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Brandt IAG, Starup-Linde J, Andersen SS, Viggers R. Diagnosing Osteoporosis in Diabetes-A Systematic Review on BMD and Fractures. Curr Osteoporos Rep 2024; 22:223-244. [PMID: 38509440 DOI: 10.1007/s11914-024-00867-1] [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] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE OF REVIEW Recently, the American Diabetes Association updated the 2024 guidelines for Standards of Care in Diabetes and recommend that a T-score of - 2.0 in patients with diabetes should be interpreted as equivalent to - 2.5 in people without diabetes. We aimed to evaluate the most recent findings concerning the bone mineral density (BMD)-derived T-score and risk of fractures related to osteoporosis in subjects with diabetes. RECENT FINDINGS The dual-energy X-ray absorptiometry (DXA) scan is the golden standard for evaluating BMD. The BMD-derived T-score is central to fracture prediction and signifies both diagnosis and treatment for osteoporosis. However, the increased fracture risk in diabetes is not sufficiently explained by the T-score, complicating the identification and management of fracture risk in these patients. Recent findings agree that subjects with type 2 diabetes (T2D) have a higher T-score and higher fracture risk compared with subjects without diabetes. However, the actual number of studies evaluating the direct association of higher fracture risk at higher T-score levels is scant. Some studies support the adjustment based on the 0.5 BMD T-score difference between subjects with T2D and subjects without diabetes. However, further data from longitudinal studies is warranted to validate if the T-score treatment threshold necessitates modification to prevent fractures in subjects with diabetes.
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Affiliation(s)
- Inge Agnete Gerlach Brandt
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
| | - Jakob Starup-Linde
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sally Søgaard Andersen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Rikke Viggers
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
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Abiri B, Valizadeh M, Ramezani Ahmadi A, Amini S, Nikoohemmat M, Abbaspour F, Hosseinpanah F. Association of vitamin D levels with anthropometric and adiposity indicators across all age groups: a systematic review of epidemiologic studies. Endocr Connect 2024; 13:e230394. [PMID: 38032745 PMCID: PMC10831555 DOI: 10.1530/ec-23-0394] [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: 09/26/2023] [Accepted: 11/30/2023] [Indexed: 12/02/2023]
Abstract
Objectives It has not been established whether vitamin D deficiency is associated with anthropometric state; therefore, this systematic review examined the relationship between serum vitamin D levels with anthropometrics and adiposity across different ages. Methods Studies that examined vitamin D deficiency with adiposity measures in different age groups were searched in the PubMed, Scopus, Embase, and Google Scholar databases until November 2023. Two investigators independently reviewed titles and abstracts, examined full-text articles, extracted data, and rated the quality in accordance with the Newcastle-Ottawa criteria. Results Seventy-two studies, with a total of 59,430 subjects, were included. Of these studies, 27 cross-sectional studies and one longitudinal study (with 25,615 participants) evaluated the possible link between 25(OH)D serum concentrations and anthropometric/adiposity indices in the pediatric population. Forty-two cross-sectional studies and two cohort investigations (with 33,815 participants) investigated the relationship between serum 25(OH)D levels and adiposity measures in adults and/or the elderly population. There is evidence supporting links between vitamin D deficiency and obesity, and revealed an inverse association between vitamin D and adiposity indicators, specifically in female subjects. However, the effects of several confounding factors should also be considered. Conclusion Most published studies, most of which were cross-sectional, reported a negative association between vitamin D and female adiposity indicators. Therefore, serum vitamin D levels should be monitored in overweight/obese individuals.
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Affiliation(s)
- Behnaz Abiri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shirin Amini
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Mohammad Nikoohemmat
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faeze Abbaspour
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chaturvedi B, Debnath S, Bareth H, Raj P, Singh P, Singh M, Nathiya D, Tomar BS. The Influence of Obesity on Bone Health in Post-COVID-19 Recovery- Single-Center Experience. Int J Gen Med 2024; 17:29-36. [PMID: 38204494 PMCID: PMC10778162 DOI: 10.2147/ijgm.s444318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction The ongoing repercussions of the COVID-19 pandemic include potentially deleterious impacts on bone health. Aim This research aimed to ascertain the effects of COVID-19 on the bone health of obese and non-obese Indian individuals. Methods We executed a case-control study enrolling individuals who recovered from COVID-19. Participants were stratified into obese and non-obese groups based on their BMI. Comprehensive assessments encompassed anthropometric evaluations, laboratory tests, and bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry (DEXA). Results From April to July 2022, we enrolled obese (n = 27, mean BMI = 30.54 ± 4.51 kg/m 2) and non-obese (n = 23, mean BMI = 21.97 ± 2.20 kg/m 2) individuals. The cohort's average age was 36.08 ± 15.81 years, with a male-to-female ratio of 1.6:1. There was a difference in BMD, especially at the total hip, between the two groups. BMD at the spine (L1-L4), the neck of the femur, and ultra-distal radius were consistent across both groups. Weight exhibited a significant positive correlation with BMD at L1-L4 (r = 0.40, p = 0.003) and the left femur total (r = 0.27, p = 0.001). Haemoglobin levels were lower in the obese group compared to their non-obese counterparts (12.3 ± 2.0 vs 13.6 ± 1.9, p = 0.01). Multivariate analysis underscored weight as a crucial predictor for BMD at the spine (L1-L4, p = 0.003) and total hip (p = 0.001). Conclusion Even with advanced age, obese post-COVID-19 individuals demonstrate a higher bone mineral density (BMD) at the hip than non-obese subjects.
