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Ma X, Tian M, Liu J, Tong L, Ding W. Impact of high fat and low lean mass phenotype on bone mineral content: A cross-sectional study of Chinese adolescent population. Bone 2024; 186:117170. [PMID: 38880171 DOI: 10.1016/j.bone.2024.117170] [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: 04/09/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND OBJECTIVE Research on body composition phenotypes and bone health in adolescents is limited. Hence, this study aimed to analyze the relationship between different body composition phenotypes, bone mineral content, and bone metabolism markers in Chinese adolescents. METHODS In this cross-sectional study, 1852 adolescents aged 12 to 18 years were selected from six schools in Yinchuan City between 2017 and 2020 using stratified cluster random sampling. The participant's body composition and bone mineral content (BMC) were measured using bioelectrical impedance analysis (BIA). Serum bone metabolic markers (OC, CTX, and Ca) were measured. Based on their FMI and LMI, individuals were categorized into four body composition phenotypes: low fat mass-low lean mass (LFMI-LLMI), low fat mass-high lean mass (LFMI-HLMI), high fat mass-high lean mass (HFMI-HLMI), high fat mass-low lean mass (HFMI-LLMI). RESULTS There was a statistically significant difference between the four different body composition phenotypes with BMC, CTX and Ca in boys (all P < 0.05), similar conclusions were found in girls, except the OC and CTX. After adjusting for age, gender, smoking, drinking, and others, compared with the LFMI-HLMI reference group, the two high FMI groups (HFMI-LLMI and HFMI-HLMI) had a greater negative correlation with BMC, while the low BMC risk of the HFMI-LLMI group was the highest (OR = 33.28; 95%CI: 11.12-99.63; P < 0.001). The correlation between BMC of different body composition phenotypes in boys was greater than that in girls. HFMI-HLMI is a risk phenotype negatively associated with Ca content (β = -0.12; 95%CI: -0.19 to -0.04; P < 0.05). Regardless of body composition level, BMC was always negatively correlated with fat mass (LLMI: β = -0.27; 95%CI: -0.32-0.21; HLMI: β = -0.52, 95%CI: -0.65-0.40) and positively correlated with lean mass (LFMI: β =0.24; 95%CI: 0.20-0.28; HFMI: β =0.23, 95%CI:0.13-0.33) (all P < 0.001). The fat mass showed different correlations with OC and CTX in girls and boys based on LLMI or HLMI (all P < 0.05). CONCLUSION HFMI-LLMI is a risk phenotype of low BMC in Chinese adolescents, and the relationship between fat mass and bone metabolism markers is affected by lean body mass and gender.
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Affiliation(s)
- Xiaoyan Ma
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Mei Tian
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Jianxi Liu
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Lingling Tong
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China
| | - Wenqing Ding
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China.
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Nomura K, Inagaki S, Muramae N, Takahashi H, Abe K, Kato K, Kido Y, Matsuda T. Association of short-term changes in HbA1c with body composition and the importance of muscle maintenance in patients with Type 2 diabetes. J Diabetes Complications 2024; 38:108746. [PMID: 38749296 DOI: 10.1016/j.jdiacomp.2024.108746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/23/2024]
Abstract
AIMS This study aimed to investigate the relationship between changes in glucose metabolism and body composition in patients with diabetes. METHODS We included 380 patients with type 2 diabetes, who underwent bioelectrical impedance analysis, in this longitudinal study. Changes in HbA1c (ΔHbA1c) levels and body composition indices were compared between baseline and 6 months. A multivariate analysis was performed to examine the relationship between ΔHbA1c and changes in body composition. RESULTS HbA1c levels were significantly decreased at 6 months (P < 0.01), but there was no significant change in BMI. A linear multiple regression analysis showed that ΔHbA1c was negatively correlated with changes in muscle mass (β = -0.18; P = 0.047) and bone mineral content (β = -0.28; P < 0.001), but there was no significant association between ΔHbA1c levels and a change in body fat percentage. CONCLUSIONS This study shows a limited association between short-term changes in glucose metabolism and changes in body composition in patients with type 2 diabetes. Therefore, interventions aimed at reducing adiposity may not affect glucose metabolism in the short term, while interventions focused on maintaining or enhancing muscle mass and bone mineral content may play an important role in diabetes management.
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Affiliation(s)
- Kazuhiro Nomura
- Matsuda Diabetes Clinic, Kobe, Japan; Department of Nutrition and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan; Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Satoshi Inagaki
- Division of Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan; School of Nursing, Kobe City College of Nursing, Kobe, Japan
| | - Naokazu Muramae
- Matsuda Diabetes Clinic, Kobe, Japan; Muramae Diabetes Clinic, Kobe, Japan
| | | | - Kozue Abe
- Matsuda Diabetes Clinic, Kobe, Japan
| | - Kenji Kato
- Faculty of Nursing Science, Kobe Women's University, Kobe, Japan
| | - Yoshiaki Kido
- Matsuda Diabetes Clinic, Kobe, Japan; Division of Medical Chemistry, Department of Metabolism and Diseases, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Ramos BVR, Massini DA, Almeida TAF, Castro EA, Espada MC, Ferreira CC, Robalo RAM, Macedo AG, Pessôa Filho DM. Relationship between Femur Mineral Content and Local Muscle Strength and Mass. J Funct Morphol Kinesiol 2024; 9:69. [PMID: 38651427 PMCID: PMC11036208 DOI: 10.3390/jfmk9020069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
Among the stimuli able to prevent early decreases in bone mineralization, exercise has a noticeable role per se as the source of mechanical stimulus or through lean tissue enlargement by its increasing of tensional stimulus. However, prevention strategies, including exercise, generally do not establish the moment in life when attention should begin to be paid to bone integrity, according to age group- and sex-related differences. Thus, this study analyzed the relationship between variables from the diagnosis of total and regional body composition, muscle strength, and bone mineral content (BMC) of femurs in young adult males. Thirty-four young Caucasian men (24.9 ± 8.6 years) had their body composition and bone density assessed by dual X-ray absorptiometry. The subjects performed a one-repetition maximum test (1-RM) in a bench press, front pulley, seated-row, push press, arm curl, triceps pulley, leg flexion, leg extension, and 45° leg press for the assessment of muscle strength in upper and lower limbs in single- and multi-joint exercises. Lean tissue mass in the trunk and upper and lower limbs were related to femoral BMC (Pearson coefficient ranging from 0.55 to 0.72, p < 0.01), and 1-RM values for different exercises involving both upper and lower limbs also correlated with femoral BMC (Pearson coefficients ranging from 0.34 to 0.46, p < 0.05). Taken together, these correlations suggest that muscle mass and strength are positively linked with the magnitude of femoral mass in men, even in early adulthood. Hence, the importance of an enhanced muscle mass and strength to the health of femoral bones in young adults was highlighted.
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Affiliation(s)
- Bruno V. R. Ramos
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (B.V.R.R.); (D.A.M.); (T.A.F.A.); (E.A.C.); (A.G.M.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Danilo A. Massini
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (B.V.R.R.); (D.A.M.); (T.A.F.A.); (E.A.C.); (A.G.M.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Tiago A. F. Almeida
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (B.V.R.R.); (D.A.M.); (T.A.F.A.); (E.A.C.); (A.G.M.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Eliane A. Castro
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (B.V.R.R.); (D.A.M.); (T.A.F.A.); (E.A.C.); (A.G.M.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
- Laboratory of Exercise Physiology Research Group (LFE—Research Group), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Mário C. Espada
- Instituto Politécnico de Setúbal, Escola Superior de Educação, 2914-504 Setúbal, Portugal; (M.C.E.); (C.C.F.); (R.A.M.R.)
- Sport Physical Activity and Health Research & INnovation CenTer (SPRINT), 2040-413 Rio Maior, Portugal
- Centre for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7004-516 Évora, Portugal
- Life Quality Research Centre (CIEQV-Leiria), 2040-413 Rio Maior, Portugal
| | - Cátia C. Ferreira
- Instituto Politécnico de Setúbal, Escola Superior de Educação, 2914-504 Setúbal, Portugal; (M.C.E.); (C.C.F.); (R.A.M.R.)
- Sport Physical Activity and Health Research & INnovation CenTer (SPRINT), 2040-413 Rio Maior, Portugal
- Training Optimization and Sports Performance Research Group (GOERD), Faculty of Sport Science, University of Extremadura, 10005 Cáceres, Spain
| | - Ricardo A. M. Robalo
- Instituto Politécnico de Setúbal, Escola Superior de Educação, 2914-504 Setúbal, Portugal; (M.C.E.); (C.C.F.); (R.A.M.R.)
- Life Quality Research Centre (CIEQV-Leiria), 2040-413 Rio Maior, Portugal
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal
| | - Anderson G. Macedo
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (B.V.R.R.); (D.A.M.); (T.A.F.A.); (E.A.C.); (A.G.M.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
- Pos-Graduation Program in Rehabilitation, Institute of Motricity Sciences, Federal University of Alfenas (UNIFAL), Alfenas 37133-840, Brazil
| | - Dalton M. Pessôa Filho
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (B.V.R.R.); (D.A.M.); (T.A.F.A.); (E.A.C.); (A.G.M.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
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Kirilov N, Vladeva S, Bischoff F, Batalov Z, Batalov A, Bischoff E. Effect of the body mass index, basal metabolic rate, and body fat on the radiofrequency echographic multi-spectrometry (REMS)-based bone mineral density and fracture risk: a cross-sectional study. Rheumatol Int 2023; 43:2271-2279. [PMID: 37728773 DOI: 10.1007/s00296-023-05460-w] [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: 08/24/2023] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Abstract
Radiofrequency echographic multi-spectrometry (REMS) is a method to assess bone mineral density (BMD) of the axial skeleton, fragility score (FS), body mass index (BMI), basal metabolic rate (BMR), and body fat (BF) in %. The aim of the study was to investigate the influence of the BMI, BMR, and BF on the BMD and fracture risk with REMS. We conducted a cross-sectional study among 313 women, aged 20-90 years who underwent a screening for osteoporosis with REMS. Kruskal-Wallis was used to analyze the differences in BMI, BMR, and BF between the groups according to the BMD: normal BMD, osteopenia and osteoporosis and differences in the FS, fracture risk assessment (FRAX) for major osteoporotic fractures and for hip fractures (HF) according to the BMI groups: underweight, normal weight, overweight, obese, and extreme obese. Linear regression was used to assess the correlations BMI-BMD, BMR-BMD, and BF-BMD. BMI, BMR, and BF differed significantly between the groups according to the BMD (p < 0.001, p = 0.028, and p < 0.001, respectively). BMR showed high positive correlation to BMD (R = 0.765) with 95% confidence interval (CI) [0.715, 0.807] and significance of p < 0.001. BMI correlated significantly to BMD (p < 0.001), the correlation was low positive (R = 0.362) with 95% CI [0.262, 0.455]. In the BMI groups, there was significant difference in FRAX for HF and FS with p value 0.014 and < 0.001, respectively. Subjects with low BMI, BMR, and BF are at high risk for osteoporosis. Underweight women show significantly high fracture risk, assessed with FRAX and FS.
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Affiliation(s)
- Nikola Kirilov
- Department of Orthopedics and Traumatology, University Hospital "UMBAL Dr. Georgi Stranski", Medical University-Pleven, Pleven, Bulgaria.
| | - Stoyanka Vladeva
- Department of Health Care, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria
| | | | - Zguro Batalov
- Department of Internal Diseases, Medical University of Plovdiv, Clinic of Rheumatology, University Hospital 'Kaspela', Plovdiv, Bulgaria
| | - Anastas Batalov
- Department of Internal Diseases, Medical University of Plovdiv, Clinic of Rheumatology, University Hospital 'Kaspela', Plovdiv, Bulgaria
| | - Elena Bischoff
- Department of Internal Diseases, Pharmacology, Paediatrics, Social Medicine, Emergency Medicine, Computer Technology, Infectious Diseases, Physiotherapy and Rehabilitation, Epidemiology and Tropical Diseases, Faculty of Medicine, University "Prof. Dr. Assen Zlatarov"-Burgas, Burgas, Bulgaria
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5
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Maïmoun L, Aouinti S, Puech M, Lefebvre P, Deloze M, de Santa Barbara P, Cristol JP, Brabant S, Gautier T, Nedelcu M, Renard E, Picot MC, Mariano-Goulart D, Nocca D. Effect of Nutritional Deprivation after Sleeve Gastrectomy on Bone Mass, Periostin, Sclerostin and Semaphorin 4D: A Two-Year Longitudinal Study. Nutrients 2023; 15:4310. [PMID: 37892386 PMCID: PMC10610316 DOI: 10.3390/nu15204310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Bariatric surgery induces bone loss, but the exact mechanisms by which this process occurs are not fully known. The aims of this 2-year longitudinal study were to (i) investigate the changes in areal bone mineral density (aBMD) and bone turnover markers following sleeve gastrectomy (SG) and (ii) determine the parameters associated with the aBMD variations. Bone turnover markers, sclerostin, periostin and semaphorin 4D were assessed before and 1, 12 and 24 months after SG, and aBMD was determined by DXA at baseline and after 12 and 24 months in 83 patients with obesity. Bone turnover increased from 1 month, peaked at 12 months and remained elevated at 24 months. Periostin and sclerostin presented only modest increases at 1 month, whereas semaphorin 4D showed increases only at 12 and 24 months. A significant aBMD decrease was observed only at total hip regions at 12 and 24 months. This demineralisation was mainly related to body weight loss. In summary, reduced aBMD was observed after SG in the hip region (mechanical-loading bone sites) due to an increase in bone turnover in favour of bone resorption. Periostin, sclerostin and semaphorin 4D levels varied after SG, showing different time lags, but contrary to weight loss, these biological parameters did not seem to be directly implicated in the skeletal deterioration.
