Physical exercise associated with improved BMD independently of sex and vitamin D levels in young adults

Secular Trends in Peak Bone Mineral Density: The National Health and Nutrition Examination Survey 1999-2018

Peak bone mineral density (BMD) is one of the most important factors influencing the development of osteoporosis. It was predicted that a 10% increase in peak BMD will delay the onset of osteoporosis by 13 years. However, changes in peak BMD over time are unknown. This study aimed to investigate secular trends in peak BMD among young adults in the United States. Based on the National Health and Nutrition Examination Survey from 1999-2018, 3,975 males aged 19-28 years and 2370 females aged 31-40 years were our target population for estimating peak lumbar spine BMD. BMD was measured by dual-energy X-ray absorptiometry. Generalized linear models adjusted for multiple covariates were used to examine the secular trends in peak BMD in males and females, respectively. Secular trends for peak lumbar spine BMD from 1999-2000 to 2017-2018 were not statistically significant in males or females (all Plinear and Pquadratic > 0.05). Similar results were observed in race/ethnicity subgroups (all Plinear and Pquadratic > 0.05). However, in stratified analyses by obesity category, peak lumbar spine BMD in obese males and females increased from 1999-2000 to 2009-2010 and then decreased until 2017-2018, while peak lumbar spine BMD in non-obese females decreased from 1999-2000 to 2005-2006 and then increased until 2017-2018 (all Pquadratic < 0.05). Peak lumbar spine BMD was greater in obese males and females than in non-obese males and females up to 2009-2010, but not from 2011-2012 onwards. Overall, there were no significant secular trends in peak lumbar spine BMD. However, secular trends differed between obese and non-obese groups.

Effect of COVID-19 pandemic on lifestyle and bone mineral density in young adults

OBJECTIVES

This study investigates the relationships between the COVID-19 pandemic, lifestyle factors, and their impact on bone mineral density in the radius forearm bone and the total bone mineral content in young adults from Slovakia.

METHODS

We assessed 773 Slovak young adults aged 18 to 30 years, divided into subgroups on their pandemic status. Bone mineral density (BMD) was analyzed by the QUS device (Sunlight MiniOmni™), and bone mineral content (BMC) and fat mass (FM) were measured by InBody 770 bioimpedance analyzer. Finally, linear regression analysis tested the associations.

RESULTS

Statistically significant lower speed of sound (SOS) along the length of the forearm radius bone and Z-score values was determined in participants during the COVID-19 pandemic than before it, and statistically significant lower BMC values were observed in the male group during COVID-19 than beforehand. Regression analysis confirmed the negative pandemic effect in the following indices: SOS (p < .001 for women and p = .035 for men), Z-score (p < .001 for women and p = .003 for men), and BMC (p = .024 for men). Vitamin D was a further significant SOS predictor in women at p = .029, but this association was not detected in men. In contrast, the significant male BMC predictors were pandemic presence (p = .028), physical activity (p = .028), and fat mass percentage (p = .001).

CONCLUSIONS

Significant COVID-19 pandemic effects on bone tissue were determined on bone mass density in the radius forearm bone and the total bone mineral content. These effects establish that the pandemic had a negative impact on both their bone quality and health.

The effect of aquatic training and vitamin D3 supplementation on bone metabolism in postmenopausal obese women

Purpose

Despite prevalence of studies indicating the positive effect of land-based exercise on bone metabolism, there are limited findings regarding the effect of aquatic exercise. The present study aimed to evaluate the effects of aquatic training and vitamin D3 supplementation on femur bone mineral density (BMD), serum 25(OH)D, and parathyroid hormone (PTH) in postmenopausal obese women with vitamin D insufficiency.

Methods

40 postmenopausal obese women were randomly divided into four groups of aquatic training + vitamin D3 intake group; (ATD), aquatic training with placebo intake group (AT), vitamin D3 intake group (D), and control group with placebo intake (CON). AT groups performed aerobic aquatic exercises for 8 weeks. Vitamin D3 supplementation groups consumed oral dose of 4000 IU/d for 8 weeks.

Results

The femur BMD was significantly higher in the ATD than the AT and D and CON groups; in AT it was higher than the D and CON groups. Serum 25(OH)D level in the ATD was more than AT and CON, and in the D was more than the CON and AT. PTH in the ATD group was lower compared to AT, D, and CON groups. PTH was lower in the AT and D compared to the CON.

Conclusion

In postmenopausal obese women with vitamin D insufficiency or deficiency, combining vitamin D supplementation and aquatic training was the most effective method for improving bone metabolism; Vitamin D supplementation (alone) was not sufficient to affect some of bone metabolism indices; Aquatic training could not improve serum vitamin D. By priority, ATD, AT, and D indicated better bone related metabolism indices.

Osteocyte-mediated mechanical response controls osteoblast differentiation and function

Low bone mass is a pervasive global health concern, with implications for osteoporosis, frailty, disability, and mortality. Lifestyle factors, including sedentary habits, metabolic dysfunction, and an aging population, contribute to the escalating prevalence of osteopenia and osteoporosis. The application of mechanical load to bone through physical activity and exercise prevents bone loss, while sufficient mechanical load stimulates new bone mass acquisition. Osteocytes, cells embedded within the bone, receive mechanical signals and translate these mechanical cues into biological signals, termed mechano-transduction. Mechano-transduction signals regulate other bone resident cells, such as osteoblasts and osteoclasts, to orchestrate changes in bone mass. This review explores the mechanisms through which osteocyte-mediated response to mechanical loading regulates osteoblast differentiation and bone formation. An overview of bone cell biology and the impact of mechanical load will be provided, with emphasis on the mechanical cues, mechano-transduction pathways, and factors that direct progenitor cells toward the osteoblast lineage. While there are a wide range of clinically available treatments for osteoporosis, the majority act through manipulation of the osteoclast and may have significant disadvantages. Despite the central role of osteoblasts to the deposition of new bone, few therapies directly target osteoblasts for the preservation of bone mass. Improved understanding of the mechanisms leading to osteoblastogenesis may reveal novel targets for translational investigation.

Association between triglyceride glucose index and total bone mineral density: a cross-sectional study from NHANES 2011-2018

The Homeostatic Model Assessment for Triglyceride Glucose Index (TyG) and its related indices, including triglyceride glucose-waist circumference (TyG-WC), triglyceride glucose-waist-to-height ratio (TyG-WHtR) and triglyceride glucose-body mass index (TyG-BMI), has emerged as a practical tool for assessing insulin resistance in metabolic disorders. However, limited studies have explored the connection between TyG, TyG-related indices and osteoporosis. This population-based study, utilizing data from the National Health and Nutrition Examination Survey 2011-2018, involved 5456 participants. Through weighted multivariate linear regression and smoothed curve fitting, a significant positive correlation was found between TyG, TyG-related indices and total bone mineral density (BMD) after adjusting for covariates [β = 0.0124, 95% CI (0.0006, 0.0242), P = 0.0390; β = 0.0004, 95% CI (0.0003, 0.0004), P < 0.0001; β = 0.0116, 95% CI (0.0076, 0.0156), P < 0.0001; β = 0.0001, 95% CI (0.0001, 0.0001), P < 0.0001]. In subgroup analysis, race stratification significantly affected the relationship between TyG and total BMD. Additionally, gender and race were both significant for TyG-related indices. Non-linear relationships and threshold effects with inflection points at 9.106, 193.9265, 4.065, and 667.5304 (TyG, TyG-BMI, TyG-WHtR, TyG-WC) were identified. Saturation phenomena were observed between TyG-BMI, TyG-WC and total BMD with saturation thresholds at 314.177 and 1022.0428. These findings contributed to understanding the association between TyG, TyG-related indices and total BMD, offering insights for osteoporosis prevention and treatment.

Predisposing factors for a second fragile hip fracture in a population of 1130 patients with hip fractures, treated at Oulu University Hospital in 2013-2016: a retrospective study

OBJECTIVE

The life-time risk of a second fragile hip fracture is 8.4%, but the risk factors that predispose to a second hip fracture remain unresolved. This study aimed to define risk factors that predisposed patients to a second hip fracture.

METHODS

For this retrospective study, we retrieved clinical data on 1130 patients with fragile hip fractures (67.2% female, mean age: 79.3 years) that underwent surgery at the Oulu University Hospital in 2013-2016. These data included the fracture risk assessment score (measured with the FRAX tool), the bone-mass T-score, laboratory values, ambulatory capacity, and the time of death.

RESULTS

In this population, 12.4% of patients sustained a second hip fracture. The predisposing factors for a second hip fracture were: female (p = 0.016), a high FRAX score (p = 0.020), and low physical capacity (p < 0.001). The vitamin D level recommended for treating osteoporosis (i.e., vitamin D > 75 nmol/l) was observed in only 24% of patients, and 42% of patients had ionized calcium levels below the reference range. According to the level of the cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), 37% of patients did not have high bone turnover. We found a positive correlation between age and ICTP (p = 0.001). The risk of death was higher after the second hip fracture (p = 0.005), but we found no difference in age between patients with first and second hip fractures (p = 0.11).

CONCLUSION

After a hip fracture, a second hip fracture is a well-known risk. Nevertheless, we found that only one-third of patients with a second hip fracture had used anti-osteoporosis medication at any time previously. These findings suggested that second hip fractures were most likely to occur in patients with osteopenic T-score values, in women more often than men, and in patients with high FRAX scores and low ambulatory capacity.

Analysis of hot trends in research on the association between vitamin D and cardiovascular disease

Objective

Vitamin D deficiency is the most common nutrient deficiency. Numerous studies suggest that vitamin D is an independent risk factor for cardiovascular disease. The objective is to visualize the research hotspots and evolution trends of the correlation between vitamin D and cardiovascular disease by using multivariate statistics and social network analysis techniques and to compare adult research with that of children in this field.

Methods

(Vitamin D [MeSH Major Topic]) AND (cardiovascular disease [MeSH Major Topic]) were retrieved from the PubMed database by time period. The bibliographic items co-occurrence matrix builder (BICOMB) was adopted to extract high-frequency subject terms and establish the core subject term co-occurrence matrix. With the Netdraw function of Ucinet 6.0 software, the social network of core subject terms was completed.

Results

Before 2010, there was a slow increase in the number of research papers covering all age groups in this field (157, 54, 84, and 211 papers were published in stages 1-4, respectively). From 2010 to 2020, there were 1,423 papers retrieved, showing a significantly increased research heat. The overall development trend of the research on the association between vitamin D and cardiovascular disease in children is similar to that in all age groups. From 2010 to 2020, 122 related papers were published (while before 2009, there were only 43 papers in all), presenting a good overall development trend. The social network analysis of core subject terms showed gradually increased correlations between research hotspots, from the early studies limited on the physiological function of vitamin D in cardiovascular diseases, to the role of vitamin D in the comorbidities of various cardiovascular diseases and its value as an intervention measure. Researches on the association between vitamin D and cardiovascular disease has a good overall development trend. Study of the mechanisms and the role of vitamin D in the common co-morbidities of cardiovascular disease and its therapeutic value will be the focus of future research.

The Saturation Effect of Body Mass Index on Bone Mineral Density for People Over 50 Years Old: A Cross-Sectional Study of the US Population

Background: Previous studies had revealed that Body Mass Index (BMI) positively affected Bone Mineral Density (BMD). However, an excessively high BMI was detrimental to health, especially for the elderly. Moreover, it was elusive how much BMI was most beneficial for BMD in older adults to maintain.

Objective: To investigate whether there was a BMI saturation effect value that existed to maintain optimal BMD.

Methods: A cross-sectional study was conducted using the datasets of the National Health and Nutrition Examination Survey (NHANES) 2005–2006, 2007–2008, 2009–2010, 2013–2014, and 2017–2018. After adjusting for covariates, an analysis of the association between BMI and BMD in different femoral regions (Total femur, Femoral neck, Trochanter, Intertrochanter, and Ward's triangle) and lumbar spine regions (Total spine, L1, L2, L3, and L4) in the whole population was performed using the multivariate linear regression models, smoothing curve fitting, and saturation effects analysis models. Then, subgroup analyses were performed according to gender, age, and race.

