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Ladang A, Rauch F, Delvin E, Cavalier E. Bone Turnover Markers in Children: From Laboratory Challenges to Clinical Interpretation. Calcif Tissue Int 2023; 112:218-232. [PMID: 35243530 DOI: 10.1007/s00223-022-00964-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/17/2022] [Indexed: 01/25/2023]
Abstract
Bone turnover markers (BTMs) have been developed many years ago to study, in combination with imaging techniques, bone remodeling in adults. In children and adolescents, bone metabolism differs from adults since it implies both growth and bone remodeling, suggesting an age- and gender-dependent BTM concentration. Therefore, specific studies have evaluated BTMs in not only physiological but also pathological conditions. However, in pediatrics, the use of BTMs in clinical practice is still limited due to these many children-related specificities. This review will discuss about physiological levels of BTMs as well as their modifications under pathological conditions in children and adolescents. A focus is also given on analytical and clinical challenges that restrain BTM usefulness in pediatrics.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU de Liège, Liège, Belgium.
| | - Frank Rauch
- Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Edgard Delvin
- Centre & Department of Biochemistry, Ste-Justine University Hospital Research, Université de Montréal, Montreal, Canada
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2
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Agostinete RR, Fernandes RA, Narciso PH, Maillane-Vanegas S, Werneck AO, Vlachopoulos D. Categorizing 10 Sports According to Bone and Soft Tissue Profiles in Adolescents. Med Sci Sports Exerc 2021; 52:2673-2681. [PMID: 32735110 DOI: 10.1249/mss.0000000000002420] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Considering the different loading and training characteristics of the sports practiced during growth, it is important to specify and categorize the bone and soft tissue adaptations in adolescent athletes. This study aimed to categorize 10 different loading sports and a nonsport group and identify the differences in bone density and soft tissues. METHODS The sample included 625 adolescents (10 to 17 yr of age) of 10 sports (soccer, basketball, volleyball, track and field, judo, karate, kung fu, gymnastics, baseball, and swimming) and a nonsport group. Dual-energy x-ray absorptiometry assessed areal bone mineral density (aBMD), bone mineral apparent density (BMAD), and soft tissues (lean soft tissue and fat mass). The results were adjusted for sex, peak height velocity status, lean soft tissue, fat mass, and weekly training volume. RESULTS The comparisons among groups showed that soccer had the highest whole-body aBMD (mean ± SEM: 1.082 ± 0.007 g·cm) and lower limb aBMD (1.302 ± 0.010 g·cm). Gymnastics presented the highest upper limb aBMD (0.868 ± 0.012 g·cm) and whole-body BMAD (0.094 ± 0.001 g·cm). Swimming presented the lowest aBMD values in all skeletal sites (except at the upper limbs) and whole-body BMAD. The soft tissue comparisons showed that soccer players had the highest lean soft tissue (43.8 ± 0.7 kg). The lowest fat mass was found in gymnasts (8.04 ± 1.0 kg). CONCLUSION The present study investigated and categorized for the first time 10 different sports according to bone density and soft tissue profiles. Soccer and gymnastics sport groups were found to have the highest bone density in most body segments, and both sports were among the groups with the lowest fat mass.
