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Lee CY, Chuang YS, Lee CH, Wu MT. Linking metabolic syndrome with low bone mass through insights from BMI and health behaviors. Sci Rep 2023; 13:14393. [PMID: 37658154 PMCID: PMC10474022 DOI: 10.1038/s41598-023-41513-7] [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: 05/17/2023] [Accepted: 08/28/2023] [Indexed: 09/03/2023] Open
Abstract
The objective of this study is to investigate the relationship between metabolic syndrome (MetS), and bone density in a 30- to 50-year-old Taiwanese population, and to explore the combined effects of BMI and health behaviors on this association. A total of 52,912 individuals aged 30-50 years from the Taiwan Biobank were included in this cross-sectional study. Bone density status was assessed using quantitative ultrasound (QUS). The joint effect was assessed by including an interaction term in the multi-logistic regression models to test the association between MetS, BMI, and bone density while controlling for potential confounders. MetS was associated with reduced bone density, with the risk of severe low bone density (SLBD) higher among BMI < 24 kg/m2 individuals with MetS (adjusted odds ratio [aOR] 1.5, 95% confidence interval [CI] 1.09-2.16), while the risk was not significant among BMI ≥ 24 kg/m2 individuals with MetS. Smoking, alcohol consumption, and lack of regular exercise among individuals with a BMI < 24 kg/m2 and MetS were associated with higher risk of severe low bone density (SLBD), the aORs (95%CI) were 2.9 (1.59-5.20), 2.1 (1.06-4.22), and 1.8 (1.24-2.54) respectively. Our study suggests that metabolic syndrome could increase the risk of severe low bone density, but this risk can be minimized through higher BMI, non-smoking, no alcohol consumption, and regular exercise. Conversely, smoking, alcohol consumption or lack of regular exercise may exacerbate the risk of severe low bone density. These findings highlight the importance of a multifactorial approach in managing bone healthcare.
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Affiliation(s)
- Chun-Ying Lee
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yun-Shiuan Chuang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Tsang Wu
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Métrailler A, Hans D, Lamy O, Gonzalez Rodriguez E, Shevroja E. Heel quantitative ultrasound (QUS) predicts incident fractures independently of trabecular bone score (TBS), bone mineral density (BMD), and FRAX: the OsteoLaus Study. Osteoporos Int 2023:10.1007/s00198-023-06728-4. [PMID: 37154943 PMCID: PMC10382398 DOI: 10.1007/s00198-023-06728-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/16/2023] [Indexed: 05/10/2023]
Abstract
This study aimed to better define the role of heel-QUS in fracture prediction. Our results showed that heel-QUS predicts fracture independently of FRAX, BMD, and TBS. This corroborates its use as a case finding/pre-screening tool in osteoporosis management. INTRODUCTION Quantitative ultrasound (QUS) characterizes bone tissue based on the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Heel-QUS predicts osteoporotic fractures independently of clinical risk factors (CRFs) and bone mineral density (BMD). We aimed to investigate whether (1) heel-QUS parameters predict major osteoporotic fractures (MOF) independently of the trabecular bone score (TBS) and (2) the change of heel-QUS parameters over 2.5 years is associated with fracture risk. METHODS One thousand three hundred forty-five postmenopausal women from the OsteoLaus cohort were followed up for 7 years. Heel-QUS (SOS, BUA, and stiffness index (SI)), DXA (BMD and TBS), and MOF were assessed every 2.5 years. Pearson's correlation and multivariable regression analyses were used to determine associations between QUS and DXA parameters and fracture incidence. RESULTS During a mean follow-up of 6.7 years, 200 MOF were recorded. Fractured women were older, more treated with anti-osteoporosis medication; had lower QUS, BMD, and TBS; higher FRAX-CRF risk; and more prevalent fractures. TBS was significantly correlated with SOS (0.409) and SI (0.472). A decrease of one SD in SI, BUA or SOS increased the MOF risk by (OR(95%CI)) 1.43 (1.18-1.75), 1.19 (0.99-1.43), and 1.52 (1.26-1.84), respectively, after adjustment for FRAX-CRF, treatment, BMD, and TBS. We found no association between the change of QUS parameters in 2.5 years and incident MOF. CONCLUSION Heel-QUS predicts fracture independently of FRAX, BMD, and TBS. Thus, QUS represents an important case finding/pre-screening tool in osteoporosis management. The change in QUS over time was not associated with future fractures, making it inappropriate for patient monitoring.
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Affiliation(s)
- Antoine Métrailler
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Didier Hans
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Olivier Lamy
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Elena Gonzalez Rodriguez
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Enisa Shevroja
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland.
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Cleminson JR, Pasco JA, Bortolasci CC, Holloway-Kew KL, Hodge JM, Anderson KB, Kotowicz MA, Samarasinghe RM, Williams LJ. Lipopolysaccharide-binding protein and bone health: data from a population-based sample of men. Osteoporos Int 2023; 34:309-317. [PMID: 36409359 DOI: 10.1007/s00198-022-06602-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022]
Abstract
UNLABELLED We aimed to investigate the association between serum lipopolysaccharide-binding protein (LBP) and bone health in men. LBP was associated with lower bone density at the mid-forearm and the quantitative heel ultrasound measure, broadband ultrasound attenuation, for heavier participants. Data do not support clear associations between serum LBP and bone health. INTRODUCTION The objective of this study was to investigate the association between serum lipopolysaccharide-binding protein (LBP) and potential downstream effects on skeletal density, quality, and turnover in a population-based sample of men. METHODS This cross-sectional study utilised data from 1149 men (aged 20-96 year) enrolled in the Geelong Osteoporosis Study. Blood samples were obtained and lipopolysaccharide-binding protein (LBP), bone resorption marker, C-telopeptide (CTx), and formation marker, type 1 procollagen amino-terminal-propeptide (P1NP), were measured. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Stiffness Index (SI), broadband ultrasound attenuation (BUA), and speed of sound (SOS) were derived from quantitative heel ultrasound (QUS). Linear regression models were developed to test associations between log-transformed LBP (ln-LBP), BMD, QUS, and bone turnover, after adjusting for potential covariates. RESULTS Serum LBP ranged from 1.07-208.53 ng/mL (median 16.53 ng/mL). Those with higher levels were older, less mobile, and had lower BMD at the mid-forearm, otherwise, groups were similar. Before and after adjustment for age, ln-LBP was associated with lower BMD at the spine, total body, and mid-forearm. Further adjustment for weight attenuated associations at the spine and total body, yet the relationship at the mid-forearm was sustained (β - 0.014 ± 0.004, p = 0.001). SOS and SI were not associated with ln-LBP either before or after adjustment for age; however, weight was identified as an effect modifier in the relationship between ln-LBP and BUA. An association was observed for those weighing greater than 82.7 kg (β 3.366 ± 0.929, p < 0.001), after adjustment for potential covariates. Neither bone turnover marker was associated with ln-LBP. CONCLUSION Our data do not support a clear association between serum LBP and measures of bone health in this sample of men.
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Affiliation(s)
- Jasmine R Cleminson
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia.
| | - Julie A Pasco
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Barwon Health, University Hospital, Geelong, VIC, Australia
| | - Chiara C Bortolasci
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
| | - Kara L Holloway-Kew
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
| | - Jason M Hodge
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
- Barwon Health, University Hospital, Geelong, VIC, Australia
- Geelong Centre for Emerging Infectious Diseases, Geelong, VIC, 3220, Australia
| | - Kara B Anderson
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
| | - Mark A Kotowicz
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Victoria, Australia
- Barwon Health, University Hospital, Geelong, VIC, Australia
| | - Rasika M Samarasinghe
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
| | - Lana J Williams
- Deakin University, School of Medicine, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), PO Box 281, Geelong, Victoria, 3220, Australia
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Bi D, Shi L, Liu C, Li B, Li Y, Le LH, Luo J, Wang S, Ta D. Ultrasonic Through-Transmission Measurements of Human Musculoskeletal and Fat Properties. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:347-355. [PMID: 36266143 DOI: 10.1016/j.ultrasmedbio.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
The study described here was aimed at investigating the feasibility of using the ultrasonic through-transmission technique to estimate human musculoskeletal and fat properties. Five hundred eighty-two volunteers were assessed by dual-energy X-ray absorptiometry (DXA) and ultrasonic transmission techniques. Bone mineral density (BMD), muscle and fat mass were measured for both legs and the whole body. Hip BMD and spine BMD were also measured. Ultrasonic transmission measurements were performed on the heel, and the measured parameters were broadband ultrasound attenuation (BUA), speed of sound (SOS), ultrasonic stiffness index (SI), T-score and Z-score, which were significantly correlated with all measured BMDs. The optimal correlation was observed between SI and left-leg BMD (p < 0.001) before and after adjustment for age, sex and body mass index (BMI). The linear and partial correlation analyses revealed that BUA and SOS were closely associated with muscle and fat mass, respectively. Multiple regressions revealed that muscle and fat mass significantly contributed to the prediction of transmission parameters, explaining up to 17.83% (p < 0.001) variance independently of BMD. The results suggest that the ultrasonic through-transmission technique could help in the clinical diagnosis of skeletal and muscular system diseases.
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Affiliation(s)
- Dongsheng Bi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Lingwei Shi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Chengcheng Liu
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Boyi Li
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Ying Li
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Lawrence H Le
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Jingchun Luo
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Sijia Wang
- Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Dean Ta
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China; Academy for Engineering and Technology, Fudan University, Shanghai, China; Human Phenome Institute, Fudan University, Shanghai, China.
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Mizukami S, Arima K, Abe Y, Tomita Y, Nakashima H, Honda Y, Uchiyama M, Ookawachi T, Goto H, Hasegawa M, Sou Y, Kanagae M, Osaki M, Aoyagi K. Association between fat mass by bioelectrical impedance analysis and bone mass by quantitative ultrasound in relation to grip strength and serum 25-hydroxyvitamin D in postmenopausal Japanese women: the Unzen study. J Physiol Anthropol 2022; 41:7. [PMID: 35264253 PMCID: PMC8908611 DOI: 10.1186/s40101-022-00281-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background Whether fat mass or lean mass affects bone mass in postmenopausal women is controversial. This study aimed to explore the association between body composition measured by bioelectrical impedance analysis (BIA) and bone mass measured by quantitative ultrasound (QUS) in postmenopausal women in Japan. Methods We conducted a cross-sectional study, The Unzen Study, on 382 community-dwelling postmenopausal Japanese women (mean (standard deviation) age: 68.2 (7.2) years) who participated in periodic health examinations. The stiffness index (SI) was measured using QUS, and body composition (e.g., fat mass and muscle mass) was measured using BIA. Grip strength was measured. Fasting blood samples were collected, and 25-hydroxyvitamin D (25(OH)D), tartrate-resistant acid phosphatase-5b (TRACP-5b), and parathyroid hormone (PTH) levels were measured. Data on current smoking, alcohol consumption, exercise, and any comorbidities (heart disease, lung disease, stroke, or diabetes mellitus) were collected. Results The SI increased with increasing quartiles of fat mass and muscle mass (both p for trend < 0.001), respectively. There were positive correlations between SI and log (25(OH)D) or grip strength. Fat mass significantly correlated with grip strength. Multiple linear regression analysis showed that higher fat mass was independently and significantly associated with higher SI after adjusting for age, height, comorbidity, current smoking, alcohol consumption, exercise, log (25(OH)D), log (TRACP-5b), log (PTH), and grip strength (p = 0.001). In contrast, no association was observed between muscle mass and SI. Conclusions Fat mass, but not muscle mass, was a significant determinant of SI in community-dwelling postmenopausal Japanese women.
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Ruiz-Vicente D, García-Pastor T, Lara B, Salinero JJ, Areces F, Gallo-Salazar C, Abián-Vicén J, Jiménez F, Del Coso J. Endurance running prevents the age-related decline of calcaneal bone stiffness. Arch Osteoporos 2021; 16:83. [PMID: 34080075 DOI: 10.1007/s11657-021-00942-5] [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: 09/18/2020] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED This investigation presents a comparison of calcaneus bone stiffness of endurance runners of different ages and age-matched controls. We found that there was an age-associated decline in calcaneus bone stiffness in the control group while endurance runners prevented this decline, with a higher effect as the participants increased their age. PURPOSE Previous investigations have found that endurance runners have higher bone mineral density and other bone quality variables in mechanically loaded bones. However, it is unknown if endurance running might counteract the decline in bone stiffness that occurs with age. The purpose of this study was to compare calcaneus bone stiffness of endurance runners of different ages to age-matched controls. METHODS In a descriptive cross-sectional study, 182 endurance-trained male runners and 116 healthy untrained male controls underwent an ultrasonographic assessment of the calcaneus bone in the right and left heels. Calcaneal bone stiffness was calculated from assessments of the broadband ultrasound attenuation and the speed of sound. RESULTS The line of best fit for the association between age and calcaneus stiffness was different between marathoners and controls (Z = - 2.1, P = 0.02). A two-way ANCOVA (condition × age) with body mass, and body mass index as covariates, revealed that there were main effects of condition (F = 26.8, P < 0.01) and age (F = 4.2, P < 0.01) for calcaneus stiffness, with a significant interaction between these two factors (F = 2.8, P = 0.03). The post hoc analysis revealed that calcaneus stiffness was significantly higher in marathoners of 40-44 years (121.5 ± 18.2 vs 101.1 ± 21.3 arbitrary units [A.U.], P = 0.01), 45-49 years (121.5 ± 19.7 vs 104.3 ± 13.4 A.U., P = 0.04), and > 50 years (111.2 ± 17.9 vs 92.4 ± 16.0 A.U., P < 0.01) than their untrained counterparts of the same age with no statistically significant differences in the remaining age groups. CONCLUSION Endurance runners of > 40 years had higher values of calcaneus stiffness than controls, providing evidence to support the potential effect of endurance running to reduce the age-related decline on calcaneus bone stiffness.
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Affiliation(s)
- Diana Ruiz-Vicente
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | | | - Beatriz Lara
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - Juan José Salinero
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain.,Faculty of Sport Sciences, Castilla La Mancha University, Toledo, Spain
| | - Francisco Areces
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | | | | | - Fernando Jiménez
- Faculty of Sport Sciences, Castilla La Mancha University, Toledo, Spain
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, C/ Camino del Molino s/n., 28943, Fuenlabrada, Spain.
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Chandrasekaran V, Pasco JA, Stuart AL, Brennan-Olsen SL, Berk M, Hodge JM, Samarasinghe RM, Williams LJ. Anticonvulsant use and bone health in a population-based study of men and women: cross-sectional data from the Geelong Osteoporosis Study. BMC Musculoskelet Disord 2021; 22:172. [PMID: 33573610 PMCID: PMC7879513 DOI: 10.1186/s12891-021-04042-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023] Open
Abstract
Background Anticonvulsant use has been linked to bone deficits in specific patient populations. We studied the association between anticonvulsant use and bone health in a population-based sample of men and women. Methods Data from 926 men (24-73 yr) and 1070 women (21-94 yr) participating in the Geelong Osteoporosis Study were included. Bone mineral density (BMD, g/cm2) of the PA-spine and total hip was measured using dual-energy X-ray absorptiometry (Lunar). Bone quality was determined using quantitative heel ultrasound (QUS). Anthropometry was conducted and socioeconomic status was determined. Medication and lifestyle information was obtained via questionnaire. Linear regression was used to test associations between anticonvulsant use and bone health before and after adjustment for potential confounders. Results Seventeen (1.8%) men and 20 (1.9%) women reported anticonvulsant use. In men, anticonvulsant users had 9.1% lower adjusted mean BMD at the spine and hip compared to non-users. Body mass index was an effect modifier at the spine. Anticonvulsant users also had 1.8% lower speed of sound (SOS), 10.6% lower broadband ultrasound attenuation (BUA) and 13.7% lower stiffness index (SI) compared to non-users. In women, BMD tended to be lower at the hip compared to non-users as with the bone quality measure, BUA. No significant associations were observed at the spine or the other bone quality measures, SOS and SI. Conclusion Our data suggest that bone quantity and quality, assessed using BMD and QUS, are lower for men and possibly women who use anticonvulsants. While further exploration into potential mechanisms is needed, our findings suggest that monitoring bone health among users of anticonvulsants is warranted.
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Affiliation(s)
- Vinoomika Chandrasekaran
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia.
| | - Julie A Pasco
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia.,Barwon Health, University Hospital, Geelong, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
| | - Amanda L Stuart
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia.,Deakin University, School of Health and Social Development, Geelong, Waterfront, Australia.,Institute for Health Transformation, Deakin University, Burwood, Australia
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia.,Barwon Health, University Hospital, Geelong, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Florey Institute of Neuroscience and Mental Health, Parkville, Australia.,Orygen the National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Jason M Hodge
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia.,Barwon Health, University Hospital, Geelong, Australia.,Geelong Centre for Emerging Infectious Diseases, Geelong, Australia
| | - Rasika M Samarasinghe
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia
| | - Lana J Williams
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia
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Economos CD, Hennessy E, Chui K, Dwyer J, Marcotte L, Must A, Naumova EN, Goldberg J. Beat osteoporosis - nourish and exercise skeletons (BONES): a group randomized controlled trial in children. BMC Pediatr 2020; 20:83. [PMID: 32093625 PMCID: PMC7038625 DOI: 10.1186/s12887-020-1964-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 02/07/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Lifelong healthy habits developed during childhood may prevent chronic diseases in adulthood. Interventions to promote these habits must begin early. The BONES (Beat Osteoporosis - Nourish and Exercise Skeletons) project assessed whether early elementary school children participating in a multifaceted health behavior change, after-school based intervention would improve bone quality and muscular strength and engage in more bone-strengthening behaviors. METHODS The 2-year BONES (B) intervention included bone-strengthening physical activity (85 min/week), educational materials (2 days/week), and daily calcium-rich snacks (380 mg calcium/day) delivered by after-school program leaders. BONES plus Parent (B + P) included an additional parent education component. From 1999 to 2004, n = 83 after-school programs (N = 1434 children aged 6-9 years) in Massachusetts and Rhode Island participated in a group randomized trial with two intervention arms (B only, n = 25 programs; B + P, n = 33) and a control arm (C, n = 25). Outcome measures (primary: bone quality (stiffness index of the calcaneus) and muscular strength (grip strength and vertical jump); secondary: bone-strengthening behaviors (calcium-rich food knowledge, preference, and intake; and physical activity level (metabolic equivalent time (MET) score, and weight-bearing factor (WBF) score)) were recorded at baseline, and after years one and two. Analyses followed an intent-to-treat protocol, and focused on individual subjects' trajectories along the three time points adjusting for baseline age and race via a mixed-effects regression framework. Analyses were performed with and without sex stratification. RESULTS Children in B + P increased bone stiffness compared to C (p = 0.05); No significant changes were observed in muscle strength, food knowledge, or vertical jump. Children in B + P showed significant improvement in their MET and WBF scores compared to C (p < 0.01) with a stronger effect in boys in both B and B + P (all p < 0.01). CONCLUSION After-school programs, coupled with parental engagement, serving early elementary school children are a potentially feasible platform to deliver bone-strengthening behaviors to prevent osteoporosis in adulthood, with some encouraging bone and physical activity outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT00065247. Retrospectively registered. First posted July 22, 2003.
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Affiliation(s)
- Christina D. