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Takahashi I, Watanabe K, Kawashima H, Noguchi H, Sato J, Ishii Y. Relationship between physical functional status indicators and bone mineral density in older women. J Orthop 2024; 57:104-108. [PMID: 39006210 PMCID: PMC11245917 DOI: 10.1016/j.jor.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/16/2024] Open
Abstract
Background Osteoporosis significantly predisposes patients to fragility fractures and a reduced quality of life. Therefore, osteoporosis prevention plays an important role in extending healthy life expectancy. The purpose of this study was to identify whether physical functional status was associated with low bone mineral density, and to determine cut-off values of physical status indicators for osteoporosis. Methods This cross-sectional study evaluated 343 women aged 60 years or older who were able to walk independently. The measured variables were the body mass index, lumbar and total hip bone mineral density, grip strength, 5-m normal walking speed, one-leg standing time, timed up-and-go test, and skeletal muscle mass using bioelectrical impedance analysis. The associations between physical status indicators and low bone mineral density were analyzed and the cut-off values for detecting osteoporosis were calculated using receiver operating characteristic curve analyses. Results The prevalence of osteoporosis was 29.2 %. All measured variables significantly differed between the osteoporotic and non-osteoporotic groups (p < 0.05). Multivariate logistic regression analysis showed that the factors associated with osteoporosis were the skeletal muscle mass index, walking speed, and body mass index. In the receiver operating characteristic curve analysis, the cut-off values of the skeletal muscle mass index, walking speed, and body mass index associated with osteoporosis were 6.31 kg/m2, 1.29 m/s, and 22.6 kg/m2, respectively. Conclusions Older women with low bone mineral density have lower skeletal muscle mass, slower walking speed, and lower body mass index. Measuring the skeletal muscle mass index, walking speed, and body mass index might be useful for daily exercise guidance or osteoporosis screening.
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Affiliation(s)
- Ikuko Takahashi
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan
| | - Kei Watanabe
- Niigata Spine Surgery Center, 2-5-22 Nishimachi, Konanku, Niigata, Niigata, 950-0165, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata, 951-8520, Japan
| | - Hideo Noguchi
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan
| | - Junko Sato
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan
| | - Yoshinori Ishii
- Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan
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Association between menopausal status and physical function: A systematic review protocol. PLoS One 2023; 18:e0280786. [PMID: 36693069 PMCID: PMC9873147 DOI: 10.1371/journal.pone.0280786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Physical function is considered an important marker of adverse health outcomes. Postmenopausal women seem to have worse physical function, but conflicting results have been reported in the literature. The aim of this systematic review is to assess the association between menopausal status and physical function in community-dwelling women. METHODS Cross-sectional and/or longitudinal studies which objectively or subjectively assess physical function at different menopausal stages will be included. Studies conducted in institutionalized populations or with any specific medical condition that may have induced menopause (i.e. cancer or degenerative diseases) will be excluded. This systematic review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The searches will be carried out in the Pubmed, Embase, SciELO (Scientific Electronic Library Online), LILACS (Latin American and Caribbean Literature on Health Sciences), VHL (Virtual Health Library), Scopus and Web of Science databases, using the search equation "Menopause AND (Physical Performance OR Function)". The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies will be considered to assess the methodological quality of the included studies. The selection and evaluation of the methodological quality of the studies will be carried out by independent researchers and the discrepancies will be resolved by a separate researcher. ETHICS AND DISCLOSURE Ethical approval is not required as this is a study using secondary data. The results will be published in a scientific journal. We intend to contribute to the expansion of knowledge regarding physical function of women according to the menopause status, thus helping in the perspective of improving health and functioning. This systematic review started in January 2022 and all steps are expected to be finished by October 2022. PROSPERO REGISTRATION NUMBER CRD42021289899.
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Effect of resistance exercise on bone health of old aged individuals: Review. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Zhang JL, Poon CCW, Wong MS, Li WX, Guo YX, Zhang Y. Vitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Endocrinol (Lausanne) 2022; 13:863448. [PMID: 35721712 PMCID: PMC9199366 DOI: 10.3389/fendo.2022.863448] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/19/2022] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION In postmenopausal women, vitamin D deficiency (as defined by the circulating level of 25(OH)D being below 20 ng/ml (50 nmol/L)) is a regular occurrence. The effect of vitamin D supplementation on the muscle function of postmenopausal women has been controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) examines and summarizes the effects of vitamin D supplementation on the muscular strength and mobility of postmenopausal women. METHODS RCTs that met the inclusion criteria for this study were identified by searching PubMed, EMBASE, and the Cochrane Library. Postmenopausal women who were included in the study were exposed to RCTs assessing the effectiveness of vitamin D supplements. Meta-analysis data were extracted by two independent reviewers and screened for methodological quality. RCTs that did not meet the minimum requirement for assessment were excluded. In the meta-analysis, the effect size (weighted mean differences, WMD) of handgrip strength (HGS) and timed-up and go test (TUG) with a 95% confidence interval (CI) was obtained to compare reported results across the included RCTs. RESULTS A total of 19 trials were included in this systematic review, among which 13 trials were eligible for the meta-analysis. In the 13 included studies, supplementing with vitamin D produced a weighted mean difference of 0.876 kg (95% CI = 0.180 to 1.571, P = 0.014, I2 = 68.5%) for HGS, a measurement of muscle strength. However, an insignificant decrease of 0.044 s was observed after analyzing the TUG (95% CI = -0.979 to 0.892, P = 0.927, I2 = 95%). According to subgroup analysis, vitamin D supplementation increased HGS in patients over the age of 60 (P = 0.001), in those without calcium supplementation (P = 0.032), and in those whose baseline vitamin D level was greater than 75 nmol/L (30 ng/ml) (P = 0.003). CONCLUSIONS Taking into account the studies in this systematic review, vitamin D supplementation improved muscle strength in postmenopausal women. However, an insignificant result was demonstrated in terms of mobility after vitamin D supplementation.
