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Wiles CC, Suh SH, Brown KR, Abel RL. The ontogeny of human fetal trabecular bone architecture occurs in a limb-specific manner. Sci Rep 2024; 14:20261. [PMID: 39217219 PMCID: PMC11365959 DOI: 10.1038/s41598-024-67566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 07/12/2024] [Indexed: 09/04/2024] Open
Abstract
Gestational growth and development of bone is an understudied process compared to soft tissues and has implications for lifelong health. This study investigated growth and development of human fetal limb bone trabecular architecture using 3D digital histomorphometry of microcomputed tomography data from the femora and humeri of 35 skeletons (17 female and 18 male) with gestational ages between 4 and 9 months. Ontogenetic data revealed: (i) fetal trabecular architecture is similar between sexes; (ii) the proximal femoral metaphysis is physically larger, with thicker trabeculae and greater bone volume fraction relative to the humerus, but other aspects of trabecular architecture are similar between the bones; (iii) between 4 and 9 months gestation there is no apparent sexual or limb dimorphism in patterns of growth, but the size of the humerus and femur diverges early in development. Additionally, both bones exhibit significant increases in mean trabecular thickness (and for the femur alone, bone volume fraction) but minimal trabecular reorganisation (i.e., no significant changes in degree of anisotropy, connectivity density, or fractal dimension). Overall, these data suggest that in contrast to data from the axial skeleton, prenatal growth of long bones in the limbs is characterised by size increase, without major reorganizational changes in trabecular architecture.
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Affiliation(s)
- Crispin Charles Wiles
- MSk Laboratory, Sir Michael Uren Hub, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W12 7ED, UK.
- Centre for Blast Injury Studies, Department of Bioengineering, Faculty of Engineering, Imperial College London, London, SW7 2AZ, UK.
- Warwick Medical School, University of Warwick, Coventry, CV4 8JE, UK.
| | - Sarah Holly Suh
- MSk Laboratory, Sir Michael Uren Hub, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W12 7ED, UK
| | - Katharine Robson Brown
- Jean Golding Institute for Data Science, University of Bristol, Bristol, BS8 IUU, UK
- School of Engineering, University of Bristol, Bristol, BS8 1UU, UK
- Department of Mechanical Engineering, University of Bristol, Bristol, BS8 1UB, UK
| | - Richard Leslie Abel
- MSk Laboratory, Sir Michael Uren Hub, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, W12 7ED, UK
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Abdelkarim O, El-Gyar N, Shalaby AM, Aly M. The Effects of a School-Based Physical Activity Program on Physical Fitness in Egyptian Children: A Pilot Study from the DELICIOUS Project. CHILDREN (BASEL, SWITZERLAND) 2024; 11:842. [PMID: 39062291 PMCID: PMC11276202 DOI: 10.3390/children11070842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the "Be Fit Program" aims to increase the level of physical fitness among Egyptian school-aged children. This study explores the effectiveness of a structured, six-week physical activity (PA) program in improving various facets of physical fitness in children, including body composition, speed, coordination, muscular strength, and cardiovascular endurance. With the increasing prevalence of sedentary lifestyles, such efforts are imperative to improve overall health outcomes. METHODS A cohort of 125 children, aged 8.50 to 12.25 y (mean age 10.19 ± 1.03 y), participated in the study. Their body composition, speed, coordination, strength, and aerobic fitness were assessed before and after the Be Fit Program using the revised International Physical Performance Test Profile. Paired t-tests were used to detect changes between the pre- and post-tests. RESULTS Following the six-week intervention, statistical analyses revealed significant improvements in coordination and lower body strength (p < 0.01). Aerobic endurance showed marginal improvements, approaching statistical significance (p = 0.06). Conversely, there were no statistically significant changes in body composition, speed, or upper body strength (p > 0.05). CONCLUSIONS The study confirms that tailored, non-competitive physical activities can positively influence specific fitness components in Egyptian children. However, achieving holistic improvements across all targeted fitness domains may require further strategic adjustments or a longer program duration. This pilot study underscores the importance of culturally tailored, school-based PA programs and highlights the continued need for research and program refinement to comprehensively improve children's fitness in the Egyptian context.
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Affiliation(s)
- Osama Abdelkarim
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt
| | - Noha El-Gyar
- Department of Pediatric, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Amira M. Shalaby
- Department of Pediatric, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed Aly
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt
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Park TH, Lin JH, Chung CH, Zheng Z, Li C. The skeletal and dental age advancements of children and adolescents with overweight and obesity: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 164:325-339. [PMID: 37367707 DOI: 10.1016/j.ajodo.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Over the past decades, a trend of increasing obesity among children has emerged. This study aimed to evaluate and summarize the impacts of overweight and obesity on children's and adolescents' skeletal and dental developmental advancement that may influence orthodontic management. METHODS Registered with the Prospective Register of Systematic Reviews (registration no. CRD42022347488), this study complies with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Particularly, relevant original studies on skeletal or dental age evaluation were screened from accessible electronic databases and supplemented by hand-searching. Meta-analysis was recruited to calculate differences (and their 95% confidence interval [CI]) between subjects with overweight or obese and normal-weight counterparts. RESULTS After applying the inclusion and exclusion criteria, 17 articles were selected for the final review. Two of the 17 selected studies were found to have a high risk of bias and moderate the other 15. A meta-analysis detected no statistically significant difference in skeletal age between children and adolescents with overweight and normal-weight counterparts (P = 0.24). However, the dental age of children and adolescents with overweight was found to be 0.49 years (95% CI, 0.29-0.70) advanced in comparison with normal-weight counterparts (P <0.00001). In contrast, children and adolescents with obesity were found to have advanced skeletal age by 1.17 (95% CI, 0.48-1.86) years (P = 0.0009) and dental age by 0.56 (95% CI, 0.37-0.76) years (P <0.00001) compared with their normal-weight counterparts. CONCLUSION Because the orthopedic outcomes of the orthodontic intervention are closely tied to the skeletal age of the patients, these results suggest that the orthodontic evaluation and treatment of children and adolescents with obesity might occur earlier than that of the normal-weight population.
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Affiliation(s)
- Tiffany H Park
- School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Jia-Hong Lin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Zhong Zheng
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif.
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa.
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Meng Z, Zhou D, Lv D, Gan Q, Liao Y, Peng Z, Zhou X, Xu S, Chi P, Wang Z, Nüssler AK, Yang X, Liu L, Deng D, Yang W. Human milk extracellular vesicles enhance muscle growth and physical performance of immature mice associating with Akt/mTOR/p70s6k signaling pathway. J Nanobiotechnology 2023; 21:304. [PMID: 37644475 PMCID: PMC10463453 DOI: 10.1186/s12951-023-02043-6] [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: 06/05/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Extracellular vesicles (EVs) play an important role in human and bovine milk composition. According to excellent published studies, it also exerts various functions in the gut, bone, or immune system. However, the effects of milk-derived EVs on skeletal muscle growth and performance have yet to be fully explored. Firstly, the current study examined the amino acids profile in human milk EVs (HME) and bovine milk EVs (BME) using targeted metabolomics. Secondly, HME and BME were injected in the quadriceps of mice for four weeks (1 time/3 days). Then, related muscle performance, muscle growth markers/pathways, and amino acids profile were detected or measured by grip strength analysis, rotarod performance testing, Jenner-Giemsa/H&E staining, Western blotting, and targeted metabolomics, respectively. Finally, HME and BME were co-cultured with C2C12 cells to detect the above-related indexes and further testify relative phenomena. Our findings mainly demonstrated that HME and BME significantly increase the diameter of C2C12 myotubes. HME treatment demonstrates higher exercise performance and muscle fiber densities than BME treatment. Besides, after KEGG and correlation analyses with biological function after HME and BME treatment, results showed L-Ornithine acts as a "notable marker" after HME treatment to affect mouse skeletal muscle growth or functions. Otherwise, L-Ornithine also significantly positively correlates with the activation of the AKT/mTOR pathway and myogenic regulatory factors (MRFs) and can also be observed in muscle and C2C12 cells after HME treatment. Overall, our study not only provides a novel result for the amino acid composition of HME and BME, but the current study also indicates the advantage of human milk on skeletal muscle growth and performance.
