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Theodorou SJ, Theodorou DJ, Kigka V, Gkiatas I, Fotopoulos A. DXA-based appendicular composition measures in healthy aging Caucasian Greek women: a cross-sectional study. Rheumatol Int 2024; 44:1715-1723. [PMID: 38860993 DOI: 10.1007/s00296-024-05622-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/26/2024] [Indexed: 06/12/2024]
Abstract
As the global population of older persons increases, age-related medical conditions will have a greater impact on public health. DXA-derived bone and soft tissue metrics are associated with adverse clinical events in aging persons. This study aims to investigate the regional body composition of the appendices by whole-body DXA scans, and the age-related relationships between measures of bone and soft tissue in healthy Caucasian females of a Greek origin residing in the Mediterranean area. Body composition of the legs and the arms was analyzed, and lean mass (LM) and fat mass (FM) metrics were calculated in 330 women aged 20-85 years, using DXA. Peak bone mineral density (BMD) of the legs and arms was achieved between ages 20-30 and 41-50 years, respectively. The overall BMD reduction with age was for the legs 43% and the arms 32.2% (p < 0.001). Peak %LM of the legs and the arms was achieved between ages 20-30. The overall reduction of %LM with age was for the legs 22.5% (p < 0.001) and arms 6.6% (p < 0.05). Peak %FM of the legs and arms was attained between ages 31-40 and 61-70, respectively. The overall %FM reduction with age was for the legs and arms 7.5% and 1.9% (p > 0.05). In appendicular sites, Greek women reach peak values of bone mass in the legs first, in early adulthood. Bone loss predominates in the legs as women age. Also, with advancing age Greek women show preferential significant decreases of %LM and %FM in the legs as opposed to the arms. Although variation in appendicular bone and soft tissue metrics is present, the implications of variable biological crosstalks among the tissue components as women age may ultimately lay the foundation for future clinical trials aimed at healthy aging.
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Affiliation(s)
| | - Daphne J Theodorou
- Department of Radiology, General Hospital of Ioannina and National Healthcare System, Ioannina, Greece
| | - Vassiliki Kigka
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Ioannis Gkiatas
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Andreas Fotopoulos
- Department of Nuclear Medicine, University of Ioannina, Ioannina, Greece
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Theodorou SJ, Theodorou DJ, Kigka V, Gkiatas I, Fotopoulos A. Age-related variations in trunk composition and patterns of regional bone and soft tissue changes in adult Caucasian women by DXA. Rheumatol Int 2024; 44:349-356. [PMID: 38135825 DOI: 10.1007/s00296-023-05514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023]
Abstract
We explored the regional variations in body composition with advancing age in healthy Caucasian females living in the Mediterranean area. The objectives of this study were to establish body composition values for the trunk in healthy women of a Greek origin and to evaluate the effects of aging on the distribution of truncal bone mass, fat mass (FM) and lean mass (LM). Body composition of the trunk and detailed analysis of its anatomical components-the ribs, the thoracic spine, the lumbar spine and the pelvis, and FM and LM ratios--were calculated in 330 women aged 20-85 years, using DXA. Peak bone mineral density (BMD) of the trunk was attained between ages 30 and 33. The overall truncal BMD reduction with age was 20.7% (p < 0.001). Peak %LM of the trunk was achieved at age 20. The overall reduction of %LM with age for the trunk was 9.8% (p < 0.001). Peak %FM of the trunk was attained between ages 68 and 73, and the overall %FM reduction with age was 2.8% (p > 0.05). Multiple comparative analyses showed that the 51-60 years age group was the landmark age for significant changes of truncal bone mass measures across all age groups (p = 0). For truncal LM and FM metrics, multigroup comparative analysis showed the turning point of significant changes in soft tissue was the 41-50 age bracket (p = 0 and p = 0, respectively). In Greek women, truncal %LM exceeded by far %FM across all ages (p = 0). Our results suggest that aging affects body composition of the trunk in ambulatory healthy women of a Greek origin differently, leading to menopausal loss of bone mass, senior adulthood loss of lean mass, and middle-age storage of fat mass. In adult women, these age-related associations between bone and soft tissue metrics on DXA exams carry implications for the attainment of optimal peak values and shifts in body composition overtime, impacting lifelong skeletal health.
