Morphological signs of connective tissue dysplasia as predictors of frequent post-exercise musculoskeletal disorders

Identifying sex-specific injury predictors as a key factor in maintaining optimal physical activity levels

BACKGROUND

Optimal physical activity is known to reduce cardiovascular, respiratory and endocrine system diseases and, as a consequence, improve quality of life. An important risk factor for reinjuries during normal exercise is the initial connective tissue pathology. The variety of clinical dysplastic manifestations significantly complicate the timely diagnosis of this comorbidity.

AIM

To establish pathognomonic sex-specific dysplasia phenotypes that indicate a particular sensitivity to physical exertion.

METHODS

The study involved 117 participants with recurrent musculoskeletal injuries that occurred during normal exercise. There were 67 women (57.26%) and 50 men (42.74%), which made it possible to compare the presence of the identified signs between sexes. A validated questionnaire was used to screen their connective tissue status.

RESULTS

Ranking the most commonly revealed dysplasia signs depending on their clinical significance made it possible to establish pathognomonic sex-specific phenotypes that indicated a particular susceptibility to injuries. Individualized programs of optimal physical activity are necessary for men with chest deformities, flat-valgus feet, dolichostenomelia, arachnodactylia, hemorrhoids, abdominal muscle diastasis and recurrent hernias. In women, special sensitivity to physical exertion was associated with a combination of signs such as asthenic body, joint hypermobility, overly soft auricles, thin hyperelastic skin, atrophic striae, telangiectasias and varicose veins. Of particular importance were universal signs such as gothic palate, scoliosis, kyphosis, leg deformities, temporomandibular joint crunching, and moderate to high myopia.

CONCLUSION

Participants’ connective tissue condition should be considered when designing optimal physical activity programs. Identifying the established sex-specific dysplasia phenotypes will allow timely optimization of training loads, thus reducing the risk of injury.

A clustering linear combination method for multiple phenotype association studies based on GWAS summary statistics

There is strong evidence showing that joint analysis of multiple phenotypes in genome-wide association studies (GWAS) can increase statistical power when detecting the association between genetic variants and human complex diseases. We previously developed the Clustering Linear Combination (CLC) method and a computationally efficient CLC (ceCLC) method to test the association between multiple phenotypes and a genetic variant, which perform very well. However, both of these methods require individual-level genotypes and phenotypes that are often not easily accessible. In this research, we develop a novel method called sCLC for association studies of multiple phenotypes and a genetic variant based on GWAS summary statistics. We use the LD score regression to estimate the correlation matrix among phenotypes. The test statistic of sCLC is constructed by GWAS summary statistics and has an approximate Cauchy distribution. We perform a variety of simulation studies and compare sCLC with other commonly used methods for multiple phenotype association studies using GWAS summary statistics. Simulation results show that sCLC can control Type I error rates well and has the highest power in most scenarios. Moreover, we apply the newly developed method to the UK Biobank GWAS summary statistics from the XIII category with 70 related musculoskeletal system and connective tissue phenotypes. The results demonstrate that sCLC detects the most number of significant SNPs, and most of these identified SNPs can be matched to genes that have been reported in the GWAS catalog to be associated with those phenotypes. Furthermore, sCLC also identifies some novel signals that were missed by standard GWAS, which provide new insight into the potential genetic factors of the musculoskeletal system and connective tissue phenotypes.

Age Pathognomonic Indicators of Injury Predisposition as a Basis for Public Health Preservation during Physical Activity

A necessary condition for public health maintenance is regular physical activity. A significant increase in the number of musculoskeletal injuries, occurring during physical education and sport activities, actualizes the development of effective measures for their prevention. Early diagnosis of injury predisposition, based on identification of connective tissue dysplasia indicators specific for different age periods, is of particular importance for the prevention of such injuries. The study, performed in accordance to STROBE guidelines, included 78 persons separated into two age subgroups: Group 1 (age 22-35) and Group 2 (age 36-47). Morphometric signs of connective tissue dysplasia and clinical symptoms associated with predisposition to chronic injury were assessed. For persons in Group 1, these indicators included: asthenic body type, joint hypermobility, thin elastic skin, keloid scars, and soft auricles. For the second group: kyphosis, skin hyperpigmentation above the spine, flatfeet, valgus installation, rectus muscles diastasis, atrophic striae, recurrent hernias, and lower-limb varicosity. Universal pathognomonic indicators, such as "crunching" in the temporomandibular joint, gothic palate, altered chest shape, scoliosis, and X- and O-shaped legs are significant at any age. The established pathognomonic indicators will promote early diagnosis of injury predisposition help, and develop effective measures of their prevention and public health preservation during physical activity.

Connective tissue disease in the practice of a cosmetologist and dermatologist. Features of diagnosis and management of patients

In the practice of a cosmetologist and a dermatologist, the functional features of the skin are of extremely important. At the same time, monogenic connective tissue disorders (hereditary connective tissue dysplasia) that underlie hereditary syndromes have been known for a long time, but in recent years more attention has been paid to genetic defects that, together with other internal and external factors, lead to manifestations of connective tissue dysfunction. Such disorders are called multifactorial, as a result, a general clinic of connective tissue dysplasia can develop. It is important for dermatologists and cosmetologists to diagnose the presence and risk of connective tissue pathology in time, since these disorders require special features in the clinical management of such patients. To date, there is a slight difference in the understanding of connective tissue pathology in Russia and abroad. Thus, the purpose of this review was to integrate ideas about connective tissue dysplasia in Russia and abroad, as well as to provide dermatologists and cosmetologists with an algorithm for diagnosing and managing patients with connective tissue dysfunction.