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Zheng Y, Nour MA, Lanovaz J, Johnston JJD, Kontulainen S. Bone and muscle differences in children and adolescents with type 1 diabetes: The mediating role of physical activity. Bone 2024; 187:117206. [PMID: 39029608 DOI: 10.1016/j.bone.2024.117206] [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: 04/07/2024] [Revised: 06/14/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
Children with type 1 diabetes (T1D) experience an increased risk of fracture, which may be related to altered bone development. We aimed to assess differences in bone, muscle and physical activity (PA), and explore if better muscle and PA measures would mitigate bone differences between children and adolescents with T1D and typically developing peers (TDP). We matched 56 children and adolescents with T1D (mean age 11.9 yrs) and 56 TDP (11.5 yrs) by sex and maturity from 171 participants with T1D and 66 TDP (6-17 yrs). We assessed the distal radius and tibia with high-resolution peripheral quantitative computed tomography (HR-pQCT), and the radius and tibia shaft bone and muscle with pQCT. We also measured muscle function from force-related measures in neuromuscular performance tests (push-up, grip test, countermovement and long jump). We compared PA based on questionnaire scores and accelerometers between groups. Bone, muscle, and neuromuscular performance measures were compared using MANOVA. We used mediation to explore the role of PA and muscle in bone differences. Children and adolescents with T1D had 6-10 % lower trabecular density, bone volume fraction, thickness and number at both distal radius and tibia, and 11 % higher trabecular separation at the distal radius than TDP. They also had 3-16 % higher cortical and tissue mineral density, and cortical thickness at the distal radius, 5-7 % higher cortical density and 1-3 % higher muscle density at both shaft sites compared to TDP. PA mediated the between-group difference in trabecular number (indirect effect -0.04) at the distal radius. Children and adolescents with T1D had lower trabecular bone density and deficits in trabecular micro-architecture, but higher cortical bone density and thickness at the radius and tibia compared to TDP. They engaged in less PA but had comparable muscle measures to those of TDP. PA participation may assist in mitigating deficit in trabecular number observed in children and adolescents with T1D.
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Affiliation(s)
- Yuwen Zheng
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B2, Canada
| | - Munier A Nour
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - Joel Lanovaz
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B2, Canada
| | - James J D Johnston
- College of Engineering, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5A9, Canada
| | - Saija Kontulainen
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B2, Canada.
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2
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Rose GL, Boytar AN, King IN, Farley MJ, Maugham-Macan M, Skinner TL, Bolam KA, Schaumberg MA. Technical and biological reliability of pQCT measured bone and muscle tissue quality across the age-span. J Clin Densitom 2024; 27:101522. [PMID: 39288472 DOI: 10.1016/j.jocd.2024.101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 07/31/2024] [Accepted: 08/09/2024] [Indexed: 09/19/2024]
Abstract
INTRODUCTION Reliable peripheral quantitative computed tomography (pQCT) assessment is essential to the accurate longitudinal reporting of bone and muscle quality. However, the between-day reliability of pQCT and the influence of age on outcome reliability is currently unknown. OBJECTIVE To quantify the same- and between-day reliability of morphological pQCT at proximal and distal segments of the forearm, shank, and thigh, and explore the influence of participant body size, age, and sex on outcome reliability. METHODS Men and women (49 % female, 18-85 years, n=72-86) completed two consecutive-day pQCT testing sessions, where repeat measurements were conducted on day-one for technical error, and between-day for biological error quantification. Testing was undertaken following best practice body composition testing guidance, including standardized presentation and consistent time-of-day. RESULTS All measurements of bone were classified as having 'good' to 'excellent' reliability [intraclass correlation coefficient (r=0.786- 0.999], as were measurements of muscle area (ICC r=0.991-0.999) and total fat (r=0.996-0.999). However, between- and same-day muscle density measurements at the thigh and forearm were classified as 'poor' (r=0.476) and 'moderate' (r=0.622), respectively. Likewise, intramuscular fat area at the thigh was classified as 'moderate' (r=0.737) for between-day measurement. Biological error was inflated compared to technical error by an average of 0.4 % for most measurements. Error values tended to increase proportionally with the amount of tissue quantified and males had significantly greater biological error for measurement of distal tibial bone (p<0.002) and trabecular area (p<0.002). Biological error was inflated among older adults for measurement of forearm muscle density (p<0.002). CONCLUSIONS Most pQCT outcomes can be implemented with confidence, especially outcomes that assess bone area and density at any of the radial, tibial, and femoral sites investigated herein. However, it is important to account for the influence of biological measurement error in further studies, especially for muscle and intramuscular fat outcomes derived by pQCT.
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Affiliation(s)
- Grace L Rose
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia; Sunshine Coast Health Institute, Birtinya, Australia.
| | - Alex N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Isabel N King
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia; Sunshine Coast Health Institute, Birtinya, Australia
| | - Morgan J Farley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia; School of Sport, Science and Rehabilitation, University of Technology Sydney, Sydney, Australia
| | | | - Tina L Skinner
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia; School of Sport, Science and Rehabilitation, University of Technology Sydney, Sydney, Australia
| | - Kate A Bolam
- Department of Physical Activity and Health, Swedish School of Sport and Health Sciences, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Mia A Schaumberg
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia; Sunshine Coast Health Institute, Birtinya, Australia
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Blay R, Flores LE, Kupzyk K, Waltman N, Lappe J, Mack L, Bilek L. Twelve-month resistance and impact exercise program or risedronate provides a relative benefit to hip bone structure in postmenopausal women: results from a randomized controlled trial. Osteoporos Int 2024; 35:877-891. [PMID: 38368307 DOI: 10.1007/s00198-023-07008-x] [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: 01/16/2023] [Accepted: 12/19/2023] [Indexed: 02/19/2024]
Abstract
Bone strength estimates are important for fracture prevention. This study compared bone strength changes in postmenopausal women with low bone mass who were assigned to 12 months of exercise, a bone medication, or control. Exercise and bone medications benefited structure at the hip. Structure should be considered in fracture prevention research. PURPOSE Exercise and bisphosphonates reduce fracture risk, but their impact on estimates of bone strength remains uncertain. This study compared changes in tibial bone strength using peripheral quantitative computed tomography (pQCT) and hip structure analysis (HSA) outcomes from dual-energy X-ray absorptiometry (DXA) scans in postmenopausal women with low bone mass assigned to 12 months of exercise, risedronate, or control. METHODS In this RCT, 276 postmenopausal women within 6 years of menopause were randomly assigned to three groups: exercise (92), risedronate (91), or control (93). Exercise included weighted jogging and progressive resistance exercises; risedronate treatment was 150 mg monthly; all groups received calcium and vitamin D. pQCT and DXA images were obtained at baseline and 6 and 12 months and compared between groups over time. RESULTS Participants had a mean (± SD) age of 54.5 (± 3.2) years with an average of 36.7 (± 40.7) months postmenopause. No significant differences were found between groups for the change in pQCT outcomes (volumetric bone mineral density, area, and strength estimates). At 12 months, mean percent differences (95% CI) in HSA measures between exercise and controls were as follows: intertrochanteric, cross-sectional area 2.25% (0.28, 4.12) (p = .03), cross-sectional moment of inertia (CSMI) 5.67% (1.47, 9.87) (p < .01), and section modulus (SM) 4.38% (1.02, 7.74) (p = .01), and narrow neck, average cortical thickness 2.37% (-0.08, 4.83) (p = .031). Mean percent differences (95% CI) in HSA measures between risedronate and control were as follows: intertrochanteric, CSMI 4.28% (-0.24, 8.81) (p = .03) and SM 3.35% (-0.21, 6.91) (p = .03), and shaft, subperiosteal width 0.82% (0.05, 1.58) (p = .047), CSMI 2.53% (0.88, 4.18) (p = .004), and SM 1.57% (0.34, 2.8) (p = .008). Exercise maintained neck-shaft angle compared to both control 1.27% (0.13, 2.41) (p = .04) and risedronate 1.31% (0.23, 2.39) (p = .03). All other differences for changes in HSA outcomes over time were not significantly different between the exercise and risedronate groups. CONCLUSION Exercise and bisphosphonates may influence structural and strength estimates at the hip, but not at peripheral sites (tibia). Neither exercise nor bisphosphonates were found to be superior in improving estimates of hip bone strength.
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Affiliation(s)
- R Blay
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - L E Flores
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - K Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - N Waltman
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - J Lappe
- Creighton Osteoporosis Research Center, Omaha, NE, USA
| | - L Mack
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - L Bilek
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.
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Benedikt S, Zelger P, Horling L, Stock K, Pallua J, Schirmer M, Degenhart G, Ruzicka A, Arora R. Deep Convolutional Neural Networks Provide Motion Grading for High-Resolution Peripheral Quantitative Computed Tomography of the Scaphoid. Diagnostics (Basel) 2024; 14:568. [PMID: 38473040 DOI: 10.3390/diagnostics14050568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
In vivo high-resolution peripheral quantitative computed tomography (HR-pQCT) studies on bone characteristics are limited, partly due to the lack of standardized and objective techniques to describe motion artifacts responsible for lower-quality images. This study investigates the ability of such deep-learning techniques to assess image quality in HR-pQCT datasets of human scaphoids. In total, 1451 stacks of 482 scaphoid images from 53 patients, each with up to six follow-ups within one year, and each with one non-displaced fractured and one contralateral intact scaphoid, were independently graded by three observers using a visual grading scale for motion artifacts. A 3D-CNN was used to assess image quality. The accuracy of the 3D-CNN to assess the image quality compared to the mean results of three skilled operators was between 92% and 96%. The 3D-CNN classifier reached an ROC-AUC score of 0.94. The average assessment time for one scaphoid was 2.5 s. This study demonstrates that a deep-learning approach for rating radiological image quality provides objective assessments of motion grading for the scaphoid with a high accuracy and a short assessment time. In the future, such a 3D-CNN approach can be used as a resource-saving and cost-effective tool to classify the image quality of HR-pQCT datasets in a reliable, reproducible and objective way.
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Affiliation(s)
- Stefan Benedikt
- Department of Orthopedics and Traumatology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Philipp Zelger
- Department of Otorhinolaryngology, Hearing, Speech & Voice Disorders, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Lukas Horling
- Department of Orthopedics and Traumatology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Kerstin Stock
- Department of Orthopedics and Traumatology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Johannes Pallua
- Department of Orthopedics and Traumatology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Michael Schirmer
- Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
- Office Dr. Schirmer, 6060 Hall, Austria
| | - Gerald Degenhart
- Department of Radiology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Alexander Ruzicka
- Department of Orthopedics and Traumatology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Rohit Arora
- Department of Orthopedics and Traumatology, University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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Bass A, Morin SN, Guidea M, Lam JTAT, Karelis AD, Aubertin-Leheudre M, Gagnon DH. Potential Effects of an Exoskeleton-Assisted Overground Walking Program for Individuals With Spinal Cord Injury Who Uses a Wheelchair on Imaging and Serum Markers of Bone Strength: Pre-Post Study. JMIR Rehabil Assist Technol 2024; 11:e53084. [PMID: 38163294 PMCID: PMC10790203 DOI: 10.2196/53084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND As many as 60% of individuals use a wheelchair long term after a spinal cord injury (SCI). This mode of locomotion leads to chronic decline in lower-extremity weight-bearing activities and contributes to the development of severe sublesional osteoporosis and high rates of fragility fracture. Overground exoskeleton-assisted walking programs provide a novel opportunity to increase lower-extremity weight bearing, with the potential to improve bone health. OBJECTIVE The aim of the study is to measure the potential effects of an exoskeleton-assisted walking program on lower-extremity bone strength and bone remodeling biomarkers in individuals with chronic (≥18 months) SCI who use a wheelchair. METHODS In total, 10 participants completed a 16-week exoskeleton-assisted walking program (34 individualized 1-hour sessions, progressing from 1 to 3 per week). Bone mineral density and bone strength markers (dual-energy x-ray absorptiometry: total body, left arm, leg, total hip, and femoral neck and peripheral quantitative computed tomography: 25% of left femur and 66% of left tibia) as well as bone remodeling biomarkers (formation=osteocalcin and resorption=C-telopeptide) were measured before and after intervention and compared using nonparametric tests. Changes were considered significant and meaningful if the following criteria were met: P<0.1, effect size ≥0.5, and relative variation >5%. RESULTS Significant and meaningful increases were observed at the femur (femoral neck bone mineral content, bone strength index, and stress-strain index) and tibia (cortical cross-sectional area and polar moment of inertia) after the intervention (all P<.10). We also noted a decrease in estimated femoral cortical thickness. However, no changes in bone remodeling biomarkers were found. CONCLUSIONS These initial results suggest promising improvements in bone strength markers after a 16-week exoskeleton-assisted walking program in individuals with chronic SCI. Additional research with larger sample sizes, longer interventions (possibly of greater loading intensity), and combined modalities (eg, pharmacotherapy or functional electrical stimulation) are warranted to strengthen current evidence. TRIAL REGISTRATION ClinicalTrials.gov NCT03989752; https://clinicaltrials.gov/ct2/show/NCT03989752. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19251.
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Affiliation(s)
- Alec Bass
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montréal, QC, Canada
| | - Michael Guidea
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Jacqueline T A T Lam
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Antony D Karelis
- Department of Exercise Science, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC, Canada
| | - Mylène Aubertin-Leheudre
- Department of Exercise Science, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
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Jaworski M, Kobylińska M. Precision errors and least significant changes in paediatric forearm measurements of bone density, mass, dimensions, mechanostat parameters and soft tissue composition by Stratec XCT-2000L. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2023; 23:397-406. [PMID: 38037358 PMCID: PMC10696365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES The peripheral quantitative computed tomography (pQCT) is gaining popularity in the field of paediatric densitometry, however, very little is known about the precision errors of this method in diseased children. The aim of the study was to evaluate the precision errors of bone density, mass, dimensions, strength, mechanostat parameters and soft tissue at the forearm in diseased children. METHODS Stratec XCT 2000L apparatus was used. The measurement sites were 4% and 66% of the forearm length. The study group consisted of 60 patients (31 girls) aged 5,7-18,0 yrs. RESULTS We observed week relationships between precision errors and body size with r from -0,37 to 0,28. Relative precision errors (CV%RMS) were from 0,85% for radius 66% cortical bone density to 3,82% for fat cross-sectional area to muscle cross-sectional area ratio. Least significant change (LSC) was from 2,73% to 10,59%, respectively. CONCLUSION Presented study reveal pQCT method at the forearm in diseased children as relatively precise technique. The results may help with planning and interpretation of pQCT studies in diseased children.