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Affiliation(s)
| | - Daphne J Theodorou
- Department of Radiology, General Hospital of Ioannina and National Healthcare System, 45444, Ioannina, Greece.
| | - Vassiliki Kigka
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Ioannis Gkiatas
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Andreas Fotopoulos
- Department of Nuclear Medicine, Bone Densitometry Section, University of Ioannina, Ioannina, Greece
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Abdinian M, Milaei M, Soltani P. Digital panoramic radiography and CBCT as auxiliary tools for detection of low bone mineral density in post-menopausal women: a cross-sectional study. BMC Med Imaging 2023; 23:78. [PMID: 37308822 DOI: 10.1186/s12880-023-01046-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/06/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Osteoporosis is a chronic, multifactorial skeletal disease that occurs especially in women following a decrease in estrogen levels and decrease in bone mineral density. The aim of this study was to evaluate the relationship between qualitative and quantitative indexes in panoramic radiographs and quantitative indexes in CBCT images with femoral and vertebral BMD in postmenopausal women. METHODS This comparative cross-sectional study was performed on postmenopausal women aging 40 to 80 years attending for obtaining either panoramic radiograph or mandibular CBCT scan. Dual energy X-ray absorptiometry (DEXA) was performed from the femur and lumbar vertebra. Quantitative parameters of mental index (MI), panoramic mandibular index (PMI), antegonial index (AI) as well as qualitative parameters of mandibular cortical index (MCI) and trabecular bone pattern (TP) were evaluated in panoramic radiographs. Quantitative parameters computed tomography mandibular index (CTMI), computed tomography index (inferior) [CTI(I)] and computed tomography index (superior) [CTI(S)] were analyzed in CBCT images. Kolmogorov-Smirnov tests and Pearson correlation coefficient were used (α = 0.05). RESULTS In individuals with panoramic radiography, statistically significant correlations were observed between MI with vertebral and femoral T-score, AI with vertebral and femoral T-score (except for the right AI with femoral T-score), and TP with vertebral and femoral T-score (p < 0.05). In the group with CBCT scans, the correlations between CTMI with vertebral and femoral T-score, CTI(I) with vertebral and femoral T-score, and CTI(S) with vertebral and femoral T-score were statistically significant (p < 0.05). CONCLUSIONS in CBCT images, quantitative indexes of CTMI, CTI(I), and CTI(S), and in panoramic images, quantitative indexes of MI and AI and qualitative index of TP can be used to predict the possibility of osteoporosis in postmenopausal women.
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Affiliation(s)
- Mehrdad Abdinian
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Hezar-Jarib Ave, P.O. 8174673461, Isfahan, Iran
| | - Mina Milaei
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Hezar-Jarib Ave, P.O. 8174673461, Isfahan, Iran.