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Affiliation(s)
- Jia-Li Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Christina Chui-Wa Poon
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Man-Sau Wong
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Wen-Xiong Li
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi-Xun Guo
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Yan Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- *Correspondence: Yan Zhang,
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da Cruz GF, Lunz TM, de Jesus TR, Costa MB, Vidigal CV, Albergaria BH, Marques-Rocha JL, Guandalini VR. Influence of the appendicular skeletal muscle mass index on the bone mineral density of postmenopausal women. BMC Musculoskelet Disord 2021; 22:861. [PMID: 34627216 PMCID: PMC8501937 DOI: 10.1186/s12891-021-04748-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The appendicular skeletal muscle mass index (ASMI) is an important risk indicator for osteoporosis because of the anatomical proximity and metabolic connection between muscle and bone mass. The present study investigated the relationship between ASMI and the bone mineral density (BMD) categories of postmenopausal women. METHODS In this cross-sectional study with a probabilistic sample, sociodemographic, lifestyle, menopause time, anthropometric, and physical activity variables were collected. ASMI and BMD were assessed by dual-energy X-ray absorptiometry (DXA). Participants were grouped according to BMD values into normal density, osteopenia, and osteoporosis. Multivariate logistic regression models were applied to verify the influence of ASMI on BMD. Data were analyzed using the SPSS statistical software, version 22. The significance level for all tests was set at 5%. RESULTS Of the 114 women analyzed, most were between 60 and 69.9 years of age (62.3%), on menopause for ≤19.0 (51.8%), self-declared brown race/color (49.1%), had < 4 years of education (41.2%), never smoked (69.0%) or drank alcohol (62.8%). Of these, 52.6% were classified as sufficiently active and 52.2% had regular sun exposure. Women with osteoporosis were older (p = 0.035), on menopause for a longer time (p = 0.011), underweight (p = 0.004), had adequate waist circumference (p = 0.017), and low ASMI values (p = 0.002). There was an association between the 1st tertile of ASMI and osteoporosis. However, after adjustments for age, race/color, and body mass index, the strength of association between BMD and ASMI was not maintained. CONCLUSIONS ASMI was not associated with the BMD of the postmenopausal women evaluated. Total body and muscle mass, in addition to bone mass, should be monitored during menopause treatment. Longitudinal studies must be conducted to elucidate the mechanisms and gaps in this relationship.
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Affiliation(s)
- Geise Ferreira da Cruz
- Postgraduate Program in Nutrition and Health, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Tatiana Mion Lunz
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Tatielle Rocha de Jesus
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Mariana Braga Costa
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Camila Vilarinho Vidigal
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Ben-Hur Albergaria
- Department of Social Medicine, Federal University of Espirito Santo, Marechal Campos avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Jose Luiz Marques-Rocha
- Postgraduate Program in Nutrition and Health, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Valdete Regina Guandalini
- Postgraduate Program in Nutrition and Health, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil.
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil.
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Miranda C, de Morais VFB, Martins FM, Pelet DCS, Orsatti CL, Cangussu-Oliveira LM, Petri Nahas EA, Santagnello SB, de Paula RF, Campos Souza MV, Orsatti FL. Different cutoff points to diagnose low muscle mass and prediction of osteoporosis in postmenopausal women. Menopause 2021; 28:1181-1185. [PMID: 34284436 DOI: 10.1097/gme.0000000000001820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to verify which of the different cutoff points of low muscle mass (LMM) based on appendicular lean mass (ALM) is associated with osteoporosis in postmenopausal women (PMW). METHODS Cross-sectional study. PMW (n = 355) were classified for the presence of osteoporosis (score <-2.5 standard deviations) at the femoral neck and lumbar spine and LMM (three cutoff points: ALM < 15 kg; ALM/height2 [ALM index] <5.67 kg/m2 and ratio between ALM and body mass index [ALMBMI] <0.512). RESULTS After adjustments for confounding factors, binary logistic regression showed that ALM and ALM index were associated with osteoporosis at the lumbar spine (odds ratio [OR] = 5.3 [95% CI: 2.3-12.5] and OR = 2.5 [95% CI: 1.0-6.2], respectively) and only ALM was associated with osteoporosis at the femoral neck (OR = 16.1 [95% CI: 4.1-62.5]). When women were classified as having osteoporosis in at least one site, only ALM was associated with osteoporosis (OR = 7.7 [95% CI: 3.3-15.6]). There was no association between ALMBMI and osteoporosis. The predictive value of ALM for osteoporosis decreased after BMI or height were included as a covariate in the model. CONCLUSION Absolute ALM (<15 kg) seems to be the most suitable for predicting osteoporosis based on LMM in PMW.