Results: A total of 10,910 participants (5,654 males and 5,256 females) over 50 years were enrolled in this population-based study. Multivariate linear regression analyses in the population older than 50 years showed that BMI was positively associated with femoral BMD and lumbar spine BMD (P < 0.001, respectively). Smoothing curve fitting showed that the relationship between BMI and BMD was not simply linear and that a saturation value existed. The saturation effect analysis showed that the BMI saturation value was 26.13 (kg/m²) in the total femur, 26.82 (kg/m²) in the total spine, and showed site-specificity in L1 (31.90 kg/m²) and L2 (30.89 kg/m²). The saturation values were consistent with the whole participants in males, while there was high variability in the females. BMI saturation values remained present in subgroup analyses by age and race, showing specificity in some age (60–70 years old) groups and in some races.

Conclusions: Our study showed a saturation value association between BMI and BMD for people over 50 years old. Keeping the BMI in the slightly overweight value (around 26 kg/m²) might reduce other adverse effects while obtaining optimal BMD.

The Impact of the Coronavirus Disease-2019 Pandemic on Childhood Obesity and Vitamin D Status

BACKGROUND

The risk of weight gain as a consequence of school closure in children during the coronavirus disease-2019 (COVID-19) pandemic has been recognized. This study was performed to investigate changes in anthropometric and metabolic parameters in children following a 6-month period of social distancing and school closure due to the pandemic.

METHODS

This retrospective cohort study was conducted in school-aged children that were on routine follow-up at the Growth Clinic of Seoul St. Mary's Hospital. Changes in body mass index (BMI) standard deviation scores (z-scores), lipid profiles, and vitamin D levels were investigated. The 1-year period prior to school closure was defined as "pre-COVID-19 period," and the subsequent 6-month period as "COVID-19 period."

RESULTS

Overall, 226 children between 4 to 14 years old without comorbidities were assessed. On average, their BMI z-scores increased by 0.219 (95% confidence interval [CI], 0.167-0.271; P < 0.001) in the COVID-19 period compared to the pre-COVID-19 period, and the proportion of overweight or obesity increased from 23.9% in the pre-COVID-19 period to 31.4% in the COVID-19 period. The number of days after school closure (P = 0.004) and being in the normoweight category in the pre-COVID-19 period (P = 0.017) were factors associated with an increased BMI in the COVID-19 period. The mean triglyceride (105.8 mg/dL vs. 88.6 mg/dL, P < 0.001) and low-density lipoprotein-cholesterol (100.2 mg/dL vs. 94.0 mg/dL, P = 0.002) levels were higher, whereas the calcidiol level (18.9 mg/dL vs. 23.8 mg/dL, P < 0.001) was lower in the COVID-19 period compared to the pre-COVID-19 period.

CONCLUSION

Within 6 months, increased childhood obesity and vitamin D deficiencies were observed. The duration of school closure was significantly associated with an increased BMI and being normoweight does not exclude the risks for gaining weight.

Protocol of a randomised controlled trial assessing the impact of physical activity on bone health in children with inflammatory bowel disease

INTRODUCTION

Low bone mineral density (BMD) is a frequent issue in children and adolescents with inflammatory bowel disease (IBD). Several studies in healthy populations have reported a positive impact of physical activity (PA) on bone health. Recently, an observational study in paediatric patients with IBD showed a significant positive relationship between daily PA and BMD. However, intervention studies investigating a causal relationship between PA and BMD are warranted to confirm these results. The aim of this randomised controlled trial will be to investigate the effect of a PA programme on BMD in paediatric patients with IBD.

METHODS AND ANALYSIS

This trial is a multicentre (four centres), randomised, controlled, blinded end-point study. Eighty children with IBD will be randomly assigned in a 1:1 ratio to receive a programme with adapted physical exercises (intervention group) or usual PA (control group) during a 9-month period. The primary outcome is the change from baseline at 9 months (the end of the study) in whole-body BMD assessed by dual-energy X-ray absorptiometry. Secondary efficacy outcomes include the changes from baseline at 9 months in: BMD assessed in the lumbar spine and trochanter; daily PA (time spent in moderate-to-vigorous PA); body composition (fat mass and fat-free mass); fatigue resistance; quality of life and activity of IBD.

ETHICS AND DISSEMINATION

The study was approved by the Research Ethics Committee in France (Comité de Protection des Personnes, Sud-Ouest and Outre-Mer III, Bordeaux, France, No 2018/27). All procedures will be performed according to the ethical standards of the Helsinki Declaration of 1975, as revised in 2008, and the European Union's Guidelines for Good Clinical Practice. Written informed consent will be obtained from the parents or legal guardian and from the children. Research findings will be disseminated in peer-reviewed journals and scientific meetings.

TRIAL REGISTRATION NUMBER

NCT03774329.

Osteoporosis pathology in people with severe motor and intellectual disability

OBJECTIVES

We assessed the severity and pathology of osteoporosis in children and adults with severe motor and intellectual disabilities (SMID) by evaluating bone enzymes, by which we aimed to determine adequate treatment approaches for preventing fractures.

METHODS

Ninety patients (44 men, 46 women; mean age, 34.5 years) underwent bone quality assessment. Quantitative ultrasonography (QUS) was used to measure the T-score and Z-score of the calcaneus, and blood tests were used to measure bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase 5b levels as bone formation and resorption markers, as well as calcium, phosphorous, and parathyroid hormone levels as routine examination.

RESULTS

Bone formation and resorption marker levels were within normal ranges in adults, although they were high during the growth period in children and adolescents and in elderly women. Patients receiving tube feeding showed a significantly lower Z-score than those without tube feeding. Tube feeding was a significant factor for the Z-score, whereas age, vitamin supplements, and anti-epileptic drugs were not.

CONCLUSIONS

The severity of osteoporosis in SMID started during the growth period and seems to be caused by a lack of an effective increase in bone mineral density. Any treatment should be started during the growth period. More study about tube feeding is needed.

The Affect of Lifestyle on Bone Mineral Density and Bone Turnover in Young Women

INTRODUCTION

This research aimed to evaluate the effect of lifestyle factors such as nutrient intake and physical activity on bone mineral density (BMD) and bone turnover in young women.

MATERIALS AND METHODS

BMD was assessed using Quantitative Ultrasound; lifestyle-related factors such as dietary habits, and physical activity were examined using questionnaires in 194 female college students. The biochemical markers of bone turnover were measured in the Osteopenia (BMD below the Young Adult Mean [YAM] -1.0SD, 16 subjects) and Normal (above the YAM-1.0SD, 31 subjects) groups.

RESULTS

The percentage of osteopenia was 11.9%. Calcium and magnesium intake (p<0.05), and physical activity (p<0.1) were found to be factors influencing BMD. The level of osteocalcin and type 1 procollagen N-terminal propeptide (P1NP) were higher in the Osteopenia group than in the Normal group (p<0.05). There was tendency that showed relationship between the level of undercarboxylated osteocalcin (ucOC) and BMD (p<0.1). The level of bone-specific alkaline phosphatase was significantly higher in the 25OH vitamin D insufficiency group compared to sufficiency group (p<0.05). The levels of OC, tartrate-resistant acid phosphatase-5b and P1NP were lower in the ucOC <4.5 ng/ml group compared to ≥4.5 ng/ml group (p<0.01, p<0.05, p<0.1), respectively.

CONCLUSION

This study showed that BMD in young women is affected by calcium and magnesium intake, physical activity, and vitamin D and K levels. It was suggested that the insufficiency of vitamin D and K might be contributable to low BMD through the change of bone turnover.