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
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Shoepe TC, LaBrie JW, Mello GT, Leggett AG, Almstedt HC. Intensity of resistance training via self-reported history is critical in properly characterizing musculoskeletal health. BMC Musculoskelet Disord 2020; 21:729. [PMID: 33172425 PMCID: PMC7654594 DOI: 10.1186/s12891-020-03753-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Intensity of resistance training history might be omitted or poorly ascertained in prescreening or data questionnaires involving musculoskeletal health. Failure to identify history of high-versus low-intensity training may overlook higher effect sizes with higher intensities and therefore diminish the precision of statistical analysis with resistance training as a covariate and bias the confirmation of baseline homogeneity for experimental group designation. The purpose was to determine the degree to which a single question assessing participant history of resistance training intensity predicted differences in musculoskeletal health. METHODS In the first research aim, participants were separated into groups with a history (RT) and no history (NRT) of resistance training. The second research aim evaluated the history of resistance training intensity on muscular strength, lean mass, and bone mineral density (BMD), RT participants were reassigned into a low- (LIRT) or high-intensity resistance training group (HIRT). 83 males and 87 females (19.3 ± 0.6 yrs., 171.1 ± 9.9 cm, 67.1 ± 10.5 kg, 22.9 ± 2.8 BMI, 26.2 ± 7.2% body fat) completed handgrip dynamometry (HG) and dual-energy x-ray absorptiometry scans (DXA) for BMD and bone mineral-free lean mass (BFLM). RESULTS A 3-group method (NRT, LIRT, HIRT) reduced type-I error compared with the 2-group method (NRT, RT) in characterizing the likely effects of one's history of resistance training. For the second aim, HIRT had significantly (p < 0.05) greater HG strength (76.2 ± 2.2 kg) and arm BFLM (6.10 ± 0.16 kg) than NRT (67.5 ± 1.3 kg; 4.96 ± 0.09 kg) and LIRT (69.7 ± 2.0 kg; 5.42 ± 0.14 kg) while also showing significantly lower muscle quality (HG/BFLM) than NRT (13.9 ± 0.2 vs. 12.9 ± 0.3). HIRT had greater BMD at all sites compared to NRT (whole body = 1.068 ± 0.008 vs. 1.120 ± 0.014; AP spine = 1.013 ± 0.011 vs. 1.059 ± 0.019; lateral spine = 0.785 ± 0.009 vs. 0.846 ± 0.016; femoral neck = 0.915 ± 0.013 vs. 0.970 ± 0.022; total hip = 1.016 ± 0.012 vs. 1.068 ± 0.021 g/cm2) while LIRT revealed no significant skeletal differences to NRT. CONCLUSIONS Retrospective identification of high-intensity history of resistance training appears critical in characterizing musculoskeletal health and can be ascertained easily in as little as a single, standalone question. Both retrospective-questionnaire style investigations and pre-screening for potential participation in prospective research studies should include participant history of resistance training intensity.
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Affiliation(s)
- Todd C Shoepe
- Health and Human Performance Laboratory, Department of Health and Human Sciences, Loyola Marymount University, Life Sciences Building 181, 1 LMU Drive, MS 8888, Los Angeles, CA, 90045, USA.
| | - Joseph W LaBrie
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, USA
| | - Grant T Mello
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, USA
| | - Allison G Leggett
- Health and Human Performance Laboratory, Department of Health and Human Sciences, Loyola Marymount University, Life Sciences Building 181, 1 LMU Drive, MS 8888, Los Angeles, CA, 90045, USA
| | - Hawley C Almstedt
- Health and Human Performance Laboratory, Department of Health and Human Sciences, Loyola Marymount University, Life Sciences Building 181, 1 LMU Drive, MS 8888, Los Angeles, CA, 90045, USA
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Aparisi Gómez MP, Weidekamm C, Aparisi F, Bazzocchi A. Sports and Metabolic Bone Disease. Semin Musculoskelet Radiol 2020; 24:277-289. [PMID: 32987426 DOI: 10.1055/s-0040-1709483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical activity (PA) increases bone mass and bone strength through different mechanisms and also reduces the risk of falls in the elderly, through proprioception and balance training. The benefits seen in adolescence continue into adulthood. Exercise delays and attenuates the effects of osteoporosis, and particular sports activities may be recommended to improve bone mineral density (BMD) of the spine or regional BMD, improve balance, and prevent falls. Stress injuries related to exercise are more common in osteopenic and osteoporotic individuals.Sports activity may in some cases be detrimental for bone health, with nutrition restriction a frequent cause for negative effects of the practice of PA on bone. The examples are the so-called female athlete triad of menstrual dysfunction resulting in reduced estrogen levels, low energy due to malnutrition, and decreased BMD. A similar triad is described in male athletes. This review analyzes the effects of sport on bone metabolism and in particular its relationship with metabolic bone disease.