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Affiliation(s)
- Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Maria Kobylińska
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
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7
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Coheley LM, Yu M, Chen X, O'Connor PJ, Kealey KS, Laing EM, Oshri A, Marand AK, Lance JM, Kindler JM, Lewis RD. The Impact of Whole Egg Consumption on Bone Accrual in Healthy Children: A Randomized Controlled Trial. J Bone Miner Res 2023; 38:1809-1821. [PMID: 37950643 PMCID: PMC11037861 DOI: 10.1002/jbmr.4929] [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: 06/22/2023] [Revised: 10/13/2023] [Accepted: 10/27/2023] [Indexed: 11/13/2023]
Abstract
Dietary interventions designed to examine the role of nutrition on childhood bone accrual have often focused on the role of individual micronutrients (eg, calcium, vitamin D, and zinc) and macronutrients (eg, protein). The osteogenic benefits of whole foods, such as eggs, are not well understood despite eggs being a source of high-quality nutrients and bioactive compounds known to positively influence bone. A significant positive cross-sectional association between whole egg consumption and tibia cortical bone mass has recently been shown in young children; however, randomized controlled trials (RCTs) have not been conducted. This study is a double-blind RCT in male and female children ages 9-13 years of different ancestries, designed to determine if consuming food products with whole eggs (equivalent to 8-10 eggs/wk) versus foods with milk or gelatin (placebo) over a 9-month period will improve measures of bone strength. Total body less head (TBLH) and lumbar spine bone mineral content (BMC) and areal bone mineral density (aBMD) were assessed using dual-energy X-ray absorptiometry (DXA). DXA Z-scores were computed using published pediatric growth charts and were adjusted for height-for-age Z-score (HAZ). Mid-tibia cortical volumetric BMD, BMC, cortical area, total bone area, cortical thickness, and strength strain index were measured using peripheral quantitative computed tomography. Overall, there were no significant intervention effects for any bone outcomes. The increase in spine BMCHAZ Z-score in the egg group versus the gelatin group approached significance (p = 0.07). Significant time effects in TBLH aBMDHAZ Z-score occurred as all groups decreased over 9 months (p < 0.03). Most tibia cortical bone outcomes increased over time (all p < 0.02), but changes did not differ across intervention groups. Whole eggs provide important nutritional benefits for children, but the bone responses to consumption of 8-10 eggs/wk over a period of 9 months in children entering the early stages of puberty were small. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Lauren M Coheley
- Department of Nutrition, Texas A&M University, College Station, TX, USA
| | - Mengyun Yu
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - Xianyan Chen
- Department of Statistics, University of Georgia, Athens, GA, USA
| | | | - Kirk S Kealey
- Food Product Innovation & Commercialization Center, University of Georgia, Griffin, GA, USA
| | - Emma M Laing
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Alicia K Marand
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Julia M Lance
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Joseph M Kindler
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Richard D Lewis
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
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Holloway-Kew KL, Anderson KB, Rufus-Membere P, Tembo MC, Sui SX, Hyde NK, Kotowicz MA, Gwini SM, Yang J, Diez-Perez A, Henneberg M, Liao WH, Pasco JA. Associations Between Aldosterone-Renin-Ratio and Bone Parameters Derived from Peripheral Quantitative Computed Tomography and Impact Microindentation in Men. Calcif Tissue Int 2023; 113:496-510. [PMID: 37690031 PMCID: PMC10618308 DOI: 10.1007/s00223-023-01131-x] [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: 05/07/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
Components of the renin-angiotensin-aldosterone system (RAAS) are present on bone cells. One measure of RAAS activity, the aldosterone-renin-ratio (ARR), is used to screen for primary aldosteronism. Associations between ARR and bone mineral density are conflicting. This study investigated associations between ARR and peripheral quantitative computed tomography (pQCT) and impact microindentation (IMI). Male participants (n = 431) were from the Geelong Osteoporosis Study. "Likely" primary aldosteronism was defined as ARR ≥ 70 pmol/mIU. Another group, "possible" primary aldosteronism, was defined as either ARR ≥ 70 pmol/mIU or taking a medication that affects the RAAS, but not a beta blocker, and renin < 15 mU/L. Using pQCT, images at 4% and 66% of radial (n = 365) and tibial (n = 356) length were obtained. Using IMI measurements, bone material strength index (BMSi; n = 332) was determined. Associations between ARR or likely/possible primary aldosteronism and IMI or pQCT-derived bone parameters were tested using median regression. ARR and aldosterone values were not associated with any of the pQCT-derived bone variables in either unadjusted or adjusted analyses. Men with likely primary aldosteronism (n = 16), had lower adjusted total bone area (radial 66% site, - 12.5%). No associations were observed for men with possible primary aldosteronism (unadjusted or adjusted). No associations with BMSi were observed (p > 0.05). There were no associations between ARR or aldosterone and pQCT-derived bone parameters. Men with likely primary aldosteronism had lower bone area, suggesting clinically high levels of ARR may have a negative impact on bone health.
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Affiliation(s)
- Kara L Holloway-Kew
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.
| | - Kara B Anderson
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Pamela Rufus-Membere
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Monica C Tembo
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Sophia X Sui
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Natalie K Hyde
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Mark A Kotowicz
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine - Western Health, The University of Melbourne, St Albans, Australia
| | - Stella M Gwini
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Australia
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia
| | - Jun Yang
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Australia
- Department of Medicine, Monash University, Clayton, Australia
| | - Adolfo Diez-Perez
- Barcelona- Department of Internal Medicine, Hospital del Mar-IMIM, Instituto Carlos III, Autonomous University of Barcelona and CIBERFES, Barcelona, Spain
| | - Maciej Henneberg
- Biological Anthropology and Comparative Anatomy Research Unit, School of Biomedicine, University of Adelaide, Adelaide, Australia
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Wan-Hui Liao
- Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei City, Taiwan
| | - Julie A Pasco
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine - Western Health, The University of Melbourne, St Albans, Australia
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia
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Redinger AL, Allen SMF, Buchanan SR, Black CD, Baker BS. Non-traditional HIIT-style ROTC training elicits positive bone quality and performance adaptations. J Sports Sci 2023; 41:1587-1595. [PMID: 38126323 DOI: 10.1080/02640414.2023.2283998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
Military personnel experience elevated bone injury incidence, partly due to arduous and repetitive training. Non-traditional High-Intensity Interval Training-style (HIIT) may benefit pre-enlisted Reserve Officer Training Corps (ROTC) cadet's musculoskeletal health and performance prior to military service. This study investigated 16 ROTC (n = 12 males; n = 4 females) and 15 physically active sex-, age-, and body mass-matched Controls' musculoskeletal health and performance from November to April. Total body, lumbar spine, and dual- hip dual-energy X-ray absorptiometry scans and 4%, 38%, 66% tibial peripheral quantitative computed tomography scans, blood draws (serum sclerostin and parathyroid hormone), and maximal muscle strength and aerobic capacity testing were completed. From November to April, ROTC improved bone density (DXA) of the dominant total hip and greater trochanter and non-dominant greater trochanter and 38% and 66% tibial total volumetric and cortical bone density (pQCT) similarly or more than Controls (all p ≤ 0.049). From November to April, ROTC also improved bench and leg press, and peak aerobic capacity (all p ≤ 0.013). From November to January, serum sclerostin increased (p ≤ 0.007) and remained elevated through April, while parathyroid hormone was unchanged. HIIT-style training induced positive musculoskeletal adaptations, suggesting it may be an excellent pre-service training modality for this injury prone group.
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Affiliation(s)
- Allen L Redinger
- Musculoskeletal Adaptations to Aging and eXercise (MAAX) Lab, Oklahoma State University, Stillwater, OK, USA
| | - Shawn M F Allen
- Musculoskeletal Adaptations to Aging and eXercise (MAAX) Lab, Oklahoma State University, Stillwater, OK, USA
| | - Samuel R Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, USA
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Christopher D Black
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Breanne S Baker
- Musculoskeletal Adaptations to Aging and eXercise (MAAX) Lab, Oklahoma State University, Stillwater, OK, USA
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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10
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Rasmussen NH, Kvist AV, Dal J, Jensen MH, van den Bergh JP, Vestergaard P. Bone parameters in T1D and T2D assessed by DXA and HR-pQCT - A cross-sectional study: The DIAFALL study. Bone 2023; 172:116753. [PMID: 37001628 DOI: 10.1016/j.bone.2023.116753] [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: 01/04/2023] [Revised: 03/12/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION/AIM People with type 1 diabetes(T1D) and type 2 diabetes(T2D) have an increased risk of fractures due to skeletal fragility. We aimed to compare areal bone mineral density(aBMD), volumetric BMD(vBMD), cortical and trabecular measures, and bone strength parameters in participants with diabetes vs. controls. METHODS In a cross-sectional study, we included participants with T1D(n = 111), T2D(n = 106) and controls(n = 328). The study comprised of whole-body DXA and HR-pQCT scans, biochemistry, handgrip strength(HGS), Timed Up and GO(TUG), vibration perception threshold (VPT), questionnaires, medical histories, alcohol use, and previous fractures. Group comparisons were performed after adjustment for sex, age, BMI, diabetes duration, HbA1c, alcohol, smoking, previous fractures, postmenopausal, HGS, TUG, and VPT. RESULTS We found decreased aBMD in participants with T1D at the femoral neck(p = 0.028), whereas T2D had significantly higher aBMD at peripheral sites(legs, arms, p < 0.01) vs. controls. In T1D we found higher vBMD(p < 0.001), cortical vBMD (p < 0.001), cortical area(p = 0.002) and thickness(p < 0.001), lower cortical porosity(p = 0.008), higher stiffness(p = 0.002) and failure load(p = 0.003) at radius and higher vBMD(p = 0.003), cortical vBMD(p < 0.001), bone stiffness(p = 0.023) and failure load(p = 0.044) at the tibia than controls. In T2D we found higher vBMD(p < 0.001), cortical vBMD(p < 0.001), trabecular vBMD(p < 0.001), cortical area (p < 0.001) and thickness (p < 0.001), trabecular number (p = 0.024), lower separation(p = 0.010), higher stiffness (p < 0.001) and failure load (p < 0.001) at the radius and higher total vBMD(p < 0.001), cortical vBMD(p < 0.011), trabecular vBMD(p = 0.001), cortical area(p = 0.002) and thickness(p = 0.021), lower trabecular separation(p = 0.039), higher stiffness(p < 0.001) and failure load(p = 0.034) at tibia compared with controls. CONCLUSION aBMD measures were as expected but favorable bone microarchitecture and strength parameters were seen at the tibia and radius for T1D and T2D.
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Affiliation(s)
| | - Annika Vestergaard Kvist
- Department of Endocrinology and Metabolism, Molecular Endocrinology & Stem Cell Research Unit (KMEB) Odense University Hospital, Odense, Denmark,; University of Southern Denmark, Odense, Denmark; Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark; Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH-Zurich, Zurich, Switzerland
| | - Jakob Dal
- Department of Endocrinology, Aalborg University Hospital, Denmark
| | - Morten H Jensen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Denmark; Department of Health Science and Technology, Aalborg University, Denmark
| | - Joop P van den Bergh
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Internal Medicine, VieCuri Medical Center, Venlo, the Netherlands
| | - Peter Vestergaard
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Denmark
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11
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Redinger AL, Baker BS. Oral Contraceptives and Female Rowers' Skeletal Health. J Strength Cond Res 2023; 37:669-677. [PMID: 36165993 DOI: 10.1519/jsc.0000000000004308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Redinger, AL and Baker, BS. Oral contraceptives and female rowers' skeletal health. J Strength Cond Res 37(3): 669-677, 2023-Previous studies suggest that women using oral contraceptives (OC) experience fewer skeletal benefits from exercise compared with non-OC users. These findings may be especially important for athletes competing in weight-supported sports with a high prevalence of low bone mineral density and fracture, such as rowing. The purpose of this study was to examine skeletal health and bone injuries in collegiate female rowers. Forty-nine National Collegiate Athletic Association Division I female rowers completed general health, menstrual history, and bone physical activity questionnaire (BPAQ) surveys. Dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) scans were used to assess bone content, density, and geometry. Contraceptive (OC users n = 14, non-OC users n = 35) and self-reported stress fracture (SFx n = 11, None n = 38) groups were analyzed using analysis of covariance and independent t -tests. Additionally, effect sizes ( d ) were calculated and significance was set at p ≤ 0.05. Oral contraceptive users had reduced lumbar spine areal bone mineral density after adjustment for Total BPAQ ( d = 0.58; p = 0.041) compared with non-OC users, but all other total body and site-specific DXA measures of bone mineral content and density were similar between contraceptive and injury groups. When comparing bone geometry of the 4, 38, and 66% tibiae using pQCT, no significant differences were found after adjustment for either contraceptive or injury group (all p > 0.060). Our findings suggest that OC usage was not associated with reduced skeletal health in competitive female rowers as evidenced by all Z-scores being above -2.0 and similar bone indices of mineralized content, density, geometry, and estimated strength between the groups.
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Affiliation(s)
- Allen L Redinger
- Musculoskeletal Adaptations to Aging and exercise (MAAX) Lab, School of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
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12
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Holloway-Kew KL, Anderson KB, Tembo MC, Sui SX, Harland JW, Hyde NK, Kotowicz MA, Pasco JA. Peripheral quantitative computed tomography-derived bone parameters in men with impaired fasting glucose and diabetes. J Bone Miner Metab 2023; 41:131-142. [PMID: 36550385 DOI: 10.1007/s00774-022-01389-5] [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: 08/17/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Individuals with type 2 diabetes mellitus (T2DM) are at higher risk of fracture, but paradoxically do not have reduced bone mineral density. We investigated associations between peripheral quantitative computed tomography (pQCT) and glycaemia status. MATERIALS AND METHODS Participants were men (n = 354, age 33-92 year) from the Geelong Osteoporosis Study. Diabetes was defined by fasting plasma glucose (FPG) ≥ 7.0 mmol/L, self-report of diabetes and/or antihyperglycaemic medication use and impaired fasting glucose (IFG) as FPG 5.6-6.9 mmol/L. Bone measures were derived using pQCT (XCT2000) at 4% and 66% radial and tibial sites. Linear regression was used, adjusting for age, body mass index and socio-economic status. RESULTS At the 4% site, men with T2DM had lower adjusted bone total area, trabecular area and cortical area at the radius (all - 6.2%) and tibia (all - 6.4%) compared to normoglycaemia. Cortical density was higher for T2DM at the radius (+ 5.8%) and tibia (+ 8.0%), as well as adjusted total bone density at the tibial site (+ 6.1%). At the 66% site, adjusted total bone area and polar stress strain index were lower for T2DM at the radius (- 4.3% and - 8.0%). Total density was also higher for T2DM (+ 1.2%). Only cortical density at the 4% tibial site was different between IFG and normoglycaemia in adjusted analyses (+ 4.5%). CONCLUSION Men with T2DM had lower total bone area, trabecular area, cortical area and polar stress strain index than the other two groups; however, total density and cortical density were higher. Only one difference was observed between IFG and normoglycaemia; increased tibial cortical density.
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Affiliation(s)
- Kara L Holloway-Kew
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia.
| | - Kara B Anderson
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
| | - Monica C Tembo
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
| | - Sophia X Sui
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
| | - Jacob W Harland
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
| | - Natalie K Hyde
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
| | - Mark A Kotowicz
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia
| | - Julie A Pasco
- IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, , VIC, 3220, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
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13
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Walle M, Eggemann D, Atkins PR, Kendall JJ, Stock K, Müller R, Collins CJ. Motion grading of high-resolution quantitative computed tomography supported by deep convolutional neural networks. Bone 2023; 166:116607. [PMID: 36368464 DOI: 10.1016/j.bone.2022.116607] [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: 06/07/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Image quality degradation due to subject motion confounds the precision and reproducibility of measurements of bone density, morphology and mechanical properties from high-resolution peripheral quantitative computed tomography (HR-pQCT). Time-consuming operator-based scoring of motion artefacts remains the gold standard to determine the degree of acceptable motion. However, due to the subjectiveness of manual grading, HR-pQCT scans of poor quality, which cannot be used for analysis, may be accepted upon initial review, leaving patients with incomplete or inaccurate imaging results. Convolutional Neural Networks (CNNs) enable fast image analysis with relatively few pre-processing requirements in an operator-independent and fully automated way for image classification tasks. This study aimed to develop a CNN that can predict motion scores from HR-pQCT images, while also being aware of uncertain predictions that require manual confirmation. The CNN calculated motion scores within seconds and achieved a high F1-score (86.8 ± 2.8 %), with good precision (87.5 ± 2.7 %), recall (86.7 ± 2.9 %) and a substantial agreement with the ground truth measured by Cohen's kappa (κ = 68.6 ± 6.2 %); motion scores of the test dataset were predicted by the algorithm with comparable accuracy, precision, sensitivity and agreement as by the operators (p > 0.05). This post-processing approach may be used to assess the effect of motion scores on microstructural analysis and can be immediately implemented into clinical protocols, significantly reducing the time for quality assessment and control of HR-pQCT scans.
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Affiliation(s)
- Matthias Walle
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | | | - Penny R Atkins
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Jack J Kendall
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Kerstin Stock
- University Hospital for Orthopedics and Traumatology, Innsbruck, Austria
| | - Ralph Müller
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Caitlyn J Collins
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Virginia Tech, Department of Biomedical Engineering and Mechanics, Blacksburg, United States.
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14
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Makrogiannis S, Okorie A, Di Iorio A, Bandinelli S, Ferrucci L. Multi-atlas segmentation and quantification of muscle, bone and subcutaneous adipose tissue in the lower leg using peripheral quantitative computed tomography. Front Physiol 2022; 13:951368. [PMID: 36311235 PMCID: PMC9614313 DOI: 10.3389/fphys.2022.951368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022] Open
Abstract
Accurate and reproducible tissue identification is essential for understanding structural and functional changes that may occur naturally with aging, or because of a chronic disease, or in response to intervention therapies. Peripheral quantitative computed tomography (pQCT) is regularly employed for body composition studies, especially for the structural and material properties of the bone. Furthermore, pQCT acquisition requires low radiation dose and the scanner is compact and portable. However, pQCT scans have limited spatial resolution and moderate SNR. pQCT image quality is frequently degraded by involuntary subject movement during image acquisition. These limitations may often compromise the accuracy of tissue quantification, and emphasize the need for automated and robust quantification methods. We propose a tissue identification and quantification methodology that addresses image quality limitations and artifacts, with increased interest in subject movement. We introduce a multi-atlas image segmentation (MAIS) framework for semantic segmentation of hard and soft tissues in pQCT scans at multiple levels of the lower leg. We describe the stages of statistical atlas generation, deformable registration and multi-tissue classifier fusion. We evaluated the performance of our methodology using multiple deformable registration approaches against reference tissue masks. We also evaluated the performance of conventional model-based segmentation against the same reference data to facilitate comparisons. We studied the effect of subject movement on tissue segmentation quality. We also applied the top performing method to a larger out-of-sample dataset and report the quantification results. The results show that multi-atlas image segmentation with diffeomorphic deformation and probabilistic label fusion produces very good quality over all tissues, even for scans with significant quality degradation. The application of our technique to the larger dataset reveals trends of age-related body composition changes that are consistent with the literature. Because of its robustness to subject motion artifacts, our MAIS methodology enables analysis of larger number of scans than conventional state-of-the-art methods. Automated analysis of both soft and hard tissues in pQCT is another contribution of this work.
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Affiliation(s)
- Sokratis Makrogiannis
- Math Imaging and Visual Computing Lab, Division of Physics, Engineering, Mathematics and Computer Science, Delaware State University, Dover, DE, United States
- *Correspondence: Sokratis Makrogiannis,
| | - Azubuike Okorie
- Math Imaging and Visual Computing Lab, Division of Physics, Engineering, Mathematics and Computer Science, Delaware State University, Dover, DE, United States
| | - Angelo Di Iorio
- Antalgic Mini-invasive and Rehab-Outpatients Unit, Department of Innovative Technologies in Medicine & Dentistry, University “G.d’Annunzio”, Chieti-Pescara, Italy
| | | | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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15
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Berryman CE, McClung HL, Sepowitz JJ, Gaffney‐Stomberg E, Ferrando AA, McClung JP, Pasiakos SM. Testosterone status following short-term, severe energy deficit is associated with fat-free mass loss in U.S. Marines. Physiol Rep 2022; 10:e15461. [PMID: 36117330 PMCID: PMC9483439 DOI: 10.14814/phy2.15461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023] Open
Abstract
The objective of this study was to determine metabolic and physiological differences between males with low testosterone (LT) versus those with normal testosterone (NT) following a period of severe energy deficit. In this secondary analysis, 68 male US Marines (mean ± SD, 24.6 ± 2.4 y) were dichotomized by testosterone concentration (< or ≥ 10.5 nmol/L as determined from a single blood sample collected between 0600-0630 after an 8-10 h overnight fast by automated immunoassay) following 7 days of near complete starvation (~300 kcal consumed/d, ~85% energy deficit) during Survival, Evasion, Resistance, and Escape (SERE) training. Dietary intake was assessed before (PRE) SERE. Body composition (dual-energy x-ray absorptiometry and peripheral quantitative computed tomography) and whole-body protein turnover (15 N alanine) were assessed before (PRE) and after (POST) SERE. Mean testosterone concentrations decreased PRE (17.5 ± 4.7 nmol/L) to POST (9.8 ± 4.0 nmol/L, p < 0.0001). When volunteers were dichotomized by POST testosterone concentrations [NT (n = 24) 14.1 ± 3.4 vs. LT (n = 44): 7.5 ± 1.8 nmol/L, p < 0.0001], PRE BMI, total fat mass, trunk fat mass, and testosterone were greater and the diet quality score and total carbohydrate intake were lower in NT compared to LT (p ≤ 0.05). LT lost more fat-free mass and less fat mass, particularly in the trunk region, compared to NT following SERE (p-interaction≤0.044). Whole-body protein synthesis, net balance, and flux decreased and whole-body protein breakdown increased from PRE to POST in both groups (p-time ≤0.025). Following short-term, severe energy deficit, Marines who exhibited low testosterone had greater fat-free mass loss than those who maintained normal testosterone concentrations. Altering body composition and dietary strategies prior to physical training that elicits severe energy deficit may provide an opportunity to attenuate post-training decrements in testosterone and its associated effects (e.g., loss of lean mass, performance declines, fatigue).
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Affiliation(s)
- Claire E. Berryman
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
- Oak Ridge Institute for Science and EducationBelcampMarylandUSA
- Department of Nutrition and Integrative PhysiologyFlorida State UniversityTallahasseeFloridaUSA
| | - Holly L. McClung
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - John J. Sepowitz
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Erin Gaffney‐Stomberg
- Military Performance DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Arny A. Ferrando
- Department of Geriatrics, The Center for Translational Research in Aging & LongevityDonald W. Reynolds Institute of Aging, University of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - James P. McClung
- Military Nutrition DivisionUS Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Stefan M. Pasiakos
- Military Performance DivisionU.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
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16
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Miller RM, Freitas ED, Heishman AD, Peak KM, Buchanan SR, Bemben DA, Bemben MG. Associations of serum IL-6 with muscle, bone, and adipose tissue in women. Cytokine 2022; 151:155787. [DOI: 10.1016/j.cyto.2021.155787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/09/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022]
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17
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Holloway-Kew KL, Rufus-Membere P, Anderson KB, Tembo MC, Sui SX, Hyde NK, Diez-Perez A, Kotowicz MA, Pasco JA. Associations between parameters of peripheral quantitative computed tomography and bone material strength index. Bone 2022; 155:116268. [PMID: 34856422 DOI: 10.1016/j.bone.2021.116268] [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: 05/06/2021] [Revised: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bone material strength index (BMSi) is measured in vivo using impact microindentation (IMI). However, the associations between BMSi and other bone measures are not clear. This study investigated whether bone parameters derived by peripheral quantitative computed tomography (pQCT) are associated with BMSi. METHODS Participants were men (n = 373, ages 34-96 yr) from the Geelong Osteoporosis Study. BMSi was measured using an OsteoProbe (Active Life Scientific, USA). Bone measures were obtained at both the radius (n = 348) and tibia (n = 342) using pQCT (XCT 2000 Stratec Medizintechnik, Germany). Images were obtained at 4% and 66% of radial and tibial length. Associations between pQCT parameters and BMSi were tested using Spearman's correlation and multivariable regression used to determine independent associations after adjustment for potential confounders. Models were checked for interaction terms. RESULTS Weak associations were observed between total bone density (radius 4%; r = +0.108, p = 0.046, tibia 4%; r = +0.115, p = 0.035), cortical density (tibia 4%; r = +0.123, p = 0.023) and BMSi. The associations were independent of weight, height, and glucocorticoid use (total bone density: radius 4%; β = 0.020, p = 0.006, tibia 4%; β = 0.020, p = 0.027 and cortical density: radius 4%; β = 4.160, p = 0.006, tibia 4%; β = 0.038, p = 0.010). Associations with bone mass were also observed at the 66% radial and tibial site, independent of age, weight, and glucocorticoid use (β = 4.160, p = 0.053, β = 1.458, p = 0.027 respectively). Total area at the 66% tibial site was also associated with BMSi (β = 0.010, p = 0.012), independent of weight and glucocorticoid use. No interaction terms were identified. CONCLUSION There were weak associations detected between some pQCT-derived bone parameters and BMSi.
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Affiliation(s)
- Kara L Holloway-Kew
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.
| | - Pamela Rufus-Membere
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Kara B Anderson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Monica C Tembo
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Sophia X Sui
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Natalie K Hyde
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Adolfo Diez-Perez
- Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Spain
| | - Mark A Kotowicz
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia; Barwon Health, Geelong, Australia; Department of Medicine, The University of Melbourne - Western Health, St Albans, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia; Barwon Health, Geelong, Australia; Department of Medicine, The University of Melbourne - Western Health, St Albans, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
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18
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Jaworski M, Wierzbicka E, Czekuć-Kryśkiewicz E, Płudowski P, Kobylińska M, Szalecki M. Bone Density, Geometry, and Mass by Peripheral Quantitative Computed Tomography and Bone Turnover Markers in Children with Diabetes Mellitus Type 1. J Diabetes Res 2022; 2022:9261512. [PMID: 35480630 PMCID: PMC9038424 DOI: 10.1155/2022/9261512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 01/12/2022] [Accepted: 02/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The type 1 diabetes mellitus (T1DM) is a chronic systemic autoimmune-mediated disease characterised by the insulin deficiency and hyperglycaemia. Its deleterious effect on bones concerns not only bone mass, density, and fracture risk but also may involve the linear growth of long bones. Studies on the lower leg in children with T1DM by pQCT have generated conflicting results, and most of the studies published so far focused only on a selected features of the bone. An additional information about growth, modelling, and remodelling processes can be gathered by the bone turnover marker measurement. The objective of the study was to evaluate bone mineral density, mass, and geometry using peripheral quantitative computed tomography as well as bone turnover markers in the patients with type 1 diabetes mellitus. Material and Methods. Bone mineral density, mass, and geometry on the lower leg using peripheral quantitative computed tomography and serum osteocalcin (OC) and carboxyterminal cross-linked telopeptide of type 1 collagen (CTx) were measured in 35 adolescents with T1DM (15 girls) aged 12.3-17.9 yrs. The results were compared to age- and sex-adjusted reference values for healthy controls. RESULTS Both sexes reveal lower than zero Z-scores for lower leg 66% total cortical bone cross-sectional area to muscle cross-sectional area ratio (-0.97 ± 1.02, p = 0.002517 and -0.98 ± 1.40, p = 0.007050, respectively) while tibia 4% trabecular bone density Z-score was lowered in boys (-0.67 ± 1.20, p = 0.02259). In boys in Tanner stage 5 bone mass and dimensions were diminished in comparison to Tanner stages 3 and 4, while in girls, such a phenomenon was not observed. Similarly, bone formation and resorption were decreased in boys but not in girls. Consistently, bone turnover markers correlated positively with bone size, dimensions, and strength in boys only. CONCLUSIONS T1DM patients revealed a decreased ratio of cortical bone area/muscle area, reflecting disturbed adaptation of the cortical shaft to the muscle force. When analyzing bone mass and dimensions, boys in Tanner stage 5 diverged from "less-mature" individuals, which may suggest that bone development in these individuals was impaired, affecting all three: mass, size, and strength. Noted in boys, suppressed bone metabolism may result in impairment of bone strength because of inadequate repair of microdamage and accumulation of microfractures.
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Affiliation(s)
- Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Elżbieta Wierzbicka
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Edyta Czekuć-Kryśkiewicz
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Paweł Płudowski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Maria Kobylińska
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Mieczysaw Szalecki
- Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, Warsaw, Poland
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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Villedon de Naide M, Pereira B, Courteix D, Dutheil F, Cassagnes L, Boirie Y, Soubrier M, Tournadre A. Assessment of Intramuscular Fat and Correlation with Body Composition in Patients with Rheumatoid Arthritis and Spondyloarthritis: A Pilot Study. Nutrients 2021; 13:nu13124533. [PMID: 34960085 PMCID: PMC8707224 DOI: 10.3390/nu13124533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 01/17/2023] Open
Abstract
Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are associated with changes in body composition. Ectopic intramuscular fat (IMAT) may alter muscle function and contribute to cardiometabolic disorders. In a pilot study, we analyzed IMAT in the calf with peripheral quantitative computed tomography (pQCT) and examined correlations between IMAT quantity and body composition parameters. In 20 patients with active RA and 23 with active SpA, IMAT was correlated with visceral fat (VAT; r = 0.5143 and 0.6314, respectively; p < 0.05) and total lean mass (r = 0.5414 and 0.8132, respectively; p < 0.05), but not with whole body fat mass. Total lean mass mediated 16% and 33% of the effects of VAT on IMAT in RA and SpA, respectively. In both RA and SpA, calf muscle area was correlated with total lean mass (r = 0.5940 and r = 0.8597, respectively; p < 0.05) and fat area was correlated with total body fat (r = 0.6767 and 0.5089, respectively; p < 0.05) and subcutaneous fat (r = 0.6526 and 0.5524, respectively; p < 0.05). Fat area was inversely correlated with handgrip and walking tests, and it was associated with disease activity and disability. We showed that ectopic IMAT, measured with pQCT, was correlated with VAT, but not with total body fat, in RA and SpA. This result suggests that metabolically active fat was specifically associated with IMAT.
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Affiliation(s)
- Marc Villedon de Naide
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.V.d.N.); (M.S.)
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P-EA 3533), University Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Frederic Dutheil
- Preventive and Occupational Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Lucie Cassagnes
- Service de Radiologie Adultes, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
- Thérapies Guidées par l’Image, Institut Pascal, UMR 6602 CNRS-SIGMA-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- Service de Nutrition Clinique, CHU Gabriel Montpied, 63003 Clermont-Ferrand, France;
- Unité de Nutrition Humaine, UMR 1019 INRAe-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Martin Soubrier
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.V.d.N.); (M.S.)
| | - Anne Tournadre
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.V.d.N.); (M.S.)
- Unité de Nutrition Humaine, UMR 1019 INRAe-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- Correspondence:
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20
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Anderson KB, Tembo MC, Sui SX, Hyde NK, Pasco JA, Kotowicz MA, Holloway-Kew KL. Peripheral quantitative computed tomography (pQCT) measures are associated with prior low trauma fracture in men. Arch Osteoporos 2021; 16:178. [PMID: 34825263 DOI: 10.1007/s11657-021-00996-5] [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: 05/06/2021] [Accepted: 08/16/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Peripheral quantitative computed tomography (pQCT) assesses bone quantity and quality, complementary to current standard practice, and has potential to improve prediction of fracture risk. This study explored whether pQCT parameters were associated with prior fracture in men and found a number of parameters to be associated, particularly at the radius. PURPOSE Peripheral quantitative computed tomography (pQCT) provides information about bone structure and density complementary to dual x-ray absorptiometry. This study aimed to determine which pQCT parameters are associated with prior fracture. METHODS Participants were men (n = 508, age 33-96 years) from the Geelong Osteoporosis Study. Parameters at 4% (n = 469) and 66% (n = 436) of radial length, and 4% (n = 449) and 66% (n = 437) of tibial length were acquired (pQCT XCT 2000, Stratec Medizintechnik, Pforzheim, Germany), and mean standardised. Low trauma prior fractures in adulthood (≥ age 20 years) were radiologically confirmed when possible. Cross-sectional associations between pQCT and fracture were tested using logistic regression adjusting for confounders. RESULTS Prior low trauma fractures were identified for 106 participants. Fracture was negatively associated with parameters at the 4% radius site: bone mass (adjusted OR = 0.67; 95%CI = 0.52-0.86), total density (OR = 0.61; 95%CI = 0.47-0.78), trabecular density (OR = 0.62; 95%CI = 0.48-0.79) and cortical subdensity (OR = 0.61; 95%CI = 0.47-0.77). At the 66% radius site, fracture was associated with total density (OR = 0.69; 95%CI = 0.55-0.87) and cortical thickness (OR = 0.68; 95%CI = 0.54-0.86). Fracture was associated with the ratio of the cortical area at the 66% site to the total area at the 4% site (OR = 0.74; 95%CI = 0.58-0.94). Prior fracture was negatively associated with parameters at the 4% tibial site: total density (OR = 0.67; 95%CI = 0.52-0.86), trabecular density (OR = 0.64; 95%CI = 0.50-0.82) and cortical subdensity (OR = 0.72; 95%CI = 0.56-0.92). Fracture was negatively associated with cortical density at the 66% site (OR = 0.74; 95%CI = 0.58-0.94), and the ratio of the cortical area at the 66% site to the total area at the 4% site (OR = 0.65; 95%CI = 0.46-0.91), but were attenuated in adjusted models. No other associations were identified. CONCLUSION Prior fracture was associated with parameters at both the radius and tibia. This study highlights key pQCT parameters that may aid in the prediction of fracture risk.
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Affiliation(s)
- Kara B Anderson
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia.
| | - Monica C Tembo
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia
| | - Sophia X Sui
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia
| | - Natalie K Hyde
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia
| | - Julie A Pasco
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Mark A Kotowicz
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kara L Holloway-Kew
- Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia
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21
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Baker BS, Buchanan SR, Black CD, Bemben MG, Bemben DA. Bone, Biomarker, Body Composition, and Performance Responses to 8 Weeks of ROTC Training. J Athl Train 2021; 57:571-580. [PMID: 34279654 DOI: 10.4085/1062-6050-0634.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Military personnel engage in vigorous exercise, often resulting in higher bone mineral density; however, lower leg bone injuries are common in this population. Predictors of change in tibial bone quality and strength need to be characterized in this high-risk population. OBJECTIVE This study aimed to examine the effects of an eight-week military training intervention on total body and site-specific bone density and tibial bone quality, serum biomarkers (parathyroid hormone and sclerostin), body composition, and physical performance. Additionally, we sought to investigate what outcome variables (biomarkers, body composition, physical performance) would be predictive of estimated tibial bone strength in college-aged Reserve Officers' Training Corps (ROTC) members. DESIGN Prospective Cohort Study. SETTING XXX University. Patients of Other Participants: ROTC (n=14 male; n=4 female) were matched for sex, age, and body mass to physically active Controls (n=14 male; n=4 female). ROTC engaged in an eight-week training intervention, while physically active Controls made no changes to their exercise routines. MAIN OUTCOME MEASURES Pre general health questionnaires and pre, mid, and post intervention bone scans (DXA, pQCT), serum blood draws (parathyroid hormone and sclerostin), and physical performance measures (muscle strength and aerobic capacity) were tested. RESULTS ROTC participants exhibited significantly increased hip bone density and content (all p≤0.03) after the eight-week intervention. Sclerostin, not PTH, was a significant positive correlate and predictor in all ROTC models for estimated bone strength at the fracture prone 38% tibial site. Both groups decreased total body and regional fat mass and ROTC increased aerobic capacity (all p≤0.05). CONCLUSIONS All bone, body composition, and performance measures either improved or were maintained in response to ROTC training and sclerostin should be further investigated as a potential early indicator of changes in estimated tibial bone strength in military cohorts.
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Affiliation(s)
- Breanne S Baker
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1100 Virginia Ave, Columbia, MO 65212, Office: 573-882-3038, , Twitter @DrBreeBaker-Also affiliated with the Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
| | - Samuel R Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, 78539. -Also affiliated with the Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
| | - Christopher D Black
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071, Twitter @ChrisBlack_PhD
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
| | - Debra A Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
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22
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Anderson KB, Tembo MC, Sui SX, Hyde NK, Rufus PG, Pasco JA, Kotowicz MA, Holloway-Kew KL. Normative data for peripheral quantitative computed tomography (pQCT) bone parameters in Australian men. Bone Rep 2021; 15:101107. [PMID: 34355046 PMCID: PMC8322301 DOI: 10.1016/j.bonr.2021.101107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/06/2021] [Indexed: 10/29/2022] Open
Abstract
Background Peripheral quantitative computed tomography (pQCT) can provide information complementary to dual x-ray absorptiometry (DXA), however, there is sparse normative data to enable meaningful clinical interpretation and comparison. This study aimed to develop age-stratified normative data for pQCT-derived bone parameters in Australian men. Methods Participants were men (n = 508, age 33-96 yr) from the Geelong Osteoporosis Study. Bone parameters at 4% (n = 469) and 66% (n = 436) of radial length, and 4% (n = 449) and 66% (n = 438) of tibial length were acquired using pQCT (XCT 2000, Stratec Medizintechnik, Pforzheim, Germany). Best models of age, height and weight for each parameter were developed and where parameters exhibited variation with age, age decade mean (±SD) values were determined. Scatterplots were used to visualise the relationships between each of the parameters and age, height and weight. Results Thirteen parameters at tibial and radial sites were correlated with age, height and weight, allowing for their inclusion in multiple linear regression models. A positive association with age was found for total area of the tibia or radius (as appropriate) (mm2) at all sites, trabecular bone area (mm2) at 4% sites, and total bone area (both long bones) (mm2) at 66% sites. A negative association with age was found for cortical density (mg/cm3) and cortical thickness (mm) at both radial and tibial 66% sites, but total density (mg/cm3) at the 66% radial site and total cortical density of both long bones (mg/cm3) at the 66% tibial site only. Conclusion This study presents normative data for pQCT-derived bone parameters and describes age related associations in a number of these variables. Broadly, parameters of bone area were positively associated with age, whereas parameters associated with bone density and structure were negatively associated with age. These data have the potential to be used in clinical settings when assessing age-related decline in bone health. Mini abstract Normative data for pQCT parameters in Australian men are presented, adjusted for age, height and weight.
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Affiliation(s)
- Kara B Anderson
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia
| | - Monica C Tembo
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia
| | - Sophia X Sui
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia
| | - Natalie K Hyde
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia
| | - Pamela G Rufus
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia
| | - Julie A Pasco
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia.,Barwon Health, Geelong, VIC, Australia.,Department of Medicine - Western Health, The University of Melbourne, St Albans, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
| | - Mark A Kotowicz
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia.,Barwon Health, Geelong, VIC, Australia.,Department of Medicine - Western Health, The University of Melbourne, St Albans, VIC, Australia
| | - Kara L Holloway-Kew
- Deakin University, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Geelong, VIC, Australia
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23
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Hildebrand KN, Sidhu K, Gabel L, Besler BA, Burt LA, Boyd SK. The Assessment of Skeletal Muscle and Cortical Bone by Second-generation HR-pQCT at the Tibial Midshaft. J Clin Densitom 2021; 24:465-473. [PMID: 33257203 DOI: 10.1016/j.jocd.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Peripheral quantitative computed tomography (pQCT) is the current densitometric gold-standard for assessing skeletal muscle at the 66% proximal tibia site. High resolution peripheral quantitative computed tomography (HR-pQCT) is a leading technology for quantifying bone microarchitecture at the distal extremities, and with the second-generation HR-pQCT it is possible to measure proximal limb sites. Therefore, the objectives of this study were to: (1) assess the feasibility of using HR-pQCT to assess skeletal muscle parameters at the 66% proximal tibia site, and (2) test HR-pQCT skeletal muscle measurement reproducibility at this site. METHODS Adult participants (9 males; 7 females; ages 31-75) received 1 pQCT scan and 2 HR-pQCT scans at the 66% proximal site of the nondominant tibia. Participants were repositioned between HR-pQCT scans to test reproducibility. HR-pQCT and pQCT scans were analyzed to quantify muscle cross-sectional area (CSA) and muscle density. Coefficients of determination and Bland-Altman plots compared muscle parameters between pQCT and HR-pQCT. For short-term reproducibility, root-mean-square of coefficient of variance and least significant change were calculated. RESULTS HR-pQCT and pQCT measured muscle density and muscle CSA were positively correlated (R2 = 0.66, R2 = 0.95, p < 0.001, respectively). Muscle density was equivalent between HR-pQCT and pQCT; however, there was systematic and directional bias for muscle CSA, such that muscle CSA was 11% lower with HR-pQCT and bias increased with larger muscle CSA. Root-mean-square of coefficient of variance was 0.67% and 0.92% for HR-pQCT measured muscle density and muscle CSA, respectively, while least significant change was 1.4 mg/cm3 and 174.0 mm2 for muscle density and muscle CSA, respectively. CONCLUSION HR-pQCT is capable of assessing skeletal muscle at the 66% site of the tibia with good precision. Measures of muscle density are comparable between HR-pQCT and pQCT.
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Affiliation(s)
- Kurt N Hildebrand
- Faculty of Kinesiology, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Karamjot Sidhu
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Bryce A Besler
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lauren A Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Steven K Boyd
- Faculty of Kinesiology, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Lambert G, Alos N, Bernier P, Laverdière C, Kairy D, Drummond K, Dahan-Oliel N, Lemay M, Veilleux LN. Home-Based Telehealth Exercise Intervention in Early-On Survivors of Childhood Acute Lymphoblastic Leukemia: Feasibility Study. JMIR Cancer 2021; 7:e25569. [PMID: 34132645 PMCID: PMC8277387 DOI: 10.2196/25569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/12/2021] [Accepted: 04/16/2021] [Indexed: 01/26/2023] Open
Abstract
Background Acute lymphoblastic leukemia is the most common type of pediatric cancer. Acute lymphoblastic leukemia causes an altered bone mineral homeostasis state, which can contribute to osteopenia, and bone fractures, most commonly vertebral fractures. With the increasing number of childhood cancer survivors, late adverse effects such as musculoskeletal comorbidities are often reported and are further influenced by inactive lifestyle habits. Physical activity has been shown to increase the mechanical workload of the bone, mitigating bone impairment in other cancer-specific populations. Objective This interventional pilot study aims to investigate the use of telehealth to deliver a home-based exercise intervention for early-on survivors of bone marrow–related hematological malignancies and to assess its impact on survivors’ musculoskeletal and functional health. Methods We aimed to recruit a group of 12 early-on survivors of acute lymphoblastic leukemia, within 6 months to 5 years of treatment, to participate in and complete the proposed telehealth intervention with a parent. The 16-week intervention included 40 potential home-based physical activity interventions supervised by a kinesiologist through a telehealth internet platform, with monthly progression. Patients were recruited to the cohort if they were able to participate in the intervention during the first month (minimum 12 weeks of intervention). Evaluation before and after the intervention protocol highlighted differences in functional capacities and musculoskeletal health of patients using mechanography, peripheral quantitative computed tomography, 6-minute walk test, and grip force test. Results The recruitment rate for the intervention was low (12/57, 21% of contacted patients). Of 12 patients, 3 were excluded (1=relapse, 1=failure to meet technical requirements, and 1=abandoned). The 9 patients who completed the intervention (6 girls; mean age 10.93, SD 2.83 years; mean BMI 21.58, SD 6.55 kg/m2; mean time since treatment completion 36.67, SD 16.37 months) had a mean adherence of 89% and a completion rate of 75%. In addition, these patients showed functional improvements in lower limb muscle force and power as well as in the 6-minute walk test distance. Participants also showed improved bone health after the intervention on the following parameters: bone mineral content, stress-strain index, total and cortical cross-sectional area at the 14% site (P=.03, P=.01, P=.01, and P=.001, respectively) and 38% site of the tibia (P=.003, P=.04, P=.001, and P=.003, respectively). Conclusions High adherence and participation rates suggest that telehealth is a feasible method to deliver exercise interventions to young early-on survivors of acute lymphoblastic leukemia. The proposed intervention seems promising in providing benefits to patients’ functional performance and bone health, but a large-scale study is needed to confirm this assumption.
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Affiliation(s)
- Genevieve Lambert
- Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Surgery-Division of Experimental Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Nathalie Alos
- Sainte-Justine University Health Center, Montreal, QC, Canada.,Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - Pascal Bernier
- Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center, Montreal, QC, Canada.,Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - Dahlia Kairy
- École de Réadaptation, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Kenneth Drummond
- Department of Surgery-Division of Experimental Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Noémi Dahan-Oliel
- School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Shriners Hospital for Children - Canada, Montreal, QC, Canada
| | - Martin Lemay
- Sainte-Justine University Health Center, Montreal, QC, Canada.,Département des Sciences de l'Activité Physique, Faculté des Sciences, Université du Québec à Montréal, Montreal, QC, Canada
| | - Louis-Nicolas Veilleux
- Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Surgery-Division of Experimental Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Motion Analysis Center, Shriners Hospital for Children - Canada, Montreal, QC, Canada
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Muscle Performance Changes with Age in Active Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094477. [PMID: 33922474 PMCID: PMC8122865 DOI: 10.3390/ijerph18094477] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 01/16/2023]
Abstract
The purpose of this study was to examine age-related differences in muscle performance in women divided into young (YW, 20–39 years, n = 29) middle-aged (MAW, 40–59 years, n = 33), and older (OW, ≥60 years, n = 40) age groups. Methods: Hand grip strength, vertical jump performance, and knee extensor (KE) strength (0 deg/s, 60 deg/s, and 240 deg/s), speed of movement (SoM; at 1 Nm, 20%, 40%, and 60% isometric strength), and endurance (30-repetition test at 60 degs/s and 240 deg/s) were assessed. Computed tomography-acquired muscle cross-sectional area (mCSA) was measured and included to determine specific strength (KE strength/mCSA). Results: Hand grip strength was similar across groups, while jump performance declined with age (YW and MAW > OW, p < 0.001). KE strength declined significantly with age (all conditions p < 0.01), while specific strength was similar across groups. SoM was significantly higher for YW and MAW compared to OW (both p < 0.01). An age × velocity interaction revealed YW KE endurance was similar between conditions, whereas MAW and OW displayed significantly better endurance during the 60 deg/s condition. OW displayed impaired KE endurance at 240 deg/s (vs. YW and MAW, p < 0.01) but improved at 60 deg/s (vs. YW, p < 0.01). Dynamic torque decline increased with age (YW < OW, p = 0.03) and was associated with intramuscular adipose tissue (r = 0.21, p = 0.04). Conclusions: Performance declines were most evident among OW, but few performance deficits had emerged in MAW. Interestingly, strength declines disappeared after normalizing to mCSA and endurance appears to be velocity-dependent.
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Via JD, Owen PJ, Daly RM, Mundell NL, Livingston PM, Rantalainen T, Foulkes SJ, Millar JL, Murphy DG, Fraser SF. Musculoskeletal Responses to Exercise plus Nutrition in Men with Prostate Cancer on Androgen Deprivation: A 12-month RCT. Med Sci Sports Exerc 2021; 53:2054-2065. [PMID: 33867499 DOI: 10.1249/mss.0000000000002682] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Androgen deprivation therapy (ADT) for prostate cancer (PCa) has multiple adverse effects on musculoskeletal health. This 12-month randomised controlled trial aimed to assess the effects of multi-component exercise training combined with whey protein, calcium and vitamin D supplementation on bone mineral density (BMD), structure and strength, body composition, muscle strength and physical function in ADT-treated men. METHODS Seventy ADT-treated men were randomised to exercise plus supplementation (Ex+Suppl; n=34) or usual care (Control; n=36). Ex+Suppl involved thrice weekly progressive resistance training plus weight-bearing impact exercise with daily multi-nutrient supplementation. Primary outcomes were DXA hip and spine areal BMD. Secondary outcomes included: tibia and radius pQCT volumetric BMD, bone structure and strength; DXA body composition; pQCT muscle and fat cross-sectional area and muscle density; muscle strength and physical function. RESULTS Sixty men (86%) completed the study. Mean exercise and supplement adherence were 56% and 77%, respectively. There were no effects of the intervention on bone or body composition outcomes. Ex+Suppl improved leg muscle strength (net difference [95% CI] 14.5% [-0.2, 29.2], P=0.007) and dynamic mobility (four-square-step test time, -9.3% [-17.3, -1.3], P=0.014) relative to controls. Per-protocol analysis of adherent participants (≥66% exercise, ≥80% supplement) showed Ex+Suppl preserved femoral neck aBMD (1.9% [0.1, 3.8], P=0.026) and improved total body lean mass (1.0 kg [-0.23, 2.22], P=0.044) relative to controls. CONCLUSION Exercise training combined with multi-nutrient supplementation had limited effect on ameliorating the adverse musculoskeletal consequences of ADT, likely related to the modest intervention adherence.
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Affiliation(s)
- Jack Dalla Via
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia Deakin University, Faculty of Health, Geelong, Victoria, Australia Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland Sports Cardiology Lab, Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
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Moradell A, Rodríguez-Gómez I, Fernández-García ÁI, Navarrete-Villanueva D, Marín-Puyalto J, Pérez-Gómez J, Villa-Vicente JG, González-Gross M, Ara I, Casajús JA, Gómez-Cabello A, Vicente-Rodríguez G. Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073757. [PMID: 33916857 PMCID: PMC8038494 DOI: 10.3390/ijerph18073757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 01/10/2023]
Abstract
With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.
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Affiliation(s)
- Ana Moradell
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (I.A.)
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Ángel Iván Fernández-García
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Department of Physiatry and Nursing, Faculty of Health, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Marín-Puyalto
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
| | - Jorge Pérez-Gómez
- HEME (Health, Economy, Motricity and Education) Research Group, Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain;
| | - José Gerardo Villa-Vicente
- VALFIS Research Group, Department of Physical Education and Sport, Institute of Biomedicine (IBIOMED), University of León, 24007 León, Spain;
| | - Marcela González-Gross
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Polytechnic University of Madrid, 28040 Madrid, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (I.A.)
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - José Antonio Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Department of Physiatry and Nursing, Faculty of Health, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
- Centro Universitario de la Defensa, 50090 Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (Á.I.F.-G.); (D.N.-V.); (J.M.-P.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón, IA2, CITA—Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-876-55-37-56
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Sui SX, Williams LJ, Holloway-Kew KL, Hyde NK, Anderson KB, Tembo MC, Addinsall AB, Leach S, Pasco JA. Skeletal Muscle Density and Cognitive Function: A Cross-Sectional Study in Men. Calcif Tissue Int 2021; 108:165-175. [PMID: 32984908 DOI: 10.1007/s00223-020-00759-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/15/2020] [Indexed: 01/08/2023]
Abstract
We aimed to investigate cross-sectional associations between skeletal muscle density, a proxy measure for fatty infiltration into muscle, and cognition. Contributions from body fat mass, systemic inflammation and lifestyle were explored, as these factors have been identified in both muscle and cognitive deterioration. For 281 men (60-95 year) from the Geelong Osteoporosis Study, radial and tibial muscle density were measured using peripheral quantitative computed tomography. Body fat and appendicular lean mass were measured using dual-energy X-ray absorptiometry. Cognitive function was assessed for psychomotor function (DET), visual identification/attention (IDN), visual learning (OCL) and working memory (OBK) (CogState Brief Battery). Composite scores signified overall cognitive function (OCF). Higher scores represent poorer performance except for OCL and OCF. Regression analyses examined associations between muscle density and cognition; potential confounders included age, muscle cross-sectional area (CSA), body composition, lifestyle and serum markers of inflammation. Negative associations with age were evident for muscle density, all cognitive domains and OCF. Muscle density at both sites was positively associated with DET, OCL and OCF. After adjustment for age, the association persisted for DET (radius: B = - 0.006, p = 0.02; tibia: B = - 0.003, p = 0.04) and OCL (radius B = + 0.004, p = 0.02; tibia: B = + 0.005, p < 0.001). At the radius, further adjustment for serum TNF-α explained the association between muscle density (B = - 0.002, p = 0.66) and DET. Education and physical activity contributed to the model for radial muscle density and DET. There were no contributions from muscle CSA, appendicular lean mass, body fat mass, other markers of inflammation or other potential confounders. At the tibia, the association between muscle density and DET (B = - 0.003, p = 0.04) was independent of TNF-α. There was an age-adjusted association between muscle density and OCL at both sites (radius: B = + 0.004, p = 0.02; tibia: B = + 0.005, p < 0.001). None of the potential confounders contributed to the models. Muscle density was associated with cognitive function in the DET and OCL domains. However, there was little evidence that this was explained by inflammation or body fat mass. No associations were identified between muscle density and IDN or OBK.
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Affiliation(s)
- Sophia X Sui
- Deakin University, IMPACT Institute, Geelong, VIC, Australia.
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT Institute, Deakin University, Barwon Health, PO Box 281, Geelong, VIC, 3220, Australia.
| | - Lana J Williams
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | | | - Natalie K Hyde
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Kara B Anderson
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Monica C Tembo
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | | | | | - Julie A Pasco
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
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Lalayiannis AD, Fewtrell M, Biassoni L, Silva S, Goodman N, Shroff R, Crabtree NJ. Studying bone mineral density in young people: The complexity of choosing a pQCT reference database. Bone 2021; 143:115713. [PMID: 33122089 DOI: 10.1016/j.bone.2020.115713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/07/2020] [Accepted: 10/24/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Many chronic illnesses affect bone health, and commonly lead to mineralization abnormalities in young people. As cortical and trabecular bone may be differentially affected in certain diseases, an imaging technique that allows for detailed study of the bone structure is required. Peripheral quantitative computed tomography (pQCT) overcomes the limitations of dual energy X-ray absorptiometry (DXA) and is perhaps more widely available for use in research than bone biopsy. However, in contrast to DXA, where there are large reference datasets, this is not the case for pQCT. METHODS Fifty-five children and young adults aged 7 to 30 years had the non-dominant tibia scanned at the 3% & 4% sites for trabecular bone mineral density and the 38% site for cortical bone mineral density and bone mineral content. Image acquisition and analysis was undertaken according to the protocols of two of the largest reference datasets for tibial pQCT. The Z-scores generated were compared to examine the differences between protocols and the differences from the expected median of zero in a healthy population. RESULTS The trabecular bone mineral density Z-scores generated by the two protocols were similar. The same was true for cortical mineral content Z-scores at the 38% site. Cortical bone mineral density was significantly different between protocols and likely affected by differences in the ethnicity of our cohort compared to the reference datasets. Only one reference dataset extended from childhood to young adulthood. Only trabecular bone mineral density, periosteal and endosteal circumference Z-scores from one methodology were not significantly biased when tested for deviation of the median from zero. CONCLUSIONS pQCT is a useful tool for studying trabecular and cortical compartments separately but, there are variations in pQCT scanning protocols, analysis methodology, and a paucity of reference data. Reference datasets may not be generalizable to local study populations, even when analysed using identical analysis protocols.
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Affiliation(s)
- A D Lalayiannis
- UCL Great Ormond Street Hospital Institute of Child Health, London, UK.
| | - M Fewtrell
- UCL Great Ormond Street Hospital Institute of Child Health, London, UK
| | - L Biassoni
- UCL Great Ormond Street Hospital Institute of Child Health, London, UK
| | - S Silva
- UCL Great Ormond Street Hospital Institute of Child Health, London, UK
| | - N Goodman
- UCL Great Ormond Street Hospital Institute of Child Health, London, UK
| | - R Shroff
- UCL Great Ormond Street Hospital Institute of Child Health, London, UK
| | - N J Crabtree
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
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30
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Bland VL, Bea JW, Blew RM, Roe DJ, Lee VR, Funk JL, Going SB. Influence of Changes in Soft Tissue Composition on Changes in Bone Strength in Peripubertal Girls: The STAR Longitudinal Study. J Bone Miner Res 2021; 36:123-132. [PMID: 32810295 DOI: 10.1002/jbmr.4168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 01/09/2023]
Abstract
Obesity and osteoporosis remain two major public health concerns. Soft tissue composition and bone are interrelated; however, it is still not well understood how changes in adiposity during adolescence affect bone development. The aim of this study was to assess how changes in DXA-derived total body lean mass (TBLM) and total body fat mass (TBFM) associate with 2-year changes in bone outcomes at the 20% femur, 66% tibia, 66% radius, and 4% tibia, as measured by pQCT, during the years surrounding the onset of menarche in a cohort of 9- to 12-year-old (baseline) adolescent girls (70% Hispanic). From baseline to 2-year follow-up, girls showed statistically significant increases in all bone outcomes, except radial endosteal circumference. In separate linear regression models, change in TBLM and change in TBFM were both positively associated with 2-year changes in bone outcomes at all measured bone sites, after controlling for relevant covariates. However, when change in TBLM and change in TBFM were included in the same model, change in TBLM was the predominant predictor of bone outcomes, explaining 4% to 14% of the variance in bone strength outcomes. Change in TBFM remained a positive predictor of tibia polar strength strain index (SSIp) (2% variance explained). A significant interaction between change in TBFM and menarcheal status was identified at the radius for SSIp and indicated that greater gains in TBFM were beneficial for SSIp in girls that were premenarcheal at baseline but detrimental for girls who were postmenarcheal at baseline. The overall findings suggest that changes in TBLM during the peripubertal years have a greater influence on bone outcomes than changes in TBFM. While gains in TBFM might benefit the weight bearing 66% tibia, greater gains in TBFM may be detrimental to bone development at the non-weight bearing 66% radius after the onset of menarche. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Victoria L Bland
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA.,Department of Medicine, University of Arizona, Tucson, AZ, USA.,The University of Arizona Cancer Center, Tucson, AZ, USA
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Denise J Roe
- The University of Arizona Cancer Center, Tucson, AZ, USA.,Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Janet L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA.,Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
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Owen PJ, Hart NH, Latella C, Hendy AM, Lamon S, Rantalainen T. Identifying and Assessing Inter-Muscular Fat at the Distal Diaphyseal Femur Measured by Peripheral Quantitative Computed Tomography (pQCT). J Clin Densitom 2021; 24:106-111. [PMID: 31848038 DOI: 10.1016/j.jocd.2019.11.001] [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: 10/07/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Inter-/intramuscular fat can be assessed with peripheral Quantitative Computed Tomography (pQCT) and is of interest as an indicator of "muscle quality." Typical pQCT scan sites (forearm, lower leg) have a low amount of inter-/intramuscular fat, however distal diaphyseal femur scan sites with conspicuous inter-/intramuscular fat have been identified as potentially more prudent scan sites, even in healthy adolescents. However, current state of the art analysis methods require labor-intensive manual segmentation of the scan. The purpose of the present study was to evaluate the reliability of a novel open source automated enclosing convex polygon approach (source code https://github.com/tjrantal/pQCT, commit cec9bce) to quantify inter-/intramuscular fat from femoral pQCT scans in healthy adults. METHODOLOGY The distal diaphyseal femur (25% of tibial length from the knee joint towards the hip) of 27 adults aged 18-50 yr were scanned twice, 1 wk apart, using pQCT. Subcutaneous fat, muscle, inter-/intramuscular fat, and marrow areas, and corresponding densities were evaluated using a method we have reported previously, as well as the novel enclosing convex polygon method. RESULTS The session-to-session reliability of the assessments was fair to excellent using the previously reported method as indicated by intraclass correlation coefficient (ICC2,1) ranging from 0.45 to 1.00, while the novel method produced excellent reliability (ICC2,1 0.78-1.00). CONCLUSION Distal diaphyseal femur appears to be a potentially informative and prudent scan site for inter-/intramuscular fat evaluation with pQCT.
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Affiliation(s)
- Patrick J Owen
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Nicolas H Hart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Western Australia, Australia; Western Australian Bone Research Collaboration, Perth, Western Australia, Australia
| | - Christopher Latella
- Neurophysiology Research Laboratory, School of Medical and Health Sciences, Edith Cowan University, Perth, Wetsern Australia, Australia
| | - Ashlee M Hendy
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Séverine Lamon
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Timo Rantalainen
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Western Australia, Australia; Western Australian Bone Research Collaboration, Perth, Western Australia, Australia; Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
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Jaworski M, Kobylińska M, Graff K. Peripheral quantitative computed tomography of the lower leg in children and adolescents: bone densities, cross-sectional sizes and muscle distribution reference data. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:215-236. [PMID: 34059567 PMCID: PMC8185261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Peripheral quantitative computed tomography is utilised in increasing numbers of paediatric studies, however, very little is known about the reference limits for pQCT tibia measurements. The purpose of this study was to establish country-specific reference data for bone densities, cross-sectional sizes, strength and regional muscle distribution measured by pQCT in children and adolescents. METHODS Stratec XCT 2000L apparatus was used. The measurement sites were 4%, 14%, 38% and 66% of the tibia length. The study group consisted of 222 participants (103 girls) aged 4,3-19,4 yrs. ANCOVA was used to assess the main determinants of pQCT outcomes. The LMS method was used to fit the percentile curves for each outcomes. RESULTS Weight and age were the main determinants for most of the pQCT outcomes. Smoothed percentile curves were developed by age and by height for both sexes. CONCLUSION In this study we present reference data for bone densities, cross-sectional size and strength as well as for regional muscle distribution measured by pQCT at certain sites of the lower leg to allow simple calculation of reliable Z scores.
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Affiliation(s)
- Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland,Corresponding author: Maciej Jaworski, Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-430 Warsaw, Poland E-mail:
| | - Maria Kobylińska
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Krzysztof Graff
- Rehabilitation Ward, The Children’s Memorial Health Institute, Warsaw, Poland,Faculty of Rehabilitation, Józef Pilsudski University of Physical Education, Warsaw, Poland
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Valkama S, Holmlund-Suila E, Ireland A, Hauta-Alus H, Enlund-Cerullo M, Rosendahl J, Andersson S, Mäkitie O. Peripheral quantitative computed tomography (pQCT) in 12- and 24-month-old children - Practical aspects and descriptive data. Bone 2020; 141:115670. [PMID: 33007527 DOI: 10.1016/j.bone.2020.115670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/31/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Peripheral quantitative computed tomography (pQCT) is a useful tool to assess detailed bone characteristics. Its utility in infants is however limited due to lack of reference data and technical challenges. The purpose of this study was to provide data on length- and weight-adjusted pQCT values and to present a quality grading system for healthy children aged 12 and 24 months. MATERIAL AND METHODS As a part of the Vitamin D intervention in Infants (VIDI) trial, we collected pQCT and anthropometric data from 855 children at 12 months and from 784 children at 24 months. Bone mineral content (BMC; mg/mm), volumetric bone mineral density (vBMD; mg/cm3), cross-sectional area (CSA; mm2), polar-moment of inertia (PMI; mm4), and periosteal circumference (PsC; mm) were assessed for total bone at 20% distal site of the left tibia using pQCT (Stratec XCT2000L). We evaluated the impact of scan quality on bone measures. Total bone parameters were assessed for boys and girls separately. The means of the bone parameters were also compared in relation to age. The associations between bone parameters and weight, length, sex and scan quality were analyzed. RESULTS We included scans with sufficient quality (Grade 1-5) in the final analyses: 679/855 (79%) at 12 months and 709/784 (90%) at 24 months. Altogether 39% of the scans at 12 months and 51% at 24 months were of good or excellent quality (Grade 1-2). Scan quality had an impact on BMCs at 12 and 24 months (p = 0.001 and p = 0.017, respectively) but not on other bone parameters. Boys presented greater total bone BMC, CSA, PMI and PsC values at 12 and 24 months but vBMDs were similar. All bone parameters showed a significant increase between 12 and 24 months for both sexes. When adjusting bone parameters for weight, length and scan quality, differences between sexes disappeared. Weight was the strongest modifier of BMC, CSA, PMI and PsS at 12 and 24 months. CONCLUSIONS This study increases our understanding on bone parameters in young children and demonstrates the suitability of pQCT in bone research in infants. The described pQCT data and scan quality grading system should prove useful in evaluating data reliability in research settings. CLINICAL TRIAL REGISTRATION NUMBER NCT1723852.
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Affiliation(s)
- Saara Valkama
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Elisa Holmlund-Suila
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Alex Ireland
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Helena Hauta-Alus
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Jenni Rosendahl
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Department of Molecular Medicine and Surgery, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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Lalayiannis AD, Crabtree NJ, Ferro CJ, Askiti V, Mitsioni A, Biassoni L, Kaur A, Sinha MD, Wheeler DC, Duncan ND, Popoola J, Milford DV, Long J, Leonard MB, Fewtrell M, Shroff R. Routine serum biomarkers, but not dual-energy X-ray absorptiometry, correlate with cortical bone mineral density in children and young adults with chronic kidney disease. Nephrol Dial Transplant 2020; 36:1872-1881. [DOI: 10.1093/ndt/gfaa199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background. Biomarkers and dual-energy X-ray absorptiometry (DXA) are thought to be poor predictors of bone mineral density (BMD). The Kidney Disease: Improving Global Outcomes guidelines suggest using DXA if the results will affect patient management, but this has not been studied in children or young adults in whom bone mineral accretion continues to 30 years of age. We studied the clinical utility of DXA and serum biomarkers against tibial cortical BMD (CortBMD) measured by peripheral quantitative computed tomography, expressed as Z-score CortBMD, which predicts fracture risk.
Methods. This was a cross-sectional multicentre study in 26 patients with CKD4 and 5 and 77 on dialysis.
Results. Significant bone pain that hindered activities of daily living was present in 58%, and 10% had at least one low-trauma fracture. CortBMD and cortical mineral content Z-scores were lower in dialysis compared with CKD patients (P = 0.004 and P = 0.02). DXA BMD hip and lumbar spine Z-scores did not correlate with CortBMD or biomarkers. CortBMD was negatively associated with parathyroid hormone (PTH; r = −0.44, P < 0.0001) and alkaline phosphatase (ALP; r = −0.22, P = 0.03) and positively with calcium (Ca; r = 0.33, P = 0.001). At PTH <3 times upper limit of normal, none of the patients had a CortBMD below −2 SD (odds ratio 95% confidence interval 7.331 to infinity). On multivariable linear regression PTH (β = −0.43 , P < 0.0001), ALP (β = −0.36, P < 0.0001) and Ca (β = 0.21, P = 0.005) together predicted 57% of variability in CortBMD. DXA measures did not improve this model.
Conclusions. Taken together, routinely used biomarkers, PTH, ALP and Ca, but not DXA, are moderate predictors of cortical BMD. DXA is not clinically useful and should not be routinely performed in children and young adults with CKD 4–5D.
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Affiliation(s)
- Alexander D Lalayiannis
- Great Ormond St Hospital for Children NHS Foundation Trust, University College London Institute of Child Health, London, UK
| | - Nicola J Crabtree
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Charles J Ferro
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | | | - Lorenzo Biassoni
- Great Ormond St Hospital for Children NHS Foundation Trust, University College London Institute of Child Health, London, UK
| | - Amrit Kaur
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Manish D Sinha
- Evelina Children’s Hospital, Guy’s & St Thomas' NHS Foundation Trust, London, UK
| | - David C Wheeler
- Department of Renal Medicine, University College London, London, UK
| | - Neill D Duncan
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK
| | - Joyce Popoola
- Department of Nephrology and Transplantation, George’s University Hospital NHS Foundation Trust, London, UK
| | - David V Milford
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Jin Long
- Stanford University, Palo Alto, CA, USA
| | | | - Mary Fewtrell
- Great Ormond St Hospital for Children NHS Foundation Trust, University College London Institute of Child Health, London, UK
| | - Rukshana Shroff
- Great Ormond St Hospital for Children NHS Foundation Trust, University College London Institute of Child Health, London, UK
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F B, L P C, V M, M D, G HB, G G, P G, P N, M AL. High intensity interval training combined with L-citrulline supplementation: Effects on physical performance in healthy older adults. Exp Gerontol 2020; 140:111036. [PMID: 32721549 DOI: 10.1016/j.exger.2020.111036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/25/2020] [Accepted: 07/20/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effect of citrulline (CIT) supplementation combined to high intensity interval training (HIIT) on physical performance in healthy older adults. METHODS This study is a secondary analysis from a double-blind, randomized trial. Among the participants (sedentary & inactive older adults aged over 65 yrs), 44 were non obese (BMI <30 kg/m2) and completed the intervention: Placebo + HIIT (PLA; n = 21) or CIT + HIIT (n = 23). All participants ingested either 10 g of CIT supplementation/day or placebo and followed HIIT sessions (30 min/session; cycle: 30 s > 85% of maximal heart rate (HR) and Borg scale >17/20 + 1:50 min at 65% HR and Borg scale between 13 and 16) on an elliptical device 3 times per week over a 12-week period. Body composition, muscle strength, muscle power, functional capacities (unipodal balance; self-paced and fast Timed Up and Go (nTUG; fTUG); chair test; step tests; 4-meter walking test; 6-minute walking test); dietary intake, energy expenditure and biological markers were measured pre and post-intervention. A repeated-measure analysis of variance was used to estimate time (HIIT intervention), group (PLA vs. CIT) and time*group effects. RESULTS The decrease in BMI (p = 0.02) and android fat mass (p = 0.05) were significantly greater in the HIIT+CIT group than in the HIIT+PLA group. Finally, a greater increase in self-paced gait speed (nTUG) (p = 0.02) and fast-paced gait speed (fTUG) (p = 0.03) were also observed in the HIIT+CIT group than in the HIIT+PLA group. CONCLUSION CIT supplementation combined to HIIT is more effective in improving functional capacities and body composition in healthy older adults than HIIT alone.
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Affiliation(s)
- Buckinx F
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Liège, Belgium
| | - Carvalho L P
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Marcangeli V
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Dulac M
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Hajj Boutros G
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Gouspillou G
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Gaudreau P
- Département de Médecine, Université de Montréal, Montréal, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Noirez P
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Inserm UMR S-1124 & IRMES EA7329, Université de Paris, Paris, France
| | - Aubertin-Leheudre M
- Département des Sciences de l'Activité Physique, GRAPA, Université du Québec À Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada.
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Bland VL, Bea JW, Roe DJ, Lee VR, Blew RM, Going SB. Physical activity, sedentary time, and longitudinal bone strength in adolescent girls. Osteoporos Int 2020; 31:1943-1954. [PMID: 32388589 DOI: 10.1007/s00198-020-05406-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
UNLABELLED The association between baseline physical activity and sedentary time with 2-year longitudinal bone strength was evaluated. The effect of physical activity on bone depended on maturity status. Sedentary time did not negatively impact bone outcomes, regardless of maturity. Maturity should be considered when developing exercise interventions to improve bone outcomes. INTRODUCTION Physical activity during adolescence is important to obtain peak bone mass; however, adolescents are increasingly sedentary, potentially increasing risk for osteoporosis later in life. The aim of this study was to assess the association of physical activity and sedentary time with 2-year longitudinal bone outcomes in adolescent females (69% Hispanic/31% non-Hispanic). METHODS Bone strength was assessed at the 66% tibia, 20% femur, and 66% radius of 9- to 12-year-old girls (n = 131) using peripheral quantitative computed tomography at baseline and 2-year follow-up. Physical activity and sedentary time were assessed via accelerometry. Linear regression analyses were used to assess whether baseline vigorous physical activity (VPA), moderate physical activity (MPA), light physical activity (LPA), or sedentary time predict longitudinal bone outcomes, adjusting for relevant confounders. RESULTS Significant interactions were found between maturity offset and physical activity. In weight-bearing bones, significant interactions were primarily identified between VPA and maturity offset. Interactions indicated that VPA was associated with favorable bone outcomes at the tibia and femur in girls further past the age of PHV. However, this favorable effect was not observed in girls closer to the age of PHV. At the radius, interactions were primarily observed between LPA and maturity offset. Again, LPA was more beneficial for girls further past the age of PHV. Sedentary time did not significantly influence bone outcomes. CONCLUSION The effects of physical activity on bone may be dependent on maturity. Therefore, physical activity interventions, with attention to maturity status, may be required to optimize bone strength in girls.
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Affiliation(s)
- V L Bland
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA.
| | - J W Bea
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
- Department of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
| | - D J Roe
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, 85724, USA
| | - V R Lee
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
| | - R M Blew
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
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Moradell A, Navarrete-Villanueva D, Fernández-García ÁI, Marín-Puyalto J, Gómez-Bruton A, Pedrero-Chamizo R, Pérez-Gómez J, Ara I, Casajus JA, Gómez-Cabello A, Vicente-Rodríguez G. Role of Dietary Intake and Serum 25(OH)D on the Effects of a Multicomponent Exercise Program on Bone Mass and Structure of Frail and Pre-Frail Older Adults. Nutrients 2020; 12:nu12103016. [PMID: 33019701 PMCID: PMC7601843 DOI: 10.3390/nu12103016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 01/10/2023] Open
Abstract
The multicomponent training (MCT) effect on bone health in frail and pre-frail elders, which is influenced by dietary intake, is still unknown. The objective of this non-randomized intervention trial was to assess the effects of a 6-month MCT on bone structure in frail and pre-frail elders, and to analyse the influence of dietary intake and serum vitamin D (25(OH)D) in these changes. Thirty MCT (TRAIN) and sixteen controls (CON), frail and pre-frail completed the information required for this study. Peripheral quantitative computed tomography measurements were taken at 4% and 38% of the tibia length and dietary intake was registered. The 25(OH)D values were obtained from blood samples. Analyses of covariance (ANCOVA) for repeated measures showed significant decreases for CON in total bone mineral content at 38% of tibia length. One factor ANOVAs showed smaller decreases in bone mineral density and cortical thickness percentage of change in TRAIN compared to CON. Linear regression analyses were performed to study the influence of nutrients and 25(OH)D on bone changes. Alcohol showed a negative influence on fracture index changes, while polyunsaturated fatty acid and vitamin A showed a positive association with some bone variables. The 25(OH)D only affected positively the cortical bone mineral density. In conclusion, our MCT seems to slow down some of the bone detriments associated with ageing in frail and pre-frail older adults, with alcohol showing a negative effect on the bone and apparent limited effect of nutrients and serum 25(OH)D on training related changes.
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Affiliation(s)
- Ana Moradell
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Ángel I. Fernández-García
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Marín-Puyalto
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
| | - Alejandro Gómez-Bruton
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Raquel Pedrero-Chamizo
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Polytechnic University of Madrid, 28040 Madrid, Spain
| | - Jorge Pérez-Gómez
- HEME Research Group, University of Extremadura, 10003 Cáceres, Spain;
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, 45071 Toledo, Spain;
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Jose A. Casajus
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn), 28029 Madrid, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn), 28029 Madrid, Spain
- Defense University Center, 50090 Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.M.); (D.N.-V.); (Á.I.F.-G.); (J.M.-P.); (A.G.-B.); (J.A.C.); (A.G.-C.)
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009 Zaragoza, Spain;
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-876-55-37-56
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Harding AT, Weeks BK, Lambert C, Watson SL, Weis LJ, Beck BR. Effects of supervised high-intensity resistance and impact training or machine-based isometric training on regional bone geometry and strength in middle-aged and older men with low bone mass: The LIFTMOR-M semi-randomised controlled trial. Bone 2020; 136:115362. [PMID: 32289518 DOI: 10.1016/j.bone.2020.115362] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/23/2020] [Accepted: 04/07/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Few data exist on the effects of bone-targeted exercise on geometric and biomechanical indices of bone strength in men. The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial was designed to compare the efficacy and safety of two novel, supervised, twice-weekly, high-intensity exercise programs in middle-aged and older men with osteopenia and osteoporosis on musculoskeletal health and risk factors related to falls and fractures. The current report includes secondary outcomes of the LIFTMOR-M exercise intervention trial. PURPOSE Our goal was to determine the effects of two supervised, twice-weekly, high-intensity exercise programs on bone geometry and strength of the proximal femur, and distal and proximal sites of the tibia and radius in middle-aged and older men with osteopenia and osteoporosis. METHODS Generally-healthy men (≥45 years), with low lumbar spine (LS) and/or proximal femur areal bone mineral density (aBMD), were recruited from the community. Eligible participants were randomised to either eight months of twice-weekly supervised high-intensity progressive resistance and impact training (HiRIT) or supervised machine-based isometric axial compression (IAC) exercise training. Intervention group outcomes were compared at baseline and eight months with a matched but non-randomised control group (CON) who self-selected to usual activities. DXA scans (Medix DR, Medilink, France) of the skeletally non-dominant proximal femur were analysed using 3D hip software (DMS Group, France) to derive femoral neck (FN) and total hip (TH) bone mineral content (BMC), volume, and volumetric bone mineral density (vBMD) for total, trabecular and cortical bone compartments. Total FN cortical thickness was determined as well as anterior, posterior, lateral and medial subregions. pQCT scans (XCT-3000, Stratec, Germany) of the 4 and 38% sites of the tibia, and 4 and 66% sites of the radius were conducted to determine a range of geometric and bone structural strength indices. Intervention effects were examined using univariate ANCOVA of percent change, and repeated measures ANCOVA of raw baseline and follow-up data, controlling for initial values, using intention-to-treat and per-protocol approaches. RESULTS Ninety-three men (67.1 ± 7.5 yrs, 175.2 ± 6.7 cm, 82.1 ± 11.6 kg, 26.7 ± 3.5 kg/m2) with lower than average aBMD (LS T-score -0.06 ± 1.04, FN T-score -1.58 ± 0.58, TH T-score -1.00 ± 0.58) were recruited, and designated CON (n = 26) or randomised to HiRIT (n = 34) or IAC (n = 33). Compliance to the supervised exercise programs did not differ (HiRIT 77.8 ± 16.6% versus IAC 78.5 ± 14.8%, p = 0.872). HiRIT improved medial FN cortical thickness compared with CON (5.6 ± 1.7% versus -0.1 ± 1.9%, p = 0.028) and IAC (5.6 ± 1.7% versus 0.7 ± 1.7%, p = 0.044). Distal tibia total BMC, vBMD, area and bone strength index, and trabecular BMC and bone strength index all declined for CON compared with maintenance for both HiRIT and IAC (all p < 0.05). HiRIT maintained distal tibia trabecular area compared with a loss in CON (0.2 ± 0.5% versus -1.6 ± 0.5%, p = 0.013). HiRIT and IAC maintained distal radius total BMC compared with loss in CON (-0.1 ± 0.7% versus -3.7 ± 0.8%, p = 0.001; 1.3 ± 0.7% versus -3.7 ± 0.8%, p < 0.001, respectively). HiRIT and IAC maintained distal radius total bone strength index compared with loss in CON (1.4 ± 1.4% versus -6.0 ± 1.6%, p = 0.001; 0.2 ± 1.3% versus -6.0 ± 1.6%, p = 0.004, respectively). HiRIT reduced proximal radius cortical area compared with CON (-3.1 ± 1.0% versus 1.1 ± 1.2%, p = 0.011) and IAC (-3.1 ± 1.0% versus -0.2 ± 1.0%, p = 0.042). No between-group differences were detected in any pQCT-derived bone outcome at the diaphyseal tibia 38% site. CONCLUSION Findings indicate that supervised HiRIT provides a positive stimulus to cortical bone at the medial FN compared with supervised IAC exercise, and both HiRIT and IAC preserve bone strength at the distal tibia and distal radius. These effects may translate into a reduced risk of lower and upper extremity fracture in middle-aged and older men with low bone mass.
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Affiliation(s)
- Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Conor Lambert
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Steven L Watson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Lisa J Weis
- The Bone Clinic, Brisbane, Queensland, Australia
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; The Bone Clinic, Brisbane, Queensland, Australia.
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Effects of slow- v. fast-digested protein supplementation combined with mixed power training on muscle function and functional capacities in older men. Br J Nutr 2020; 125:1017-1033. [PMID: 32498755 DOI: 10.1017/s0007114520001932] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Ageing leads to a progressive loss of muscle function (MF) and quality (MQ: muscle strength (MS)/lean muscle mass (LM)). Power training and protein (PROT) supplementation have been proposed as efficient interventions to improve MF and MQ. Discrepancies between results appear to be mainly related to the type and/or dose of proteins used. The present study aimed at determining whether or not mixed power training (MPT) combined with fast-digested PROT (F-PROT) leads to greater improvements in MF and MQ in elderly men than MPT combined with slow-digested PROT (S-PROT) or MPT alone. Sixty elderly men (age 69 (sd 7) years; BMI 18-30 kg/m2) were randomised into three groups: (1) placebo + MPT (PLA; n 19); (2) F-PROT + MPT (n 21) and (3) S-PROT + MPT (n 20) completed the intervention. LM, handgrip and knee extensor MS and MQ, functional capacity, serum metabolic markers, skeletal muscle characteristics, dietary intake and total energy expenditure were measured. The interventions consisted in 12 weeks of MPT (3 times/week; 1 h/session) combined with a supplement (30 g:10 g per meal) of F-PROT (whey) or S-PROT (casein) or a placebo. No difference was observed among groups for age, BMI, number of steps and dietary intake pre- and post-intervention. All groups improved significantly their LM, lower limb MS/MQ, functional capacity, muscle characteristics and serum parameters following the MPT. Importantly, no difference between groups was observed following the MPT. Altogether, adding 30 g PROT/d to MPT, regardless of the type, does not provide additional benefits to MPT alone in older men ingesting an adequate (i.e. above RDA) amount of protein per d.
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Baker BS, Buchanan SR, Bemben DA. Skeletal Health and Associated Injury Risk in Collegiate Female Rowers. J Strength Cond Res 2020; 36:1125-1133. [PMID: 32324717 DOI: 10.1519/jsc.0000000000003588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Baker, BS, Buchanan, SR, and Bemben, DA. Skeletal health and associated injury risk in collegiate female rowers. J Strength Cond Res XX(X): 000-000, 2020-Rowing has been associated with low bone mass and stress fractures. The aim of this study was to compare bone density, geometry, and skeletal asymmetries between competitive female rowers and matched controls and within rowers based on reported injury status, allowing for the calculation of practical injury risk prediction equations. Rowers (n = 24) and controls (n = 24) completed total body, lumbar spine, and and dual femur and radii dual energy x-ray absorptiometry and peripheral quantitative computed tomography scans. One-way analyses of covariance were performed between rowers and controls, and one-way analyses of variance were performed between rowers based on reported rib injury status (injured [n = 11]; injury-free [n = 13]). Logistic regression was used to create prediction models of rowers' injury status. Significance was set at p ≤ 0.05. Rowers were taller, had greater lean mass, less fat mass, and mostly equivalent skeletal measures compared to controls, which were within normal ranges (p < 0.048). Injury-free rowers consumed over 500 mg·d more calcium and were less symmetrical at the 4% tibiae and hips (p < 0.015). The strongest predictive regression model of reported rib injury in rowers comprised calcium intake and the symmetry index of hip strength index (R = 0.833; p < 0.001). A more practical model including daily calcium intake and total bone specific physical activity (PA) scores can be used to correctly predict injury status 75% of the time (R = 0.750; p = 0.022). This is the first study to provide practitioners an injury prediction model for competitive rowers, reiterating the importance of proper nutrition and auxiliary PA focusing on balanced movement patterns.
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Affiliation(s)
- Breanne S Baker
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma
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Baker BS, Chen Z, Larson RD, Bemben MG, Bemben DA. Sex differences in bone density, geometry, and bone strength of competitive soccer players. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:62-76. [PMID: 32131370 PMCID: PMC7104578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/17/2019] [Indexed: 11/02/2022]
Abstract
OBJECTIVES To examine sex differences in bone characteristics in competitive soccer players. METHODS 43 soccer players (male, n=23; female, n=20), and 43 matched controls (males, n=23; females, n=20), completed the study. Areal BMD (aBMD) of the total body, lumbar spine, and dual femur and tibiae volumetric BMD (vBMD), bone geometry, and bone strength variables (pQCT) were measured. Bone-specific physical activity and training history were assessed. RESULTS Male soccer players had significantly greater (p≤0.05) total body and hip aBMD, hip strength indices and 4% and 38% tibia variables than females. Regression analyses determined that BFLBM, not sex, was the strongest predictor of bone variables. Female soccer players exhibited significantly greater percent differences from controls for tibiae variables than males (p≤0.05). Soccer players had greater aBMD and hip strength indices than controls (p≤0.040). Soccer-specific asymmetries were found for 38% total area (2.1%) and pSSI (3.8%), favoring the non-dominant leg (both p≤0.017). CONCLUSION Bone characteristics adjusted for body size were greater in male versus female soccer players. However, body composition variables were more important predictors of bone characteristics than sex. There were no sex differences in the magnitude of limb asymmetries, suggesting skeletal responsiveness to mechanical loading was similar in males and females.
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Affiliation(s)
- Breanne S. Baker
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Zhaojing Chen
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Rebecca D. Larson
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Michael G. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Debra A. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
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Jenkins M, Hart NH, Nimphius S, Chivers P, Rantalainen T, Rothacker KM, Beck BR, Weeks BK, McIntyre F, Hands B, Beeson BP, Siafarikas A. Characterisation of peripheral bone mineral density in youth at risk of secondary osteoporosis - a preliminary insight. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:27-52. [PMID: 32131368 PMCID: PMC7104582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To describe peripheral long bone material and structural differences in youth at risk of secondary osteoporosis across disease-specific profiles. METHODS Upper- and lower limbs of children and adolescents were scanned at 4% distal and 66% mid-shaft sites using peripheral Quantitative Computed Tomography sub-categorised as (1) increased risk of secondary osteoporosis (neuromuscular disorders; chronic diseases; endocrine diseases; inborn errors of metabolism; iatrogenic conditions), (2) low motor competence and (3) non-affected controls. RESULTS Children with disease-specific profiles showed a range of bone deficits compared to the control group with these predominantly indicated for neuromuscular disorders, chronic diseases and low motor competence. Deficits between upper arm and lower leg long bone parameters were different for disease-specific profiles compared to the control group. Endocortical radius, muscle area, and mid-cortical ring density were not significantly different for any disease-specific profile compared to the control group for any bone sites. CONCLUSIONS Neuromuscular disorders, chronic diseases and low motor competence have a strong correlation to bone health for appendicular bone parameters in youth, suggesting a critical mechanical loading influence which may differ specific to disease profile. As mechanical loading effects are observed in regional bone analyses, targeted exercise interventions to improve bone strength should be implemented to examine if this is effective in reducing the risk of secondary osteoporosis in youth.
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Affiliation(s)
- Mark Jenkins
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia,Western Australian Bone Research Collaboration, Perth, W.A., Australia
| | - Nicolas H. Hart
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia,Western Australian Bone Research Collaboration, Perth, W.A., Australia,Institute for Health Research, University of Notre Dame Australia, Perth, W.A., Australia,Exercise Medicine Research Institute, Edith Cowan University, Perth, W.A., Australia,Corresponding author: Dr Nicolas H. Hart - PhD, AES, CSCS, ESSAM, Senior Research Fellow, Exercise Medicine Research Institute. Building 21, Room 222 - Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, W.A., Australia E-mail:
| | - Sophia Nimphius
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia,Western Australian Bone Research Collaboration, Perth, W.A., Australia
| | - Paola Chivers
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia,Western Australian Bone Research Collaboration, Perth, W.A., Australia,Institute for Health Research, University of Notre Dame Australia, Perth, W.A., Australia,Exercise Medicine Research Institute, Edith Cowan University, Perth, W.A., Australia
| | - Timo Rantalainen
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia,Western Australian Bone Research Collaboration, Perth, W.A., Australia,Institute for Health Research, University of Notre Dame Australia, Perth, W.A., Australia,Exercise Medicine Research Institute, Edith Cowan University, Perth, W.A., Australia,Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Karen M. Rothacker
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, W.A., Australia,Keogh Institute for Medical Research, Perth, W.A., Australia,Telethon Kids Institute for Child Health Research, Perth, W.A., Australia
| | - Belinda R. Beck
- Menzies Health Institute Queensland, Bone Densitometry Research Laboratory, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Benjamin K. Weeks
- Menzies Health Institute Queensland, Bone Densitometry Research Laboratory, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Fleur McIntyre
- Western Australian Bone Research Collaboration, Perth, W.A., Australia,School of Health Sciences, University of Notre Dame Australia, Perth, W.A., Australia
| | - Beth Hands
- Western Australian Bone Research Collaboration, Perth, W.A., Australia,Institute for Health Research, University of Notre Dame Australia, Perth, W.A., Australia
| | - Brendan P. Beeson
- Department of Medical Imaging, Perth Children’s Hospital, Perth, W.A., Australia
| | - Aris Siafarikas
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia,Western Australian Bone Research Collaboration, Perth, W.A., Australia,Institute for Health Research, University of Notre Dame Australia, Perth, W.A., Australia,Exercise Medicine Research Institute, Edith Cowan University, Perth, W.A., Australia,Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, W.A., Australia,Telethon Kids Institute for Child Health Research, Perth, W.A., Australia,University of Western Australia, Medical School, Division of Paediatrics, Perth, W.A., Australia
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Dalla Via J, Daly RM, Owen PJ, Mundell NL, Rantalainen T, Fraser SF. Bone mineral density, structure, distribution and strength in men with prostate cancer treated with androgen deprivation therapy. Bone 2019; 127:367-375. [PMID: 31189088 DOI: 10.1016/j.bone.2019.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 12/26/2022]
Abstract
Androgen deprivation therapy (ADT) improves survival in men with advanced prostate cancer (PCa), but has been associated with compromised skeletal health and increased fracture risk. However, limited previous research has investigated determinants of bone strength beyond DXA-derived areal bone mineral density (aBMD) in this population group. The aim of this cross-sectional study was to investigate the effects of ADT in men with PCa on BMD, bone structure, estimates of whole bone strength and cortical bone distribution. A total of 70 ADT-treated men, 52 PCa controls and 70 healthy controls had DXA lumbar spine and proximal femur aBMD and pQCT distal (4%) and proximal (66%) tibia and radius cortical and trabecular volumetric BMD (vBMD), bone structure, strength and cortical bone distribution assessed. Analyses included BMI and/or tibia/radius length as covariates. On average, ADT-treated men had a higher BMI than PCa (P < 0.05) but not healthy controls. ADT-treated men had 7.2-7.8% lower lumbar spine aBMD than PCa (P = 0.037) and healthy controls (P = 0.010), with a trend for a lower total hip aBMD in the ADT-treated men (P = 0.07). At the distal tibia, total bone area was 6.2-7.3% greater in ADT-treated men than both controls (P < 0.01), but total vBMD was 8.4-8.7% lower in ADT-treated men than both controls (P < 0.01). Moreover, bone strength index (BSI) was 10.8% lower relative to healthy controls only (P < 0.05). At the distal radius, ADT-treated men had lower total and trabecular vBMD (10.7-14.8%, P < 0.05) and BSI (23.6-27.5%, P < 0.001) compared to both controls. There were no other differences in bone outcomes at the proximal tibia or radius. In conclusion, ADT treatment for PCa was associated with lower BMD and estimated compressive bone strength, particularly at trabecular skeletal sites (lumbar spine, and distal tibia and radius), compared to controls, but there were no consistent differences in cortical bone structure, distribution or bending strength.
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Affiliation(s)
- Jack Dalla Via
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Niamh L Mundell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Timo Rantalainen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia; Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Initial Dietary Protein Intake Influence Muscle Function Adaptations in Older Men and Women Following High-Intensity Interval Training Combined with Citrulline. Nutrients 2019; 11:nu11071685. [PMID: 31336654 PMCID: PMC6683270 DOI: 10.3390/nu11071685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 12/21/2022] Open
Abstract
Background: This study evaluates whether the initial amount of dietary protein intake could influence the combined effect of high-intensity interval training (HIIT) and citrulline (CIT), or HIIT alone, on body composition, muscle strength, and functional capacities in obese older adults. Methods: Seventy-three sedentary obese older men and women who completed a 12-week elliptical HIIT program with double-blinded randomized supplementation of CIT or placebo (PLA) were divided into four groups according to their initial protein intake (CIT–PROT+: n = 21; CIT–PROT−: n = 19; PLA–PROT+: n = 19; PLA–PROT−: n = 14). Body composition (fat and fat-free masses), handgrip (HSr) strength, knee extensor (KESr) strength, muscle power, and functional capacities were measured pre-intervention and post-intervention. Results: Following the intervention, the four groups improved significantly regarding all the parameters measured. For the same initial amount of protein intake, the CIT–PROT− group decreased more gynoid fat mass (p = 0.04) than the PLA–PROT− group. The CIT–PROT+ group increased more KESr (p = 0.04) than the PLA–PROT+ group. In addition, the CIT–PROT− group decreased more gynoid FM (p = 0.02) and improved more leg FFM (p = 0.02) and HSr (p = 0.02) than the CIT–PROT+ group. Conclusion: HIIT combined with CIT induced greater positive changes than in the PLA groups. The combination seems more beneficial in participants consuming less than 1 g/kg/d of protein, since greater improvements on body composition and muscle strength were observed.