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Affiliation(s)
- Laurent Maïmoun
- Département de Biophysique, Université Montpellier, Service de Médecine Nucléaire, Hôpital Lapeyronie, 371, Avenue du Doyen Gaston Giraud, CHU de Montpellier, CEDEX 5, 34295 Montpellier, France;
- Physiology and Experimental Medecine of the Heart and Muscles (PhyMedExp), Université de Montpellier, INSERM, CNRS, 34295 Montpellier, France;
| | - Safa Aouinti
- Unité de Recherche Clinique et Epidémiologie, CHU de Montpellier, Université de Montpellier, 34295 Montpellier, France; (S.A.); (M.-C.P.)
| | - Marion Puech
- Service de Chirurgie Digestive A, Hôpital Saint Eloi, CHU de Montpellier, 34295 Montpellier, France; (M.P.); (M.D.); (D.N.)
| | - Patrick Lefebvre
- Department of Endocrinology and Diabetes, Lapeyronie Hospital, CHU de Montpellier, University of Montpellier, INSERM, CNRS, 34295 Montpellier, France; (P.L.); (E.R.)
| | - Mélanie Deloze
- Service de Chirurgie Digestive A, Hôpital Saint Eloi, CHU de Montpellier, 34295 Montpellier, France; (M.P.); (M.D.); (D.N.)
| | - Pascal de Santa Barbara
- Physiology and Experimental Medecine of the Heart and Muscles (PhyMedExp), Université de Montpellier, INSERM, CNRS, 34295 Montpellier, France;
| | - Jean-Paul Cristol
- Laboratoire de Biochimie, Hôpital Lapeyronie, CHU de Montpellier, 34295 Montpellier, France;
| | - Séverine Brabant
- Laboratoire des Explorations Fonctionnelles, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France;
| | | | | | - Eric Renard
- Department of Endocrinology and Diabetes, Lapeyronie Hospital, CHU de Montpellier, University of Montpellier, INSERM, CNRS, 34295 Montpellier, France; (P.L.); (E.R.)
| | - Marie-Christine Picot
- Unité de Recherche Clinique et Epidémiologie, CHU de Montpellier, Université de Montpellier, 34295 Montpellier, France; (S.A.); (M.-C.P.)
| | - Denis Mariano-Goulart
- Département de Biophysique, Université Montpellier, Service de Médecine Nucléaire, Hôpital Lapeyronie, 371, Avenue du Doyen Gaston Giraud, CHU de Montpellier, CEDEX 5, 34295 Montpellier, France;
- Physiology and Experimental Medecine of the Heart and Muscles (PhyMedExp), Université de Montpellier, INSERM, CNRS, 34295 Montpellier, France;
| | - David Nocca
- Service de Chirurgie Digestive A, Hôpital Saint Eloi, CHU de Montpellier, 34295 Montpellier, France; (M.P.); (M.D.); (D.N.)
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6
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Abstract
Changes in bone architecture and metabolism with aging increase the likelihood of osteoporosis and fracture. Age-onset osteoporosis is multifactorial, with contributory extrinsic and intrinsic factors including certain medical problems, specific prescription drugs, estrogen loss, secondary hyperparathyroidism, microenvironmental and cellular alterations in bone tissue, and mechanical unloading or immobilization. At the histological level, there are changes in trabecular and cortical bone as well as marrow cellularity, lineage switching of mesenchymal stem cells to an adipogenic fate, inadequate transduction of signals during skeletal loading, and predisposition toward senescent cell accumulation with production of a senescence-associated secretory phenotype. Cumulatively, these changes result in bone remodeling abnormalities that over time cause net bone loss typically seen in older adults. Age-related osteoporosis is a geriatric syndrome due to the multiple etiologies that converge upon the skeleton to produce the ultimate phenotypic changes that manifest as bone fragility. Bone tissue is dynamic but with tendencies toward poor osteoblastic bone formation and relative osteoclastic bone resorption with aging. Interactions with other aging physiologic systems, such as muscle, may also confer detrimental effects on the aging skeleton. Conversely, individuals who maintain their BMD experience a lower risk of fractures, disability, and mortality, suggesting that this phenotype may be a marker of successful aging. © 2023 American Physiological Society. Compr Physiol 13:4355-4386, 2023.
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Affiliation(s)
- Robert J Pignolo
- Department of Medicine, Divisions of Geriatric Medicine and Gerontology, Endocrinology, and Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,The Department of Physiology and Biomedical Engineering, and the Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, USA
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7
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Inoue G, Miyagi M, Saito W, Shirasawa E, Uchida K, Hosogane N, Watanabe K, Katsumi K, Kaito T, Yamashita T, Fujiwara H, Nagamoto Y, Nojiri K, Suzuki S, Okada E, Ueda S, Hikata T, Shiono Y, Watanabe K, Terai H, Tamai K, Matsuoka Y, Suzuki H, Nishimura H, Tagami A, Yamada S, Adachi S, Ohtori S, Furuya T, Orita S, Inage K, Yoshii T, Ushio S, Funao H, Isogai N, Harimaya K, Okada S, Kawaguchi K, Yokoyama N, Oishi H, Doi T, Kiyasu K, Imagama S, Ando K, Kobayashi K, Sakai D, Tanaka M, Kimura A, Inoue H, Nakano A, Ikegami S, Shimizu M, Futatsugi T, Kakutani K, Yurube T, Nakanishi K, Oshima M, Uei H, Aoki Y, Takahata M, Iwata A, Endo H, Seki S, Murakami H, Kato S, Yoshioka K, Hongo M, Abe T, Tsukanishi T, Takaso M, Ishii K. Effect of low body mass index on clinical recovery after fusion surgery for osteoporotic vertebral fracture: A retrospective, multicenter study of 237 cases. Medicine (Baltimore) 2022; 101:e32330. [PMID: 36595994 PMCID: PMC9803438 DOI: 10.1097/md.0000000000032330] [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] [Indexed: 12/31/2022] Open
Abstract
A retrospective multicenter study. Body mass index (BMI) is recognized as an important determinant of osteoporosis and spinal postoperative outcomes; however, the specific impact of BMI on surgery for osteoporotic vertebral fractures (OVFs) remains inconclusive. This retrospective multicenter study investigated the impact of BMI on clinical outcomes following fusion surgery for OVFs. 237 OVF patients (mean age, 74.3 years; 48 men and 189 women) with neurological symptoms who underwent spinal fusion were included in this study. Patients were grouped by World Health Organization BMI categories: low BMI (<18.5 kg/m2), normal BMI (≥18.5 and <25 kg/m2), and high BMI (≥25 kg/m2). Patients' backgrounds, surgical method, radiological findings, pain measurements, activities of daily living (ADL), and postoperative complications were compared after a mean follow-up period of 4 years. As results, the proportion of patients able to walk independently was significantly smaller in the low BMI group (75.0%) compared with the normal BMI group (89.9%; P = .01) and the high BMI group (94.3%; P = .04). Improvement in the visual analogue scale for leg pain was significantly less in the low BMI group than the high BMI group (26.7 vs 42.8 mm; P = .046). Radiological evaluation, the Frankel classification, and postoperative complications were not significantly different among all 3 groups. Improvement of pain intensity and ADL in the high BMI group was equivalent or non-significantly better for some outcome measures compared with the normal BMI group. Leg pain and independent walking ability after fusion surgery for patients with OVFs improved less in the low versus the high BMI group. Surgeons may want to carefully evaluate at risk low BMI patients before fusion surgery for OVF because poor clinical results may occur.
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Affiliation(s)
- Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara City, Kanagawa, Japan
- * Correspondence: Gen Inoue, Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan (e-mail: )
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara City, Kanagawa, Japan
| | - Wataru Saito
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara City, Kanagawa, Japan
| | - Eiki Shirasawa
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara City, Kanagawa, Japan
| | - Kentaro Uchida
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara City, Kanagawa, Japan
- Shonan University of Medical Sciences Research Institute, Chigasaki City, Kanagawa, Japan
| | - Naobumi Hosogane
- Department of Orthopaedic Surgery, Kyorin University, Mitaka City, Tokyo, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University, Chuo-ku, Niigata City, Japan
| | - Keiichi Katsumi
- Department of Orthopaedic Surgery, Niigata University, Chuo-ku, Niigata City, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University, Suita City, Osaka, Japan
| | - Tomoya Yamashita
- Department of Orthopaedic Surgery, Osaka University, Suita City, Osaka, Japan
| | - Hiroyasu Fujiwara
- Department of Orthopaedic Surgery, Osaka University, Suita City, Osaka, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka University, Suita City, Osaka, Japan
| | - Kenya Nojiri
- Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Seiji Ueda
- Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Tomohiro Hikata
- Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, Minato-ku, Tokyo, Japan
| | - Yuta Shiono
- Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka City University, Abeno-ku, Osaka City, Japan
| | - Koji Tamai
- Department of Orthopaedic Surgery, Osaka City University, Abeno-ku, Osaka City, Japan
| | - Yuji Matsuoka
- Department of Orthopaedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hidekazu Suzuki
- Department of Orthopaedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hirosuke Nishimura
- Department of Orthopaedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Atsushi Tagami
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki City, Japan
| | - Shuta Yamada
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki City, Japan
| | - Shinji Adachi
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki City, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Chiba University, Chuo-ku, Chiba City, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University, Chuo-ku, Chiba City, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Chiba University, Chuo-ku, Chiba City, Japan
- Center for Medical Engineering, Chiba University, Inage-ku, Chiba City, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Chiba University, Chuo-ku, Chiba City, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Shuta Ushio
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Haruki Funao
- Department of Orthopaedic Surgery, International University of Health and Welfare, Narita City, Chiba, Japan
- Spine and Spinal cord Center, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Norihiro Isogai
- Spine and Spinal cord Center, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Katsumi Harimaya
- Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka City, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka City, Japan
| | - Kenichi Kawaguchi
- Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka City, Japan
| | - Nobuhiko Yokoyama
- Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka City, Japan
| | - Hidekazu Oishi
- Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka City, Japan
| | - Toshio Doi
- Department of Orthopaedic Surgery, Kyushu University, Higashi-ku, Fukuoka City, Japan
| | - Katsuhito Kiyasu
- Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, Nankoku City, Kochi, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University, Showa-ku, Nagoya City, Aichi, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University, Showa-ku, Nagoya City, Aichi, Japan
| | - Kazuyoshi Kobayashi
- Department of Orthopaedic Surgery, Nagoya University, Showa-ku, Nagoya City, Aichi, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Tokai University, Isehara City, Kanagawa, Japan
| | - Masahiro Tanaka
- Department of Orthopaedic Surgery, Tokai University, Isehara City, Kanagawa, Japan
| | - Atsushi Kimura
- Department of Orthopaedic Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan
| | - Hirokazu Inoue
- Department of Orthopaedic Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan
| | - Atsushi Nakano
- Department of Orthopaedic Surgery, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University, Matsumoto City, Nagano, Japan
| | - Masayuki Shimizu
- Department of Orthopaedic Surgery, Shinshu University, Matsumoto City, Nagano, Japan
| | - Toshimasa Futatsugi
- Department of Orthopaedic Surgery, Shinshu University, Matsumoto City, Nagano, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University, Chuou-ku, Kobe City, Hyogo, Japan
| | - Takashi Yurube
- Department of Orthopaedic Surgery, Kobe University, Chuou-ku, Kobe City, Hyogo, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan
| | - Masashi Oshima
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan
| | - Hiroshi Uei
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane City, Chiba, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University, Kita-ku, Sapporo City, Hokkaido, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University, Kita-ku, Sapporo City, Hokkaido, Japan
| | - Hirooki Endo
- Department of Orthopaedic Surgery, Iwate Medical University, Yahaba-cho, Iwate, Japan
| | - Shoji Seki
- Department of Orthopaedic Surgery, University of Toyama, Toyama City, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Nagoya City University, Mizuho-ku, Nagoya City, Aichi, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa City, Japan
| | - Katsuhito Yoshioka
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa City, Japan
| | - Michio Hongo
- Department of Orthopaedic Surgery, Akita University, Akita City, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba City, Ibaraki, Japan
| | - Toshinori Tsukanishi
- Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba City, Ibaraki, Japan
| | - Masashi Takaso
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara City, Kanagawa, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, International University of Health and Welfare, Narita City, Chiba, Japan
- Spine and Spinal cord Center, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
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8
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BALA MM, BALA KA, PEKER G, ÜNSAL SŞ, GÜRLER M. Relationship between bone mineral density and biochemical parameters in obese children and adolescents. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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9
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Correia IM, Navarro AM, Corrêa Cordeiro JF, Gomide EBG, Mazzonetto LF, de Sousa Oliveira A, Sebastião E, Aguilar BA, de Andrade D, Machado DRL, dos Santos AP. Bone Mineral Content Estimation in People Living with HIV: Prediction and Validation of Sex-Specific Anthropometric Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12336. [PMID: 36231634 PMCID: PMC9566219 DOI: 10.3390/ijerph191912336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
People living with HIV (PWH) experience an accelerated reduction in bone mineral content (BMC), and a high risk of osteopenia and osteoporosis. Anthropometry is an accurate and low-cost method that can be used to monitor changes in body composition in PWH. To date, no studies have used anthropometry to estimate BMC in PWH. To propose and validate sex-specific anthropometric models to predict BMC in PWH. This cross-sectional study enrolled 104 PWH (64 males) aged >18 years at a local university hospital. BMC was measured using dual energy X-ray absorptiometry (DXA). Anthropometric measures were collected. We used linear regression analysis to generate the models. Cross-validations were conducted using the "leave one out", from the predicted residual error sum of squares (PRESS) method. Bland-Altman plots were used to explore distributions of errors. We proposed models with high coefficient of determination and reduced standard error of estimate for males (r2 = 0.70; SEE = 199.97 g; Q2PRESS = 0.67; SEEPRESS = 208.65 g) and females (r2 = 0.65; SEE = 220.96 g; Q2PRESS = 0.62; SEEPRESS = 221.90 g). Our anthropometric predictive models for BMC are valid, practical, and a low-cost alternative to monitoring bone health in PWH.
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Affiliation(s)
- Igor Massari Correia
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | | | | | - Euripedes Barsanulfo Gonçalves Gomide
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Lisa Fernanda Mazzonetto
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Alcivandro de Sousa Oliveira
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - Emerson Sebastião
- Health and Exercise Research Group, Department of Kinesiology and Physical Education, Northern Illinois University, Dekalb, IL 60115, USA
| | - Bruno Augusto Aguilar
- Faculty of Medicine, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14049-900, Brazil
| | - Denise de Andrade
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Department, Human Exposome and Infectious Diseases Network (HEID), Ribeirao Preto, Sao Paulo 14040-902, Brazil
| | - Dalmo Roberto Lopes Machado
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
| | - André Pereira dos Santos
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- College of Nursing, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-902, Brazil
- Anthropometry, Training and Sport Study and Research Group, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo at Ribeirao Preto, Sao Paulo 14040-900, Brazil
- Department, Human Exposome and Infectious Diseases Network (HEID), Ribeirao Preto, Sao Paulo 14040-902, Brazil
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10
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Moon HU, Han SJ, Kim HJ, Chung YS, Kim DJ, Choi YJ. The Positive Association between Muscle Mass and Bone Status Is Conserved in Men with Diabetes: A Retrospective Cross-Sectional and Longitudinal Study. J Clin Med 2022; 11:jcm11185370. [PMID: 36143016 PMCID: PMC9505062 DOI: 10.3390/jcm11185370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Bone and muscle are known to be correlated and interact chemically each other. Diabetes affects the health status of these two types of organ. There has been lack of studies of men on this topic. This study aims to investigate the relationship between bone and muscle status in men with and without diabetes. This study enrolled 318 and 88 men with and without diabetes, respectively, between April 2007 and December 2017. The appendicular skeletal muscle index (ASMI) was correlated with femoral neck bone mineral density (BMD), total hip BMD, and the trabecular bone score (TBS) in both groups (p < 0.001−0.008). In analysis of the changes in muscle mass and bone-related parameters over the 3 years, the ASMI was correlated with total hip BMD only in diabetes group (p = 0.016) and the TBS in both groups (p < 0.001−0.046). This study showed that the positive correlation between muscle mass and bone status was largely conserved in diabetic group in men. Moreover, in a long-term perspective, muscle mass might be more correlated with the bone microarchitecture or bone quality than bone density, and the association between muscle mass and total hip BMD could be stronger in the diabetic group.
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Affiliation(s)
| | | | | | | | - Dae Jung Kim
- Correspondence: (D.J.K.); (Y.J.C.); Tel.: +82-31-219-5128 (D.J.K.); +82-31-219-4491 (Y.J.C.)
| | - Yong Jun Choi
- Correspondence: (D.J.K.); (Y.J.C.); Tel.: +82-31-219-5128 (D.J.K.); +82-31-219-4491 (Y.J.C.)
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11
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Jiang Y, Kang Zhuo BM, Guo B, Zeng PB, Guo YM, Chen GB, Wei J, He RF, Li ZF, Zhang XH, Wang ZY, Li X, Wang L, Zeng CM, Chen L, Xiao X, Zhao X. Living near greenness is associated with higher bone strength: A large cross-sectional epidemiological study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 831:155393. [PMID: 35461937 DOI: 10.1016/j.scitotenv.2022.155393] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Living near green spaces may benefit various health outcomes. However, no studies have investigated the greenness-bone linkage in the general population. Moreover, to which extent ambient air pollution (AAP), physical activity (PA), and body mass index (BMI) mediate this relationship remains unclear. We aimed to explore the association between greenness and bone strength and the potential mediating roles of AAP, PA, and BMI in Chinese adults. METHODS This cross-sectional analysis enrolled 66,053 adults from the China Multi-Ethnic Cohort in 2018-2019. The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were employed to define residential greenness. The calcaneus quantitative ultrasound index (QUI) was used to indicate bone strength. Multiple linear regression models and mediation analyses were used to estimate the residential greenness-bone strength association and potential pathways operating through AAP (represented by PM2.5 [particulate matter <2.5 μm in diameter]), PA, and BMI. Stratification analyses were performed to identify susceptible populations. RESULTS Higher residential exposure to greenness was significantly associated with an increase in QUI, with changes (95% confidence interval) of 3.28 (3.05, 3.50), 3.57 (3.34, 3.80), 2.68 (2.46, 2.90), and 2.93 (2.71, 3.15) for every interquartile range increase in NDVI500m, NDVI1000m, EVI500m, and EVI1000m, respectively. Sex, urbanicity, annual family income, smoking, and drinking significantly modified the association of greenness-bone strength, with more remarkable associations in males, urban residents, subjects from wealthier families, smokers, and drinkers. For the NDVI500m/EVI500m-QUI relationship, the positive mediating roles of PM2.5 and PA were 6.70%/8.50 and 2.43%/2.69%, respectively, whereas those negative for BMI and PA-BMI were 0.88%/1.06% and 0.05%/0.05%, respectively. CONCLUSION Living in a greener area may predict higher bone strength, particularly among males, urban residents, wealthier people, smokers, and drinkers. AAP, PA, BMI, and other factors may partially mediate the positive association. Our findings underscore the importance of optimizing greenness planning and management policies.
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Affiliation(s)
- Ye Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bai Ma Kang Zhuo
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; School of Medicine, Tibet University, Lhasa, Tibet, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Pei-Bin Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu-Ming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gong-Bo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Rui-Feng He
- Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China
| | - Zhi-Feng Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xue-Hui Zhang
- School of public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Zi-Yun Wang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, China
| | - Xuan Li
- Jianyang Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lei Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chun-Mei Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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12
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Lopes MB, Lyra AC, Rocha R, Coqueiro FG, Lima CA, de Oliveira CC, Santana GO. Overweight and abdominal fat are associated with normal bone mineral density in patients with ulcerative colitis. World J Gastrointest Pharmacol Ther 2022; 13:57-66. [PMID: 36051180 PMCID: PMC9297289 DOI: 10.4292/wjgpt.v13.i4.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/27/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Low bone mineral density (BMD) is common in patients with inflammatory bowel disease. However, nutritional risk factors for low BMD in the ulcerative colitis (UC) population are still poorly understood.
AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.
METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis. A control group consisting of healthy volunteers, family members, and close people was also included. The nutritional indicators evaluated were body mass index (BMI), total body mass (TBM), waist circumference (WC), body fat in kg (BFkg), body fat in percentage (BF%), trunk BF (TBF), and also lean mass. Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.
RESULTS The sociodemographic characteristics of patients with UC (n = 68) were similar to those of healthy volunteers (n = 66) (P > 0.05). Most patients (97.0%) were in remission of the disease, 58.8% were eutrophic, 33.8% were overweight, 39.0% had high WC, and 67.6% had excess BF%. However, mean BMI, WC, BFkg, and TBF of UC patients were lower when compared to those of the control group (P < 0.05). Reduced BMD was present in 41.2% of patients with UC (38.2% with osteopenia and 2.9% with osteoporosis) and 3.0% in the control group (P < 0.001). UC patients with low BMD had lower BMI, TBM, and BFkg values than those with normal BMD (P < 0.05). Male patients were more likely to have low BMD (prevalence ratio [PR] = 1.86; 95% confidence interval [CI]: 1.07-3.26). Those with excess weight (PR = 0.43; 95%CI: 0.19-0.97) and high WC (PR = 0.44; 95%CI: 0.21-0.94) were less likely to have low BMD.
CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases. Body fat appears to protect against the development of low BMD in these patients.
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Affiliation(s)
- Mirella Brasil Lopes
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Andre Castro Lyra
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Raquel Rocha
- Departamento Ciências da Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Fernanda Gomes Coqueiro
- Departamento Ciências da Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Carla Andrade Lima
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | | | - Genoile Oliveira Santana
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
- Departamento Ciências da Vida, Universidade do Estado da Bahia, Salvador 41.150-000, Brazil
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13
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Shu L, Fu Y, Sun H. The association between common serum adipokines levels and postmenopausal osteoporosis: A meta‐analysis. J Cell Mol Med 2022; 26:4333-4342. [PMID: 35791510 PMCID: PMC9344814 DOI: 10.1111/jcmm.17457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/09/2022] Open
Abstract
The clinical relevance of blood levels of adipokines in individuals with postmenopausal osteoporosis (PMOP) has not been previously clarified. We performed this meta‐analysis to clarify the association between three common adipokines levels and the occurrence of PMOP. PubMed, Embase, Cochrane library, and China National Knowledgement Infrastructure (CNKI) were searched for collecting articles published before 31 October 2021, without language and status restrictions. Fourteen studies met the selection criteria. Meta‐analysis revealed that blood leptin level was remarkably lower (mean difference [MD], −1.94; 95% confidence interval [CI], −3.83 to −0.06; I2 = 96%) and adiponectin level was remarkably higher (MD, 3.48; 95% CI, 2.36 to 4.60; I2 = 90%) in individuals with PMOP than healthy individuals with normal bone mineral density (BMD). However, the statistical difference in leptin level was changed after eliminating the confounding influence of leptin sources and assay approaches. Furthermore, a positive association (r = 0.28) between leptin level and body mass index (BMI) as well as a negative association (r = −0.33) between adiponectin level and BMD was found. Moreover, adiponectin had the highest probability of predicting PMOP (84%). Current evidence suggests that leptin positively affects BMI and adiponectin negatively affects BMD, and adiponectin is the most relevant adipokine negatively associated with PMOP.
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Affiliation(s)
- Linyuan Shu
- Department of Emergency Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
| | - Yimu Fu
- Department of Emergency Medicine Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
| | - Hui Sun
- Department of Orthopaedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
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14
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Effects of Dietary Protein Source and Quantity on Bone Morphology and Body Composition Following a High-Protein Weight-Loss Diet in a Rat Model for Postmenopausal Obesity. Nutrients 2022; 14:nu14112262. [PMID: 35684064 PMCID: PMC9183012 DOI: 10.3390/nu14112262] [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: 05/01/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/10/2022] Open
Abstract
Higher protein (>30% of total energy, HP)-energy restriction (HP-ER) diets are an effective means to improve body composition and metabolic health. However, weight loss (WL) is associated with bone loss, and the impact of HP-ER diets on bone is mixed and controversial. Recent evidence suggests conflicting outcomes may stem from differences in age, hormonal status, and the predominant source of dietary protein consumed. Therefore, this study investigated the effect of four 12-week energy restriction (ER) diets varying in predominate protein source (beef, milk, soy, casein) and protein quantity (normal protein, NP 15% vs. high, 35%) on bone and body composition outcomes in 32-week-old obese, ovariectomized female rats. Overall, ER decreased body weight, bone quantity (aBMD, aBMC), bone microarchitecture, and body composition parameters. WL was greater with the NP vs. HP-beef and HP-soy diets, and muscle area decreased only with the NP diet. The HP-beef diet exacerbated WL-induced bone loss (increased trabecular separation and endocortical bone formation rates, lower bone retention and trabecular BMC, and more rod-like trabeculae) compared to the HP-soy diet. The HP-milk diet did not augment WL-induced bone loss. Results suggest that specific protein source recommendations may be needed to attenuate the adverse alterations in bone quality following an HP-ER diet in a model of postmenopausal obesity.
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15
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López-Gómez JJ, Pérez-Castrillón JL, García de Santos I, Pérez-Alonso M, Izaola-Jauregui O, Primo-Martín D, De Luis-Román DA. Influence of Obesity on Bone Turnover Markers and Fracture Risk in Postmenopausal Women. Nutrients 2022; 14:nu14081617. [PMID: 35458178 PMCID: PMC9029584 DOI: 10.3390/nu14081617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/10/2022] Open
Abstract
Background and aims: The relationship between obesity and bone metabolism is controversial. In recent decades, the protective role of obesity in the development of osteoporosis is questioned. The aims of this study are the following: to evaluate the differences in bone turnover markers between postmenopausal women with and without obesity and to compare the risk of fracture at five years between these groups. Methods: An observational longitudinal prospective cohort study of postmenopausal women with obesity (O) (body mass index (BMI) > 30 kg/m2) and non-obesity (NoO) (BMI < 30 kg/m2) is designed. 250 postmenopausal women are included in the study (NoO: 124 (49.6%) and O: 126 (50.4%)). It measures epidemiological variables, dietary variables (calcium intake, vitamin D intake, smoking, alcohol consumption, and physical activity), biochemicals (β-crosslap, type I procollagen amino-terminal peptide (P1NP), 25OH-vitamin D, and parathyroid hormone (PTH)), anthropometric variables, and fracture data five years after the start of the study. The mean age is 56.17 (3.91) years. Women with obesity showed lower levels of vitamin D (O: 17.27 (7.85) ng/mL, NoO: 24.51 (9.60) ng/mL; p < 0.01), and higher levels of PTH (O: 53.24 (38.44−65.96) pg/mL, NoO: 35.24 (25.36−42.40) pg/mL; p < 0.01). Regarding the bone formation marker (P1NP), it was found to be high in women without obesity, O: 45.46 (34.39−55.16) ng/mL, NoO: 56.74 (45.34−70.74) ng/mL; p < 0.01; the bone resorption marker (β-crosslap) was found to be high in women with obesity, being significant in those older than 59 years (O: 0.39 (0.14) ng/mL, NoO 0.24 (0.09) ng/mL; p < 0.05). No differences are observed in the risk of fracture at 5 years based on BMI (OR = 0.90 (95%CI 0.30−2.72); p = 0.85). Conclusions: Postmenopausal women with obesity showed lower levels of bone formation markers; older women with obesity showed higher markers of bone resorption.
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Affiliation(s)
- Juan J. López-Gómez
- Department of Endocrinology and Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain; (J.L.P.-C.); (M.P.-A.)
- Correspondence:
| | - José L. Pérez-Castrillón
- Centro de Investigación Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain; (J.L.P.-C.); (M.P.-A.)