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Affiliation(s)
- Ricardo Ribeiro Agostinete
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, BRAZIL
| | - Romulo Araújo Fernandes
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, BRAZIL
| | - Pedro Henrique Narciso
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, BRAZIL
| | - Santiago Maillane-Vanegas
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, BRAZIL
| | - André Oliveira Werneck
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, BRAZIL
| | - Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
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Ghayomzadeh M, Earnest CP, Hackett D, SeyedAlinaghi S, Navalta JW, Gholami M, Hosseini Rouzbahani N, Mohraz M, Voltarelli FA. Combination of resistance and aerobic exercise for six months improves bone mass and physical function in HIV infected individuals: A randomized controlled trial. Scand J Med Sci Sports 2020; 31:720-732. [PMID: 33185897 DOI: 10.1111/sms.13871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/28/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023]
Abstract
To evaluate the effect of combined resistance and aerobic training (RT+AT) on regional bone mineral density (BMD) and physical performance in people living with HIV (PLWH). Forty PLWH (20 men and 20 women) were randomized into RT+AT group (n = 20; age = 38.3 ± 4.9) or non-exercise control group (n = 20; age = 37.9 ± 5.1). The RT+AT group was required to perform a nonlinear periodized resistance training program targeting large muscle groups followed by 20 min aerobic exercise at 65-80% of maximal heart rate. Participants in RT+AT performed three supervised sessions per week for 6-months, whereas participants in the control group were instructed to continue with their current lifestyle habits. The primary outcome was bone mineral density (lumbar spine (L2-L4), femoral neck, and distal 1/3 radius). Secondary outcomes included physical function, anthropometry, inflammatory markers, and growth factors. The RT+AT group demonstrated a significant increase in BMD at follow-up for the Lumbar spine (L2-L4), femoral neck, and 1/3 radius (all, P < .05), and There were no gender differences in the training response between men and women for any of the BMD regions. Similar findings were also observed for lean body mass, IGF1and Adiponectin (P < .001). We observed a decrease in percent body fat, fat mass, IL-6, TNF-α, and myostatin in the RT+AT group (P < .001). Finally, there was a significant increase in handgrip strength and gait speed for both women and men in the RT+AT group (P < .001). A combination of resistance and aerobic training appears to be a feasible and effective means for counteracting bone loss and improving various inflammatory markers, physical function, and growth hormones in PLWH.
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Affiliation(s)
- Morteza Ghayomzadeh
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia.,Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Conrad P Earnest
- Health and Kinesiology, Texas A&M University College Station, College Station, TX, USA
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - James Wilfred Navalta
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
| | - Mohammad Gholami
- Department of Medical Microbiology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Negin Hosseini Rouzbahani
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabrício Azevedo Voltarelli
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiab'a, Brazil
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Comparison between type A and type B early adiposity rebound in predicting overweight and obesity in children: a longitudinal study. Br J Nutr 2020; 124:501-512. [PMID: 32174289 DOI: 10.1017/s0007114520000987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Early adiposity rebound (EAR) predicts paediatric overweight/obesity, but current approaches do not consider both the starting point of EAR and the BMI trajectory. We compared the clinical characteristics at birth, age 3-5 and 6-8 years of children, according to the EAR and to its type (type A/type B-EAR). We assessed the children's odds of being classified as overweight/obese at age 6-8 years, according to the type of EAR as defined at age 3-5 years. As part of this two-wave observational study, 1055 children were recruited and examined at age 3-5 years. Antenatal and postnatal information was collected through interviews with parents, and weight and height from the health records. Type A and type B-EAR were defined in wave 1 according to the BMI nadir and the variation of BMI z-score between the starting point of the adiposity rebound and the last point on the curve. At 6-8 years (wave 2), 867 children were followed up; 426 (40·4 %) children demonstrated EAR. Among them, 172 had type A-EAR, higher rates of parental obesity (P < 0·05) and greater birth weight compared with other children (P < 0·001). Odds for overweight/obesity at 6-8 years, when adjusting for antenatal and postnatal factors, was 21·35 (95 % CI 10·94, 41·66) in type A-EAR children and not significant in type B-EAR children (OR 1·76; 95 % CI 0·84, 3·68) compared with children without EAR. Classification of EAR into two subtypes provides physicians with a reliable approach to identify children at risk for overweight/obesity before the age of 5 years.