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Affiliation(s)
- Zitong Meng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Dong Zhou
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, 745 Wuluo Road, Wuhan, 430000, China
- Department of Critical Care Medicine, Maternal and Child Health Hospital of Hubei Province, 745 Wuluo Road, Wuhan, 430000, China
| | - Dan Lv
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Quan Gan
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, 745 Wuluo Road, Wuhan, 430000, China
- Department of Critical Care Medicine, Maternal and Child Health Hospital of Hubei Province, 745 Wuluo Road, Wuhan, 430000, China
| | - Yuxiao Liao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Zhao Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Xiaolei Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Shiyin Xu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Penglong Chi
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Zhipeng Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Andreas K Nüssler
- Department of Traumatology, BG Trauma Center, University of Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China
| | - Dongrui Deng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Wei Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China.
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, China.
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Proctor KB, Rodrick E, Belcher S, Sharp WG, Kindler JM. Bone health in avoidant/restrictive food intake disorder: a narrative review. J Eat Disord 2023; 11:44. [PMID: 36949522 PMCID: PMC10031860 DOI: 10.1186/s40337-023-00766-3] [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: 08/23/2022] [Accepted: 03/03/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Avoidant/restrictive food intake disorder (ARFID) is an eating/feeding disturbance characterized by severe food avoidance or restriction that results in faltering growth, nutritional deficiencies, dependence on formula supplementation, and/or significant psychosocial impairment. Compared to other eating disorders, ARFID is observed to have an earlier childhood onset and chronic course without intervention. Childhood represents a sensitive period for longitudinal growth and bone accrual, setting the stage for long-term health outcomes associated with longevity and quality of life, including risk for fracture and osteoporosis. RESULTS This narrative review discusses published scientific literature on bone health in individuals with ARFID by describing the current understanding of ARFID's effect on bone health, how common dietary constraints characteristic of ARFID may present unique risks to bone health, and the current clinical recommendations for bone health assessment. Reviewing what is known of clinical data from anorexia nervosa (AN) and similar cohorts, the chronicity and etiology of dietary restriction observed in ARFID are hypothesized to compromise bone health significantly. Although limited, examination of bone health in ARFID patients suggests children with ARFID tend to have shorter stature compared to healthy reference datasets and have lower bone density compared to healthy individuals, similar to those with AN. There remains a substantial knowledge gap in how ARFID may interrupt bone accrual during childhood and adolescence, and subsequent impact on attainment of peak bone mass and peak bone strength. The longitudinal effects of ARFID may be subtle and overlooked clinically in the absence of severe weight loss or growth stunting. Early identification and remediation of threats to bone mass accrual have significant personal and population-level implications. CONCLUSION For patients with ARFID, delayed identification and intervention to address feeding disturbances may have a long-lasting impact on various body systems and processes, including those relating to longitudinal growth and bone mass accrual. Further research employing rigorous prospective observational and/or randomized study designs are required to clearly define effects of ARFID, as well as clinical interventions aimed at addressing ARFID-related feeding disturbances, on bone accrual.
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Affiliation(s)
- Kaitlin B. Proctor
- Emory University School of Medicine and Children’s Healthcare of Atlanta, Athens, GA USA
| | - Eugene Rodrick
- Department of Nutritional Sciences, University of Georgia, Room 279 Dawson Hall, 305 Sanford Drive, Athens, GA 30606 USA
| | - Staci Belcher
- Department of Nutritional Sciences, University of Georgia, Room 279 Dawson Hall, 305 Sanford Drive, Athens, GA 30606 USA
| | - William G. Sharp
- Emory University School of Medicine and Children’s Healthcare of Atlanta, Athens, GA USA
| | - Joseph M. Kindler
- Department of Nutritional Sciences, University of Georgia, Room 279 Dawson Hall, 305 Sanford Drive, Athens, GA 30606 USA
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Sahai A, Jones DL, Hughes M, Pu A, Williams K, Iyer SR, Rathinam C, Davis DL, Lovering RM, Gilotra MN. Fibroadipogenic progenitor cell response peaks prior to progressive fatty infiltration after rotator cuff tendon tear. J Orthop Res 2022; 40:2743-2753. [PMID: 35239216 PMCID: PMC9440165 DOI: 10.1002/jor.25321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023]
Abstract
Fibroadipogenic progenitor (FAP) cells are implicated as a major source of fatty infiltration (FI) in murine rotator cuff (RC) injury, but FAP cell response after RC tear in a rabbit model is unknown. This study determined whether changes in FAP cell count after an RC tear predate muscle degeneration in a clinically relevant rabbit model. We hypothesized increases in FAP cell count correlate temporally with RC degeneration. New Zealand white rabbits (n = 26) were evaluated at 1, 2, 4, and 6 weeks after unilateral full-thickness tenotomy of supraspinatus and infraspinatus tendons. FI area and adipocyte size were histologically analyzed, muscle density was measured by computerized tomography, and quantification of FAP cells was measured by flow cytometry and immunohistochemistry. The percentage of intrafascicular adipocyte area increased over time in supraspinatus muscle samples (p = 0.03), significantly between 1- and 6-week samples (p = 0.04). There were no differences in perifascicular adipocyte area percentages between time points. Peak increase in FAP cell count occurred at 1-week (p = 0.03), with a decrease in the following weeks. There was a negative correlation between supraspinatus adipocyte area and FAP cell count (p < 0.05). On computed tomography (CT) scan, maximal decrease in muscle density was observed in the 4th to 6th weeks. In summary, FAP cell response occurred early after tenotomy and did not correlate temporally with increases in FI. This suggests that FAP cell response may predate degenerative changes, and early targeting of FAPs before adipocyte maturation could blunt FI after RC tear.