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Affiliation(s)
- Camila Miranda
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Vinicius Faria Borges de Morais
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Fernanda Maria Martins
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Danyelle Cristina Silva Pelet
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Cláudio Lera Orsatti
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
- Department Health Science, Oeste Paulista University (UNOESTE), Jau, Sao Paulo, Brazil
| | - Luciana Mendes Cangussu-Oliveira
- Department of Sport Sciences, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
- Physiotherapy Course, Department of Health Sciences, Rehabilitation and Functional Performance Program, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Eliana Aguiar Petri Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil
| | - Samarita Beraldo Santagnello
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Rodolfo Ferreira de Paula
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Markus Vinicius Campos Souza
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
- Department of Sport Sciences, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Fábio Lera Orsatti
- Applied Physiology, Aging, Nutrition and Exercise Research Group (PHYANER), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
- Department of Sport Sciences, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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Low Grip Strength and Muscle Mass Increase the Prevalence of Osteopenia and Osteoporosis in Elderly Women. Healthcare (Basel) 2021; 9:healthcare9040476. [PMID: 33923692 PMCID: PMC8072912 DOI: 10.3390/healthcare9040476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/28/2022] Open
Abstract
The risk of developing low muscle strength and muscle mass is affected by aging, osteopenia, and osteoporosis and increases with age. The purpose of this study was to investigate the prevalence and cutoff values for osteoporosis and osteopenia according to the level of grip strength and muscle mass associated with sarcopenia. A cross-sectional study was conducted, and data from 734 women aged from 60 to 79 years old who visited the healthcare center from 2016 to 2019 were analyzed. Bone mineral density was measured on the lumbar spine from 1-4 using dual X-ray absorptiometry. Osteopenia and osteoporosis were classified on the basis of a T-score ranging from -1.0 to -2.4 and under -2.5, respectively. The diagnostic criteria for sarcopenia were a grip strength of <18 kg and muscle mass of <5.7 kg/m2 according to the Asian Working Group of Sarcopenia. Logistic regression analysis was used to determine the odds ratio, and the receiver operating characteristic curve was applied for the cutoff values. There were 351 (47.8%) patients with osteopenia and 152 (20.7%) patients with osteoporosis. The prevalence of osteopenia increased 1.593 times in the lowest grip strength group and 1.810 times in the lowest muscle mass group (p < 0.05). For osteoporosis, the lowest grip strength increased 2.512 times and the lowest muscle mass increased 2.875 times, compared to the highest grip strength group. In the sarcopenia group, osteopenia increased 2.451 times and osteoporosis increased 3.137 times, compared to the non-sarcopenia group (p < 0.05). In conclusion, the prevalence of osteoporosis and osteopenia was increased in elderly women with low grip strength and muscle mass.
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Confortin S, Ono L, Marques L, Ceolin G, d’Orsi E, Barbosa A. Osteopenia/Osteoporosis and Its Association with Sarcopenia: EpiFloripa Aging Study 2013/2014. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000508924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Tabrizi R, Hallajzadeh J, Mirhosseini N, Lankarani KB, Maharlouei N, Akbari M, Asemi Z. The effects of vitamin D supplementation on muscle function among postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. EXCLI JOURNAL 2019; 18:591-603. [PMID: 31611742 PMCID: PMC6785780 DOI: 10.17179/excli2019-1386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/23/2019] [Indexed: 02/05/2023]
Abstract
The loss of muscle mass and its strength is one of the most critical changes in aging which is associated with an increased risk of falls, osteoporotic fractures and mobility disability. Vitamin D, with its extra-skeletal benefits, might improve muscle function in elderly. The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize available relevant data and determine the effect of vitamin D supplementation on muscle function among postmenopausal women. We reached databases including; Cochrane library, Embase, PubMed, and Web of Science database until the end of May 2018 to identify relevant published RCTs. Heterogeneity among included studies was assessed using Q-test and I2 statistics. Random-effect model was applied to pool data and weighted mean difference (WMD) was calculated representing summary effect size. Outcomes of interest included the effects of vitamin D supplementation on hand grip strength (HGS), back muscle strength (BMS), and Timed Up and Go (TUG). Twelve RCTs out of 1739 potential reports were included in our meta-analysis. The pooled findings showed that vitamin D supplementation had no significant effect on HGS (WMD -0.03 kilogram (Kg); 95 % CI, -0.26, 0.20; P=0.78), BMS (WMD 7.21 newton (N); 95 % CI, -5.98, 20.40; P=0.28), and TUG (WMD 0.01 second (S); 95 % CI, -0.17, 0.18; P=0.93) in postmenopausal women. Overall, the current meta-analysis showed that taking vitamin D supplementation by postmenopausal women did not affect markers of muscle function. Further studies are required to confirm the effect of vitamin D supplementation on markers of muscle function.
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Affiliation(s)
- Reza Tabrizi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Clinical Neurology Research Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Jamal Hallajzadeh
- Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maraghe University of Medical Science, Maraghe, Iran
| | | | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Akbari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Kelly OJ, Gilman JC, Boschiero D, Ilich JZ. Osteosarcopenic Obesity: Current Knowledge, Revised Identification Criteria and Treatment Principles. Nutrients 2019; 11:E747. [PMID: 30935031 PMCID: PMC6520721 DOI: 10.3390/nu11040747] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 02/06/2023] Open
Abstract
Osteosarcopenic obesity (OSO) syndrome describes the simultaneous deterioration of bone, muscle and excess fat, resulting in reduced functionality and systemic metabolic dysregulation. The key component contributing to this may be ectopic fat in the viscera, bone and muscle. OSO research to date is summarized, and the revised criteria for its identification for research purposes are reviewed and proposed, including new criteria to assess visceral fat in males and females. Finally, nutritional and physical activity recommendations are consolidated into a treatment algorithm, which can be validated in future studies and which may also be applied to preventative management.
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Affiliation(s)
| | | | | | - Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32306, USA.