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A multidisciplinary weight loss intervention in obese adolescents with and without sleep-disordered breathing improves cardiometabolic health, whether SDB was normalized or not. Sleep Med 2020; 75:225-235. [PMID: 32861060 DOI: 10.1016/j.sleep.2020.06.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Pediatric obesity and sleep-disordered breathing (SDB) are strongly associated, and both promote metabolic impairments. However, the effects of a lifestyle intervention on the overall metabolic syndrome (MetS) are unknown. The objectives were i) to evaluate the effects of a lifestyle intervention on cardiometabolic risk (CMR), assessed with a dichotomous (MetS) and a continuous (MetScoreFM) instrument, in obese adolescents with and without SDB and ii) to compare the post-intervention cardiometabolic responses between adolescents with persistent (apnea-hypopnea index; AHI≥2) or normalized-SDB (AHI<2). METHODS Seventy-six adolescents with obesity recruited from two specialized institutions underwent a 9-12month diet and exercise intervention. Sleep and SDB (AHI≥2) were studied by polysomnography. Anthropometric parameters, fat mass (FM), glucose, insulin, lipid and leptin profiles, blood pressure (BP), MetScoreFM and MetS were assessed pre- and post-intervention. We performed comparisons between Non-SDB and SDB groups and between Normalized-SDB and Persistent-SDB subgroups. RESULTS Fifty participants completed the study. Pre-intervention, twenty youth had SDB (40%) with higher insulin concentrations and systolic BP than Non-SDB participants (p < 0.01), for a similar degree of obesity. Post-intervention, MetScoreFM (p < 0.001) and MetS prevalence (p < 0.05) were decreased in both groups. Eleven participants (55%) normalized SDB along with a decrease in insulin concentrations and BP (p < 0.05). Triglycerides, total cholesterol and LDL-cholesterol concentrations (p < 0.01) improved equally in the Normalized and Persistent-SDB subgroups. CONCLUSION SDB was associated with lower insulin sensitivity and higher BP but did not affect the lipid profile. A diet and exercise lifestyle intervention is effective in decreasing the CMR whether or not SDB was normalized in obese adolescents.
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Luiz-de-Marco R, Gobbo LA, Castoldi RC, Maillane-Vanegas S, da Silva Ventura Faustino-da-Silva Y, Exupério IN, Agostinete RR, Fernandes RA. Impact of changes in fat mass and lean soft tissue on bone mineral density accrual in adolescents engaged in different sports: ABCD Growth Study. Arch Osteoporos 2020; 15:22. [PMID: 32090287 DOI: 10.1007/s11657-020-0707-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/27/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Body composition can have a significant impact on bone mineral density (BMD) in pediatric patients and may cause bone disease. This study demonstrated that lean soft tissue (LST) seems to have a greater impact on BMD gain in the lower limbs of adolescents. PURPOSE To analyze the impact of changes in lean soft tissue (LST) and fat mass on areal bone mineral density (BMD) accrual in the lower limbs among adolescents engaged in sports with different weight-bearing levels. METHODS Longitudinal (12 months: measurements at two time points). Adolescents of both sexes (n = 191; 62 girls [32.5%] and 129 boys [67.5%]) were divided into three groups: control group (n = 65), swimming group (n = 25), and weight-bearing sports group (n = 100). Absolute changes in LST (kg) and fat mass (kg) were the independent variables, while BMD accrual (left and right legs) was the dependent variable. Linear regression was used to assess the relationship between dependent and independent variables in a multivariate model adjusted by sex, body weight, somatic maturation, serum osteocalcin, and baseline values of BMD of the lower limbs. RESULTS For the left leg, LST was positively related to areal BMD accrual in the control (β = 0.021 [95%CI: 0.001 to 0.042]) and weight-bearing sport groups (β = 0.051 [95%CI: 0.037 to 0.065]), but not among swimmers (β = 0.029 [95%CI: - 0.004 to 0.062]). For the right leg, LST was positively related to areal BMD accrual in the swimming group (β = 0.065 [95%CI: 0.031 to 0.100]) and weight-bearing sport groups (β = 0.048 [95%CI: 0.034 to 0.062]), but not in the control group (β = 0.014 [95%CI: - 0.002 to 0.030]). Fat mass was not significantly related to areal BMD in either leg. CONCLUSIONS Changes in LST were the most relevant determinant of BMD accrual in the lower limbs, mainly among adolescents engaged in sports.