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Affiliation(s)
- Amil Sahai
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Derek L. Jones
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Marcus Hughes
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Alex Pu
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Katrina Williams
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Shama R. Iyer
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Chozha Rathinam
- Department of Immunology, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Derik L. Davis
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Richard M. Lovering
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
| | - Mohit N. Gilotra
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Baltimore, USA
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Ahmed I, Amarnani R, Fisher C. The metabolic crossroad of the adolescent athlete: achieving peak bone mass during athletic development. Br J Sports Med 2022; 56:1330-1331. [PMID: 35902209 DOI: 10.1136/bjsports-2022-105685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Irfan Ahmed
- Sports Medicine Department, Homerton University Hospital, London, UK
| | - Raj Amarnani
- Sports Medicine Department, Imperial College Healthcare NHS Trust, London, UK
| | - Corinne Fisher
- Adolescent Rheumatology Department, University College London Hospitals NHS Foundation Trust, London, UK
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Kindler JM, Guo M, Baker J, McCormack S, Armenian SH, Zemel BS, Leonard MB, Mostoufi-Moab S. Persistent Musculoskeletal Deficits in Pediatric, Adolescent and Young Adult Survivors of Allogeneic Hematopoietic Stem-Cell Transplantation. J Bone Miner Res 2022; 37:794-803. [PMID: 35080067 DOI: 10.1002/jbmr.4513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/08/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a common therapy for pediatric hematologic malignancies. With improved supportive care, addressing treatment-related late effects is at the forefront of survivor long-term health and quality of life. We previously demonstrated that alloHSCT survivors had increased adiposity, decreased lean mass, and lower bone density and strength, 7 years (median) from alloHSCT compared to their healthy peers. Yet it is unknown whether these deficits persist. Our longitudinal study characterized changes in muscle and bone over a period of 3.4 (range, 2.0 to 4.9) years in 47 childhood alloHSCT survivors, age 5-26 years at baseline (34% female). Tibia cortical bone geometry and volumetric density and lower leg muscle cross-sectional area (MCSA) were assessed via peripheral quantitative computed tomography (pQCT). Anthropometric and pQCT measurements were converted to age, sex, and ancestry-specific standard deviation scores, adjusted for leg length. Muscle-specific force was assessed as strength relative to MCSA adjusted for leg length (strength Z-score). Measurements were compared to a healthy reference cohort (n = 921), age 5-30 years (52% female). At baseline and follow-up, alloHSCT survivors demonstrated lower height Z-scores, weight Z-scores, and leg length Z-scores compared to the healthy reference cohort. Deficits in MCSA, trabecular volumetric bone density, and cortical bone size and estimated strength (section modulus) were evident in survivors (all p < 0.05). Between the two study time points, anthropometric, muscle, and bone Z-scores did not change significantly in alloHSCT survivors. Approximately 15% and 17% of alloHSCT survivors had MCSA and section modulus Z-score < -2.0, at baseline and follow-up, respectively. Furthermore, those with a history of total body irradiation compared to those without demonstrated lower MCSA at follow-up. The persistent muscle and bone deficits in pediatric alloHSCT survivors support the need for strategies to improve bone and muscle health in this at-risk population. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Joseph M Kindler
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michelle Guo
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Joshua Baker
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.,Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shana McCormack
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Saro H Armenian
- Department of Pediatrics, City of Hope, Duarte, CA, USA.,Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mary B Leonard
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Sogol Mostoufi-Moab
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Cossio-Bolanos M, Vidal-Espinoza R, Fuentes-Lopez J, Castelli Correia de Campos LF, Andruske CL, Urra-Albornoz C, Alvear Vasquez F, Gomez-Campos R. Reference values for bone density and bone mineral content from 5 to 80 years old in a province of Chile. PeerJ 2022; 10:e13092. [PMID: 35345584 PMCID: PMC8957281 DOI: 10.7717/peerj.13092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/18/2022] [Indexed: 01/12/2023] Open
Abstract
Background The assessment of bone health throughout the life cycle is essential to determine fracture risk. The objectives of the work were (a) compare bone mineral density and content with international references from the United States, (b) determine maximum bone mass, (c) propose references for bone health measurements from ages 5 to 80 years old. Methods Research was carried out on 5,416 subjects. Weight and height were measured. Body Mass Index (BMI) was calculated. The total body was scanned using dual energy X-ray absorptiometry (DXA). Information was extracted from the bone health measures (bone mineral density (BMD) and bone mineral content (BMC)) for both sexes, according to pediatric and adult software. Results and Discussion Differences were identified between the mean values of Chilean and American men for BMD (~0.03 to 0.11 g/cm2) and BMC (~0.15 to 0.46 g). Chilean females showed average values for BMD similar to the US references (~-0.01 to 0.02 g/cm2). At the same time, they were relatively higher for BMC (~0.07 to 0.33 g). The cubic polynomial regression model reflected a relationship between BMD and BMC with chronological age in both sexes. For males, R2 was higher (R2 = 0.72 and 0.75) than for females (R2 = 0.59 and 0.66). The estimate of maximum bone mass (MBM) for males emerged at 30 years old (1.45 ± 0.18 g/cm2 of BMD and 3.57 ± 0.60 g of BMC) and for females at age 28 (1.22 ± 0.13 g/cm2 of BMD and 2.57 ± 0.44 g of BMC). The LMS technique was used to generate smoothed percentiles for BMD and BMC by age and sex. Results showed that maximum bone mass occurred in females at age 28 and in males at 30. Reference values obtained from this research may be used to evaluate bone health, diagnose bone fragility and osteoporosis in individuals and regional population groups.
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Affiliation(s)
- Marco Cossio-Bolanos
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Maule, Talca, Chile
| | | | - Jose Fuentes-Lopez
- Instituto de Investigación en Ciencias de la Educación (IICE), Escuela Profesional de Educación Física, Universidad Nacional del Altiplano de Puno, Puno, Perú
| | | | | | - Camilo Urra-Albornoz
- Escuela de Ciencias del Deporte y Actividad Física, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | | | - Rossana Gomez-Campos
- Departamento de Diversidad e Inclusividad Educativa, Universidad Católica del Maule, Talca, Chile
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10
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Kindler J, Zhan D, Sattler ELP, Ishikawa Y, Chen X, Gallo S. Bone density in youth with prediabetes: results from the National Health and Nutrition Examination Survey, 2005-2006. Osteoporos Int 2022; 33:467-474. [PMID: 34523010 DOI: 10.1007/s00198-021-06148-2] [Citation(s) in RCA: 2] [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: 05/05/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
UNLABELLED Youth with type 2 diabetes might have suboptimal peak bone mass, but it is unknown whether similar effects are evident in youth with prediabetes. Results from this study suggest that diabetes-related effects on peak bone mass likely occur before disease onset, and involve the muscle-bone unit. INTRODUCTION Type 2 diabetes might adversely influence bone health around the age of peak bone mass, but it is unknown whether diabetes-related effects on areal bone mineral density (aBMD) are evident in youth with prediabetes. We compared age-related trends in aBMD and associations between lean body mass (LBM) and aBMD between children and adolescents with prediabetes vs. normal glucose regulation. METHODS Cross-sectional analysis of data from the National Health and Nutrition Examination Survey (2005-2006) in youth ages 12-20 years (49% female, 34% black) with prediabetes (n = 267) and normal glucose regulation (n = 1664). Whole body aBMD and LBM were assessed via DXA. LBM index (LBMI) and Z-scores for aBMD and LBMI were computed. RESULTS Unadjusted between-group comparisons revealed greater mean weight and LBMI Z-scores in youth with prediabetes vs. normal glucose regulation, but similar bone Z-scores between the two groups. While accounting for differences in BMI Z-score, there was a significant interaction between prediabetes status and age with respect to whole body aBMD Z-score (P < 0.05), such that children with prediabetes tended to have increased aBMD but adolescents and young adults with prediabetes tended have lower aBMD. Furthermore, the positive association between LBMI and whole body aBMD was moderated in youth with prediabetes (P < 0.001), who had slightly lower whole body aBMD for a given LBMI (P = 0.068). Lumbar spine bone measures did not differ between the two groups. CONCLUSIONS Type 2 diabetes-related threats to peak bone mass might occur prior to disease onset, therefore potentially impacting a considerable proportion of US youth.