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Wong RMY, Wong H, Zhang N, Chow SKH, Chau WW, Wang J, Chim YN, Leung KS, Cheung WH. The relationship between sarcopenia and fragility fracture-a systematic review. Osteoporos Int 2019; 30:541-553. [PMID: 30610245 DOI: 10.1007/s00198-018-04828-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022]
Abstract
Sarcopenia is a common geriatric syndrome characterized by progressive decrease of muscle mass and function leading to an increased risk of physical disability, poor quality of life, and mortality. Increasing evidence shows that sarcopenia is related with fragility fractures. This systematic review aimed to summarize the following: (1) the prevalence of sarcopenia in patients with fragility fracture and (2) the associated risk factors for fragility fracture in patients with sarcopenia. Literature search was conducted in PubMed and Cochrane databases. Studies with the prevalence of sarcopenia in elderly patients with fragility fracture and associated risk factors in patients with sarcopenia were included. A total of 15 papers were included, with 10 reporting sarcopenia prevalence, and 5 on fracture risk in patients with sarcopenia. The prevalence of sarcopenia after fracture ranged from 12.4 to 95% in males and 18.3 to 64% in females. The prevalence of sarcopenia in elderly patients with fragility fracture was high, especially in men. Two studies showed that sarcopenia was a risk factor for fragility fracture when associated with low bone mineral density (BMD) but only in men. Caution should be taken for male patients with sarcopenia and low BMD, which is related to significantly increased risk of fractures. There is a pressing need for further research on sarcopenia and its risk on fragility fracture to better understand the relationship, pathophysiology, and mechanisms, which may shed light on potential interventions to improve clinical outcomes.
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Affiliation(s)
- R M Y Wong
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - H Wong
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - N Zhang
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - S K H Chow
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
- The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, People's Republic of China
| | - W W Chau
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - J Wang
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - Y N Chim
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - K S Leung
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - W H Cheung
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China.
- The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, People's Republic of China.
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Patel HP, Dawson A, Westbury LD, Hasnaoui G, Syddall HE, Shaw S, Sayer AA, Cooper C, Dennison EM. Muscle Mass, Muscle Morphology and Bone Health Among Community-Dwelling Older Men: Findings from the Hertfordshire Sarcopenia Study (HSS). Calcif Tissue Int 2018; 103:35-43. [PMID: 29372275 PMCID: PMC6010484 DOI: 10.1007/s00223-018-0388-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/04/2018] [Indexed: 12/21/2022]
Abstract
Sarcopenia and osteoporosis are associated with poor health outcomes in older people. Relationships between muscle and bone have typically been reported at a functional or macroscopic level. The aims of this study were to describe the relationships between muscle morphology and bone health among participants of the Hertfordshire Sarcopenia Study (HSS). 105 older men, mean age 72.5 (SD 2.5) years, were recruited into the HSS. Whole body lean mass as well as appendicular lean mass, lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD) were obtained through dual-energy X-ray absorptiometry scanning. Percutaneous biopsy of the vastus lateralis was performed successfully in 99 participants. Image analysis was used to determine the muscle morphology variables of slow-twitch (type I) and fast-twitch (type II) myofibre area, myofibre density, capillary and satellite cell (SC) density. There were strong relationships between whole and appendicular lean body mass in relation to femoral neck BMC and BMD (r ≥ 0.43, p < 0.001). Type II fibre area was associated with both femoral neck BMC (r = 0.27, p = 0.01) and BMD (r = 0.26, p = 0.01) with relationships robust to adjustment for age and height. In unadjusted analysis, SC density was associated with whole body area (r = 0.30, p = 0.011) and both BMC (r = 0.26, p = 0.031) and area (r = 0.29, p = 0.017) of the femoral neck. We have demonstrated associations between BMC and changes in muscle at a cellular level predominantly involving type II myofibres. Interventions targeted at improving muscle mass, function and quality may improve overall musculoskeletal health. Larger studies that include women are needed to explore these relationships further.
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Affiliation(s)
- H. P. Patel
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
- 0000 0004 1936 9297grid.5491.9Academic Geriatric Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- grid.430506.4National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD UK
| | - A. Dawson
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - L. D. Westbury
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - G. Hasnaoui
- 0000 0004 1936 9297grid.5491.9Academic Geriatric Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | - H. E. Syddall
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - S. Shaw
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - A. A. Sayer
- 0000 0004 1936 9297grid.5491.9Academic Geriatric Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- AGE Research Group, Institute of Neuroscience, Newcastle, UK
- 0000 0001 0462 7212grid.1006.7NIHR Newcastle Biomedical Research Centre, Newcastle upon-Tyne NHS Foundation Trust and Newcastle University, Newcastle, UK
| | - C. Cooper
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
- 0000 0004 1936 8948grid.4991.5National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - E. M. Dennison
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
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Orsatti FL, Nunes PRP, Souza ADP, Martins FM, de Oliveira AA, Nomelini RS, Michelin MA, Murta EFC. Predicting Functional Capacity From Measures of Muscle Mass in Postmenopausal Women. PM R 2016; 9:596-602. [DOI: 10.1016/j.pmrj.2016.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/26/2016] [Accepted: 10/02/2016] [Indexed: 12/14/2022]
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Rossi FE, Fortaleza ACS, Neves LM, Buonani C, Picolo MR, Diniz TA, Kalva-Filho CA, Papoti M, Lira FS, Freitas Junior IF. Combined Training (Aerobic Plus Strength) Potentiates a Reduction in Body Fat but Demonstrates No Difference on the Lipid Profile in Postmenopausal Women When Compared With Aerobic Training With a Similar Training Load. J Strength Cond Res 2016; 30:226-34. [PMID: 26038818 DOI: 10.1519/jsc.0000000000001020] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study was to verify the effects of aerobic and combined training on the body composition and lipid profile of obese postmenopausal women and to analyze which of these models is more effective after equalizing the training load. Sixty-five postmenopausal women (age = 61.0 ± 6.3 years) were divided into 3 groups: aerobic training (AT, n = 15), combined training (CT [strength + aerobic], n = 32), and control group (CG, n = 18). Their body composition upper body fat (TF), fat mass (FM), percentage of FM, and fat-free mass (FFM) were estimated by dual-energy x-ray absorptiometry. The lipid profile, total cholesterol, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein cholesterol were assessed. There was a statistically significant difference in the TF (AT = -4.4%, CT = -4.4%, and CG = 1.0%, p = 0.001) and FFM (AT = 1.7%, CT = 2.6%, and CG = -1.4%, p = 0.0001) between the experimental and the control groups. Regarding the percentage of body fat, there was a statistically significant difference only between the CT and CG groups (AT = -2.8%, CT = -3.9%, and CG = 0.31%; p = 0.004). When training loads were equalized, the aerobic and combined training decreased core fat and increased FFM, but only the combined training potentiated a reduction in percentage of body fat in obese postmenopausal women after the training program. High-density lipoprotein-c levels increased in the combined group, and the chol/HDL ratio (atherogenic index) decreased in the aerobic group; however, there were no significant differences between the intervention programs. Taken together, both the exercise training programs were effective for improving body composition and inducing an antiatherogenic status.
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Affiliation(s)
- Fabrício E Rossi
- 1Institute of Bioscience, Paulista State University, Rio Claro, Brazil; 2School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil; 3Department of Physical Education, Paulista State University, Presidente Prudente, São Paulo, Brazil; 4Department of Physiotherapy, Paulista State University, Presidente Prudente, São Paulo, Brazil; 5Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Ribeirão Preto, Brazil; 6School of Physical Education and Sports, University of São Paulo, Ribeirão Preto, Brazil; and 7Exercise and Immunometabolism Research Group, Department of Physical Education, Paulista State University, UNESP, Presidente Prudente, São Paulo, Brazil
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Cangussu LM, Nahas-Neto J, Orsatti CL, Bueloni-Dias FN, Nahas EAP. Effect of vitamin D supplementation alone on muscle function in postmenopausal women: a randomized, double-blind, placebo-controlled clinical trial. Osteoporos Int 2015; 26:2413-21. [PMID: 25956283 DOI: 10.1007/s00198-015-3151-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 04/26/2015] [Indexed: 12/19/2022]
Abstract
UNLABELLED The present study investigates the effects of vitamin D on muscle function in postmenopausal women. It has been shown that vitamin D supplementation in postmenopausal women with hypovitaminosis D provides significant protective factor against sarcopenia, with significant increases in muscle strength and control of progressive loss of lean mass. INTRODUCTION We aimed to evaluate the effect of supplementation of vitamin D (VITD) alone on muscle function in younger postmenopausal women. METHODS In this double-blind, placebo-controlled clinical trial, 160 Brazilian postmenopausal women were randomized into two groups: VITD group consisting of patients receiving vitamin D3 1000 IU/day orally (n = 80) or placebo group (n = 80). Women with amenorrhea for more than 12 months and age 50-65 years, with a history of falls (previous 12 months), were included. The intervention time was 9 months, with assessments at two points, start and end. Lean mass was estimated by total-body dual-energy X-ray absorptiometry (DXA) and muscle strength by handgrip strength and chair rising test. The plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by high-performance liquid chromatography (HPLC). Statistical analysis was by intention to treat (ITT), using ANOVA, Student's t test, and Tukey's test. RESULTS After 9 months, average values of 25(OH)D increased from 15.0 ± 7.5 to 27.5 ± 10.4 ng/ml (+45.4%) in the VITD group and decreased from 16.9 ± 6.7 to 13.8 ± 6.0 ng/ml (-18.5%) in the placebo group (p < 0.001). In the VITD group, there was significant increase in muscle strength (+25.3%) of the lower limbs by chair rising test (p = 0.036). In women in the placebo group, there was considerable loss (-6.8%) in the lean mass (p = 0.030). CONCLUSION The supplementation of vitamin D alone in postmenopausal women provided significant protective factor against the occurrence of sarcopenia, with significant increases in muscle strength and control of progressive loss of lean mass.
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Affiliation(s)
- L M Cangussu
- Department of Obstetrics and Gynecology, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.
| | - J Nahas-Neto
- Department of Obstetrics and Gynecology, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.
| | - C L Orsatti
- Department of Obstetrics and Gynecology, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.
| | - F N Bueloni-Dias
- Department of Obstetrics and Gynecology, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.
| | - E A P Nahas
- Department of Obstetrics and Gynecology, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.