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Affiliation(s)
- Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | | | - Francisco Aparisi
- Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Kerkadi A, Suleman D, Abu Salah L, Lotfy C, Attieh G, Bawadi H, Shi Z. Adiposity Indicators as Cardio-Metabolic Risk Predictors in Adults from Country with High Burden of Obesity. Diabetes Metab Syndr Obes 2020; 13:175-183. [PMID: 32021363 PMCID: PMC6983675 DOI: 10.2147/dmso.s238748] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In Qatar more than 70% 0f the adults are overweight and obese. Different adiposity assessment methods have been proposed to identify individuals at cardio-metabolic risk. PURPOSE This study aimed to compare anthropometric indicators with Dual-energy X-ray absorptiometry (DXA) -derived adiposity indicators in predicting cardio-metabolic risk among Qatari adults. PATIENTS AND METHODS A random sample of five hundred and fifty-eight (558) healthy Qatari adults (men and women) aged 20 to 50 years was obtained from Qatar Biobank survey data. Anthropometric data (weight, height, and waist circumference), the DXA-derived data, and cardio-metabolic (CM) risk parameters were analyzed. A Spearman partial correlation coefficient, Receiver Operating Characteristics (ROC) curve and an area under curve (AUC) were used to assess the predicting ability of adiposity indicators for CM risk factors. RESULTS Adiposity indices (anthropometric and DXA) were significantly correlated with most of the CM indicators (r= -0.292 to 0.486, p< 0.001). The AUC of waist to height ratio (WHtR) was significantly higher than that of body mass index (BMI) and waist circumference (WC) in the prediction of low high density lipoprotein (HDL) (AUC=0.65, AUC=0.59; AUC=0.64), high low density lipoprotein (LDL) (AUC=0.67; AUC=0.62; AUC=0.66), high cholesterol (AUC=0.66; AUC=0.63; AUC=0.63), and high Homeostatic Model Assessment- (HOMA) (AUC= 0.81; AUC= 0.78; AUC=0.78). Among DXA- parameters, trunk fat had the highest AUCs for total cholesterol (AUC= 0.64, CI=0.56, 0.73), triglycerides and glucose index (TyG) (AUC=0.69, CI=0.64, 0.74), and HOMA (AUC=0.78, CI= 0.73, 0.84). CONCLUSION Results of the present study show that adiposity indicators (WC and WHtR) are clinically valuable tools to identify individuals at risk of CVD compared to DXA-derived parameters, while DXA can provide more accurate estimates.
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Affiliation(s)
- Abdelhamid Kerkadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
- Correspondence: Abdelhamid Kerkadi Tel +974 4403 4806Fax +974 4403 4801 Email
| | - Dana Suleman
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Lana Abu Salah
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Christina Lotfy
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Grace Attieh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
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Grzegorczyk J, Woloszyn N, Perenc L. Comparison of selected body composition parameters in women using DXA and anthropometric method. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:70. [PMID: 31523256 PMCID: PMC6734665 DOI: 10.4103/jrms.jrms_1021_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/10/2019] [Accepted: 05/31/2019] [Indexed: 11/04/2022]
Abstract
Background An excessive accumulation of the adipose tissue in women's organism is a frequent and important medical problem which should be monitored. The aim of this study was to explore correlations between the selected parameters of body composition assessed using DXA and anthropometric methods. Materials and Methods The study group consisted of 50 women aged 51-85. Both adipose mass and fat-free mass were assessed with the DXA method, and the nutritional status of the participants was evaluated with the anthropometric methods. Results The mean body mass index (BMI) value assessed with the DXA method amounted to 28.4 (±5.12). The Spearman's Rho correlation indicated the presence of a moderate association (0.27-0.50) between: (1) right arm lean and the circumference of the arm (P = 0.020), forearm (P = 0.011), and transverse cross-section of the arm (P = 0.020), (2) right leg fat and circumference of the thigh (P = 0.003), shin (P = 0.009), and also the musculature index of the lower extremity (P = 0.034), (3) visceral adipose tissue (VAT) mass and BMI (P = 0.050), Waist to HeightRatio (WtHR) (P = 0.031), (4) Android fat and WHtR (P = 0.044), and (5) gynoid fat and Škerlj index (P = 0.025). Conclusion The selected parameters assessed with DXA were significantly correlated with the selected parameters assessed with anthropometric methods. WHtR anthropometric parameter is significantly correlated with DXA parameters: VAT mass, gynoid region % fat and android region % fat.