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Affiliation(s)
- J Kindler
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA.
| | - D Zhan
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - E L P Sattler
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, USA
| | - Y Ishikawa
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
| | - X Chen
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - S Gallo
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
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11
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Baronio F, Baptista F. Editorial: Bone health and development in children and adolescents. Front Endocrinol (Lausanne) 2022; 13:1101403. [PMID: 36578952 PMCID: PMC9791941 DOI: 10.3389/fendo.2022.1101403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Federico Baronio
- Department Hospital of Woman and Child, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- *Correspondence: Federico Baronio,
| | - Fátima Baptista
- Department of Sport and Health, CIPER - Centro Interdisciplinar do Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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12
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Chang CY, Arasu K, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM, Chee WSS. Factors associated with bone health status of Malaysian pre-adolescent children in the PREBONE-Kids Study. BMC Pediatr 2021; 21:382. [PMID: 34479539 PMCID: PMC8414720 DOI: 10.1186/s12887-021-02842-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent (N = 243) Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ physical activity questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results The mean calcium intake was 349 ± 180 mg/day and mean serum 25(OH)D level was 43.9 ± 14.5 nmol/L. In boys, lean mass (LM) was a significant predictor of LSBMC (β = 0.539, p < 0.001), LSBMD (β = 0.607, p < 0.001), TBBMC (β = 0.675, p < 0.001) and TBBMD (β = 0.481, p < 0.01). Height was a significant predictor of LSBMC (β = 0.346, p < 0.001) and TBBMC (β = 0.282, p < 0.001) while fat mass (FM) (β = 0.261, p = 0.034) and physical activity measured as MET scores (β = 0.163, p = 0.026) were significant predictors of TBBMD in boys. Among girls, LM was also a significant predictor of LSBMC (β = 0.620, p < 0.001), LSBMD (β = 0.700, p < 0.001), TBBMC (β = 0.542, p < 0.001) and TBBMD (β = 0.747, p < 0.001). Calcium intake was a significant predictor of LSBMC (β = 0.102, p = 0.034), TBBMC (β = 0.122, p < 0.001) and TBBMD (β = 0.196, p = 0.002) in girls. Conclusions LM was the major determinant of BMC and BMD among pre-adolescent Malaysian children alongside other modifiable lifestyle factors such as physical activity and calcium intake.
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Affiliation(s)
- Chung Yuan Chang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Kanimolli Arasu
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Soon Yee Wong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Shu Hwa Ong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Wai Yew Yang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Megan Hueh Zan Chong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Negeri Sembilan, 70300, Seremban, Malaysia
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Negeri Sembilan, 70300, Seremban, Malaysia
| | - Karuthan Chinna
- Faculty of Health & Medical Sciences, School of Medicine, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
| | | | - Winnie Siew Swee Chee
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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13
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Mendiola AJP, LaSalle JM. Epigenetics in Prader-Willi Syndrome. Front Genet 2021; 12:624581. [PMID: 33659026 PMCID: PMC7917289 DOI: 10.3389/fgene.2021.624581] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/18/2021] [Indexed: 11/16/2022] Open
Abstract
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder that affects approximately 1 in 20,000 individuals worldwide. Symptom progression in PWS is classically characterized by two nutritional stages. Stage 1 is hypotonia characterized by poor muscle tone that leads to poor feeding behavior causing failure to thrive in early neonatal life. Stage 2 is followed by the development of extreme hyperphagia, also known as insatiable eating and fixation on food that often leads to obesity in early childhood. Other major features of PWS include obsessive-compulsive and hoarding behaviors, intellectual disability, and sleep abnormalities. PWS is genetic disorder mapping to imprinted 15q11.2-q13.3 locus, specifically at the paternally expressed SNORD116 locus of small nucleolar RNAs and noncoding host gene transcripts. SNORD116 is processed into several noncoding components and is hypothesized to orchestrate diurnal changes in metabolism through epigenetics, according to functional studies. Here, we review the current status of epigenetic mechanisms in PWS, with an emphasis on an emerging role for SNORD116 in circadian and sleep phenotypes. We also summarize current ongoing therapeutic strategies, as well as potential implications for more common human metabolic and psychiatric disorders.
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Affiliation(s)
| | - Janine M. LaSalle
- Department of Medical Microbiology and Immunology, Genome Center, MIND Institute, University of California, Davis, Davis, CA, United States
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14
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Liddle DG, Changstrom B, Senter C, Meirick P, Stern N, Putukian M, Shah S, Powell A, Dixit S, Eerkes K, Moran B, Barnes KP, Dal Molin C, Myers R, Waterbrook AL. Recommended Musculoskeletal and Sports Medicine Curriculum for Internal Medicine Residency Training. Curr Sports Med Rep 2021; 20:113-123. [PMID: 33560036 DOI: 10.1249/jsr.0000000000000811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
ABSTRACT Patients present to primary care physicians with musculoskeletal complaints more often than they do for upper respiratory infections, hypertension, or diabetes. Despite this, instruction in musculoskeletal medicine for internal medicine residents represents less than 1% of their total didactic and clinical education time. We recognize the immense breadth of knowledge and skill required to train residents in the practice of internal medicine. This curriculum guideline defines a recommended training strategy, and supplies relevant resources, to improve musculoskeletal education among internal medicine residents to optimize patient care. This curriculum guideline was created by internists who are sports medicine specialists. Sports medicine physicians promote overall health and well-being while providing expertise in acute and chronic musculoskeletal conditions, as well as how disease affects exercise and using exercise as medicine for people with chronic disease.
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Affiliation(s)
- David G Liddle
- Intermountain Sports Medicine, Intermountain Healthcare, Logan Regional Orthopedics and Sports Medicine, Logan, UT
| | - Bradley Changstrom
- Department of Medicine, Division of Internal Medicine, University of Colorado, Denver, CO
| | - Carlin Senter
- Department of Orthopaedic Surgery, Division of Sports Medicine, University of California San Francisco, San Francisco, CA
| | | | | | - Margot Putukian
- Princeton University, McCosh Health Center, University Health Services, Preinceton, NJ
| | - Selina Shah
- Center for Sports Medicine, Walnut Creek, CA
| | - Amy Powell
- Department of Orthopaedic Surgery and Department of Internal Medicine, Division of General Internal Medicine, University of Utah, Salt Lake City, UT
| | - Sameer Dixit
- Department of Primary Care Sports Medicine, Hospital for Special Surgery, New York, NY
| | - Kevin Eerkes
- NYU Langone Health, Department of Internal Medicine, New York University, New York, NY
| | - Byron Moran
- Department of Orthopaedic Surgery, Division of Sports Medicine, College of Medicine, University of South Florida, Tampa, FL
| | - Kenneth P Barnes
- Department of Orthopaedic Surgery, Division of Sports Medicine, Moses H. Cone Memorial Hospital, Greensboro, NC
| | - Claudia Dal Molin
- Department of Internal Medicine and Department of Orthopaedic Surgery, Division of Sports Medicine, University of Maryland, Baltimore, MD
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15
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Fintini D, Cianfarani S, Cofini M, Andreoletti A, Ubertini GM, Cappa M, Manco M. The Bones of Children With Obesity. Front Endocrinol (Lausanne) 2020; 11:200. [PMID: 32390939 PMCID: PMC7193990 DOI: 10.3389/fendo.2020.00200] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
Excess adiposity in childhood may affect bone development, ultimately leading to bone frailty. Previous reports showing an increased rate of extremity fractures in children with obesity support this fear. On the other hand, there is also evidence suggesting that bone mineral content is higher in obese children than in normal weight peers. Both adipocytes and osteoblasts derive from multipotent mesenchymal stem cells (MSCs) and obesity drives the differentiation of MSCs toward adipocytes at the expense of osteoblast differentiation. Furthermore, adipocytes in bone marrow microenvironment release a number of pro-inflammatory and immunomodulatory molecules that up-regulate formation and activation of osteoclasts, thus favoring bone frailty. On the other hand, body adiposity represents a mechanical load, which is beneficial for bone accrual. In this frame, bone quality, and structure result from the balance of inflammatory and mechanical stimuli. Diet, physical activity and the hormonal milieu at puberty play a pivotal role on this balance. In this review, we will address the question whether the bone of obese children and adolescents is unhealthy in comparison with normal-weight peers and discuss mechanisms underlying the differences in bone quality and structure. We anticipate that many biases and confounders affect the clinical studies conducted so far and preclude us from achieving robust conclusions. Sample-size, lack of adequate controls, heterogeneity of study designs are the major drawbacks of the existing reports. Due to the increased body size of children with obesity, dual energy absorptiometry might overestimate bone mineral density in these individuals. Magnetic resonance imaging, peripheral quantitative CT (pQCT) scanning and high-resolution pQCT are promising techniques for the accurate estimate of bone mineral content in obese children. Moreover, no longitudinal study on the risk of incident osteoporosis in early adulthood of children and adolescents with obesity is available. Finally, we will address emerging dietary issues (i.e., the likely benefits for the bone health of polyunsaturated fatty acids and polyphenols) since an healthy diet (i.e., the Mediterranean diet) with balanced intake of certain nutrients associated with physical activity remain the cornerstones for achieving an adequate bone accrual in young individuals regardless of their adiposity degree.
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Affiliation(s)
- Danilo Fintini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
- *Correspondence: Danilo Fintini
| | - Stefano Cianfarani
- Diabetes and Growth Disorders Unit, Dipartimento Pediatrico Universitario Ospedaliero Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Marta Cofini
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Angela Andreoletti
- Pediatric Resident, Pediatric Clinic, University of Brescia, Brescia, Italy
| | - Grazia Maria Ubertini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Marco Cappa
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Bambino Gesù Children's Hospital, Rome, Italy
- Melania Manco
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16
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Morales-Suarez-Varela M, Peraita-Costa I, Guillamon Escudero C, Llopis-Morales A, Llopis-Gonzalez A. Total body skeletal muscle mass and diet in children aged 6-8 years: ANIVA Study. Appl Physiol Nutr Metab 2019; 44:944-951. [PMID: 31389713 DOI: 10.1139/apnm-2018-0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective was to assess if there was any relationship between the amount of skeletal muscle mass (SMM) in children aged 6-8 years and their nutritional intake. The Valencian Anthropometry and Child Nutrition (ANIVA) study is a cross-sectional study with children aged between 6-8 years (n = 1988) from schools in Valencia. Children were distributed into 4 groups for comparison: normal and high SMM and by sex. Anthropometric data were obtained following World Health Organization protocols. Nutritional intake was measured using a prospective 3-day food journal and the KIDMED questionnaire. Of the whole child sample, 63.9% had high SMM values. No differences were found in adherence to a Mediterranean diet or absolute energy intake. Significant differences were found in the proportion of energy intake in relation to estimated energy requirements and between nutritional intake of certain macro or micronutrients with SMM. This study provides values of SMM for children. Children's adherence to a Mediterranean diet was not related to total SMM. At the same time, the consumption of excess calories or overeating is associated with SMM, with those children overeating more having lower SMM values. The differences in the intake of the other macro- and micronutrients were not associated with children's SMM.
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Affiliation(s)
- Maria Morales-Suarez-Varela
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Isabel Peraita-Costa
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Carlos Guillamon Escudero
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain
| | - Agustin Llopis-Morales
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain
| | - Agustin Llopis-Gonzalez
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
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17
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Kindler JM, Laing EM, Liu W, Dain JA, Lewis RD. Pentosidine Is Associated With Cortical Bone Geometry and Insulin Resistance in Otherwise Healthy Children. J Bone Miner Res 2019; 34:1446-1450. [PMID: 31220375 PMCID: PMC6697211 DOI: 10.1002/jbmr.3727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/04/2019] [Accepted: 03/10/2019] [Indexed: 01/22/2023]
Abstract
Pentosidine is an advanced glycation end product (AGE) associated with fracture in adults with diabetes. AGE accumulation in bone collagen contributes to bone fragility but might also adversely influence bone turnover and, consequently, bone geometry. The relationships between AGEs and bone health have yet to be studied in children. Thus, the objective of this study was to assess relationships between pentosidine and cortical bone volumetric density, geometry, and estimated strength in children. Participants were otherwise healthy black and white boys and girls, ages 9 to 13 years, who were at sexual maturation stage 2 or 3 (N = 160). Tibia and radius cortical bone and muscle area (66% site) were assessed via pQCT. In fasting sera, insulin, glucose, and pentosidine were measured. The Quantitative Insulin Sensitivity Check Index (QUICKI), a measure of insulin sensitivity, was calculated. While controlling for race, sex, maturation, and height, pentosidine negatively correlated with QUICKI (P < 0.05). In unadjusted analyses, pentosidine was associated with lower radius and tibia cortical volumetric bone mineral density, bone mineral content (Ct.BMC), area (Ct.Ar), and thickness (Ct.Th); a larger radius endosteal circumference (Endo.Circ); and lower tibia polar strength strain index (all P < 0.05). While controlling for race, sex, maturation, height, and muscle area, pentosidine was negatively associated with tibia Ct.BMC, Ct.Ar, and Ct.Th but positively associated with Endo.Circ (all P < 0.05). Linear regression revealed a significant interaction between pentosidine and QUICKI in relation to tibia Ct.Th (pinteraction = 0.049), indicating that the negative relationship between pentosidine and Ct.Th was stronger in those with lower QUICKI (ie, greater insulin resistance). This is the first study to report evidence of a potentially adverse influence of AGEs on bone strength in otherwise healthy children. This relationship was strongest in children with the greatest insulin resistance, supporting further work in youth with chronic metabolic health conditions. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Joseph M Kindler
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | - Emma M Laing
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | - Weixi Liu
- Department of Chemistry, University of Rhode Island, Kingston, RI, USA
| | - Joel A Dain
- Department of Chemistry, University of Rhode Island, Kingston, RI, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
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18
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Waters DL. Intermuscular Adipose Tissue: A Brief Review of Etiology, Association With Physical Function and Weight Loss in Older Adults. Ann Geriatr Med Res 2019; 23:3-8. [PMID: 32743278 PMCID: PMC7387605 DOI: 10.4235/agmr.19.0001] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/26/2019] [Accepted: 01/26/2019] [Indexed: 12/21/2022] Open
Abstract
Adipose tissue redistributes during aging resulting in increased intermuscular adipose tissue (IMAT), intramuscular, and intramyocellular lipid while subcutaneous fat decreases. IMAT has been associated with lower muscle strength, power, and quality, chronic inflammation, impaired glucose tolerance, and elevated total cholesterol in older adults. This review focused on trials investigating the role of age, physical activity and diet on IMAT. The studies agreed that IMAT increases with age and seems to be responsive to physical activity, particularly the combination of aerobic and resistance exercise. However, some reported this could occur with or without weight loss, and some reported that high IMAT at baseline may blunt the muscle quality adaptive response to physical training. Larger and longer trials are needed to differentiate the independent or synergistic effects of resistance and/or aerobic training, and obesity and weight loss combined with resistance, aerobic or combination of aerobic and resistance training on IMAT.