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López-Larramona G, Lucendo AJ, Tenías JM. Association between nutritional screening via the Controlling Nutritional Status index and bone mineral density in chronic liver disease of various etiologies. Hepatol Res 2015; 45:618-28. [PMID: 25059921 DOI: 10.1111/hepr.12395] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 07/04/2014] [Accepted: 07/21/2014] [Indexed: 12/13/2022]
Abstract
AIM Bone density disorders are prevalent in patients with chronic liver disease (CLD), who commonly present with hepatic osteodystrophy. However, the relationship between nutritional status and bone mineral density (BMD) has been scarcely studied in CLD. METHODS This single-center, cross-sectional study included outpatients consecutively diagnosed with CLD during a 1.5-year period. The nutritional status was assessed with the Controlling Nutritional Status (CONUT) index; dual-energy X-ray absorptiometry scans and parameters of bone mineral metabolism were carried out. Bone fracture risk was estimated with the World Health Organization FRAX tool. RESULTS Among the 126 patients recruited (58.7% male), osteopenia and osteoporosis were present in 31.1% and 10.7%, respectively. The 10-year fracture risk was significantly higher among women. Malnutrition estimated with the CONUT index was present in 29.9% of patients and was significantly more frequent in cirrhotic patients, 63.4% of whom were malnourished. Malnutrition stage directly correlated with hepatic function as expressed by the Model for End-Stage Liver Disease index. A non-significant relationship between CONUT-assessed nutritional status and BMD was documented. 25-Hydroxyvitamin-D3 (25[OH]-D3) and fracture risk correlated positively with the CONUT stage, and total cholesterol had an inverse relationship with BMD. CONCLUSION Malnutrition assessed by the CONUT was very frequent in patients with liver cirrhosis. The CONUT score inversely correlated with liver function, while malnutrition stage directly correlated with BMD, fracture risk and 25(OH)-D3. Total cholesterol showed a negative association with BMD in this population.
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Affiliation(s)
| | - Alfredo J Lucendo
- Gastroenterology Department, Hospital General de Tomelloso, Tomelloso, Spain
| | - José María Tenías
- Research Support Unit, Hospital Mancha-Centro, Alcázar de San Juan, Spain
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Tarantino U, Piccirilli E, Fantini M, Baldi J, Gasbarra E, Bei R. Sarcopenia and fragility fractures: molecular and clinical evidence of the bone-muscle interaction. J Bone Joint Surg Am 2015; 97:429-37. [PMID: 25740034 DOI: 10.2106/jbjs.n.00648] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Bone and muscle tissues are in close relationship, and the aging process is a factor involved in the loss of the functionality of both bones and muscles.➤ Sarcopenia and osteoporosis are linked from a biological and functional perspective and are related to an increased fracture risk in the elderly.➤ The increased fracture risk in sarcopenic and osteoporotic subjects is due to the decline of muscle mass and strength, the decrease in bone mineral density, and limited mobility.
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Affiliation(s)
- Umberto Tarantino
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Eleonora Piccirilli
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Massimo Fantini
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Via Montpellier 1, 00133 Rome Italy
| | - Jacopo Baldi
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Elena Gasbarra
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Roberto Bei
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Via Montpellier 1, 00133 Rome Italy
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Ferrucci L, Baroni M, Ranchelli A, Lauretani F, Maggio M, Mecocci P, Ruggiero C. Interaction between bone and muscle in older persons with mobility limitations. Curr Pharm Des 2015; 20:3178-97. [PMID: 24050165 DOI: 10.2174/13816128113196660690] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/13/2013] [Indexed: 12/18/2022]
Abstract
Aging is associated with a progressive loss of bone-muscle mass and strength. When the decline in mass and strength reaches critical thresholds associated with adverse health outcomes, they are operationally considered geriatric conditions and named, respectively, osteoporosis and sarcopenia. Osteoporosis and sarcopenia share many of the same risk factors and both directly or indirectly cause higher risk of mobility limitations, falls, fractures and disability in activities of daily living. This is not surprising since bones adapt their morphology and strength to the long-term loads exerted by muscle during anti-gravitational and physical activities. Non-mechanical systemic and local factors also modulate the mechanostat effect of muscle on bone by affecting the bidirectional osteocyte-muscle crosstalk, but the specific pathways that regulate these homeostatic mechanisms are not fully understood. More research is required to reach a consensus on cut points in bone and muscle parameters that identify individuals at high risk for adverse health outcomes, including falls, fractures and disability. A better understanding of the muscle-bone physiological interaction may help to develop preventive strategies that reduce the burden of musculoskeletal diseases, the consequent disability in older persons and to limit the financial burden associated with such conditions. In this review, we summarize age-related bone-muscle changes focusing on the biomechanical and homeostatic mechanisms that explain bone-muscle interaction and we speculate about possible pathological events that occur when these mechanisms become impaired. We also report some recent definitions of osteoporosis and sarcopenia that have emerged in the literature and their implications in clinical practice. Finally, we outline the current evidence for the efficacy of available anti-osteoporotic and proposed antisarcopenic interventions in older persons.
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Affiliation(s)
| | | | | | | | | | | | - C Ruggiero
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, S. Andrea delle Fratte, 06100, Perugia, Italy.
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Liu PY, Ilich JZ, Brummel-Smith K, Ghosh S. New insight into fat, muscle and bone relationship in women: determining the threshold at which body fat assumes negative relationship with bone mineral density. Int J Prev Med 2014; 5:1452-63. [PMID: 25538842 PMCID: PMC4274553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 10/17/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The aim was to investigate the relationships among lean mass (LM), fat mass (FM), and bone mineral density (BMD) in women stratified by body mass index (BMI) (BMI - normal-weight, overweight, obese) and to determine threshold at which body fat assumes negative relationship with BMD. METHODS This was a cross-sectional study in 471 healthy Caucasian women, aged 18-67 years. BMD, LM, and FM were measured using dual-energy X-ray absorptiometry. Analysis of variance with Bonferroni corrections was used to test the BMI group differences. Linear regression was used to examine independent contributions of LM and FM on BMD of various skeletal sites (controlling for age and height). In overweight/obese women PROC LOESS plots were used to determine the inflection points at which either LM or FM relationship with BMD changes direction. Separate analyses in pre- and post-menopausal women were conducted as well. RESULTS Spine and femoral neck BMD were not different among three BMI groups while total body, femur and radius BMD were statistically different (the highest in the obese group). Linear regression revealed that LM had significant positive association with BMD of various skeletal sites in all groups. FM showed a negative association with BMD of femoral neck and femur in normal-weight and spine in overweight women, but a positive association with radius in obese women. Inflection points showed that body fat between 33% and 38% assumed negative relationship with BMD for most skeletal sites in overweight and obese women. CONCLUSIONS Although LM has strong positive relationship with BMD, FM above 33% in overweight/obese women is negatively related to BMD of most skeletal sites. Therefore, overweight/obesity after certain amount of FM, may not be a protective factor against osteoporosis in females. For clinical practice in women, it is important to maintain LM and keep FM accrual below ~30% body fat to maintain good skeletal health.