- Department of Internal Medicine, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain
| | | | - María Pérez-Alonso
- Centro de Investigación Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain; (J.L.P.-C.); (M.P.-A.)
| | - Olatz Izaola-Jauregui
- Department of Endocrinology and Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain; (J.L.P.-C.); (M.P.-A.)
| | - David Primo-Martín
- Department of Endocrinology and Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain; (J.L.P.-C.); (M.P.-A.)
| | - Daniel A. De Luis-Román
- Department of Endocrinology and Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (D.A.D.L.-R.)
- Centro de Investigación Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain; (J.L.P.-C.); (M.P.-A.)
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Paul E, Pant A, George S, Willson J, Meardon S, Vahdati A. In silicomodeling of tibial fatigue life in physically active males and females during different exercise protocols. Biomed Phys Eng Express 2022; 8. [PMID: 35393943 DOI: 10.1088/2057-1976/ac62ff] [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: 12/12/2021] [Accepted: 03/31/2022] [Indexed: 11/11/2022]
Abstract
Preventing bone stress injuries (BSI) requires a deep understanding of the condition's underlying causes and risk factors. Subject-specific computer modeling studies of gait mechanics, including the effect of changes in running speed, stride length, and landing patterns on tibial stress injury formation can provide essential insights into BSI prevention. This study aimed to computationally examine the effect of different exercise protocols on tibial fatigue life in male and female runners during prolonged walking and running at three different speeds. To achieve these aims, we combined subject-specific magnetic resonance imaging (MRI), gait data, finite element analysis, and a fatigue life prediction algorithm, including repair and adaptation's influence. The algorithm predicted a steep increase in the likelihood of developing a BSI within the first 40 days of activity. In five of the six subjects simulated, faster running speeds corresponded with higher tibial strains and higher probability of failure. Our simulations also showed that female subjects had a higher mean peak probability of failure in all four gait conditions than the male subjects studied. The approach used in this study could lay the groundwork for studies in larger populations and patient-specific clinical tools and decision support systems to reduce BSIs in athletes, military personnel, and other active individuals.
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Affiliation(s)
- Elliot Paul
- Department of Engineering, College of Engineering and Technology, East Carolina University, Greenville, NC, United States of America
| | - Anup Pant
- Department of Engineering, College of Engineering and Technology, East Carolina University, Greenville, NC, United States of America
| | - Stephanie George
- Department of Engineering, College of Engineering and Technology, East Carolina University, Greenville, NC, United States of America
| | - John Willson
- Department of Physical Therapy, College of Allied Health Sciences, East Carolina University, Greenville, NC, United States of America
| | - Stacey Meardon
- Department of Physical Therapy, College of Allied Health Sciences, East Carolina University, Greenville, NC, United States of America
| | - Ali Vahdati
- Department of Engineering, College of Engineering and Technology, East Carolina University, Greenville, NC, United States of America
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Auslander A, Liang MTC, Gavin J, Jo E, Rocha-Rangel J, Lin JH, Kwoh YL, Arnaud SB. Association between body mass index, bone bending strength, and BMD in young sedentary women. Osteoporos Int 2022; 33:673-683. [PMID: 34655302 DOI: 10.1007/s00198-021-06201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
UNLABELLED The rationale was to determine whether body mass index (BMI) is a predictor of bone bending strength and bone mineral density (BMD) in young sedentary women. Results show that BMI is not a predictor of bone bending strength and that young women with low BMI also have low BMD. INTRODUCTION The purpose of this study was to determine whether body mass index (BMI) is a predictor of tibial or ulnar bending strength and bone mineral density (BMD) in sedentary women. METHODS Sedentary women (n = 34), age 19-27 years, with low BMI (LBMI < 18.5 kg/m2, n = 16), and normal or high BMI (NHBMI between 18.5 and 29.9 kg/m2, n = 18) participated as study subjects. Study outcomes included tibial and ulnar bending strength (EI in Nm2) using a non-invasive mechanical response tissue analyzer (MRTA); BMD and bone mineral content (BMC) of the whole body (WB), femoral neck (FN), total hip (TH), lumbar spine 1-4 (LS1-4), and ulna; and bone turnover biomarkers. RESULTS The LBMI group have lower (p < 0.01) body weight [group difference (Δ) = 32.0%], lean mass (LM) (Δ = 23.1%), fat mass (FM) (Δ = 77.2%), and tibial bending strength (Δ = 22.0%), compared to the NHBMI. The LBMI group also have lower (all p < 0.025) BMC in WB (Δ = 19.9%), FN (Δ = 20.1%) and TH (Δ = 19.0%), compared to the NHMBI, not in BMD results. Multivariate regression analysis shows that significant predictors of tibial bending strength are tibia length (adjusted R2 = .341), age (adjusted R2 = .489), ulna BMD (adjusted R2 = .536), and LM (adjusted R2 = .580). BMI was positively correlated with tibial EI (p < 0.05), height, weight, FM, LM, body fat% (all p < 0.01), and BMD of WB, FN, TH, and LS 1-4 (p < 0.05 or < 0.01). CONCLUSIONS Our results show that BMI is not a significant predictor of tibial or ulnar bending strength in young sedentary women.
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Affiliation(s)
- A Auslander
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91765, USA
| | - M T C Liang
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91765, USA.
| | - J Gavin
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91765, USA
| | - E Jo
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91765, USA
| | - J Rocha-Rangel
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91765, USA
| | - J-H Lin
- Department of Physical Education, National Pingtung University, Pingtung, Taiwan
| | - Y-L Kwoh
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA, 91765, USA
| | - S B Arnaud
- Life Science Division, NASA Ames Research Center, Moffett Field, Santa Clara, CA, USA
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Singh S, Singh V, Yadav A, Bansal A, Singh V, Verma S, Saxena S, Kirar V, Singh M, Kumar B. Impact of vegetarian and nonvegetarian dietary habits and age on body composition and bone mineral density of office workers. BLDE UNIVERSITY JOURNAL OF HEALTH SCIENCES 2022. [DOI: 10.4103/bjhs.bjhs_8_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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One week of high-fat overfeeding alters bone metabolism in healthy males: A pilot study. Nutrition 2022; 96:111589. [DOI: 10.1016/j.nut.2022.111589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/11/2021] [Accepted: 12/29/2021] [Indexed: 11/19/2022]
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20
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Mele C, Caputo M, Ferrero A, Daffara T, Cavigiolo B, Spadaccini D, Nardone A, Prodam F, Aimaretti G, Marzullo P. Bone Response to Weight Loss Following Bariatric Surgery. Front Endocrinol (Lausanne) 2022; 13:921353. [PMID: 35873004 PMCID: PMC9301317 DOI: 10.3389/fendo.2022.921353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
Obesity is a global health challenge that warrants effective treatments to avoid its multiple comorbidities. Bariatric surgery, a cornerstone treatment to control bodyweight excess and relieve the health-related burdens of obesity, can promote accelerated bone loss and affect skeletal strength, particularly after malabsorptive and mixed surgical procedures, and probably after restrictive surgeries. The increase in bone resorption markers occurs early and persist for up to 12 months or longer after bariatric surgery, while bone formation markers increase but to a lesser extent, suggesting a potential uncoupling process between resorption and formation. The skeletal response to bariatric surgery, as investigated by dual-energy X-ray absorptiometry (DXA), has shown significant loss in bone mineral density (BMD) at the hip with less consistent results for the lumbar spine. Supporting DXA studies, analyses by high-resolution peripheral quantitative computed tomography (HR-pQCT) showed lower cortical density and thickness, higher cortical porosity, and lower trabecular density and number for up to 5 years after bariatric surgery. These alterations translate into an increased risk of fall injury, which contributes to increase the fracture risk in patients who have been subjected to bariatric surgery procedures. As bone deterioration continues for years following bariatric surgery, the fracture risk does not seem to be dependent on acute weight loss but, rather, is a chronic condition with an increasing impact over time. Among the post-bariatric surgery mechanisms that have been claimed to act globally on bone health, there is evidence that micro- and macro-nutrient malabsorptive factors, mechanical unloading and changes in molecules partaking in the crosstalk between adipose tissue, bone and muscle may play a determining role. Given these circumstances, it is conceivable that bone health should be adequately investigated in candidates to bariatric surgery through bone-specific work-up and dedicated postsurgical follow-up. Specific protocols of nutrients supplementation, motor activity, structured rehabilitative programs and, when needed, targeted therapeutic strategies should be deemed as an integral part of post-bariatric surgery clinical support.
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Affiliation(s)
- Chiara Mele
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Chiara Mele,
| | - Marina Caputo
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Alice Ferrero
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Tommaso Daffara
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Beatrice Cavigiolo
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Daniele Spadaccini
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Antonio Nardone
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Unit of Pavia Institute, Pavia, and Neurorehabilitation of Montescano Institute, Montescano, PV, Italy
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Gianluca Aimaretti
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Paolo Marzullo
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Istituto Auxologico Italiano, IRCCS, Laboratory of Metabolic Research, S. Giuseppe Hospital, Piancavallo, Italy
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Wang H, Peng H, Zhang L, Gao W, Ye J. Novel Insight into the Relationship Between Muscle-Fat and Bone in Type 2 Diabetes Ranging from Normal Weight to Obesity. Diabetes Metab Syndr Obes 2022; 15:1473-1484. [PMID: 35586203 PMCID: PMC9109979 DOI: 10.2147/dmso.s364112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Decreased bone mineral density (BMD) is a common complication in individuals with type 2 diabetes mellitus (T2DM). Body weight, mainly consisting of muscle and fat, is the main determinant of BMD and fracture risks but does not accurately describe nutritional status. Most studies suggest that skeletal muscle mass (SMM) promotes BMD, while body fat mass (BFM) decreases BMD. However, the combined effect of SMM and BFM on BMD is elusive. Thus, the study aims to explore the combined effect of fat and muscle by the ratio index SMM/BFM on BMD in T2DM. METHODS BFM and SMM were measured by the bioelectrical impedance analysis (BIA) method among 593 T2DM individuals ranging from normal weight and obesity. BMD was analyzed by DXA. Novel non-linear generalized additive models (GAMs) were used as the statistical analysis method. RESULTS The results demonstrated that BMD T score/Z score of both femur and lumbar vertebrae were significantly higher and waist-hip ratio (WHR) was significantly lower in the high SMM/BFM group of both normal weight and overweight groups in T2DM individuals. Hence, SMM/BFM might be a good factor indicating BMD in different weight ranges. Additionally, the relationship between muscle fat and BMD was not linear. Notably, this correlation was not influenced by hyperglycemia in T2DM since different analytic models adjusted with the age, gender, BMI and HbA1c were adopted in this study. Furthermore, the impact of trunk fat (central, visceral fat most) and non-trunk fat (peripheral, the sum of subcutaneous limb fat most) on BMD was inconsistent. BMD presented unlimited reduction with trunk BFM increasing, while sustaining minimal diminishment with non-trunk BFM accumulation. CONCLUSION Our study provided a novel viewpoint relationship between muscle-fat and bone, and SMM/BFM might be a potential biomarker for bone health and clinical treatments of diabetes and related metabolic syndromes.
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Affiliation(s)
- Hui Wang
- Department of Endocrinology, Yancheng City No.6 People’s Hospital, Yancheng, Jiangsu Province, People’s Republic of China
| | - Huaiming Peng
- Department of Endocrinology, Yancheng City No.6 People’s Hospital, Yancheng, Jiangsu Province, People’s Republic of China
| | - Linlin Zhang
- Department of Endocrinology, Yancheng City No.6 People’s Hospital, Yancheng, Jiangsu Province, People’s Republic of China
| | - Wei Gao
- Department of Endocrinology, Yancheng City No.6 People’s Hospital, Yancheng, Jiangsu Province, People’s Republic of China
| | - Jingya Ye
- Department of Endocrinology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu, People’s Republic of China
- Correspondence: Jingya Ye, Department of Endocrinology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, People’s Republic of China, Tel +011-86-571-87783882, Fax +011-86-571-87022776, Email
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22
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Hong C, Choi S, Park M, Park SM, Lee G. Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses. J Cachexia Sarcopenia Muscle 2021; 12:2247-2258. [PMID: 34706399 PMCID: PMC8718033 DOI: 10.1002/jcsm.12850] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Obesity is protective of bone health; however, abdominal obesity is associated with a higher fracture risk. Little is known about whether body composition protects or adversely affects osteoporotic fractures because of practical issues regarding assessment tools. This study aimed to evaluate the association of predicted body composition with fracture risk to determine the distinctive and differing effects of muscle or fat mass on bone health outcomes in the general population. METHODS This population-based, longitudinal cohort study used 2009-2010 Korean National Health Insurance Service data and follow-up data from 1 January 2011 to 31 December 2013, to determine the incidence of osteoporotic fracture (total, spine, and non-spine) defined using the International Classification of Diseases, Tenth Revision codes. The study participants were aged ≥50 years (men, 158 426; women, 131 587). The predicted lean body mass index (pLBMI), appendicular skeletal muscle index (pASMI), and body fat mass index (pBFMI) were used to assess body composition, using anthropometric prediction equations. RESULTS Over a 3 year follow-up, we identified 2350 and 6175 fractures in men and women, respectively. The mean age of the participants was 60.2 ± 8.3 and 60.7 ± 8.4 years in men and women, respectively. In a multivariable-adjusted Cox proportional hazards regression model, increasing pLBMI or pASMI was significantly associated with a decreased risk of total fractures in men and women. When comparing individuals in the lowest pLBMI and pASMI (reference groups), men with the highest pLBMI and pASMI had adjusted hazard ratios of 0.63 [95% confidence interval (CI) 0.47-0.83] and 0.62 (95% CI 0.47-0.82), and women with the highest pLBMI and pASMI had adjusted hazard ratios of 0.72 (95% CI 0.60-0.85) and 0.71 (95% CI 0.60-0.85), respectively, for total fractures. The pBFMI had no significant association with total fractures in men or women. Regarding sex-specific or site-specific differences, the protective effects of the pLBMI and pASMI on fractures were greater in men and reduced the risk of spinal fractures. An increased pBFMI was associated with an increased risk of spinal fractures in women. CONCLUSIONS An increased pLBMI or pASMI was significantly associated with decreased total osteoporotic fracture risk; however, the pBFMI showed no statistically significant association. Muscle mass was more important than fat mass in preventing future osteoporotic fractures based on anthropometric prediction equations.
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Affiliation(s)
- Changbin Hong
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Minseon Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
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Rathnayake H, Lekamwasam S, Wickramatilake C, De Zoysa E, Lenora J. Age-related trends and reference intervals of cross-linked C-telopeptide of type I collagen and procollagen type I N-propeptide from a reference population of Sri Lankan adult women. Arch Osteoporos 2021; 16:164. [PMID: 34727246 DOI: 10.1007/s11657-021-01022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 10/06/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Refer ence values of bone turnover markers (BTMs) are determined by factors that are country-specific. In Sri Lanka, unavailability of BTM reference data has led to their non-use in management of osteoporosis. The results of this study can be used as reference data for women in Sri Lanka. INTRODUCTION This study was performed to establish age-related reference intervals for bone resorption marker; cross-linked C-telopeptide of type I collagen (CTX) and bone formation marker; procollagen type I N-propeptide (PINP) in a group of Sri Lankan adult women. METHODS Adult women (n = 347) aged 20-70 years were recruited using age-stratified random sampling technique and categorized into age groups by decades. Serum CTX and PINP concentration were measured using enzyme-linked immunosorbent assay (ELISA). The geometric mean (95% confidence interval) and 2.5th and 97.5th percentiles were calculated. ANOVA was used to compare the means between groups. RESULTS Mean CTX levels were relatively low and remained unchanged between 20 and 49 years. After the age of 49 years, mean CTXconcentration elevated significantly until the age of 70 years (43%, p < 0.001). Mean PINP concentrations were not significantly different between age categories (p > 0.05). Reference intervals of CTX and PINP were based on 2.5th and 97.5th percentile values. Reference intervals of CTX for the age groups of 20-29, 30-39, 40-49, 50-59, and 60-70 years were 0.19-0.97 ng/mL, 0.18-0.95 ng/mL, 0.20-1.29 ng/mL, 0.17-2.20 ng/mL, and 0.17-2.85 ng/mL respectively. Reference intervals of PINP for the same age groups were 118-810 pg/mL, 119-772 pg/mL, 116-645 pg/mL, 108-684 pg/mL, and 108-715 pg/mL respectively. CONCLUSION In Sri Lanka, bone turnover markers are not used in evaluating patients mainly due to lack of normative data. These values can be used as reference data for women in this age group.
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Affiliation(s)
- Hasanga Rathnayake
- Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
| | - Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | | - Eric De Zoysa
- Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.,Nuclear Medicine Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Janaka Lenora
- Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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Obesity and Bone Loss at Menopause: The Role of Sclerostin. Diagnostics (Basel) 2021; 11:diagnostics11101914. [PMID: 34679612 PMCID: PMC8534901 DOI: 10.3390/diagnostics11101914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 11/20/2022] Open
Abstract
Background. Peripheral fat tissue is known to positively influence bone health. However, evidence exists that the risk of non-vertebral fractures can be increased in postmenopausal women with obesity as compared to healthy controls. The role of sclerostin, the SOST gene protein product, and body composition in this condition is unknown. Methods. We studied 28 severely obese premenopausal (age, 44.7 ± 3.9 years; BMI, 46.0 ± 4.2 kg/m2) and 28 BMI-matched post-menopausal women (age, 55.5 ± 3.8 years; BMI, 46.1 ± 4.8 kg/m2) thorough analysis of bone density (BMD) and body composition by dual X-ray absorptiometry (DXA), bone turnover markers, sclerostin serum concentration, glucose metabolism, and a panel of hormones relating to bone health. Results. Postmenopausal women harbored increased levels of the bone turnover markers CTX and NTX, while sclerostin levels were non-significantly higher as compared to premenopausal women. There were no differences in somatotroph, thyroid and adrenal hormone across menopause. Values of lumbar spine BMD were comparable between groups. By contrast, menopause was associated with lower BMD values at the hip (p < 0.001), femoral neck (p < 0.0001), and total skeleton (p < 0.005). In multivariate regression analysis, sclerostin was the strongest predictor of lumbar spine BMD (p < 0.01), while menopausal status significantly predicted BMD at total hip (p < 0.01), femoral neck (p < 0.001) and total body (p < 0.05). Finally, lean body mass emerged as the strongest predictor of total body BMD (p < 0.01). Conclusions. Our findings suggest a protective effect of obesity on lumbar spine and total body BMD at menopause possibly through mechanisms relating to lean body mass. Given the mild difference in sclerostin levels between pre- and postmenopausal women, its potential actions in obesity require further investigation.
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Chaves Pereira de Holanda N, de Lima Carlos I, Chaves de Holanda Limeira C, Cesarino de Sousa D, Serra de Lima Junior FA, Telis de Vilela Araújo A, Peres Montenegro AC, Bandeira F. Fracture Risk After Bariatric Surgery: A Systematic Literature Review and Meta-Analysis. Endocr Pract 2021; 28:58-69. [PMID: 34563701 DOI: 10.1016/j.eprac.2021.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Bariatric surgery has undeniable benefits for cardiovascular and metabolic health, but it can result in negative effects on mineral and bone metabolism. This study aimed to review the current data on fractures after the main types of bariatric surgery. METHODS Therefore, a systematic review was performed using the electronic literature available in the databases LILACS, CENTRAL, Web of Science, Embase, and PubMed/MEDLINE, with results until January 2021. Keywords were descriptors for bariatric surgery or bariatric medicine or bariatrics or gastroplasty and bone or bones or bone fractures, referenced in all words of the text in the study. RESULTS The meta-analysis of observational studies and interventional trials showed that the risk of any type of fracture was higher in the surgical group than in the nonsurgical group (relative risk [RR], 1.20 [95% confidence interval {CI}, 1.15-1.26; P < .00001; Phetero < 0.000001; I2 = 94%], and RR, 1.16 [95% CI, 1.00-1.33; P = .04; Phetero = 0.27; I2 = 23%], respectively). It is worth noting that the included interventional studies have a low rating on the risk of bias assessment scales. Compared with those who underwent restrictive procedures, subjects had an increased fracture risk after malabsorptive procedures (RR, 0.49 [95% CI, 0.40-0.61; P < .00001); Phetero = 0.96; I2 = 0%). CONCLUSION We found that bariatric procedures are associated with an increased risk of fractures, especially the malabsorptive techniques.
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Affiliation(s)
- Narriane Chaves Pereira de Holanda
- Department of Endocrinology, Federal University of Paraiba, João Pessoa, Brazil; Post-Graduated Program in Health Sciences, University of Pernambuco Medical School, Recife, Brazil.
| | | | | | | | | | | | | | - Francisco Bandeira
- Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Brazil; Post-Graduated Program in Health Sciences, University of Pernambuco Medical School, Recife, Brazil
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Maïmoun L, Renard E, Humbert L, Aouinti S, Mura T, Boudousq V, Lefebvre P, Mahadea K, Philibert P, de Santa-Barbara P, Avignon A, Guillaume S, Sultan A, Nocca D, Mariano-Goulart D. Modification of bone mineral density, bone geometry and volumetric BMD in young women with obesity. Bone 2021; 150:116005. [PMID: 33992821 DOI: 10.1016/j.bone.2021.116005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/15/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Most obese women with low-trauma fractures present normal areal bone mineral density (aBMD), suggesting that other bone parameters are more determinant for fracture risk in these patients. OBJECTIVES (i) Determine the effects of obesity in young women on areal bone mineral density (aBMD), bone geometry, strength, and volumetric BMD determined by advanced DXA-based methods; (ii) model the profiles of bone parameters for each population with age; and (iii) determine the factors related to body composition (i.e. lean tissue mass and fat mass) potentially implicated in the "bone adaptation" in the femoral region. SUBJECTS AND METHODS Two hundred and twenty adolescent and young women from 18 to 35 years old were enrolled in this study: 128 patients with obesity and 92 age-matched (±6 months) normal-weight controls. aBMD was determined with DXA, whereas hip geometry and strength parameters were assessed by hip structural analysis (HSA) and volumetric BMD by 3D-SHAPER® software. RESULTS Compared with controls, subjects with obesity presented significantly higher aBMD at all bone sites, but the difference was greater at hip compared with lumbar spine or radius. Bone size estimates (i.e. cortical thickness), as well as strength estimates (i.e. cross-sectional area) were higher at all femoral subregions including femoral neck, intertrochanteric region and femoral shaft in young women with obesity. In whole proximal femur and all femoral compartments, vBMD was also higher in subjects with obesity, but the difference between groups was greater for cortical vBMD compared with trabecular vBMD. When hip bone parameters were modelled for each group from individual values, maximal values were reached between 20 and 26 years in both groups but, whatever the age, subjects with obesity presented higher values than controls. In both groups, lean body mass (LBM) was the parameter most positively associated with the greatest number of bone parameters studied. CONCLUSION Our study confirmed that young women with obesity presented higher aBMD, better hip geometry and greater strength compared with normal-weight controls. Additionally, cortical and trabecular compartments measured by 3D-SHAPER® were favourably and concomitantly modified. However, it remains to be demonstrated whether the evaluation of these new parameters would provide better prediction of fracture risk in this population than aBMD.
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Affiliation(s)
- Laurent Maïmoun
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.
| | - Eric Renard
- Departement d'Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France; CIC INSERM 1001, Hôpital Gui de Chauliac, CHRU Montpellier, Montpellier cedex 5, France; Institut de Génomique Fonctionnelle, CNRS UMR 5203/INSERM U661/Université Montpellier, Montpellier, France
| | | | - Safa Aouinti
- Unité de Recherche Clinique et Epidémiologie, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | - Thibault Mura
- Unité de Recherche Clinique et Epidémiologie, Hôpital Carémeau, CHRU Nîmes, Nîmes, France
| | - Vincent Boudousq
- Département de Médecine Nucléaire, Hôpital Carémeau, CHRU Nîmes, Nîmes, France
| | - Patrick Lefebvre
- Departement d'Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | | | - Pascal Philibert
- Département de Biochimie et d'Hormonologie, Hôpital Carémeau, CHRU Nîmes, Nîmes, France
| | | | - Antoine Avignon
- Département Endocrinologie, Nutrition, Diabète, Equipe Nutrition, Diabète, CHRU Montpellier, Montpellier, France
| | - Sébastien Guillaume
- Département d'Urgence et Post-Urgence Psychiatrique, Hôpital Lapeyronie, CHRU Montpellier, UMI, INSERM U1061, 34295 Montpellier, France
| | - Ariane Sultan
- Département Endocrinologie, Nutrition, Diabète, Equipe Nutrition, Diabète, CHRU Montpellier, Montpellier, France
| | - David Nocca
- Département de Chirurgie Digestive, Hôpital St Eloi, CHRU Montpellier, Montpellier, France
| | - Denis Mariano-Goulart
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
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The Effect of Endurance and Endurance-Strength Training on Bone Mineral Density and Content in Abdominally Obese Postmenopausal Women: A Randomized Trial. Healthcare (Basel) 2021; 9:healthcare9081074. [PMID: 34442211 PMCID: PMC8391265 DOI: 10.3390/healthcare9081074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 01/21/2023] Open
Abstract
The optimal type of exercise that simultaneously decreases body weight and preserves bone health in people with obesity is unknown. This parallel randomized trial aimed to compare the effect of endurance and endurance-strength training on bone mineral density (BMD) and content (BMC) in abdominally obese postmenopausal women. A total of 101 women were recruited and randomly assigned to endurance or endurance-strength training groups. Participants trained for 60 min per day, three times per week for 12 weeks. The endurance exercises were performed at an intensity of 50–75% of the maximum heart rate, whereas the strength exercises were at 50–60% of the one-repetition maximum. Pre- and post-intervention BMD and BMC of the total body, lumbar spine, and femoral neck and physical capacity were measured. There were no differences among the densitometric parameters in the endurance group, but a significant increase in whole-body BMD in the endurance-strength group was found. Moreover, there was a significant difference between the groups in the changes in the lumbar spine BMC. Furthermore, both training programs significantly improved physical capacity with no differences between groups. Endurance training was more effective in maintaining BMC at the lumbar spine. However, both groups did not differ in effect on BMD. Further studies with a long-term follow-up should be considered to confirm these findings. The study was registered with the German Clinical Trials Register within the number DRKS00019832, and the date of registration was 26 February 2020 (retrospective registration).
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McMichan L, Dick M, Skelton DA, Chastin SFM, Owen N, Dunstan DW, Fraser WD, Tang JCY, Greig CA, Agyapong-Badu S, Mavroeidi A. Sedentary behaviour and bone health in older adults: a systematic review. Osteoporos Int 2021; 32:1487-1497. [PMID: 33768342 DOI: 10.1007/s00198-021-05918-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Older adults spend more than 8 h/day in sedentary behaviours. Detrimental effects of sedentary behaviour (SB) on health are established, yet little is known about SB and bone health (bone mineral density; BMD) in older adults. The purpose of this review is to examine associations of SB with BMD in older adults. Five electronic databases were searched: Web of Science (Core Collection); PubMed; EMBASE; Sports Medicine and Education and PsycInfo. Inclusion criteria were healthy older adults mean age ≥ 65 years; measured SB and measured BMD using dual-energy X-ray absorptiometry. Quality was assessed using National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. After excluding duplicates 17813 papers were assessed; 17757 were excluded on title/abstract, 49 at full text, resulting in two prospective and five cross-sectional observational studies reviewed. Four were rated 'good' and three were rated 'fair' using the quality assessment criteria. Findings varied across the studies and differed by gender. In women, four studies reported significant positive associations of SB with BMD at different sites, and two found significant negative associations. Five studies which examined both men and women, men reported negative or no associations of SB with femoral neck, pelvic, whole body, spine or leg BMD. Whilst these findings suggest differences between men and women in the associations of SB with BMD, they may be due to the varying anatomical sections examined for BMD, the different methods used to measure SB, the varied quality of the studies included and the limited number of published findings.