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Affiliation(s)
- Debra Lynn Waters
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand
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19
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Kaniewska M, Schenkel M, Eid K, Bühler T, Kubik-Huch RA, Anderson SE. Anatomy-based MRI assessment of the iliopsoas muscle complex after pertrochanteric femoral fracture. Skeletal Radiol 2019; 48:421-428. [PMID: 30178103 DOI: 10.1007/s00256-018-3048-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 08/06/2018] [Accepted: 08/14/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the quality of the iliopsoas muscle complex after pertrochanteric femoral fracture, using MRI; to propose an anatomy-based evaluation of the iliopsoas muscle complex; and to determine the inter-reader reliability of two classifications of fatty muscle degeneration. MATERIALS AND METHODS We included adult patients with a displaced lesser trochanter following pertrochanteric femoral fracture. Muscle quality was evaluated using the Goutallier and Slabaugh classifications at three levels (L4/L5, L5/S1, and the anterior inferior iliac spine). Two radiologists independently reviewed the MRIs, and force measurement was performed on both hips. Linear mixed-effects models were used to determine the effect of fracture on muscle quality and strength, and Cohen's kappa statistic was used to assess inter-reader agreement. RESULTS In the 18 patients included, the iliopsoas muscle complex showed higher grades of fatty muscle degeneration on the fractured side than on the non-fractured side. The mean difference between muscle strength on the fractured vs the non-fractured side was -12 N (p > 0.05). Inter-reader agreement for the Goutallier and Slabaugh classifications was good and very good respectively (weighted K = 0.78 and 0.85 respectively). CONCLUSION Fatty muscle degeneration of the iliopsoas muscle complex after pertrochanteric femoral fracture was evident using both classification systems; however, fatty muscle degeneration resulted in only a minimal reduction of muscle strength. To provide a thorough assessment of iliopsoas muscle complex quality, we suggest evaluating it at different anatomical levels. Regarding inter-reader agreement, the Slabaugh classification was superior to the Goutallier classification.
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Affiliation(s)
- Malwina Kaniewska
- Institute of Radiology, Kantonsspital Baden, Baden, Switzerland. .,Chefarztsekretariat Radiologie Bea Engeli, Kantonsspital Baden, Im Ergel 4, 5404, Baden, Switzerland.
| | - Matthias Schenkel
- Centre for Orthopaedic Surgery, Kantonsspital Aarau und Baden, Baden, Switzerland
| | - Karim Eid
- Centre for Orthopaedic Surgery, Kantonsspital Aarau und Baden, Baden, Switzerland
| | - Tobias Bühler
- Centre for Orthopaedic Surgery, Kantonsspital Aarau und Baden, Baden, Switzerland
| | | | - Suzanne E Anderson
- Institute of Radiology, Kantonsspital Baden, Baden, Switzerland.,The University of Notre Dame Australia, Sydney School of Medicine, Sydney, Australia
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20
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Brett NR, Weiler HA. Reply to T Sugiyama. Am J Clin Nutr 2018; 108:898. [PMID: 30169730 DOI: 10.1093/ajcn/nqy156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Neil R Brett
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Hope A Weiler
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
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21
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Influence of Physical Activity on Bone Mineral Content and Density in Overweight and Obese Children with Low Adherence to the Mediterranean Dietary Pattern. Nutrients 2018; 10:nu10081075. [PMID: 30103535 PMCID: PMC6116035 DOI: 10.3390/nu10081075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 02/06/2023] Open
Abstract
The objective of the present cross-sectional study was to examine the associations of physical activity and the adherence to the Mediterranean dietary pattern (MDP) with bone mineral content (BMC) and density (BMD) in children with overweight and obesity. A total of 177 (n = 80 girls) children with overweight and obesity aged 8 to 12 years old participated in the study. Both BMC and BMD were assessed by Dual-Energy X-ray absorptiometry. Dietary patterns were assessed by the KIDMED questionnaire and two 24-hour recalls. Physical activity was assessed by accelerometers for 7 consecutive days (24 hours/day). Low adherence to the MDP was observed in 82.4% of participants. Higher physical activity levels (of at least moderate intensity) and lower sedentary time were significantly associated with BMC and BMD in children with low adherence to the MDP (all p < 0.05). No associations were observed between physical activity and BMC and BMD in children with high adherence to the MDP. In conclusion, engaging in moderate to vigorous physical activity and reducing the time spent in sedentary behavior might be particularly beneficial for improving bone health in overweight or obese children with poor adherence to the Mediterranean dietary pattern.
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Coheley LM, Kindler JM, Laing EM, Oshri A, Hill Gallant KM, Warden SJ, Peacock M, Weaver CM, Lewis RD. Whole egg consumption and cortical bone in healthy children. Osteoporos Int 2018; 29:1783-1791. [PMID: 29713797 PMCID: PMC6604058 DOI: 10.1007/s00198-018-4538-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
Abstract
UNLABELLED Eggs contain bioactive compounds thought to benefit pediatric bone. This cross-sectional study shows a positive link between childhood egg intake and radius cortical bone. If randomized trials confirm our findings, incorporating eggs into children's diets could have a significant impact in preventing childhood fractures and reducing the risk of osteoporosis. INTRODUCTION This study examined the relationships between egg consumption and cortical bone in children. METHODS The cross-sectional study design included 294 9-13-year-old black and white males and females. Three-day diet records determined daily egg consumption. Peripheral quantitative computed tomography measured radius and tibia cortical bone. Body composition and biomarkers of bone turnover were assessed using dual-energy X-ray absorptiometry and ELISA, respectively. RESULTS Egg intake was positively correlated with radius and tibia cortical bone mineral content (Ct.BMC), total bone area, cortical area, cortical thickness, periosteal circumference, and polar strength strain index in unadjusted models (r = 0.144-0.224, all P < 0.050). After adjusting for differences in race, sex, maturation, fat-free soft tissue mass (FFST), and protein intakes, tibia relationships were nullified; however, egg intake remained positively correlated with radius Ct.BMC (r = 0.138, P = 0.031). Egg intake positively correlated with total body bone mineral density, BMC, and bone area in the unadjusted models only (r = 0.119-0.224; all P < 0.050). After adjusting for covariates, egg intake was a positive predictor of radius FFST (β = 0.113, P < 0.050) and FFST was a positive predictor of Ct.BMC (β = 0.556, P < 0.050) in path analyses. There was a direct influence of egg on radius Ct.BMC (β = 0.099, P = 0.035), even after adjusting for the mediator, FFST (β = 0.137, P = 0.020). Egg intake was positively correlated with osteocalcin in both the unadjusted (P = 0.005) and adjusted (P = 0.049) models. CONCLUSION If the positive influence of eggs on Ct.BMC observed in this study is confirmed through future randomized controlled trials, whole eggs may represent a viable strategy to promote pediatric bone development and prevent fractures.
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Affiliation(s)
- L M Coheley
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - J M Kindler
- Department of Nutrition Science, Purdue University, Stone Hall 220-B, 770 West State Street, West Lafayette, IN, USA
| | - E M Laing
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - A Oshri
- Department of Human Development and Family Science, The University of Georgia, 208 Family Science Center (House A), 403 Sanford Drive, Athens, GA, USA
| | - K M Hill Gallant
- Department of Nutrition Science, Purdue University, STON 207, 700 West State Street, West Lafayette, IN, USA
| | - S J Warden
- School of Health and Rehabilitation Sciences, Indiana University-Purdue University Indianapolis, 1140 West Michigan Street, Indianapolis, IN, USA
| | - M Peacock
- Department of Medicine, Indiana University, Gatch Hall Suite 265, 1120 West Michigan Street, Indianapolis, IN, USA
| | - C M Weaver
- Department of Nutrition Science, Purdue University, Stone Hall 220-B, 770 West State Street, West Lafayette, IN, USA
| | - R D Lewis
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA.
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Maiers M, Agaoglu M, Brown R, Cassirer C, DaSilva K, Lystad RP, Mohammad S, Wong JJ. Chiropractic in Global Health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic. Chiropr Man Therap 2018; 26:26. [PMID: 30026909 PMCID: PMC6048707 DOI: 10.1186/s12998-018-0194-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/21/2018] [Indexed: 12/28/2022] Open
Abstract
The World Federation of Chiropractic supports the involvement of chiropractors in public health initiatives, particularly as it relates to musculoskeletal health. Three topics within public health have been identified that call for a renewed professional focus. These include healthy ageing; opioid misuse; and women's, children's, and adolescents' health. The World Federation of Chiropractic aims to enable chiropractors to proactively participate in health promotion and prevention activities in these areas, through information dissemination and coordinated partnerships. Importantly, this work will align the chiropractic profession with the priorities of the World Health Organization. Successful engagement will support the role of chiropractors as valued partners within the broader healthcare system and contribute to the health and wellbeing of the communities they serve.