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Affiliation(s)
- Pei-Yang Liu
- School of Nutrition and Dietetics, University of Akron, Akron, Ohio, USA
| | - Jasminka Z. Ilich
- Department of Nutrition, Food and Exercise Sciences, College of Human Sciences, Florida State University, Florida, USA,Correspondence to: Prof. Jasminka Z. Ilich, Nutrition, Food and Exercise Sciences, Florida State University, 120 Convocation Way, 418 Sandels, Tallahassee, FL 32306-1493, USA. E-mail:
| | - Ken Brummel-Smith
- Department of Geriatrics, College of Medicine, Florida State University, Florida, USA
| | - Sunita Ghosh
- Department of Medical Oncology, University of Alberta and Alberta Health Services-CancerControl, Edmonton, Canada
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Yu R, Leung J, Woo J. Incremental Predictive Value of Sarcopenia for Incident Fracture in an Elderly Chinese Cohort: Results From the Osteoporotic Fractures in Men (MrOs) Study. J Am Med Dir Assoc 2014; 15:551-8. [DOI: 10.1016/j.jamda.2014.02.005] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 02/14/2014] [Indexed: 12/29/2022]
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Ilich JZ, Kelly OJ, Inglis JE, Panton LB, Duque G, Ormsbee MJ. Interrelationship among muscle, fat, and bone: connecting the dots on cellular, hormonal, and whole body levels. Ageing Res Rev 2014; 15:51-60. [PMID: 24632496 DOI: 10.1016/j.arr.2014.02.007] [Citation(s) in RCA: 171] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/25/2014] [Accepted: 02/28/2014] [Indexed: 12/24/2022]
Abstract
While sarcopenia and sarcopenic obesity have been recognized in the last decade, a combined concept to include decreased muscle mass and strength, as well as decreased bone mass with coexistence of adiposity is discussed here. We introduce a new term, osteopenic obesity, and operationalize its meaning within the context of osteopenia and obesity. Next, we consolidate osteopenic obesity with the already existing and more familiar term, sarcopenic obesity, and delineate the resulting combined condition assigning it the term osteosarcopenic obesity. Identification and possible diagnosis of each condition are discussed, as well as the interactions of muscle, fat and bone tissues on cellular level, considering their endocrine features. Special emphasis is placed on the mesenchymal stem cell commitment into osteoblastogenic, adipogenic and myogenic lineages and causes of its deregulation. Based on the presented evidence and as expounded within the text, it is reasonable to say that under certain conditions, osteoporosis and sarcopenia could be the obesity of bone and muscle, respectively, with the term osteosarcopenic obesity as an encompassment for all.
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Alioglu K, Dogu B, Sirzai H, Yilmaz F, Kuran B. Hand bone mineral density reference values in a Turkish healthy female population. Int J Rheum Dis 2013; 20:1965-1972. [DOI: 10.1111/1756-185x.12159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Kenan Alioglu
- Department of Physical and Rehabilitation Medicine; Sisli Etfal Training and Research Hospital; Istanbul Turkey
| | - Beril Dogu
- Department of Physical and Rehabilitation Medicine; Sisli Etfal Training and Research Hospital; Istanbul Turkey
| | - Hulya Sirzai
- Department of Physical and Rehabilitation Medicine; Sisli Etfal Training and Research Hospital; Istanbul Turkey
| | - Figen Yilmaz
- Department of Physical and Rehabilitation Medicine; Sisli Etfal Training and Research Hospital; Istanbul Turkey
| | - Banu Kuran
- Department of Physical and Rehabilitation Medicine; Sisli Etfal Training and Research Hospital; Istanbul Turkey
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23
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Wu N, Chen SY, Lee YC, Zhao Y. Demographics and clinical and economic characteristics of patients receiving total hip arthroplasty with and without muscle atrophy/weakness. CLINICOECONOMICS AND OUTCOMES RESEARCH 2013; 5:271-80. [PMID: 23836997 PMCID: PMC3699054 DOI: 10.2147/ceor.s46332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study analyzed administrative claims by a US population with commercial or Medicare supplemental insurance to compare demographics, comorbid medical conditions, and health care utilization and costs among patients undergoing total hip arthroplasty (THA) with and without muscle atrophy/weakness (MAW). Patients were classified into three cohorts: having MAW during the 12 months previous to THA (pre-MAW); having MAW during or over the 12 months after THA (post-MAW); or no MAW claim (no-MAW). In total, 19,607 Medicare and 23,127 commercially insured patients were examined. Controlling for cross-cohort differences, both pre-MAW and post-MAW commercial cohorts had significantly higher total costs ($6,697 and $8,594, in USD respectively) and higher risk of all-cause hospitalization (odds ratios, 1.66 and 1.57, respectively) than the no-MAW cohort (all P < 0.05) during the 1-year follow-up. Similar trends were observed in the Medicare population.