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Affiliation(s)
- Joanna Grzegorczyk
- Medical Faculty, Institute of Physiotherapy, University of Rzeszow, Rzeszow, Poland.,Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Natalia Woloszyn
- Medical Faculty, Institute of Physiotherapy, University of Rzeszow, Rzeszow, Poland.,Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Lidia Perenc
- Medical Faculty, Institute of Physiotherapy, University of Rzeszow, Rzeszow, Poland.,Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty, University of Rzeszow, Rzeszow, Poland
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Gender-specific association of body composition with inflammatory and adipose-related markers in healthy elderly Europeans from the NU-AGE study. Eur Radiol 2019; 29:4968-4979. [PMID: 30715588 PMCID: PMC6682581 DOI: 10.1007/s00330-018-5973-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/22/2018] [Accepted: 12/14/2018] [Indexed: 01/17/2023]
Abstract
Objectives The aim of this work was to examine the cross-sectional relationship between body composition (BC) markers for adipose and lean tissue and bone mass, and a wide range of specific inflammatory and adipose-related markers in healthy elderly Europeans. Methods A whole-body dual-energy X-ray absorptiometry (DXA) scan was made in 1121 healthy (65–79 years) women and men from five European countries of the “New dietary strategies addressing the specific needs of elderly population for a healthy aging in Europe” project (NCT01754012) cohort to measure markers of adipose and lean tissue and bone mass. Pro-inflammatory (IL-6, IL-6Rα, TNF-α, TNF-R1, TNF-R2, pentraxin 3, CRP, alpha-1-acid glycoprotein, albumin) and anti-inflammatory (IL-10, TGF-β1) molecules as well as adipose-related markers such as leptin, adiponectin, ghrelin, and resistin were measured by magnetic bead-based multiplex-specific immunoassays and biochemical assays. Results BC characteristics were different in elderly women and men, and more favorable BC markers were associated with a better adipose-related inflammatory profile, with the exception of skeletal muscle mass index. No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-β1, TNF-α, IL-6Rα, glycoprotein 130, TNF-α-R1, and TNF-α-R2. Conclusions The association between BC and inflammatory and adipose-related biomarkers is crucial in decoding aging and pathophysiological processes, such as sarcopenia. DXA can help in understanding how the measurement of fat and muscle is important, making the way from research to clinical practice. Key Points • Body composition markers concordantly associated positively or negatively with adipose-related and inflammatory markers, with the exception of skeletal muscle mass index. • No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-β1, TNF-α, IL-6Rα, gp130, TNF-α-R1, and TNF-α-R2. • Skeletal muscle mass index (SMI) shows a good correlation with inflammatory profile in age-related sarcopenia. Electronic supplementary material The online version of this article (10.1007/s00330-018-5973-2) contains supplementary material, which is available to authorized users.