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Affiliation(s)
- Bhumi Chaturvedi
- Department of Pharmacy Practice, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
| | - Sourav Debnath
- Department of Pharmacy Practice, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
| | - Hemant Bareth
- Department of Pharmacy Practice, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
| | - Preeti Raj
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Pratima Singh
- Public Health and Preventive Medicine, University of Alberta, Edmonton, AB, Canada
| | - Mahaveer Singh
- Department of Endocrinology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
| | - Deepak Nathiya
- Department of Pharmacy Practice, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
- Department of Clinical Studies, Fourth Hospital of Yulin (Xingyuan), Yulin, Shaanxi, People’s Republic of China
- Department of Clinical Sciences, Shenmu Hospital, Shenmu, Shaanxi, People’s Republic of China
| | - Balvir Singh Tomar
- Department of Clinical Studies, Fourth Hospital of Yulin (Xingyuan), Yulin, Shaanxi, People’s Republic of China
- Department of Clinical Sciences, Shenmu Hospital, Shenmu, Shaanxi, People’s Republic of China
- Institute of Pediatric Gastroenterology and Hepatology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
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Li S, Guo R, Wang J, Zheng X, Zhao S, Zhang Z, Yu W, Li S, Zheng P. The effect of blood flow restriction exercise on N-lactoylphenylalanine and appetite regulation in obese adults: a cross-design study. Front Endocrinol (Lausanne) 2023; 14:1289574. [PMID: 38116312 PMCID: PMC10728722 DOI: 10.3389/fendo.2023.1289574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Background N-lactoylphenylalanine (Lac-Phe) is a new form of "exerkines" closely related to lactate (La), which may be able to inhibit appetite. Blood flow restriction (BFR) can lead to local tissue hypoxia and increase lactate accumulation. Therefore, this study investigated the effects of combining Moderate-intensity Continuous Exercise (MICE) with BFR on Lac-Phe and appetite regulation in obese adults. Methods This study employed the cross-design study and recruited 14 obese adults aged 18-24 years. The participants were randomly divided into three groups and performed several tests with specific experimental conditions: (1) M group (MICE without BFR, 60%VO2max, 200 kJ); (2) B group (MICE with BFR, 60%VO2max, 200 kJ); and (3) C group (control session without exercise). Participants were given a standardized meal 60 min before exercise and a ad libitum 60 min after exercise. In addition, blood and Visual Analogue Scale (VAS) were collected before, immediately after, and 1 hour after performing the exercise. Results No significant difference in each index was detected before exercise. After exercise, the primary differential metabolites detected in the M and B groups were xanthine, La, succinate, Lac-Phe, citrate, urocanic acid, and myristic acid. Apart from that, the major enrichment pathways include the citrate cycle, alanine, aspartate, and glutamate metabolism. The enhanced Lac-Phe and La level in the B group was higher than M and C groups. Hunger of the B group immediately after exercise substantially differed from M group. The total ghrelin, glucagon-like peptide-1 and hunger in the B group 1 hour after exercise differed substantially from M group. The results of calorie intake showed no significant difference among the indexes in each group. Conclusions In conclusion, this cross-design study demonstrated that the combined MICE and BFR exercise reduced the appetite of obese adults by promoting the secretion of Lac-Phe and ghrelin. However, the exercise did not considerably affect the subsequent ad libitum intake.
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Affiliation(s)
- Shuoqi Li
- School of Sports Science, Nantong University, Nantong, China
| | - Rong Guo
- School of Foreign Languages, Ludong University, Yantai, China
| | - Juncheng Wang
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Xinyu Zheng
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Shuo Zhao
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Zhiru Zhang
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Wenbing Yu
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Shiming Li
- Department of Physical Education, Ocean University of China, Qingdao, China
| | - Peng Zheng
- Department of Physical Education, Ocean University of China, Qingdao, China
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Rushan Z, Kumar S. Letter to editor: Effect of obesity on fragility fractures, BMD and vitamin D levels in postmenopausal women. Influence of type 2 diabetes mellitus. Acta Diabetol 2023; 60:1595-1596. [PMID: 37640798 DOI: 10.1007/s00592-023-02156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Zahira Rushan
- Shifa College of Medicine, H-8/4, Islamabad, Pakistan.
| | - Satesh Kumar
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari Karachi, Karachi, Pakistan
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