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Affiliation(s)
- Michele Maiers
- Northwestern Health Sciences University, 2501 W 84th St, Bloomington, MN 55431 USA
| | - Mustafa Agaoglu
- Bahçeşehir University Health Sciences School of Chiropractic, No:10, Gayrettepe, 34353 Beşiktaş, Istanbul, Turkey
| | - Richard Brown
- World Federation of Chiropractic, 160 Eglinton Avenue East Suite 601, Toronto, ON M4P 3B5 Canada
| | - Christopher Cassirer
- Northwestern Health Sciences University, 2501 W 84th St, Bloomington, MN 55431 USA
| | - Kendrah DaSilva
- Chiropractic Association of South Africa, Crossway Office Park, 240 Lenchen Ave, Centurion, Pretoria, 0157 South Africa
| | - Reidar P. Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Sarkaw Mohammad
- Hillcrest Spinal Centre, 174 Cambridge Road Hillcrest Hamilton, Hamilton, 3216 New Zealand
| | - Jessica J. Wong
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON M2H 3J1 Canada
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Donze SH, Kuppens RJ, Bakker NE, van Alfen-van der Velden JAEM, Hokken-Koelega ACS. Bone mineral density in young adults with Prader-Willi syndrome: A randomized, placebo-controlled, crossover GH trial. Clin Endocrinol (Oxf) 2018; 88:806-812. [PMID: 29418016 DOI: 10.1111/cen.13567] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 12/24/2022]
Abstract
CONTEXT The prevalence of osteoporosis is increased in adults with Prader-Willi syndrome (PWS). In children with PWS, growth hormone (GH) treatment has beneficial effects on bone mineral density (BMD). BMD might deteriorate after cessation of GH at adult height (AH), while continuing GH might maintain BMD. OBJECTIVE To investigate the effects of GH vs placebo, and furthermore the effects of sex steroid replacement therapy (SSRT), on BMD in GH-treated young adults with PWS who had attained AH. DESIGN Two-year, randomized, double-blind, placebo-controlled, crossover GH study. PATIENTS Twenty-seven young adults with PWS were stratified for gender and BMI and then randomly and blindly assigned to receive GH (0.67 mg/m2 /day) or placebo for 1 year, after which they crossed over to the alternative treatment for another year. MEASUREMENTS Bone mineral density of the total body (BMDTB ) and lumbar spine (BMDLS ) SDS were measured by dual-energy x-ray absorptiometry. RESULTS At AH, BMDTB SDS was significantly lower compared to healthy peers (P < .01), while BMADLS SDS was similar. Both BMDTB SDS and BMADLS SDS were similar during 1 year of GH vs 1 year of placebo. In hypogonadal young adults without SSRT, BMDTB SDS and BMADLS SDS decreased during the 2-year study (P = .11 and P = .01), regardless of GH or placebo, while BMDTB SDS increased in those with SSRT (P < .01). CONCLUSIONS Compared to GH treatment, 1 year of placebo after attainment of AH does not deteriorate BMD SDS in young adults with PWS. In addition, our data suggest that GH is not able to prevent the decline in BMD SDS in hypogonadal young adults with PWS, unless it is combined with SSRT.
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Affiliation(s)
- Stephany H Donze
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Renske J Kuppens
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nienke E Bakker
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Anita C S Hokken-Koelega
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
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Thomas JD, Oliveira R, Sznajder ŁJ, Swanson MS. Myotonic Dystrophy and Developmental Regulation of RNA Processing. Compr Physiol 2018; 8:509-553. [PMID: 29687899 PMCID: PMC11323716 DOI: 10.1002/cphy.c170002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Myotonic dystrophy (DM) is a multisystemic disorder caused by microsatellite expansion mutations in two unrelated genes leading to similar, yet distinct, diseases. DM disease presentation is highly variable and distinguished by differences in age-of-onset and symptom severity. In the most severe form, DM presents with congenital onset and profound developmental defects. At the molecular level, DM pathogenesis is characterized by a toxic RNA gain-of-function mechanism that involves the transcription of noncoding microsatellite expansions. These mutant RNAs disrupt key cellular pathways, including RNA processing, localization, and translation. In DM, these toxic RNA effects are predominantly mediated through the modulation of the muscleblind-like and CUGBP and ETR-3-like factor families of RNA binding proteins (RBPs). Dysfunction of these RBPs results in widespread RNA processing defects culminating in the expression of developmentally inappropriate protein isoforms in adult tissues. The tissue that is the focus of this review, skeletal muscle, is particularly sensitive to mutant RNA-responsive perturbations, as patients display a variety of developmental, structural, and functional defects in muscle. Here, we provide a comprehensive overview of DM1 and DM2 clinical presentation and pathology as well as the underlying cellular and molecular defects associated with DM disease onset and progression. Additionally, fundamental aspects of skeletal muscle development altered in DM are highlighted together with ongoing and potential therapeutic avenues to treat this muscular dystrophy. © 2018 American Physiological Society. Compr Physiol 8:509-553, 2018.
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Affiliation(s)
- James D. Thomas
- Department of Molecular Genetics and Microbiology, Center for NeuroGenetics and the Genetics Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - Ruan Oliveira
- Department of Molecular Genetics and Microbiology, Center for NeuroGenetics and the Genetics Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - Łukasz J. Sznajder
- Department of Molecular Genetics and Microbiology, Center for NeuroGenetics and the Genetics Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - Maurice S. Swanson
- Department of Molecular Genetics and Microbiology, Center for NeuroGenetics and the Genetics Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
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Kindler JM, Pollock NK, Ross HL, Modlesky CM, Singh H, Laing EM, Lewis RD. Obese Versus Normal-Weight Late-Adolescent Females have Inferior Trabecular Bone Microarchitecture: A Pilot Case-Control Study. Calcif Tissue Int 2017; 101:479-488. [PMID: 28710506 PMCID: PMC5705220 DOI: 10.1007/s00223-017-0303-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/06/2017] [Indexed: 12/16/2022]
Abstract
Though still a topic of debate, the position that skeletal health is compromised with obesity has received support in the pediatric and adult literature. The limited data relating specifically to trabecular bone microarchitecture, however, have been relatively inconsistent. The aim of this pilot cross-sectional case-control study was to compare trabecular bone microarchitecture between obese (OB) and normal-weight (NW) late-adolescent females. A secondary aim was to compare diaphyseal cortical bone outcomes between these two groups. Twenty-four non-Hispanic white females, ages 18-19 years, were recruited into OB (n = 12) or NW (n = 12) groups based on pre-specified criteria for percent body fat (≥32 vs. <30, respectively), body mass index (>90th vs. 20th-79th, respectively), and waist circumference (≥90th vs. 25th-75th, respectively). Participants were also individually matched on age, height, and oral contraceptive use. Using magnetic resonance imaging, trabecular bone microarchitecture was assessed at the distal radius and proximal tibia metaphysis, and cortical bone architecture was assessed at the mid-radius and mid-tibia diaphysis. OB versus NW had lower apparent trabecular thickness (radius and tibia), higher apparent trabecular separation (radius), and lower apparent bone volume to total volume (radius; all P < 0.050). Some differences in radius and tibia trabecular bone microarchitecture were retained after adjusting for insulin resistance or age at menarche. Mid-radius and mid-tibia cortical bone volume and estimated strength were lower in the OB compared to NW after adjusting for fat-free soft tissue mass (all P < 0.050). These trabecular and cortical bone deficits might contribute to the increased fracture risk in obese youth.