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Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Martucci M, Sangiorgi L, Franceschi C, Bazzocchi A. Aging and Imaging Assessment of Body Composition: From Fat to Facts. Front Endocrinol (Lausanne) 2019; 10:861. [PMID: 31993018 PMCID: PMC6970947 DOI: 10.3389/fendo.2019.00861] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/25/2019] [Indexed: 01/10/2023] Open
Abstract
The aging process is characterized by the chronic inflammatory status called "inflammaging", which shares major molecular and cellular features with the metabolism-induced inflammation called "metaflammation." Metaflammation is mainly driven by overnutrition and nutrient excess, but other contributing factors are metabolic modifications related to the specific body composition (BC) changes occurring with age. The aging process is indeed characterized by an increase in body total fat mass and a concomitant decrease in lean mass and bone density, that are independent from general and physiological fluctuations in weight and body mass index (BMI). Body adiposity is also re-distributed with age, resulting in a general increase in trunk fat (mainly abdominal fat) and a reduction in appendicular fat (mainly subcutaneous fat). Moreover, the accumulation of fat infiltration in organs such as liver and muscles also increases in elderly, while subcutaneous fat mass tends to decrease. These specific variations in BC are considered risk factors for the major age-related diseases, such as cardiovascular diseases, type 2 diabetes, sarcopenia and osteoporosis, and can predispose to disabilities. Thus, the maintenance of a balance rate of fat, muscle and bone is crucial to preserve metabolic homeostasis and a health status, positively contributing to a successful aging. For this reason, a detailed assessment of BC in elderly is critical and could be an additional preventive personalized strategy for age-related diseases. Despite BMI and other clinical measures, such as waist circumference measurement, waist-hip ratio, underwater weighing and bioelectrical impedance, are widely used as a surrogate measure for body adiposity, they barely reflect the distribution of body fat. Because of the great advantages offered by imaging tools in research and clinics, the attention of clinicians is now moving to powerful imaging techniques such as computed tomography, magnetic resonance imaging, dual-energy X-ray absorptiometry and ultrasound to obtain a more accurate estimation of BC. The aim of this review is to present the state of the art of the imaging techniques that are currently available to measure BC and that can be applied to the study of BC changes in the elderly, outlining advantages and disadvantages of each technique.
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Affiliation(s)
- Federico Ponti
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- *Correspondence: Aurelia Santoro
| | - Daniele Mercatelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Morena Martucci
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopedic Disease & CLIBI Laboratory, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Department of Applied Mathematics, Institute of Information Technology, Mathematics and Mechanics (ITMM), Lobachevsky State University of Nizhny Novgorod-National Research University (UNN), Nizhny Novgorod, Russia
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Santoro A, Bazzocchi A, Guidarelli G, Ostan R, Giampieri E, Mercatelli D, Scurti M, Berendsen A, Surala O, Jennings A, Meunier N, Caumon E, Gillings R, Kadi F, Capel F, Cashman KD, Pietruszka B, Feskens EJM, De Groot LCPGM, Battista G, Salvioli S, Franceschi C. A Cross-Sectional Analysis of Body Composition Among Healthy Elderly From the European NU-AGE Study: Sex and Country Specific Features. Front Physiol 2018; 9:1693. [PMID: 30555339 PMCID: PMC6283977 DOI: 10.3389/fphys.2018.01693] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/09/2018] [Indexed: 12/31/2022] Open
Abstract
Body composition (BC) is an emerging important factor for the characterization of metabolic status. The assessment of BC has been studied in various populations and diseases such as obesity, diabetes, endocrine diseases as well as physiological and paraphysiological conditions such as growth and aging processes, and physical training. A gold standard technique for the assessment of human BC at molecular level is represented by dual-energy X-ray absorptiometry (DXA), which is able to precisely assess the body mass (and areal bone mineral density-aBMD) on a regional and whole-body basis. For the first time, within the framework of the NU-AGE project, BC has been assessed by means of a whole-body DXA scan in 1121 sex-balanced free-living, apparently healthy older adults aged 65–79 years enrolled in 5 European countries (Italy, France, United Kingdom, Netherlands, and Poland). The aim of this analysis is to provide a complete profile of BC in healthy elderly participants from five European countries and to investigate country- and sex-related differences by state-of-the-art DXA technology. To compare BC data collected in different centers, specific indexes and ratios have been used. Non-parametric statistical tests showed sex-specific significant differences in certain BC parameters. In particular, women have higher fat mass (FM) (Fat/Lean mass ratio: by 67%, p < 2.2e-16) and lower lean mass (Lean Mass index: by -18%, p < 2.2e-16) than men. On the other hand, men have higher android FM than women (Android/gynoid FM ratio: by 56%, p < 2.2e-16). Interesting differences also emerged among countries. Polish elderly have higher FM (Fat/Lean mass ratio: by 52%, p < 2.2e-16) and lower lean mass (Skeletal Mass index: by -23%, p < 2.2e-16) than elderly from the other four countries. At variance, French elderly show lower FM (Fat/Lean mass ratio: by -34%, p < 2.2e-16) and higher lean mass (Skeletal Mass index: by 18%, p < 2.2e-16). Moreover, five BC profiles in women and six in men have been identified by a cluster analysis based on BC parameters. Finally, these data can serve as reference for normative average and variability of BC in the elderly populations across Europe.