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Affiliation(s)
- Rafael Luiz-de-Marco
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil.
| | - Luis Alberto Gobbo
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Robson Chacon Castoldi
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Santiago Maillane-Vanegas
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Yuri da Silva Ventura Faustino-da-Silva
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Isabela Neto Exupério
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Ricardo Ribeiro Agostinete
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Romulo A Fernandes
- Department of Physical Education, São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, BR, Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
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Jiang WY, Xing C, Wang HW, Wang W, Chen SZ, Ning LF, Xu X, Tang QQ, Huang HY. A Lox/CHOP-10 crosstalk governs osteogenic and adipogenic cell fate by MSCs. J Cell Mol Med 2018; 22:5097-5108. [PMID: 30044535 PMCID: PMC6156357 DOI: 10.1111/jcmm.13798] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 05/31/2018] [Accepted: 06/23/2018] [Indexed: 12/20/2022] Open
Abstract
Accelerated marrow adipogenesis has been associated with ageing and osteoporosis and is thought to be because of an imbalance between adipogenic and osteogenic differentiation of mesenchymal stem cell (MSCs). We have previously found that lysyl oxidase (Lox) inhibition disrupts BMP4‐induced adipocytic lineage commitment and differentiation of MSCs. In this study, we found that lox inhibition dramatically up‐regulates BMP4‐induced expression of CCAAT/enhancer binding protein (C/EBP) homologous protein 10 (CHOP‐10), which then promotes BMP4‐induced osteogenesis of MSCs both in vitro and in vivo. Specifically, Lox inhibition or CHOP‐10 up‐regulation activated Wnt/β‐catenin signalling to enhance BMP4‐induced osteogenesis, with pro‐adipogenic p38 MAPK and Smad signalling suppressed. Together, we demonstrate that Lox/CHOP‐10 crosstalk regulates BMP4‐induced osteogenic and adipogenic fate determination of MSCs, presenting a promising therapeutic target for osteoporosis and other bone diseases.
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Affiliation(s)
- Wen-Yan Jiang
- Key Laboratory of Metabolism and Molecular Medicine, The Ministry of Education, Shanghai, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Chun Xing
- Key Laboratory of Metabolism and Molecular Medicine, The Ministry of Education, Shanghai, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Hong-Wei Wang
- Biliary and Pancreatic Center, Huadong Hospital, Fudan University, Shanghai, China
| | - Wei Wang
- Biliary and Pancreatic Center, Huadong Hospital, Fudan University, Shanghai, China
| | - Su-Zhen Chen
- Key Laboratory of Metabolism and Molecular Medicine, The Ministry of Education, Shanghai, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Liu-Fang Ning
- Key Laboratory of Metabolism and Molecular Medicine, The Ministry of Education, Shanghai, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xu Xu
- Institute of Stem Cell Research and Regenerative Medicine, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Qi-Qun Tang
- Key Laboratory of Metabolism and Molecular Medicine, The Ministry of Education, Shanghai, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.,Institute of Stem Cell Research and Regenerative Medicine, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Hai-Yan Huang
- Key Laboratory of Metabolism and Molecular Medicine, The Ministry of Education, Shanghai, China.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.,Institute of Stem Cell Research and Regenerative Medicine, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
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Yamanaka JS, Yanagihara GR, Carlos BL, Ramos J, Brancaleon BB, Macedo AP, Issa JPM, Shimano AC. A high-fat diet can affect bone healing in growing rats. J Bone Miner Metab 2018; 36:255-263. [PMID: 28516218 DOI: 10.1007/s00774-017-0837-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/24/2017] [Indexed: 12/11/2022]
Abstract
A high-fat diet (HFD) can have a negative effect on bone quality in young and old people. Although bone healing in children is normally efficient, there is no evidence that children who have a diet rich in fat have compromised bone fracture regeneration compared with children with recommended dietary fat levels. The purpose of the present study was to evaluate the effects of an HFD on bone healing in growing female rats. Twenty-six postweaning female Wistar rats were divided into two groups (13 animals per group): a standard diet (SD) group and an HFD (with 60% of energy from fat) group. The rats received the assigned diets for 5 weeks, and in the third week they were submitted to an osteotomy procedure of the left tibia. Body mass and feed intake were recorded during the experiment. One day before euthanasia, an insulin tolerance test was performed. After euthanasia, the tibiae were removed and analyzed by densitometry, mechanical testing, histomorphometry, stereology and immunohistochemistry. An HFD caused an adaptive response to maintain energetic balance by decreasing feed intake and causing insulin insensitivity. There was no change in bone mineral density, collagen amount and immunostaining for bone formation, but maximal load and stiffness were decreased in the HFD group. In addition, bone volume had a tendency to be higher in the SD group than in the HFD group. Compared with rats receiving an SD, growing rats receiving an HFD for 5 weeks had similar bone mineral density but altered mechanical properties at the osteotomy defect site.