Physical activity is associated with improved bone health in children with inflammatory bowel disease

BACKGROUND & AIMS

Bone health is an important concern in patients with inflammatory bowel disease (IBD). Low bone mineral density (BMD) is a powerful predictor of fracture risk in IBD patients. Physical activity (PA) plays an important role in bone health. However, PA data for children and adolescents with IBD are scarce. The primary aim is to evaluate the relationship between PA and BMD in children with IBD. The secondary aim was to assess the relationship between PA and quality of life.

METHODS

Eighty-four IBD paediatric patients (45 boys) aged 14.3 ± 2.7 years were included (disease activity: (i) remission, n = 62; (ii) mild, n = 18; (iii) severe disease, n = 1). BMD was measured using dual-energy X-ray absorptiometry and expressed as age- and sex-based Z-scores. Each patient wore a triaxial accelerometer for seven consecutive days for objective PA quantification. Quality of life was assessed using the PedsQL™ and energy intake was assessed prospectively for three days using a dietary diary.

RESULTS

BMD Z-score was -0.96 ± 1.11. Only five patients (6%) fulfilled the recommendation of 60 min of daily moderate-to-vigorous PA (MVPA). The proportion of children with osteopenia and osteoporosis was 51% and 4%, respectively. After adjustment for confounders (pubertal status and body mass index), total PA and time in MVPA were positively associated with BMD (regression coefficient per one standard deviation increase in PA parameters = 0.26; P < 0.05). There was no association between time spent in MVPA and total PA, and total quality of life score.

CONCLUSIONS

PA likely is associated with improved bone health in IBD children. Intervention studies investigating a causal relationship between PA and BMD in paediatric patients with IBD are warranted.

Modulation of the sympathetic nervous system in youngsters by vitamin-D supplementation

The level of circulating vitamin D is known to be associated with the ejection fraction in heart failure patients and studies in rats have shown that vitamin D depletion leads to increased levels of circulating norepinephrine and decreased atrial contractility. We elucidated the effects of vitamin D supplementation on the autonomous nervous system in healthy youngsters. Thirty healthy subjects aged 18–25 years were recruited based on their serum 25‐hydroxyvitamin D (25[OH]D): 15 vitamin D insufficient (25[OH]D < 50 nmol/L) and 15 vitamin D sufficient (25[OH]D > 80 nmol/L) subjects. Both groups had vitamin D supplementation (30 microg/day) and were tested at baseline and after 30, 90, and 180 days. At each visit the serum 25‐hydroxyvitamin D was measured and the head‐up tilt test performed. Serum 25[OH]D remained stable in the vitamin D sufficient group, while the insufficient group had a significant increase (32.0–64.5 nmol/L), P < 0.0001. Despite the increase, the insufficient group did not reach the level of the vitamin D sufficient group within the 6 months observational period (96.1 vs 64.5 nmol/L), P < 0.01. Serum norepinephrine at baseline was higher in the insufficient group (mean = 1.61 nmol/L) than in the vitamin D sufficient group (mean = 0.94 nmol/L), P < 0.01, whereas the response to tilt was lower in the insufficient group (mean = 0.69 nmol/L) compared to the sufficient group (mean = 1.17 nmol/L), P < 0.01. The heart rate at rest was higher in the insufficient group (mean = 67.7 bpm) than in the vitamin D sufficient group (mean = 56.6 bpm), P < 0.01, for the three first visits. At the last visit no difference was found. The systolic and diastolic blood pressure differed between the groups after a month, with higher pressures in the insufficient group than in the sufficient group. Vitamin D supplementation modulates the sympathetic nervous system in healthy youngsters with low serum vitamin D. The observation might lead to a greater focus on possible prevention of cardiac disease later on in life by vitamin D supplementation early in life.