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Affiliation(s)
- Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Giulia Guidarelli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Enrico Giampieri
- Department of Physics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Maria Scurti
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
| | - Agnes Berendsen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Olga Surala
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw, Poland
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | | | | | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Fawzi Kadi
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Frederic Capel
- Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw, Poland
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Lisette C P G M De Groot
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Stefano Salvioli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
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11
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Correlation between DXA and laboratory parameters in normal weight, overweight, and obese patients. Nutrition 2018; 61:143-150. [PMID: 30711863 DOI: 10.1016/j.nut.2018.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/18/2018] [Accepted: 10/19/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to review the existence and types of correlations between body composition densitometric parameters and laboratory values associated to cardiometabolic risk. METHODS We retrospectively analyzed data from 316 individuals in the weight range from normality to super-obesity, submitted to total body dual-energy x-ray absorptiometry (DXA) scans and routine biochemistry at S.Orsola-Malpighi Hospital from June 2010 to March 2014. The study included 182 women, 45.8 ± 13.4 y of age, with a body mass index (BMI) of 31.5 (± 11) kg/m2 (group F) and 134 men, 45.4 ± 13.6 y of age, with a BMI of 27.6 (± 7.8) kg/m2 (group M). All patients underwent whole-body scan (Lunar iDXA, GE Healthcare, Madison, WI, USA) and laboratory analysis (blood fasting glucose, total cholesterol, high-density lipoprotein cholesterol, tricylglycerides [TGs], aspartate aminotransferase, and alanine aminotransferase). Correlation between laboratory values and total body and regional fat mass (including visceral adipose tissue [VAT] and subcutaneous adipose tissue in the android region), and lean mass parameters were analyzed with linear and stepwise regressions analysis (significance limit, P < 0.05). Receiver operating characteristic curves were performed to assess the accuracy of the best-fit DXA parameter (VAT) to identify at least one laboratory risk factor. RESULTS In both groups, BMI and densitometric parameters showed a linear correlation with fasting blood glucose and TG levels and an inverse correlation with high-density lipoprotein cholesterol (P < 0.05), whereas no correlation was observed with total cholesterol levels. The only densitometric parameter retained in the final model of stepwise multiple regression was VAT for fasting blood glucose (group F: β = 0.4627, P < 0.0001; group M: β = 0.6221, P < 0.0001) and TG levels (group F: β = 0.4931, P < 0.0001; group M: β = 0.1990, P < 0.0261) independently of BMI. The optimal cutoff points of VAT to identify the presence of at least one laboratory risk factor were >1395 g and >1479 cm3 for men and >1281 g and >1357 cm3 for women. CONCLUSIONS DXA analysis of VAT is associated with selected laboratory parameters used for the evaluation of cardiometabolic risk and could be per se a helpful parameter in the assessment of clinical risk.