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Affiliation(s)
- Jéssica Suzuki Yamanaka
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Rezende Yanagihara
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Bruna Leonel Carlos
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Júnia Ramos
- Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Brígida Batista Brancaleon
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Ana Paula Macedo
- Departamento de Materiais Dentários e Próteses, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João Paulo Mardegan Issa
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil
- Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Carlos Shimano
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Rua Pedreira de Freitas, s/n, 14049-900, Ribeirão Preto, São Paulo, Brazil.
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Gajewska J, Ambroszkiewicz J, Klemarczyk W, Chełchowska M, Weker H, Szamotulska K. The effect of weight loss on body composition, serum bone markers, and adipokines in prepubertal obese children after 1-year intervention. Endocr Res 2018; 43:80-89. [PMID: 29192796 DOI: 10.1080/07435800.2017.1403444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED Purpose/Aim: The influence of weight loss on bone turnover and bone quality in childhood remains controversial, but it may implicate interactions between adiposity and bone metabolism. Therefore, we studied the relationships between bone markers and adipokines during weight loss in obese children. MATERIALS AND METHODS We determined serum leptin, soluble leptin receptor, adiponectin, bone alkaline phosphatase (BALP), C-terminal telopeptide of type I collagen (CTX-I), osteocalcin (OC), carboxylated-OC (Gla-OC), undercarboxylated-OC (Glu-OC), sclerostin, body composition, and bone mineral density (BMD) in 40 obese prepubertal children before and after therapy. The control group, matched for sex and age, consisted of 40 non-obese children. RESULTS We found that values of the total body less head-bone mineral content (TBLH-BMC) and TBLH-BMD were significantly increased, but TBLH-BMD Z-score was decreased by 25% (p = 0.002) in obese children with weight loss after therapy. We observed increases of CTX-I to OC ratio (p = 0.009), and Gla-OC concentrations (p = 0.049). Changes in TBLH-BMD Z-score in patients were positively correlated with changes in BMI Z-score (p = 0.001), percentage of fat mass (p = 0.004), and BALP activity (p = 0.01). Changes in BALP activity were negatively correlated (p < 0.001) with changes in adiponectin concentrations, while changes in sclerostin levels were positively correlated (p = 0.001) with leptin changes. CONCLUSIONS We suggest that alterations in adipokines metabolism were associated with a lower rate of bone mineral accrual as a result of decreased bone formation rather than increased bone resorption. The lower rate of bone mass accrual in weight losing children may be an effect of reduced BALP levels related to increase in adiponectin levels.
