European healthy pre- and primary school children. Participants were 7,447 children from the IDEFICS study (spread over eight different European countries), age 6.1 ± 1.8 years (range 2.1-9.9), 50.5 % boys. Anthropometric measurements (weight, height, bioelectrical impedance, waist and hip circumference, and tricipital and subscapular skinfold thickness) as well as quantitative ultrasonographic measurements to determine calcaneal stiffness index (SI) were performed. Partial correlation analysis, linear regression analysis, and ANCOVA were stratified by sex and age group: preschool boys (n = 1,699) and girls (n = 1,599) and primary school boys (n = 2,062) and girls (n = 2,087). In the overall study population, the average calcaneal SI was equal to 80.2 ± 14.0, ranging 42.4-153. The results showed that preschool children with higher body fat had lower calcaneal SI (significant correlation coefficients between -0.05 and -0.20), while primary school children with higher body fat had higher calcaneal SI (significant correlation coefficients between 0.05 and 0.13). After adjusting for fat-free mass, both preschool and primary school children showed an inverse relationship between body fat and calcaneal stiffness. To conclude, body fat is negatively associated with calcaneal bone stiffness in children after adjustment for fat-free mass. Fat-free mass may confound the association in primary school children but not in preschool children. Muscle mass may therefore be an important determinant of bone stiffness.
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Affiliation(s)
- Isabelle Sioen
- Department of Public Health, Ghent University, Ghent, Belgium.
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