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Carnevale V, Castriotta V, Piscitelli PA, Nieddu L, Mattera M, Guglielmi G, Scillitani A. Assessment of Skeletal Muscle Mass in Older People: Comparison Between 2 Anthropometry-Based Methods and Dual-Energy X-ray Absorptiometry. J Am Med Dir Assoc 2018; 19:793-796. [DOI: 10.1016/j.jamda.2018.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/11/2018] [Accepted: 05/20/2018] [Indexed: 12/25/2022]
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13
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Rathnayake N, Alwis G, Lenora J, Lekamwasam S. Concordance between appendicular skeletal muscle mass measured with DXA and estimated with mathematical models in middle-aged women. J Physiol Anthropol 2018; 37:19. [PMID: 30064499 PMCID: PMC6069740 DOI: 10.1186/s40101-018-0179-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 07/16/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Appendicular skeletal muscle mass (ASMM) is a measure of body muscle content, and it correlates with nutrition and physical status. Estimation of ASMM using anthropometric models is a well-established strategy to overcome issues related to the restricted availability of sophisticated techniques in measuring ASMM. This study aimed to assess the validity of four selected anthropometric models in estimating ASMM in middle-aged women in Sri Lanka. METHODS A group of women (n = 165) aged 30-60 years underwent a series of anthropometric measurements such as body weight, height, circumferences, and skin fold thickness at specific sites. The limb circumferences were corrected for subcutaneous adipose tissue thickness. Two models developed by Lee et al. (ASM 1, ASM2) and two models developed by Wen et al. (ASM3, ASM4) were validated using ASMM measured by dual energy x-ray absorptiometry (ASMMDXA) as the reference standard. RESULTS Mean (SD) age of the study group was 49.0 (8.2) years. Mean (SD) ASMMDXA and ASMM estimated by the four models were ASMMDXA = 15.39 (2.75) kg, ASM1 = 18.36 (3.27) kg, ASM2 = 16.46 (3.01) kg, ASM3 = 15.44 (2.40) kg, and ASM4 = 14.44 (2.45) kg. Correlations of ASMMDXA with ASMM estimated by the models were as follows: ASM1, r = 0.68, R2 = 0.46, SEE = 2.02 kg; ASM2, r = 0.90, R2 = 0.81, SEE = 1.18 kg; ASM3, r = 0.90, R2 = 0.81, SEE = 1.17 kg; and ASM4, r = 0.91, R2 = 0.82, SEE = 1.14 kg. ASMM estimated by ASM3 was not significantly different (P > 0.05) from ASMMDXA with mean difference of - 0.05 (range, 0.12 to - 0.23). Bland and Altman plot revealed satisfactory measurement agreements between ASM3 and ASMMDXA. The ASMM estimated by the other three models was significantly different from the ASMMDXA (P < 0.05). CONCLUSION The ASM3 model introduced by Wen et al. met all validation criteria and can be recommended for the estimation of ASMM in middle-aged women in Sri Lanka.
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Affiliation(s)
- Nirmala Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka.
| | - Gayani Alwis
- Department of Anatomy, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Janaka Lenora
- Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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14
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Li G, Qian H, Guo S, Wang D, Sun C, Du Y, Cheng J, Jiang H. Assessment of aging characteristics of female condylar trabecular structure by cone-beam computed tomography. Oral Radiol 2018; 35:16-22. [DOI: 10.1007/s11282-018-0322-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/18/2017] [Indexed: 10/17/2022]
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15
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Guerri S, Mercatelli D, Aparisi Gómez MP, Napoli A, Battista G, Guglielmi G, Bazzocchi A. Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia. Quant Imaging Med Surg 2018. [PMID: 29541624 DOI: 10.21037/qims.2018.01.05] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs. Several imaging techniques are currently available for the non-invasive investigation of bone and muscle mass and quality. Conventional radiology, dual energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound often play a complementary role in the study of osteoporosis and sarcopenia, depicting different aspects of the same pathology. This paper presents the different imaging modalities currently used for the investigation of bone and muscle mass and quality in osteoporosis and sarcopenia with special emphasis on the clinical applications and limitations of each technique and with the intent to provide interesting insights into recent advances in the field of conventional imaging, novel high-resolution techniques and fracture risk.
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Affiliation(s)
- Sara Guerri
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine, Division of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Daniele Mercatelli
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Grafton, Auckland, New Zealand.,Department of Radiology, Hospital Nueve de Octubre, Valencia, Spain
| | - Alessandro Napoli
- Radiology Section, Department of Radiological, Oncological and Anatomopathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Radiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy.,Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Alberto Bazzocchi
- The Unit of Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
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