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Affiliation(s)
- L McMichan
- Department of Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.
| | - M Dick
- Department of Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - D A Skelton
- Centre for Living, Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - S F M Chastin
- Centre for Living, Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Science, Ghent University, Ghent, Belgium
| | - N Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Centre for Urban Transitions, Swinburne University, Melbourne, Australia
| | - D W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - W D Fraser
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J C Y Tang
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C A Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - S Agyapong-Badu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - A Mavroeidi
- Department of Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Abstract
Obesity has previously been thought to protect bone since high body weight and body mass index are associated with high bone mass. However, some more recent studies suggest that increased adiposity negatively impacts bone mass. Here, we aimed to test whether acute loss of adipose tissue, via adipocyte apoptosis, alters bone mass in age-related obese mice. Adipocyte apoptosis was induced in obese male FAT-ATTAC mice through AP20187 dimerizer-mediated activation of caspase 8 selectively in adipocytes. In a short-term experiment, dimerizer was administered to 5.5 month-old mice that were terminated 2 weeks later. At termination, the total fat mass weighed 58% less in dimerizer-treated mice compared with vehicle-treated controls, but bone mass did not differ. To allow for the detection of long-term effects, we used 9-month-old mice that were terminated six weeks after dimerizer administration. In this experiment, the total fat mass weighed less (− 68%) in the dimerizer-treated mice than in the controls, yet neither bone mass nor biomechanical properties differed between groups. Our findings show that adipose tissue loss, despite the reduced mechanical loading, does not affect bone in age-related obese mice. Future studies are needed to test whether adipose tissue loss is beneficial during more severe obesity.
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Cherukuri L, Kinninger A, Birudaraju D, Lakshmanan S, Li D, Flores F, Mao SS, Budoff MJ. Effect of body mass index on bone mineral density is age-specific. Nutr Metab Cardiovasc Dis 2021; 31:1767-1773. [PMID: 33934946 DOI: 10.1016/j.numecd.2021.02.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Obesity and osteoporosis are two important and growing public health problems worldwide. Body mass index (BMI) has been found to be inversely related to the risk of osteoporotic fracture. We aimed to assess the association of BMI with thoracic vertebral bone mineral density (BMD) measured from a quantitative computed tomography (QCT). METHODS AND RESULTS We retrospectively evaluated the data from 15,758 consecutive patients (5675 females and 10,083 males) between age 20-90 years, who underwent Coronary Artery Calcium (CAC) scoring. Quantitative data analyses of thoracic trabecular BMD (mg/cm3) was performed with a phantom system or phantomless using validated software. The gender-specific subgroup was divided based on age (<45, 45-55, 55-65, >65 yrs in females; <40,40-60,>60 yrs in Males) and weight by BMI (kg/m2) as < 25 (normal or low weight), >25 - <30 (overweight) and >30 (obesity). Analysis of variance (ANOVA) and Scheffe's post hoc procedure tested the association of body weight/BMI on BMD. A significant positive association between the body weight and BMD existed in obese population in elder groups in both genders (p < 0.05). There was no significant difference in BMD in 40-60 years in men and <55 years in women with normal or low weight compared to overweight or obese cohorts. CONCLUSIONS We concluded that the effect of weight on BMD is age-specific and the BMD should be monitored routinely with a cardiac CT scan in the senile population.
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Affiliation(s)
- Lavanya Cherukuri
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - April Kinninger
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Divya Birudaraju
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Suvasini Lakshmanan
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Dong Li
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Ferdinand Flores
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Song S Mao
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Matthew J Budoff
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA, USA.
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Jung YW, Hong N, Kim CO, Kim HC, Youm Y, Choi JY, Rhee Y. The diagnostic value of phase angle, an integrative bioelectrical marker, for identifying individuals with dysmobility syndrome: the Korean Urban-Rural Elderly study. Osteoporos Int 2021; 32:939-949. [PMID: 33128075 DOI: 10.1007/s00198-020-05708-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/20/2020] [Indexed: 12/25/2022]
Abstract
UNLABELLED Low phase angle, a non-invasive bioimpedance marker, is associated with elevated odds of dysmobility syndrome and its components. Phase angle (estimated cutoffs: < 4.8° in men; < 4.5° in women) can be used to detect dysmobility syndrome in community-dwelling older adults as a simple, integrative screening tool. INTRODUCTION Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs. METHODS In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance. RESULTS Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002). CONCLUSION Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.
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Affiliation(s)
- Y W Jung
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - N Hong
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - C O Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H C Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y Youm
- Department of Sociology, Yonsei University, Seoul, Korea
| | - J -Y Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Y Rhee
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
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Valentini A, Perrone MA, Cianfarani MA, Tarantino U, Massoud R, Merra G, Bernardini S, Morris HA, Bertoli A. Obesity, vitamin D status and physical activity: 1,25(OH)2D as a potential marker of vitamin D deficiency in obese subjects. Panminerva Med 2021; 62:83-92. [PMID: 32515572 DOI: 10.23736/s0031-0808.20.03770-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obesity has been regarded to be protective against fracture in spite of its association with low levels of vitamin D. Vitamin D is the key regulator of bone metabolism and its deficiency contributes to higher level of parathyroid hormone (PTH), leading to the activation of bone turnover. METHODS We studied 161 subjects of which 65 were young healthy subjects and 96 were elderly subjects. We measured creatinine, 25(OH)D, 1,25(OH)2D, PTH, albumin, and calcium plasma levels, we evaluated physical activity, and we calculated BMI. A sub-cohort of elderly subjects also underwent DXA scans. RESULTS Overweight and obese subjects, as well as underweight ones, had lower levels of vitamin D but normal serum concentrations of 1,25(OH)2D and PTH was higher in underweight and obese subjects. Moreover, we found a nonlinear relationship between body mass index (BMI) and PTH with a significant U-shaped exponential regression. Regardless of BMI, 25(OH)D mean levels were higher in subjects who practice physical activity. CONCLUSIONS These findings suggest that physical activity and BMI had a significant effect on the metabolism of bone and vitamin D, but the effect of BMI was different in underweight, normal weight or obese subjects. In obesity the real vitamin D deficiency could be estimate by serum 1,25(OH)2D concentrations whose lower levels contribute to the higher PTH production and consequently to bone loss and to a greater fracture risk.
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Affiliation(s)
| | - Marco A Perrone
- Division of Cardiology, Tor Vergata University, Rome, Italy - .,University Sports Center, Tor Vergata University, Rome, Italy
| | | | - Umberto Tarantino
- Department of Orthopedics and Traumatology, Tor Vergata University, Rome, Italy
| | - Renato Massoud
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Giuseppe Merra
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Sergio Bernardini
- University Sports Center, Tor Vergata University, Rome, Italy.,Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Howard A Morris
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Aldo Bertoli
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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Mitchell A, Fall T, Melhus H, Wolk A, Michaëlsson K, Byberg L. Is the effect of Mediterranean diet on hip fracture mediated through type 2 diabetes mellitus and body mass index? Int J Epidemiol 2021; 50:234-244. [PMID: 33367703 PMCID: PMC7938512 DOI: 10.1093/ije/dyaa239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND We examined whether the inverse association between adherence to a Mediterranean diet and hip fracture risk is mediated by incident type 2 diabetes mellitus (T2DM) and body mass index (BMI). METHODS We included 50 755 men and women from the Cohort of Swedish Men and the Swedish Mammography Cohort who answered lifestyle and medical questionnaires in 1997 and 2008 (used for calculation of the Mediterranean diet score 9mMED; low, medium, high) and BMI in 1997, and incident T2DM in 1997-2008). The cumulative incidence of hip fracture from the National Patient Register (2009-14) was considered as outcome. RESULTS We present conditional odds ratios (OR) 9[95% confidence interval, CI) of hip fracture for medium and high adherence to mMED, compared with low adherence. The total effect ORs were 0.82 (0.71, 0.95) and 0.75 (0.62, 0.91), respectively. The controlled direct effect of mMED on hip fracture (not mediated by T2DM, considering BMI as an exposure-induced confounder), calculated using inverse probability weighting of marginal structural models, rendered ORs of 0.82 (0.72, 0.95) and 0.73 (0.60, 0.88), respectively. The natural direct effect ORs (not mediated by BMI or T2DM, calculated using flexible mediation analysis) were 0.82 (0.71, 0.95) and 0.74(0.61, 0.89), respectively. The path-specific indirect and partial indirect natural effects ORs (through BMI or T2DM) were close to 1. CONCLUSIONS Mediterranean diet has a direct effect on hip fracture risk via pathways other than through T2DM and BMI. We cannot exclude mediating effects of T2DM or BMI, or that their effects cancel each other out.
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Affiliation(s)
- Adam Mitchell
- Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Håkan Melhus
- Department of Medical Sciences, Clinical Pharmacogenomics and Osteoporosis, Uppsala University, Uppsala, Sweden
| | - Alicja Wolk
- Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden
- Institute of Environmental Medicine, Cardiovascular and Nutritional Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden
| | - Liisa Byberg
- Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden
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Abstract
UNLABELLED In a large population-based study of Iran, the age-standardized prevalence of osteoporosis was 24.6% in men and 62.7% in women aged ≥ 60 years. Osteoporosis was negatively associated with body mass index in both sexes, and with diabetes in men and hypertriglyceridemia in women. PURPOSE Population aging has made osteoporosis and osteoporotic fractures an important health problem, especially in developing countries. This study aimed to explore the prevalence of osteoporosis and associated factors among the elderly population of the south-west of Iran. METHODS Baseline data of the second stage of the Bushehr Elderly Health program was used. Spinal, total hip, or femoral neck osteoporosis was described as a BMD that lies 2.5 standard deviations or more, below the average values of a young healthy adult in the lumbar spine, total hip, or femoral neck, respectively. Osteoporosis at either site was defined as total osteoporosis. Age-standardized prevalence of osteoporosis was estimated. We used the modified Poisson regression with a robust variance estimator to identify the factors related to osteoporosis, adjusting for potential confounders. RESULTS Overall, 2425 individuals (1166 men) aged over 60 years were included. In all, total osteoporosis was detected in 1006 (41.5%) of the participants. Using the reference value derived from Caucasian women aged 20-29 years, the age-standardized prevalence of total osteoporosis was 24.6 (95% CI: 21.9-27.3) in men, and 62.7 (95% CI: 60.0-65.4) in women. In men, osteoporosis was positively associated with age, smoking, history of fracture, and history of renal/liver diseases and negatively associated with body mass index (BMI) and diabetes. BMI, hypertriglyceridemia, and education were negatively correlated with osteoporosis in women, while years after menopause and history of fracture increased the likelihood of osteoporosis, significantly. CONCLUSION Results support the high prevalence of osteoporosis and osteopenia in the elderly population. Considering the importance of severe complications, especially fractures, comprehensive interventions should be expanded.
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Mohd Ramli ES, Sukalingam K, Kamaruzzaman MA, Soelaiman IN, Pang KL, Chin KY. Direct and Indirect Effect of Honey as a Functional Food Against Metabolic Syndrome and Its Skeletal Complications. Diabetes Metab Syndr Obes 2021; 14:241-256. [PMID: 33500644 PMCID: PMC7822078 DOI: 10.2147/dmso.s291828] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022] Open
Abstract
Metabolic syndrome (MetS) refers to the simultaneous presence of hypertension, hyperglycemia, dyslipidemia and/or visceral obesity, which predisposes a person to cardiovascular diseases and diabetes. Evidence suggesting the presence of direct and indirect associations between MetS and osteoporosis is growing. Many studies have reported the beneficial effects of polyphenols in alleviating MetS in in vivo and in vitro models through their antioxidant and anti-inflammation actions. This review aims to summarize the effects of honey (based on unifloral and multi-floral nectar sources) on bone metabolism and each component of MetS. A literature search was performed using the PubMed and Scopus databases using specific search strings. Original studies related to components of MetS and bone, and the effects of honey on components of MetS and bone were included. Honey polyphenols could act synergistically in alleviating MetS by preventing oxidative damage and inflammation. Honey intake is shown to reduce blood glucose levels and prevent excessive weight gain. It also improves lipid metabolism by reducing total cholesterol, triglycerides and low-density lipoprotein, as well as increasing high-density lipoprotein. Honey can prevent bone loss by reducing the adverse effects of MetS on bone homeostasis, apart from its direct action on the skeletal system. In conclusion, honey supplementation could be integrated into the management of MetS and MetS-induced bone loss as a preventive and adjunct therapeutic agent.