Bone Mass Development in Childhood and Its Association with Physical Activity and Vitamin D Levels. The CHAMPS-Study DK

This longitudinal study examined associations of bone mass with physical activity and vitamin D level over more than 6 years through puberty. A total of 663 participants (320 boys) with mean age 9.6 years at baseline (10-17 years at follow-up), underwent dual energy X-ray absorptiometry, anthropometry and blood samples for vitamin D at least twice during the study period (with three possible time-points). Physical activity was assessed using accelerometers at follow-up. A positive association was found between percent time spent at vigorous physical activity and total-body less head bone mineral content (β = 5.8, p = 0.002). The magnitude of this association increased with maturational development; thus physical activity may have a greater influence on bone mass in the more mature participants. The vitamin D levels were also positively associated with bone mass. A high degree of tracking was observed with changes in anthropometric Z scores predictive of deviation from tracking. No environmental factor predicted deviation from tracking.

Management of Reduced Bone Mineral Density in HIV: Pharmacological Challenges and the Role of Exercise

Low bone mineral density is becoming more common among people living with HIV following the use of current antiretroviral therapy drugs such as tenofovir. Although pharmacological therapies used to treat low bone mineral density are associated with adverse effects and may increase the pill burden in people living with HIV who are already burdened by antiretroviral therapy drugs, non-pharmacological strategies to prevent and treat reduced bone mineral density resulting from antiretroviral therapy drugs in people living with HIV have not been fully explored. Despite evidence that exercise is effective in increasing bone mineral density, effects of exercise on low bone mineral density resulting from antiretroviral therapy drugs in HIV infected individuals are still unknown. This review highlights gaps in the strategies used to manage reduced bone mineral density resulting from antiretroviral therapy drugs and focuses on exercise as an alternative or adjunctive strategy.

Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population - a cross-sectional retrospective study

OBJECTIVES

An understanding of bone mineral density (BMD) pattern in a population is crucial for prevention and diagnosis of osteoporosis and management of its complications in later life. This study aimed to screen the bone health status and factors associated with osteoporosis in an apparently healthy Indian population.

METHODS

A retrospective review of medical records was done in a tertiary-care hospital for the subjects who had undergone preventive health-check-ups that included BMD measurements at femur-neck, total-femur, and lumbar-spine.

RESULTS

We evaluated 524 subjects (age, 50.0 ± 12.4 years) including 41.2% female and 58.8% male subjects. Osteoporosis was present in 6.9% subjects (female, 11.1%; male, 4.2%) and osteopenia in 34% subjects (female, 40.3%; male, 29.9%). Absolute BMD was higher in male subjects (P < 0.001) compared to female subjects at all bone sites. Prevalence of osteoporosis increased with age in female subjects, but not in male subjects. Osteoporosis rates in the age-groups of 30-39, 40-49, 50-59, 60-69, and ≥70 years were 3%, 3.4%, 14.3%, 18.6%, and 36.4%, respectively in female subjects while prevalence in male subjects was 0%, 4%, 6.5%, 4.3%, and 5.6%, respectively, at lumbar spine. Height (r = 0.234-0.358), weight (r = 0.305-0.388), body mass index (r = 0.143-0.285) and physical activity (r = 0.136-0.153) were positively; and alkaline phosphatase (r = -0.133 to -0.203) was negatively correlated with BMD (all P < 0.01) at all sites. These parameters retained significant correlation after controlling for age and sex. No correlation of serum 25-hydroxy-vitamin-D and calcium was noted with BMD (P > 0.05) at any site.

CONCLUSIONS

Further data on absolute BMD, T scores, and prevalence rates of osteoporosis/osteopenia on multiple bone sites have been presented in this article.

HIP RANGE OF MOTION IN RECREATIONAL WEIGHT TRAINING PARTICIPANTS: A DESCRIPTIVE REPORT

BACKGROUND

The surveillance of hip injuries and risk factors have become an emerging focus in sports medicine due to the increased recognition of hip pathologies. Researchers suggest that decreased hip range of motion (ROM) is a risk factor for injury in various athletic activities. One under reported population that has potential for hip injuries is recreational weight training (WT) participants. Currently, no studies have reported hip ROM values in WT participants which creates a knowledge gap in this population.

PURPOSE

The purpose of this study was to report hip passive ROM values of WT participants to develop reference data for future research on injury patterns and prevention strategies for this population.

STUDY DESIGN

Descriptive cross sectional study.

METHODS

Two-hundred healthy recreational adult WT participants (age = 27.18 ± 9.3 years, height = 174.84 ± 9.8 cm, mass = 91.0 ± 17.9 kg, body mass index = 29.6 ± 4.5 kg/m2) were recruited. Bilateral hip passive ROM was assessed for flexion, extension, internal rotation, external rotation, and abduction. Statistical analysis included subject demographics (means and SD) and a two-tailed independent t-test to compare mean passive hip ROM values between sexes and hips. Statistical significance was considered p < .05.

RESULTS

A total of 400 hundred hips (right + left) were measured for this analysis. When comparing hip ROM values within sexes, men had no significant difference (p≥.28) between the right and left hip for all motions. Women did have a significant difference (p≤.05) between the right and left hip for all motions. The right hip had lower values for all motions than the left hip suggesting a more global decrease in right hip ROM. When comparing hip ROM values between men and women, there was a significant difference (p≤.05) between men and women for all motions. Men had lower ROM values for all hip motions when compared to women.

CONCLUSION

This is the first investigation to provide a descriptive analysis of hip ROM in healthy recreational WT participants. These data provide a starting point for clinicians and researchers to further study this population for injury prevention.

EVIDENCE LEVEL

2.

Determinants of bone mineral density in young Australian women; results from the Safe-D study

The study aimed to explore determinants of bone parameters in young women. Most bone parameters were associated with height and lean mass. Bone parameters were not associated with vitamin D status. Future research should address whether interventions aimed at improving lean mass are beneficial to bone health in young women.

INTRODUCTION

The implementation of prevention strategies during young adulthood may be crucial for osteoporosis prevention in later life, yet literature examining the determinants of bone health in premenopausal women is limited. We aimed to assess determinants of bone health, including serum 25-hydroxyvitamin D (25OHD), in females aged 16-25 years, living in Victoria, Australia, recruited through Facebook advertising.

METHODS

Serum 25OHD was measured by liquid chromatography-tandem mass spectrometry and bone health was measured using dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) in 326 participants.

RESULTS

Mean (± standard deviation) serum 25OHD was 69 ± 28 nmol/L and the prevalence of vitamin D deficiency (serum 25OHD <50 nmol/L) was 26%. Seven percent of participants (n = 23) reported taking a vitamin D supplement. Two percent of participants had low lumbar spine bone mineral density (Z-score <-2.0), 5% at the hip and 7% at the femoral neck. Serum 25OHD levels were not associated with DXA bone parameters, nor with pQCT bone parameters. Most bone parameters were positively associated with height and lean mass.

CONCLUSION

Vitamin D status was not associated with bone health in young women in the current study. Our findings suggest that targeting other modifiable factors, such as lean body mass, is likely to be beneficial to bone health in young women. Longitudinal studies examining the association between vitamin D status and bone health in young women are necessary to confirm our findings. In addition, whether raising 25OHD levels is advantageous for young women's bone health is yet to be determined.

Lifestyle factors influencing bone health in young adult women in Saudi Arabia

AIM

To analyze risk factors leading to osteopenia and osteoporosis among young female students.

METHODS

Quantitative Ultrasonography measurements were performed in the calcaneal region of 101 young Saudi females. Dietary habits, exercising and sun exposure were assessed using questionnaires. The association between the different studied factors was assessed by Pearson test and multiple linear regression model.

RESULTS

Participants diagnosed with either osteopenia or osteoporosis (>33%.) showed significant higher soft drinks consumption, reduced exercise, limited intake of milk and dairy products, calcium and vitamin D supplementation compared to the healthy group. Multiple regression analysis showed that T-score and Z-score were negatively associated with soft drink intake and positively associated with exercising, milk and dairy products consumption, and calcium and vitamin D supplementation use (p <0.05).

CONCLUSION

High soft drink intake, lack of exercising and limited calcium and vitamin D supplementation are the combined lifestyle factors leading to osteopenia and osteoporosis among young Saudi females. These findings might serve as a basis of nutrition education intervention to promote healthy bones among this population.