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Affiliation(s)
- Joseph M Kindler
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - Norman K Pollock
- Department of Pediatrics, Augusta University, HS-1640 Health Sciences Campus, Augusta, GA, USA
| | - Hannah L Ross
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - Christopher M Modlesky
- Department of Kinesiology, The University of Georgia, Ramsey Center, 330 River Rd, Athens, GA, USA
| | - Harshvardhan Singh
- Department of Kinesiology & Applied Physiology, University of Delaware, 201 N STAR Health Sciences Complex, Newark, DE, USA
| | - Emma M Laing
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA.
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27
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Kindler JM, Pollock NK, Laing EM, Oshri A, Jenkins NT, Isales CM, Hamrick MW, Ding KH, Hausman DB, McCabe GP, Martin BR, Hill Gallant KM, Warden SJ, Weaver CM, Peacock M, Lewis RD. Insulin Resistance and the IGF-I-Cortical Bone Relationship in Children Ages 9 to 13 Years. J Bone Miner Res 2017; 32:1537-1545. [PMID: 28300329 PMCID: PMC5489353 DOI: 10.1002/jbmr.3132] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 03/03/2017] [Accepted: 03/04/2017] [Indexed: 12/27/2022]
Abstract
IGF-I is a pivotal hormone in pediatric musculoskeletal development. Although recent data suggest that the role of IGF-I in total body lean mass and total body bone mass accrual may be compromised in children with insulin resistance, cortical bone geometric outcomes have not been studied in this context. Therefore, we explored the influence of insulin resistance on the relationship between IGF-I and cortical bone in children. A secondary aim was to examine the influence of insulin resistance on the lean mass-dependent relationship between IGF-I and cortical bone. Children were otherwise healthy, early adolescent black and white boys and girls (ages 9 to 13 years) and were classified as having high (n = 147) or normal (n = 168) insulin resistance based on the homeostasis model assessment of insulin resistance (HOMA-IR). Cortical bone at the tibia diaphysis (66% site) and total body fat-free soft tissue mass (FFST) were measured by peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA), respectively. IGF-I, insulin, and glucose were measured in fasting sera and HOMA-IR was calculated. Children with high HOMA-IR had greater unadjusted IGF-I (p < 0.001). HOMA-IR was a negative predictor of cortical bone mineral content, cortical bone area (Ct.Ar), and polar strength strain index (pSSI; all p ≤ 0.01) after adjusting for race, sex, age, maturation, fat mass, and FFST. IGF-I was a positive predictor of most musculoskeletal endpoints (all p < 0.05) after adjusting for race, sex, age, and maturation. However, these relationships were moderated by HOMA-IR (pInteraction < 0.05). FFST positively correlated with most cortical bone outcomes (all p < 0.05). Path analyses demonstrated a positive relationship between IGF-I and Ct.Ar via FFST in the total cohort (βIndirect Effect = 0.321, p < 0.001). However, this relationship was moderated in the children with high (βIndirect Effect = 0.200, p < 0.001) versus normal (βIndirect Effect = 0.408, p < 0.001) HOMA-IR. These data implicate insulin resistance as a potential suppressor of IGF-I-dependent cortical bone development, though prospective studies are needed. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Joseph M Kindler
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | | | - Emma M Laing
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
| | - Nathan T Jenkins
- Department of Kinesiology, The University of Georgia, Athens, GA, USA
| | - Carlos M Isales
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Mark W Hamrick
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Ke-Hong Ding
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Dorothy B Hausman
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | - George P McCabe
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Berdine R Martin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Stuart J Warden
- Department of Physical Therapy, Indiana University, Indianapolis, IN, USA
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Munro Peacock
- Department of Medicine, Indiana University, Indianapolis, IN, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
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Kindler JM, Pollock NK, Laing EM, Jenkins NT, Oshri A, Isales C, Hamrick M, Lewis RD. Insulin Resistance Negatively Influences the Muscle-Dependent IGF-1-Bone Mass Relationship in Premenarcheal Girls. J Clin Endocrinol Metab 2016; 101:199-205. [PMID: 26574958 PMCID: PMC4701844 DOI: 10.1210/jc.2015-3451] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT IGF-1 promotes bone growth directly and indirectly through its effects on skeletal muscle. Insulin and IGF-1 share a common cellular signaling process; thus, insulin resistance may influence the IGF-1-muscle-bone relationship. OBJECTIVE We sought to determine the effect of insulin resistance on the muscle-dependent relationship between IGF-1 and bone mass in premenarcheal girls. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional study conducted at a university research center involving 147 girls ages 9 to 11 years. MAIN OUTCOME MEASURES Glucose, insulin, and IGF-1 were measured from fasting blood samples. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Fat-free soft tissue (FFST) mass and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry. Our primary outcome was BMC/height. RESULTS In our path model, IGF-1 predicted FFST mass (b = 0.018; P = .001), which in turn predicted BMC/height (b = 0.960; P < .001). IGF-1 predicted BMC/height (b = 0.001; P = .002), but not after accounting for the mediator of this relationship, FFST mass. The HOMA-IR by IGF-1 interaction negatively predicted FFST mass (b = -0.044; P = .034). HOMA-IR had a significant and negative effect on the muscle-dependent relationship between IGF-1 and BMC/height (b = -0.151; P = .047). CONCLUSIONS Lean body mass is an important intermediary factor in the IGF-1-bone relationship. For this reason, bone development may be compromised indirectly via suboptimal IGF-1-dependent muscle development in insulin-resistant children.
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Affiliation(s)
- J M Kindler
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - N K Pollock
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - E M Laing
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - N T Jenkins
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - A Oshri
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - C Isales
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - M Hamrick
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - R D Lewis
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
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Hamrick MW, McGee-Lawrence ME, Frechette DM. Fatty Infiltration of Skeletal Muscle: Mechanisms and Comparisons with Bone Marrow Adiposity. Front Endocrinol (Lausanne) 2016; 7:69. [PMID: 27379021 PMCID: PMC4913107 DOI: 10.3389/fendo.2016.00069] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 06/07/2016] [Indexed: 12/11/2022] Open
Abstract
Skeletal muscle and bone share common embryological origins from mesodermal cell populations and also display common growth trajectories early in life. Moreover, muscle and bone are both mechanoresponsive tissues, and the mass and strength of both tissues decline with age. The decline in muscle and bone strength that occurs with aging is accompanied in both cases by an accumulation of adipose tissue. In bone, adipocyte (AC) accumulation occurs in the marrow cavities of long bones and is known to increase with estrogen deficiency, mechanical unloading, and exposure to glucocorticoids. The factors leading to accumulation of intra- and intermuscular fat (myosteatosis) are less well understood, but recent evidence indicates that increases in intramuscular fat are associated with disuse, altered leptin signaling, sex steroid deficiency, and glucocorticoid treatment, factors that are also implicated in bone marrow adipogenesis. Importantly, accumulation of ACs in skeletal muscle and accumulation of intramyocellular lipid are linked to loss of muscle strength, reduced insulin sensitivity, and increased mortality among the elderly. Resistance exercise and whole body vibration can prevent fatty infiltration in skeletal muscle and also improve muscle strength. Therapeutic strategies to prevent myosteatosis may improve muscle function and reduce fall risk in the elderly, potentially impacting the incidence of bone fracture.
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Affiliation(s)
- Mark W. Hamrick
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta, GA, USA
- *Correspondence: Mark W. Hamrick,
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