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Affiliation(s)
- Elvy Suhana Mohd Ramli
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Kumeshini Sukalingam
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Amir Kamaruzzaman
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Ima Nirwana Soelaiman
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Lun Pang
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
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Hong N, Lee DC, Khosla S, Keaveny TM, Rhee Y. Comparison of Vertebral and Femoral Strength Between White and Asian Adults Using Finite Element Analysis of Computed Tomography Scans. J Bone Miner Res 2020; 35:2345-2354. [PMID: 32750185 PMCID: PMC9260814 DOI: 10.1002/jbmr.4149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/20/2020] [Accepted: 07/30/2020] [Indexed: 11/09/2022]
Abstract
Given non-optimal testing rates for dual-energy X-ray absorptiometry (DXA) and the high use of computed tomography (CT) in some Asian countries, biomechanical computed tomography analysis (BCT)-based bone strength testing, which utilizes previously taken clinical CT scans, may improve osteoporosis testing rates. However, an understanding of ethnic differences in such bone strength measurements between Whites and Asians is lacking, which is an obstacle to clinical interpretation. Using previously taken CT and DXA scans, we analyzed bone strength and bone mineral density (BMD) at the hip and spine in two sex- and age-matched community-based cohorts, aged 40 to 80 years: Whites (Rochester, MN, USA) and Koreans (Seoul, South Korea). For both the spine and femur, the age dependence of bone strength was similar for both groups, White (n = 371; women n = 202, 54.5%) and Korean (n = 396; women n = 199, 50.3%). For both sexes, mean spine strength did not differ between groups, but femur strength was 9% to 14% higher in Whites (p ≤ 0.001), an effect that became non-significant after weight adjustment (p = 0.375). For Koreans of both sexes, the fragile bone strength thresholds for classifying osteoporosis, when derived from regional DXA BMD T-score references, equaled the clinically validated thresholds for Whites (in women and men, femoral strength, 3000 N and 3500 N; vertebral strength 4500 N and 6500 N, respectively). Using these thresholds, classifications for osteoporosis for Koreans based on bone strength versus based on DXA BMD T-scores were consistent (89.1% to 94.4% agreement) at both the hip and spine and for both sexes. The BCT-based, clinically validated bone strength thresholds for Whites also applied to Koreans, which may facilitate clinical interpretation of CT-based bone strength measurements for Koreans. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Namki Hong
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | | | - Sundeep Khosla
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Tony M Keaveny
- Departments of Mechanical Engineering and Bioengineering, University of California, Berkeley, CA, USA
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Nguyen HG, Pham MT, Ho-Pham LT, Nguyen TV. Lean mass and peak bone mineral density. Osteoporos Sarcopenia 2020; 6:212-216. [PMID: 33426311 PMCID: PMC7783218 DOI: 10.1016/j.afos.2020.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives The association between body composition parameters and peak bone mineral density is not well documented. The aim of this study is to assess the relative contributions of lean mass and fat mass on peak bone mineral density (BMD). Methods The study involved 416 women and 334 men aged between 20 and 30 years who were participants in the population-based Vietnam Osteoporosis Study. Whole body composition parameters (eg, fat mass and lean mass) and BMD at the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. The association between lean mass and fat mass and BMD was analyzed by the linear regression model using the Least Absolute Shrinkage and Selection Operator (LASSO). Results Peak BMD in men was higher than women, and the difference was more pronounced at the femoral neck (average difference: 0.123 g/cm2; 95% confidence interval [CI] 0.105–0.141 g/cm2) than at the lumbar spine (average difference 0.019 g/cm2; 95% CI, 0.005–0.036 g/cm2). Results of LASSO regression indicated that lean mass was the only predictor of BMD for either men or women. Each kilogram increase in lean mass was associated with ∼0.01 g/cm2 increase in BMD. Lean mass alone explained 16% and 36% of variation in lumbar spine and femoral neck BMD, respectively. Conclusions Lean mass, not fat mass, is the main determinant of peak bone mineral density. This finding implies that good physical activity during adulthood can contribute to the maximization of peak bone mass during adulthood.
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Affiliation(s)
- Huy G Nguyen
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Minh Td Pham
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Lan T Ho-Pham
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tuan V Nguyen
- School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia.,Garvan Institute of Medical Research, Sydney, Australia
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Moon HU, Lee N, Chung YS, Choi YJ. Reduction of visceral fat could be related to the improvement of TBS in diabetes mellitus. J Bone Miner Metab 2020; 38:702-709. [PMID: 32399674 DOI: 10.1007/s00774-020-01107-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes has been proposed as a risk factor for increased skeletal fragility. Visceral fat is known to yield adverse effects on bone metabolism in people with diabetes. We investigated the relationship between the change in visceral fat mass over time and TBS or BMD. MATERIALS AND METHODS This retrospective study enrolled 690 (male: 367; female: 323) subjects with type 2 diabetes mellitus. Visceral fat mass, lumbar and femoral neck BMD, and lumbar spine TBS were measured via dual-energy X-ray absorptiometry (DXA), including the follow-up data within a 3-year period. RESULTS TBS significantly increased as visceral fat mass decreased in both sexes (p < 0.001), whereas lumbar BMD and femoral neck BMD showed meaningful changes only in men. The multiple regression model with adjustment for age, weight, creatinine level, lipid profile, HbA1C, and status of osteoporosis medication use revealed that TBS and femoral neck BMD were correlated with visceral fat mass. However, regarding longitudinal changes, only the change in visceral fat mass had a significant relationship with TBS (males: β = - 0.298, p < 0.001; females: β = - 0.216, p < 0.001). CONCLUSIONS The results of this study may suggest the beneficial effect of controlling visceral fat mass on bone health in type 2 diabetes patients. Besides, DXA-derived TBS could be a useful diagnostic tool for evaluating the bone changes according to metabolic changes in type 2 diabetes, which are not entirely achieved with BMD.
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Affiliation(s)
- Hyun Uk Moon
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Nami Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea
| | - Yong Jun Choi
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, South Korea.
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Foll CL, Lutz TA. Systemic and Central Amylin, Amylin Receptor Signaling, and Their Physiological and Pathophysiological Roles in Metabolism. Compr Physiol 2020; 10:811-837. [PMID: 32941692 DOI: 10.1002/cphy.c190034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article in the Neural and Endocrine Section of Comprehensive Physiology discusses the physiology and pathophysiology of the pancreatic hormone amylin. Shortly after its discovery in 1986, amylin has been shown to reduce food intake as a satiation signal to limit meal size. Amylin also affects food reward, sensitizes the brain to the catabolic actions of leptin, and may also play a prominent role in the development of certain brain areas that are involved in metabolic control. Amylin may act at different sites in the brain in addition to the area postrema (AP) in the caudal hindbrain. In particular, the sensitizing effect of amylin on leptin action may depend on a direct interaction in the hypothalamus. The concept of central pathways mediating amylin action became more complex after the discovery that amylin is also synthesized in certain hypothalamic areas but the interaction between central and peripheral amylin signaling remains currently unexplored. Amylin may also play a dominant pathophysiological role that is associated with the aggregation of monomeric amylin into larger, cytotoxic molecular entities. This aggregation in certain species may contribute to the development of type 2 diabetes mellitus but also cardiovascular disease. Amylin receptor pharmacology is complex because several distinct amylin receptor subtypes have been described, because other neuropeptides [e.g., calcitonin gene-related peptide (CGRP)] can also bind to amylin receptors, and because some components of the functional amylin receptor are also used for other G-protein coupled receptor (GPCR) systems. © 2020 American Physiological Society. Compr Physiol 10:811-837, 2020.
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Affiliation(s)
- Christelle Le Foll
- Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
| | - Thomas A Lutz
- Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland
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40
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Pahk K, Kwon Y, Kim MK, Park S, Kim S. Visceral fat metabolic activity evaluated by 18F-FDG PET/CT is associated with osteoporosis in healthy postmenopausal Korean women. Obes Res Clin Pract 2020; 14:339-344. [PMID: 32561167 DOI: 10.1016/j.orcp.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/12/2020] [Accepted: 05/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Traditionally, obesity has been regarded as protective against osteoporosis. However, recent accumulating evidences suggest that visceral obesity can increase the risk of osteoporosis and obesity-driven dysfunctional metabolic activity in visceral adipose tissue (VAT) is considered as a key underlying mechanism. Visceral obesity is known to increase during menopausal transition.18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to assess the degree of VAT metabolic activity. We aimed to investigate the association between VAT metabolic activity evaluated by 18F-FDG PET/CT and osteoporosis in healthy postmenopausal Korean women. METHODS A total of 115 postmenopausal women who underwent routine health check-up were enrolled in this study, retrospectively. They all underwent dual-energy X-ray absorptiometry and 18F-FDG PET/CT. Osteoporosis was defined as bone mineral density (BMD) T-score ≤ -2.5 at either lumbar spine or femoral neck. VAT metabolic activity was defined as the maximum standardized uptake value (SUVmax) of VAT divided by the SUVmax of subcutaneous adipose tissue (V/S ratio). RESULTS The participants with osteoporosis showed significantly higher V/S ratio, age, body mass index, waist circumference, and postmenopausal period than the participants without osteoporosis. V/S ratio of 1.33 was proposed as an optimal cut-off value for identifying osteoporosis. Furthermore, V/S ratio was the most significant predictive factor for osteoporosis in postmenopausal woman by uni-and multivariate analyses. Interestingly, V/S ratio showed significant positive correlation with high sensitivity C-reactive protein, a surrogate marker for systemic inflammation. CONCLUSION VAT metabolic activity assessed by 18F-FDG PET/CT is associated with osteoporosis in healthy postmenopausal Korean women.
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Affiliation(s)
- Kisoo Pahk
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Yeongkeun Kwon
- Center for Obesity and Metabolic Disease, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Meyoung-Kon Kim
- Department of Medical Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sungsoo Park
- Center for Obesity and Metabolic Disease, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Sungeun Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.
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E Hassan N, El Shebini SM, Ahmed NH, A El-Masry S, Y El Sherity S, Rasheed EA, S El-Saeed G, Kamal AN. Dietary Pattern and Bone Health in Pre and Post-menopausal Obese Women. Pak J Biol Sci 2020; 23:602-611. [PMID: 32363816 DOI: 10.3923/pjbs.2020.602.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Obesity and osteoporosis are worldwide health problems that interact with each other. There are also affected by the menopause and dietary pattern. So, this study aimed to find the relation between osteoporosis, body weight and intake of protein, calcium and vitamin D in obese pre and post-menopausal women. MATERIALS AND METHODS One hundred and sixteen shared as volunteers in a cross-section study lasted for 2 years. They were divided into 2 groups, pre and post-menopausal women. All women were subjected to, clinical examination, anthropometric measurements and 24 dietary recalls. They were evaluated for bone mass density, biochemical analysis for serum lipids, calcium and vitamin D. RESULTS Osteopenia and osteoporosis were higher among normal-weight and overweight (non-obese) women compared to obese as well weakly associated with their serum lipids. The mean daily protein consumption was high as compared to recommended daily allowances (RDAs), especially among osteoporotic women. The mean daily intake of vitamin D and calcium was low as the lower level was noticed among the osteoporotic premenopausal patients. The means serum concentration of calcium and vitamin D were adequate. CONCLUSION Data revealed that the prevalence of osteoporosis was lower among obese patients compared to non-obese women. Inadequate daily dietary intake of calcium and vitamin D was reported, however, physiological compensation maintained their optimal normal serum levels.
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Lee JW, Cho HE, Kang SW, Choi WA, Suh MR, Kim B. Correlation of Bone Mineral Density with Pulmonary Function in Advanced Duchenne Muscular Dystrophy. PM R 2020; 13:166-170. [PMID: 32306557 DOI: 10.1002/pmrj.12386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND A relationship between bone mineral density (BMD) and physical function has been revealed in the general population and various diseases. However, there is a lack of research investigating the correlation between BMD and respiratory function, one of few measurable physical parameters in patients with advanced Duchenne muscular dystrophy (DMD). OBJECTIVE To determine whether pulmonary function parameters, including respiratory muscle strength, are related to BMD. DESIGN Retrospective observational study. SETTING A tertiary university hospital. PATIENTS DMD patients who were over 20 years of age, nonambulatory, and supported by mechanical ventilators. METHODS The patients' age, weight, and pulmonary function as well as the BMD of the first and the fourth lumbar vertebra were assessed. Pulmonary function includes forced vital capacity (FVC), unassisted and assisted peak cough flow (UPCF and APCF), maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP). MAIN OUTCOME MEASURES A bivariate correlation for BMD and other pulmonary parameters was calculated, and hierarchical regression analysis was used to determine predictors of spine Z-score. RESULTS It was observed that the decrease in the spine BMD was not significantly correlated with age. However, the body mass index (BMI) and all parameters of pulmonary function were correlated with BMD. Partial correlation analysis adjusted by BMI showed that UPCF and APCF were powerful predictors of spine BMD. CONCLUSIONS The BMD of the lumbar spine correlated with BMI and PCF in patients with DMD at an advanced stage.
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Affiliation(s)
- Jang Woo Lee
- Department of Medicine, The Graduate School, Yonsei University, Seoul, South Korea.,Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Han Eol Cho
- Department of Medicine, The Graduate School, Yonsei University, Seoul, South Korea.,Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, South Korea
| | - Seong-Woong Kang
- Department of Medicine, The Graduate School, Yonsei University, Seoul, South Korea.,Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, South Korea
| | - Won Ah Choi
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, South Korea
| | - Mi Ri Suh
- Department of Physical Medicine and Rehabilitation, CHA University, Seongnam, South Korea
| | - Bitnarae Kim
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, South Korea.,Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, South Korea
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Modification of Muscle-Related Hormones in Women with Obesity: Potential Impact on Bone Metabolism. J Clin Med 2020; 9:jcm9041150. [PMID: 32316563 PMCID: PMC7230770 DOI: 10.3390/jcm9041150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
Lean body mass (LBM) is a determinant of areal bone mineral density (aBMD) through its mechanical actions and quite possibly through its endocrine functions. The threefold aims of this study are: to determine the effects of obesity (OB) on aBMD and myokines; to examine the potential link between myokines and bone parameters; and to determine whether the effects of LBM on aBMD are mediated by myokines. aBMD and myokine levels were evaluated in relation to the body mass index (BMI) in 179 women. Compared with normal-weight controls (CON; n = 40), women with OB (n = 139) presented higher aBMD, myostatin and follistatin levels and lower irisin levels. Except for irisin levels, all differences between the OB and CON groups were accentuated with increasing BMI. For the whole population (n = 179), weight, BMI, fat mass (FM) and LBM were positively correlated with aBMD at all bone sites, while log irisin were negatively correlated. The proportion of the LBM effect on aBMD was partially mediated (from 14.8% to 29.8%), by log irisin, but not by follistatin or myosin. This study showed that myokine levels were greatly influenced by obesity. However, irisin excepted, myokines do not seem to mediate the effect of LBM on bone tissue.