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Affiliation(s)
- Joanna Gajewska
- a Screening Department , Institute of Mother and Child , Warsaw , Poland
| | | | - Witold Klemarczyk
- b Department of Nutrition , Institute of Mother and Child , Warsaw , Poland
| | | | - Halina Weker
- b Department of Nutrition , Institute of Mother and Child , Warsaw , Poland
| | - Katarzyna Szamotulska
- c Department of Epidemiology and Biostatistics , Institute of Mother and Child , Warsaw , Poland
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Chaplais E, Naughton G, Greene D, Dutheil F, Pereira B, Thivel D, Courteix D. Effects of interventions with a physical activity component on bone health in obese children and adolescents: a systematic review and meta-analysis. J Bone Miner Metab 2018; 36:12-30. [PMID: 28779404 DOI: 10.1007/s00774-017-0858-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 06/27/2017] [Indexed: 12/11/2022]
Abstract
Given the rise in pediatric obesity, clarifications on the relationship between obesity and bone health and on the impact of structured intervention on this relationship are needed. This systematic review and meta-analysis investigated the effect of obesity on bone health and assessed the effect of structured intervention in children and adolescents with obesity. Medline complete, OVID, CINAHL, EMBASE and PubMed databases were searched for studies on obesity and bone health variables up to September 2016, then an update occurred in March 2016. Search items included obesity, childhood, dual energy X-ray absorptiometry and peripheral quantitative computed tomography. Twenty-three studies (14 cross-sectional and nine longitudinal) matched the inclusion criteria. Results from the meta-analysis (cross-sectional studies) confirmed that children and adolescents with obesity have higher bone content and density than their normal weight peers. Results from longitudinal studies remain inconclusive as only 50% of the included studies reported a positive effect of a structured intervention program on bone health. As such, the meta-analysis reported that structured intervention did not influence bone markers despite having beneficial effects on general health in youth with obesity.
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Affiliation(s)
- Elodie Chaplais
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA 3533, Blaise Pascal University, 5 Impasse Amelie Murat, TS60026 cs 60026, Aubière Cedex, 63178, Clermont-Ferrand, France.
- School of Exercise Science, Australian Catholic University, Strathfield Campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia.
- School of Exercise Science, Australian Catholic University, Melbourne Campus, Locked Bag 4115, Fitzroy MDC, Fitzroy, VIC, 3065, Australia.
- Clermont University, Clermont-Ferrand, France.
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Strathfield Campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- School of Exercise Science, Australian Catholic University, Melbourne Campus, Locked Bag 4115, Fitzroy MDC, Fitzroy, VIC, 3065, Australia
| | - David Greene
- School of Exercise Science, Australian Catholic University, Strathfield Campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- School of Exercise Science, Australian Catholic University, Melbourne Campus, Locked Bag 4115, Fitzroy MDC, Fitzroy, VIC, 3065, Australia
| | - Frederic Dutheil
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA 3533, Blaise Pascal University, 5 Impasse Amelie Murat, TS60026 cs 60026, Aubière Cedex, 63178, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield Campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- CRNH-Auvergne, Clermont-Ferrand, France
- Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Melbourne Campus, Locked Bag 4115, Fitzroy MDC, Fitzroy, VIC, 3065, Australia
- Clermont University, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), University Hospital CHU G. Montpied, 63000, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA 3533, Blaise Pascal University, 5 Impasse Amelie Murat, TS60026 cs 60026, Aubière Cedex, 63178, Clermont-Ferrand, France
- CRNH-Auvergne, Clermont-Ferrand, France
- Clermont University, Clermont-Ferrand, France
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA 3533, Blaise Pascal University, 5 Impasse Amelie Murat, TS60026 cs 60026, Aubière Cedex, 63178, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield Campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- CRNH-Auvergne, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Melbourne Campus, Locked Bag 4115, Fitzroy MDC, Fitzroy, VIC, 3065, Australia
- Clermont University, Clermont-Ferrand, France