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Affiliation(s)
- Nin Wu
- United BioSource Corporation, Lexington, MA, USA
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Li J, Spieker AJ, Rosen GD, Rutkove SB. Electrical impedance alterations in the rat hind limb with unloading. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2013; 13:37-44. [PMID: 23445913 PMCID: PMC3984464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Methods are needed for quantifying muscle deconditioning due to immobilization, aging, or spaceflight. Electrical impedance myography (EIM) is one technique that may offer easy-to-follow metrics. Here, we evaluate the time course and character of the change in single- and multi-frequency EIM parameters in the hind-limb suspension model of muscle deconditioning in rats. METHODS Sixty-two rats were studied with EIM during a two-week period of hind limb unloading followed by a two-week recovery period. Random subsets of animals were sacrificed at one-week time intervals to measure muscle fiber size. RESULTS Significant alterations were observed in nearly all impedance parameters. The 50 kHz phase and multi-frequency phase-slope, created by taking the slope of a line fitted to the impedance values between 100-500 kHz, appeared most sensitive to disuse atrophy, the latter decreasing by over 33.0±6.6% (p<0.001), a change similar to the maximum reduction in muscle fiber size. Impedance alterations, however, lagged changes in muscle fiber size. CONCLUSIONS EIM is sensitive to disuse change in the rat, albeit with a delay relative to alterations in muscle fiber size. Given the rapidity and simplicity of EIM measurements, the technique could prove useful in providing a non-invasive approach to measuring disuse change in animal models and human subjects.
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Affiliation(s)
- J Li
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School,USA
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Abstract
Osteoporosis is a common skeletal complication seen in patients with chronic liver disease. Osteoporosis is usually asymptomatic and, if untreated, can result in fractures and impaired quality of life. For this review, we performed a systematic search of the PubMed database, and all recent peer-reviewed articles regarding the prevalence, pathophysiology, diagnosis, and management of osteoporosis in chronic liver disease were included. The prevalence of osteoporosis varies between 11% and 58% in patients with chronic liver disease and in transplant recipients. The etiology of osteoporosis is multifactorial and only partially understood. Various factors linked to the pathogenesis of bone loss are vitamin D, calcium, insulin growth factor-1, receptor activation of nuclear factor-κB ligand (RANKL), bilirubin, fibronectin, leptin, proinflammatory cytokines, and genetic polymorphisms. Management of osteoporosis involves early diagnosis, identifying and minimizing risk factors, general supportive care, nutrition therapy, and pharmacotherapy. Osteoporosis is diagnosed based on the bone mineral density (BMD) assessment using dual-energy X-ray absorptiometry scan. Measurement of BMD should be considered in all patients with advanced liver disease and in transplant recipients. Vitamin D and calcium supplementation is recommended for all patients with osteoporosis. Specific agents used for treatment of osteoporosis include bisphosphonates, calcitonin, hormonal therapy, and raloxifene. Bisphosphonates have become the mainstay of therapy for osteoporosis prevention and treatment. Prolonged suppression of bone remodeling resulting in atypical fractures has emerged as a significant complication with long-term use of bisphosphonates. Newer treatment agents and better fracture prevention strategies are necessary to prevent and treat osteoporosis.
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Affiliation(s)
- Anitha Yadav
- Division of Transplant Hepatology, Mayo Clinic Hospital, Phoenix, AZ 85054, USA
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Kim JH, Lee DC. Mitochondrial DNA copy number in peripheral blood is associated with femoral neck bone mineral density in postmenopausal women. J Rheumatol 2012; 39:1465-72. [PMID: 22589267 DOI: 10.3899/jrheum.111444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE It has been suggested that mitochondrial dysfunction is related to aging and metabolic disorders. Yet there are few studies of the relationship between bone mineral density (BMD) and mitochondrial content in humans. We investigated the relationship between BMD and mitochondrial DNA (mtDNA) copy number in peripheral blood of postmenopausal women. METHODS The study included 146 postmenopausal women. Enrolled subjects were taking no medications and had no disorders that altered bone metabolism. We measured BMD using dual-energy x-ray absorptiometry and leukocyte mtDNA copy number using real-time polymerase chain reaction. Anthropometric evaluations and biochemical tests were performed. RESULTS Patients with osteopenia or osteoporosis had lower mtDNA copy numbers than normal subjects (p < 0.0001). Femoral neck BMD was negatively correlated with age (r = -0.01, p = 0.04) and with serum levels of adiponectin (r = -0.22, p = 0.01) and osteocalcin (r = -0.31, p = 0.0001). Serum levels of 25-OH vitamin D (r = 0.32, p < 0.0001) and mtDNA copy number (r = 0.36, p < 0.0001) were positively correlated with femoral neck BMD. Multiple regression analysis showed that mtDNA copy number (ß = 0.156, p < 0.001) was an independent factor associated with femoral neck BMD after adjustment for age, body mass index, waist circumference, waist-hip ratio, blood pressure, homeostatic model assessment of insulin resistance, high-sensitivity C-reactive protein, adiponectin, osteocalcin, homocysteine, lipid profiles, 25-OH vitamin D, and regular exercise. mtDNA copy number was not related to lumbar BMD. CONCLUSION Low mtDNA content in peripheral blood is related to decreased femoral neck BMD in postmenopausal women. Our findings suggest that mitochondrial dysfunction may be a potential pathophysiologic mechanism of osteoporosis in postmenopausal women.
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Affiliation(s)
- Jung-Ha Kim
- Department of Family Medicine, Chung-Ang University Healthcare Center, Korea
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