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Maïmoun L, Garnero P, Mura T, Nocca D, Lefebvre P, Philibert P, Seneque M, Gaspari L, Vauchot F, Courtet P, Sultan A, Piketty ML, Sultan C, Renard E, Guillaume S, Mariano-Goulart D. Specific Effects of Anorexia Nervosa and Obesity on Bone Mineral Density and Bone Turnover in Young Women. J Clin Endocrinol Metab 2020; 105:5672712. [PMID: 31821467 DOI: 10.1210/clinem/dgz259] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/09/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The threefold aim was to (1) compare areal bone mineral density (aBMD), bone turnover markers, and periostin levels in young women with either anorexia nervosa (AN) or obesity (OB) and controls (CON); (2) model the profiles according to age; and (3) determine the parameters associated with aBMD. SUBJECTS AND METHODS One hundred and fifty-two young women with ages ranging from 16.0 to 27.0 years were subdivided into 3 groups (AN, OB, CON). The CON group was age-matched by ±6 months. aBMD, bone turnover markers, and periostin levels were evaluated. RESULTS aBMD modeling showed that hip aBMD was higher in OB than in the other 2 groups from 19 years, and AN presented lower values than CON from 21 years. aBMD at the lumbar spine was higher in older OB and CON women, starting from 20 to 22 years, but in AN the difference with the other 2 groups increased with age. Periostin levels were lower in OB than in AN or CON, but no variation with age was observed. Compared with controls, OB and AN presented similarly lower markers of bone formation, although markers of bone resorption were lower in OB and higher in AN. A modeling approach showed that markers of bone formation and resorption were lower in older than in younger CON, whereas the values of these bone markers remained relatively constant in AN and OB. In all groups, lean body mass (LBM) was the parameter most positively correlated with aBMD. CONCLUSION This study demonstrated that weight extremes (AN or OB) influence aBMD, bone remodeling and periostin profiles. Moreover, factors related to aBMD were specific to each condition, but LBM was the parameter most consistently associated with aBMD.
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Affiliation(s)
- Laurent Maïmoun
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France
- PhyMedExp, Université de Montpellier (UM), INSERM, CNRS, Montpellier, France
| | | | - Thibault Mura
- Unité de Recherche Clinique et Epidémiologie, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | - David Nocca
- Département de Chirurgie Digestive, Hôpital St Eloi, CHRU Montpellier
| | - Patrick Lefebvre
- Departement d'Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | - Pascal Philibert
- Departement de Biochimie et d'Hormonologie, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | - Maude Seneque
- Département d'Urgence et Post-Urgence Psychiatrique, Hôpital Lapeyronie, CHRU Montpellier, UM, INSERM U1061, Montpellier, France
| | - Laura Gaspari
- Unité d'Endocrinologie et Gynécologie Pédiatrique, Département de Pédiatrie, Hôpital Arnaud de Villeneuve, CHRU Montpellier et UM, Montpellier, France
| | - Fabien Vauchot
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France
| | - Philippe Courtet
- Département d'Urgence et Post-Urgence Psychiatrique, Hôpital Lapeyronie, CHRU Montpellier, UM, INSERM U1061, Montpellier, France
| | - Ariane Sultan
- PhyMedExp, Université de Montpellier (UM), INSERM, CNRS, Montpellier, France
- Département Endocrinologie, Nutrition, Diabète; Equipe Nutrition, Diabète, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | | | - Charles Sultan
- Unité d'Endocrinologie et Gynécologie Pédiatrique, Département de Pédiatrie, Hôpital Arnaud de Villeneuve, CHRU Montpellier et UM, Montpellier, France
| | - Eric Renard
- Departement d'Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
- CIC INSERM 1001, Hôpital Gui de Chauliac, CHRU Montpellier, France
- Institut de Génomique Fonctionnelle, CNRS UMR 5203/INSERM U661/UM, Montpellier, France
| | - Sébastien Guillaume
- Département d'Urgence et Post-Urgence Psychiatrique, Hôpital Lapeyronie, CHRU Montpellier, UM, INSERM U1061, Montpellier, France
| | - Denis Mariano-Goulart
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France
- PhyMedExp, Université de Montpellier (UM), INSERM, CNRS, Montpellier, France
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Sarcopenia negatively affects hip structure analysis variables in a group of Lebanese postmenopausal women. BMC Bioinformatics 2020; 21:86. [PMID: 32164524 PMCID: PMC7068911 DOI: 10.1186/s12859-020-3353-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The current study's purpose is to compare hip structural analysis variables in a group of postmenopausal women with sarcopenia and another group of postmenopausal women with normal skeletal muscle mass index. To do so, the current study included 8 postmenopausal women (whose ages ranged between 65 and 84 years) with sarcopenia and 60 age-matched controls (with normal skeletal muscle mass index (SMI)). Body composition and bone parameters were evaluated by dual-energy X-ray absorptiometry (DXA). RESULTS Weight, lean mass, body mass index, femoral neck cross-sectional area (FN CSA), FN section modulus (Z), FN cross sectional moment of inertia (CSMI), intertrochanteric (IT) CSA, IT Z, IT CSMI, IT cortical thickness (CT), femoral shaft (FS) CSA, FS Z and FS CSMI were significantly greater (p < 0.05) in women with normal SMI compared to women with sarcopenia. In the whole population, SMI was positively associated with IT CSA, IT Z, IT CSMI, IT CT, FS CSA, FS Z, FS CSMI, FS CT but negatively correlated to IT buckling ratio (BR) and FS BR. CONCLUSION The current study suggests that sarcopenia has a negative effect on hip bone strength indices in postmenopausal women.
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Associations of Weight-Adjusted Body Fat and Fat Distribution with Bone Mineral Density in Chinese Children Aged 6-10 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051763. [PMID: 32182741 PMCID: PMC7084411 DOI: 10.3390/ijerph17051763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/25/2020] [Accepted: 03/06/2020] [Indexed: 02/07/2023]
Abstract
Although obesity is considered osteoprotective, the effects of body fat and fat distribution on bone tissue after adjusting for the effects of body weight remain uncertain. This study evaluated the relationships between fat mass, fat distribution, and bone mineral status beyond its weight-bearing effect. We recruited 466 children aged 6–10 years in China. Dual-energy X-ray absorptiometry was used to determine the bone mineral density (BMD) and bone mineral content (BMC) in the total body and total body less head (TBLH), as well as the fat mass (FM) and percentage fat mass (%FM) of the total and segmental body. Weight-adjusted measures of FM and %FM were derived using the residual method. After adjusting for the effects of covariates, we observed statistically significant, dose-dependent negative relationships between the TBLH·BMD/BMC and various weight-adjusted measures of body fat (p for trend: <0.001–0.038). For each standard deviation increment in the weight-adjusted total body, TBLH, trunk and limbs, the size-adjusted BMC decreased approximately 9.44, 9.28, 8.13, and 6.65 g in boys, respectively, and by approximately 13.74, 13.71, 7.84, and 12.95 g in girls, respectively. Significant inverse associations between FM accumulation in the total body and most body parts with the BMD/BMC were observed in both boys and girls after adjusting for weight and potential confounders.
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Armamento-Villareal R, Aguirre L, Waters DL, Napoli N, Qualls C, Villareal DT. Effect of Aerobic or Resistance Exercise, or Both, on Bone Mineral Density and Bone Metabolism in Obese Older Adults While Dieting: A Randomized Controlled Trial. J Bone Miner Res 2020; 35:430-439. [PMID: 31797417 PMCID: PMC7064383 DOI: 10.1002/jbmr.3905] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/14/2019] [Accepted: 10/19/2019] [Indexed: 12/21/2022]
Abstract
Weight loss therapy of older adults with obesity is limited by weight loss-induced decrease in bone mineral density (BMD), which could exacerbate ongoing age-related bone loss and increase the risk for fractures. Therefore, it is recommended that weight loss therapy of older adults with obesity should include an intervention such as regular exercise to reduce the concomitant bone loss. However, the most appropriate exercise types to combine with weight loss therapy in this older population is unknown. In a randomized controlled trial, we performed a head-to-head comparison of aerobic or resistance exercise, or both, during matched ~10% weight loss in 160 older adults with obesity. We measured changes in BMD (total hip, femoral neck, trochanter, intertrochanter, one-third radius, lumbar spine) and bone markers. Changes between groups were analyzed using mixed-model repeated measures analyses of variance. After 6 months of intensive lifestyle interventions, BMD decreased less in the resistance group (-0.006 g/cm2 [-0.7%]) and combination group (-0.012 g/cm2 [-1.1%]) than in the aerobic group (-0.027 g/cm2 [-2.6%]) (p = 0.001 for between-group comparisons). Serum C-telopeptide, procollagen type 1 N-propeptide, and osteocalcin concentrations increased more in the aerobic group (33%, 16%, and 16%, respectively) than in the resistance group (7%, 2%, and 0%, respectively) and combination group (11%, 2%, and 5%, respectively) (p = 0.004 to 0.048 for between-group comparisons). Multiple regression analyses revealed that the decline in whole body mass and serum leptin were the independent predictors of the decline in hip BMD (multiple R = 0.45 [p < .001]). These findings indicate that compared with aerobic exercise, resistance and combined aerobic and resistance exercise are associated with less weight loss-induced decrease in hip BMD and less weight loss-induced increase in bone turnover. Therefore, both resistance and combined aerobic and resistance exercise can be recommended to protect against bone loss during weight loss therapy of older adults with obesity. (LITOE ClinicalTrials.gov number NCT01065636.) © 2019 American Society for Bone and Mineral Research. Published 2019. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Reina Armamento-Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA.,Center for Translational Research on Inflammatory Diseases (CTRID), Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - Lina Aguirre
- Medicine Care Line, New Mexico VA Health Care System, Albuquerque, NM, USA.,Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Debra L Waters
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.,Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Nicola Napoli
- Division of Bone and Mineral Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Clifford Qualls
- Department of Mathematics and Statistics, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA.,Center for Translational Research on Inflammatory Diseases (CTRID), Michael E DeBakey VA Medical Center, Houston, TX, USA
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48
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Qiao D, Li Y, Liu X, Zhang X, Qian X, Zhang H, Zhang G, Wang C. Association of obesity with bone mineral density and osteoporosis in adults: a systematic review and meta-analysis. Public Health 2020; 180:22-28. [PMID: 31837611 DOI: 10.1016/j.puhe.2019.11.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/02/2019] [Accepted: 11/04/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Results from previous studies investigating the association of obesity with bone mineral density (BMD) and osteoporosis (OP) are inconsistent. The purpose of the present study was to examine whether obesity is associated with BMD and the risk of OP. STUDY DESIGN This is a meta-analysis. METHODS A computerised literature search was conducted using the PubMed, Web of Science, China National Knowledge Internet (CNKI) (Chinese) and Wanfang (Chinese) databases for relevant articles published in English or Chinese before the end of December 2017. Means with standard deviations and odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were computed to estimate the association between obesity and BMD and the risk of OP by using a random-effects model. In addition, a heterogeneity test and sensitivity analysis were conducted. RESULTS Adults with obesity had higher BMD than healthy-weight subjects in both the lumbar spine and femoral neck measurement sites. Obesity was positively related to BMD in the two sites, with merged weighted mean difference (WMD) of 0.07 g/cm2 in the lumbar spine (95% CI: 0.045, 0.095; P < 0.001; Pheterogeneity <0.001; I2 = 89.1%) and WMD of 0.087 g/cm2 in the femoral neck (95% CI: 0.063, 0.112; P < 0.001; Pheterogeneity <0.001; I2 = 92.8%). General obesity was negatively related to femoral neck OP, indicating that obesity is a protective factor for OP, with a merged OR of 0.169 (95% CI: 0.132, 0.216; P < 0.001; Pheterogeneity = 0.716; I2 = 0.0%). CONCLUSIONS Adults with obesity had significantly higher BMD than healthy-weight adults. Obesity was positively associated with BMD and negatively correlated with OP.
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Affiliation(s)
- D Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Y Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - X Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - X Qian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - H Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - G Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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49
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Association Between Muscular Strength and Bone Health from Children to Young Adults: A Systematic Review and Meta-analysis. Sports Med 2020; 50:1163-1190. [DOI: 10.1007/s40279-020-01267-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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50
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Asli IN, Sheikhnezami M, Qutbi M, Farsad F, Asli SN, Ranji S, Karami M. Less influence of body mass index on bone mineral density of radius as compared to proximal femur: Possible role in the diagnosis of osteoporosis. World J Nucl Med 2020; 19:118-123. [PMID: 32939198 PMCID: PMC7478315 DOI: 10.4103/wjnm.wjnm_39_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/20/2019] [Indexed: 12/21/2022] Open
Abstract
It has been shown that body mass index (BMI) and obesity may affect the mineral density of bones, regionally on weight-bearing bones or systemically through hormones and cytokines. The objective of this study was to evaluate the effect of BMI on bone mineral density (BMD) of the radius. In this cross-sectional study, 260 patients, 233 postmenopausal women and 27 men over 50, were included who underwent a bone densitometry scanning using dual-energy X-ray absorptiometry after obtaining an informed consent. The scanning was performed in three areas (i.e., spine, proximal femur, and radius), then densitometric data (BMD, T- and Z-score) were extracted. Regression analysis was performed to evaluate the effect of independent variables of age, gender, and BMI on the BMD of the above regions. By grouping the patients in two categories (BMI <25 as normal or underweight and BMI >25 as overweight and obese), the discordance in the diagnosis following the inclusion of radius into interpretation (diagnosis based on 2 vs. 3 areas), was assessed by an agreement test. The study is approved by the ethics committee of the university. Of 260 participants in the present study, mean and standard deviation for age were 61.48 ± 8.95 for all patients, 65.81 ± 10.59 for male and 60.98 ± 8.62 for women. An increasing effect of BMI was found to be statistically significant in weight-bearing areas (total femur and femoral neck) and BMI increase was not associated with increased BMD of radius. An agreement test between two diagnoses is used that showed a discordance of 28.5% in diagnosis (diagnosis based on 2 vs. 3 areas) with a kappa coefficient of 0.547 (P = 0.001). In total, 25.4% was minor discordance and 3.1% was major discordance. Based on the results of this study, it is concluded that the BMI is not associated with increased BMD in bones that are not weight bearing, such as radius. Therefore, it may be preferred to include the densitometric data of radius into the diagnosis.
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Affiliation(s)
- Isa Neshandar Asli
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Sheikhnezami
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Qutbi
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faraneh Farsad
- Department of Rheumatology, Loghman Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadaf Neshandar Asli
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahla Ranji
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Karami
- Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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