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Vlok J, Simm PJ, Lycett K, Clifford SA, Grobler AC, Lange K, Ismail N, Osborn W, Wake M. pQCT bone geometry and strength: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:63-74. [PMID: 31273017 PMCID: PMC6624036 DOI: 10.1136/bmjopen-2018-022400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 12/24/2018] [Accepted: 04/04/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To describe the epidemiology and concordance of bone health in a population-based sample of Australian parent-child dyads at child age 11-12 years. DESIGN Population-based cross-sectional study (the Child Health CheckPoint) nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven cities around Australia, February 2015-March 2016. PARTICIPANTS of all participating CheckPoint families (n=1874), bone data were available for 1222 dyads (1271 children, 50% girls; 1250 parents, 86% mothers). OUTCOME MEASURES Peripheral quantitative CT (pQCT) of the non-dominant leg scanned at the 4% (distal) and 66% (mid-calf) tibial sites. Stratec XCT 2000 software generated estimates of bone density, geometry and polar stress-strain index.Parent-child concordance were assessed using Pearson's correlation coefficients and multivariable linear regression models. Percentiles were determined using survey weights. Survey weights and methods accounted for LSAC's complex sampling, stratification and clustering within postcodes. RESULTS Concordances were greater for the geometric pQCT parameters (periosteal circumference 0.38, 95% CI 0.33 to 0.43; endosteal circumference 0.42, 95% CI 0.37 to 0.47; total cross-sectional area 0.37, 95% CI 0.32 to 0.42) than density (cortical density 0.25, 95% CI 0.19 to 0.30). Mother-child and father-child values were similar. Relationships attenuated only slightly on adjustment for age, sex and body mass index. Percentiles and concordance are presented for the whole sample and by sex. CONCLUSIONS There is strong parent-child concordance in bone geometry and, to a lesser extent, density even before the period of peak adolescent bone deposition. This geometrical concordance suggests that future intergenerational bone studies could consider using pQCT rather than the more commonly used dual X-ray absorptiometry (DXA).
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Affiliation(s)
- Jennifer Vlok
- Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Peter J Simm
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Najmi Ismail
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - William Osborn
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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Gaffney-Stomberg E, Nakayama AT, Guerriere KI, Lutz LJ, Walker LA, Staab JS, Scott JM, Gasier HG, McClung JP. Calcium and vitamin D supplementation and bone health in Marine recruits: Effect of season. Bone 2019; 123:224-233. [PMID: 30902791 DOI: 10.1016/j.bone.2019.03.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/13/2019] [Accepted: 03/17/2019] [Indexed: 12/16/2022]
Abstract
Stress fractures are common overuse injuries caused by repetitive bone loading. These fractures are of particular concern for military recruits and athletes resulting in attrition in up to 60% of recruits that sustain a fracture. Army and Navy recruits supplemented with daily calcium and vitamin D (Ca + D) demonstrated improved bone strength and reduced stress fractures. The aim of the current study was to evaluate whether Ca + D supplementation improves measures of bone health in recruits undergoing United States Marine Corps initial military training (IMT), and whether the effect of supplementation on indices of bone health varied by season. One-hundred ninety-seven Marine recruits (n = 107 males, n = 90 females, mean age = 18.9 ± 1.6 y) were randomized to receive either Ca + D fortified snack bars (2000 mg Ca and 1000 IU vitamin D per day) or placebo divided into twice daily doses during 12 weeks of IMT. Anthropometrics, fasted blood samples, and peripheral quantitative computed tomography (pQCT) scans of the tibial metaphysis and diaphysis were collected upon entrance to- and post-training (12 weeks later). Half of the volunteers entered training in July and the other half started in February. Time-by-group interactions were observed for vitamin D status (25OHD) and the bone turnover markers, BAP, TRAP and OCN. 25OHD increased and BAP, TRAP and OCN all decreased in the Ca + D group (p < .05). Training increased distal tibia volumetric BMD (+1.9 ± 2.8%), BMC (+2.0 ± 3.1%), and bone strength index (BSI; +4.0 ± 4.0%) and diaphyseal BMC (+1.0 ± 2.2%) and polar stress strain index (SSIp; +0.7 ± 2.1%) independent of Ca + D supplementation (p < .05 for all). When analyzed by season, change in BSI was greater in the Ca + D group as compared to placebo in the summer iteration only (T*G; p < .05). No other effects of supplementation on bone tissue were observed. When categorized by tertile of percent change in BSI, recruits demonstrating the greatest changes in BSI and 25OHD entered training with the lowest levels of 25OHD (p < .05). Over all, these results suggest that Ca + D supplementation reduced some markers of bone formation and resorption and the decline in 25OHD over training in volunteers that started training in the summer was prevented by supplementation. Baseline 25OHD and trajectory may impact bone responses to IMT, but little effect of Ca + D supplementation was observed at the investigated doses.
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Affiliation(s)
- Erin Gaffney-Stomberg
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America.
| | - Anna T Nakayama
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America; Oak Ridge Institute for Science and Education, Oakridge, TN 37830, United States of America
| | - Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Laura J Lutz
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Leila A Walker
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jonathan M Scott
- Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, United States of America
| | - Heath G Gasier
- Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, United States of America
| | - James P McClung
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
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47
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Buckinx F, Gaudreau P, Marcangeli V, Boutros GEH, Dulac MC, Morais JA, Aubertin-Leheudre M. Muscle adaptation in response to a high-intensity interval training in obese older adults: effect of daily protein intake distribution. Aging Clin Exp Res 2019; 31:863-874. [PMID: 30806907 DOI: 10.1007/s40520-019-01149-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/11/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Aging is associated with declines in muscle mass, strength and quality, leading to physical impairments. An even protein distribution in daily meals has recently been proposed along with adequate total protein intake as important modulators of muscle mass. In addition, due to its short duration, high-intensity interval training (HIIT) has been highlighted as a promising intervention to prevent physical deterioration. However, the interaction between daily protein intake distribution and HIIT intervention in elderlies remain unknown. OBJECTIVE To investigate muscle adaptation following HIIT in older adults according to daily protein intake distribution. METHODS Thirty sedentary obese subjects who completed a 12-week elliptical HIIT program were matched [criteria: age (± 2 years), sex, BMI (± 2 kg/m2)] and divided a posteriori into 2 groups according to the amount of protein ingested at each meal: < 20 g in at least one meal (P20-, n = 15, 66.8 ± 3.7 years) and ≥ 20 g in each meal (P20+, n = 15, 68.1 ± 4.1 years). Body composition, functional capacity, muscle strength, muscle power, physical activity level, and nutritional intakes were measured pre- and post-intervention. A two way repeated ANOVA was used to determine the effect of the intervention (HIIT) and protein distribution (P20- vs P20+, p < 0.05). RESULTS No difference was observed at baseline between groups. Following the HIIT intervention, we observed a significant decrease in waist and hip circumferences and improvements in functional capacities in both P20- and P20 + group (p < 0.05). However, no protein distribution effect was observed. CONCLUSION A 12-week HIIT program is achievable and efficient to improve functional capacities as well as body composition in obese older adults. However, consuming at least 20 g of proteins in every meal does not further enhance muscle performance in response to a 12-week HIIT intervention.
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Affiliation(s)
- F Buckinx
- Département des Sciences de l'activité physique, Faculté des Sciences, UQAM, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Pavillon Sciences Biologiques, SB-4615, 141, Avenue du Président Kennedy, Montréal, QC, H2X 1Y4, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Liège, Belgium
| | - P Gaudreau
- Département de médecine de l'Université de Montréal, Centre de recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Université de Montréal, Montréal, Canada
| | - V Marcangeli
- Département des Sciences de l'activité physique, Faculté des Sciences, UQAM, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Pavillon Sciences Biologiques, SB-4615, 141, Avenue du Président Kennedy, Montréal, QC, H2X 1Y4, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - G El Hajj Boutros
- Département des Sciences de l'activité physique, Faculté des Sciences, UQAM, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Pavillon Sciences Biologiques, SB-4615, 141, Avenue du Président Kennedy, Montréal, QC, H2X 1Y4, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - M C Dulac
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - J A Morais
- Division of Geriatric Medicine, McGill University Health Centre (MUHC), McGill University, Montréal, QC, Canada
| | - M Aubertin-Leheudre
- Département des Sciences de l'activité physique, Faculté des Sciences, UQAM, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Pavillon Sciences Biologiques, SB-4615, 141, Avenue du Président Kennedy, Montréal, QC, H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada.
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48
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Rowe GS, Blazevich AJ, Haff GG. pQCT- and Ultrasound-based Muscle and Fat Estimate Errors after Resistance Exercise. Med Sci Sports Exerc 2019; 51:1022-1031. [PMID: 30986813 DOI: 10.1249/mss.0000000000001873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Resistance exercise increases blood flow, induces osmotic and hydrostatic fluid shifts during and immediately after exercise, and may trigger inflammatory responses for several days in the working muscle. The resultant muscle swelling can subsequently affect muscle size and quality assessments. However, the effects of muscle swelling on x-ray attenuation of adipose estimate errors are unknown. METHODS Peripheral quantitative computed tomography (pQCT) and ultrasonography were used to assess muscle and adipose tissue properties of both upper arms before, 24, 48, and 72 h after unilateral resistance exercise. Recreationally active participants (n = 17) completed the exercise while their contralateral limb served as a control. RESULTS Resistance exercise resulted in a significant increase in pQCT-derived muscle cross-sectional area (includes intermuscular adipose tissue [IMAT] area), muscle area (excludes IMAT area) and IMAT area, and ultrasound-derived muscle thickness at 24, 48, and 72 h. A significant decrease in pQCT-derived muscle density was also detected as well as an increase in ultrasound-derived echo intensity at 48 and 72 h. The changes in muscle area, IMAT area, and muscle density were significantly correlated with changes in echo intensity, whereas the changes in muscle cross-sectional area and IMAT area were significantly correlated with changes in muscle thickness. CONCLUSION Unaccustomed resistance exercise can cause errors in pQCT- and ultrasound-based muscle and adipose estimates for at least 72 h. These errors are the result of muscle swelling likely caused by muscle blood flow and inflammation-dependent fluid shifts in muscle. These findings may have implications for measurements in other inflammatory conditions.
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Affiliation(s)
- Grant Simon Rowe
- Centre for Exercise and Sports Science Research, Edith Cowan University, AUSTRALIA
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49
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Higgins S, Sokolowski CM, Vishwanathan M, Anderson JG, Schmidt MD, Lewis RD, Evans EM. Predicting Diaphyseal Cortical Bone Status Using Measures of Muscle Force Capacity. Med Sci Sports Exerc 2019; 50:1433-1441. [PMID: 29462101 DOI: 10.1249/mss.0000000000001581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Muscle cross-sectional area (MCSA) is often used as a surrogate for the forces applied to bones during physical activity. Although MCSA is a strong predictor of cortical bone status, its use makes assumptions about the relationship between muscle size and force that are inaccurate. Furthermore, to measure MCSA and other muscle force surrogates typically requires expensive and/or radiative laboratory equipment. Thus, this study aimed to determine whether clinical laboratory- and field-based methodologies for measuring muscular force capacity accounted for similar variance in diaphyseal cortical bone status as a commonly used muscular force surrogate, MCSA, at the midtibia in young men and women. METHODS Healthy young adults (n = 142, 19.7 ± 0.7 yr old, 52.8% female) were assessed via peripheral quantitative computed tomography at the midtibia for cortical bone status and MCSA. Muscle force capacity was measured via Biodex dynamometer, Nottingham leg extensor power rig, and Vertec vertical jump. Regression analysis compared the independent variance predicted by each muscle force measure with that of MCSA, accounting for relevant confounders. RESULTS MCSA, knee extension peak torque, and peak anaerobic power from vertical jump were independent predictors of select cortical structural outcomes (cortical thickness and area, periosteal and endosteal circumference, and estimated strength) accounting for up to 78.4% of the variance explained (all P < 0.05). However, cortical volumetric bone mineral density was unrelated to any measure or surrogate of muscle force capacity. CONCLUSIONS MCSA is a strong independent predictor of cortical bone structure; however, both laboratory- and field-based measures of peak torque and/or peak anaerobic power are promising alternatives, explaining similar and sometimes greater variance than MCSA.
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Affiliation(s)
- Simon Higgins
- Department of Kinesiology, University of Georgia, Athens, GA.,Department of Exercise Science, Elon University, Elon, NC
| | | | | | | | | | - Richard D Lewis
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Ellen M Evans
- Department of Kinesiology, University of Georgia, Athens, GA
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50
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Nakayama AT, Lutz LJ, Hruby A, Karl JP, McClung JP, Gaffney-Stomberg E. A dietary pattern rich in calcium, potassium, and protein is associated with tibia bone mineral content and strength in young adults entering initial military training. Am J Clin Nutr 2019; 109:186-196. [PMID: 30615068 DOI: 10.1093/ajcn/nqy199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/20/2018] [Indexed: 12/28/2022] Open
Abstract
Background Stress fracture risk is elevated during initial military training (IMT), particularly in lower-extremity bones such as the tibia. Although the etiology of stress fractures is multifactorial, lower bone strength increases risk. Objective The objective of this study was to assess, through the use of peripheral quantitative computed tomography, whether adherence to a dietary pattern rich in calcium, potassium, and protein before IMT is positively associated with bone indexes in young adults entering IMT. Design A cross-sectional analysis was performed with the use of baseline data from 3 randomized controlled trials in Army, Air Force, and Marine recruits (n = 401; 179 men, 222 women). Dietary intake was estimated from a food-frequency questionnaire. A dietary pattern characterized by calcium, potassium, and protein was derived via reduced rank regression and a pattern z score was computed for each volunteer, where higher scores indicated greater adherence to the pattern. At the 4% (metaphysis) and 14% (diaphysis) sites of the tibia, bone mineral content (BMC), volumetric bone mineral density, robustness, and strength indexes were evaluated. Associations between dietary pattern z score as the predictor variable and bone indexes as the response variables were evaluated by multiple linear regression. Results Pattern z score was positively associated with BMC (P = 0.004) and strength (P = 0.01) at the metaphysis and with BMC (P = 0.0002), strength (P = 0.0006), and robustness (P = 0.02) at the diaphysis when controlling for age, sex, race, energy, smoking, education, and exercise. Further adjustment for BMI attenuated the associations, except with diaphyseal BMC (P = 0.005) and strength (P = 0.01). When height and weight were used in place of body mass index, the association with BMC remained (P = 0.046). Conclusions A dietary pattern rich in calcium, potassium, and protein is positively associated with measures of tibia BMC and strength in recruits entering IMT. Whether adherence to this dietary pattern before IMT affects injury susceptibility during training remains to be determined. These trials were registered at clinicaltrials.gov as NCT01617109 and NCT02636348.
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Affiliation(s)
- Anna T Nakayama
- Oak Ridge Institute for Science and Education supporting the Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA.,Military Performance, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Laura J Lutz
- Military Performance, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Adela Hruby
- Oak Ridge Institute for Science and Education supporting the Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA.,Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - James P Karl
- Oak Ridge Institute for Science and Education supporting the Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - James P McClung
- Military Nutrition Divisions, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Erin Gaffney-Stomberg
- Military Performance, US Army Research Institute of Environmental Medicine, Natick, MA
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