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Chaplais E, Dutheil F, Naughton G, Greene D, Pereira B, Thivel D, Courteix D. Cross-sectional and longitudinal study protocols of the 'ADIposity and BOne metabolism: effects of eXercise-induced weight loss in obese adolescents' (ADIBOX) project. BMJ Open 2016; 6:e011407. [PMID: 27797988 PMCID: PMC5073595 DOI: 10.1136/bmjopen-2016-011407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/28/2016] [Accepted: 07/20/2016] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION A need exists for sustainable and clinically effective weight management interventions, suitable for preventing well-linked chronic disease such as diabetes and cardiovascular disease and some less investigated secondary conditions such as bone alteration. The ADIposity and BOne metabolism: effects of eXercise-induced weight loss in obese adolescents (ADIBOX) protocol was designed to provide a better understanding of the interaction between adipokines and bone hormones in adolescents with obesity and how a 10-month physical activity programme may affect these interactions. METHODS AND ANALYSIS The ADIBOX protocol combines 2 studies. The first study involves a total of 68 adolescents aged 12-16 years. This cross-sectional study will include both males and females (1:1 ratio), either living with obesity/overweight (n=34; body mass index (BMI) ≤97th centile and ≥85th centile) or normal weight (n=34; BMI<85th centile). The second study is a longitudinal study that will include 50 obese adolescent girls and track them over a period of 42 weeks. Weight loss programme will consist of a combination of physical activity and a normocaloric diet. Bone and adiposity-related measurements will be performed every 14 weeks. Both studies will assess participants' anthropometric profile, nutrition and physical activity, body composition, bone densitometry and blood markers of bone, growth and adiposity. ETHICS AND DISSEMINATION The ADIBOX protocol complies with the ethics guidelines for clinical research and has been approved by their respective ethics committee (Australian Catholic University Committee Ethic, Australia and Hospital Sud Est 1 committee, France). Findings from this protocol are expected to clarify the possible interactions between adiposity and bone in childhood obesity and will be disseminated at several research conferences and published articles in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02626273; Pre-results.
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Affiliation(s)
- Elodie Chaplais
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Frédéric Dutheil
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield, New South Wales, Australia
- CRNH-Auvergne, Clermont-Ferrand, France
- Department of Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Strathfield, New South Wales, Australia
| | - David Greene
- School of Exercise Science, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Bruno Pereira
- Biostatistics Unit (DRCI), University Hospital CHU G. Montpied, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- CRNH-Auvergne, Clermont-Ferrand, France
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield, New South Wales, Australia
- CRNH-Auvergne, Clermont-Ferrand, France
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Courteix D, Valente-dos-Santos J, Ferry B, Lac G, Lesourd B, Chapier R, Naughton G, Marceau G, João Coelho-e-Silva M, Vinet A, Walther G, Obert P, Dutheil F. Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome--the RESOLVE Randomized Controlled Trial. PLoS One 2015; 10:e0136491. [PMID: 26376093 PMCID: PMC4574281 DOI: 10.1371/journal.pone.0136491] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 08/01/2015] [Indexed: 01/04/2023] Open
Abstract
Background Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD). Methods We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention. Results This intensive lifestyle intervention (15–20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC. Conclusion After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program. Trial Registration ClinicalTrials.gov NCT00917917
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Affiliation(s)
- Daniel Courteix
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - João Valente-dos-Santos
- Lusófona University of Humanities and Technologies, Faculty of Physical Education and Sport, Lisbon, Portugal
- University of Coimbra, Faculty of Sport Sciences and Physical Education, Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Béatrice Ferry
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - Gérard Lac
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - Bruno Lesourd
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
- Auvergne University, Faculty of Medicine, Geriatric, Clermont-Ferrand, France
| | - Robert Chapier
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - Geraldine Naughton
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
| | - Geoffroy Marceau
- University Hospital of Clermont-Ferrand (CHU), Biochemistry, Clermont-Ferrand, France
| | - Manuel João Coelho-e-Silva
- University of Coimbra, Faculty of Sport Sciences and Physical Education, Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Agnès Vinet
- Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France
| | - Guillaume Walther
- Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France
| | - Philippe Obert
- Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France
| | - Frédéric Dutheil
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
- University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France
- * E-mail:
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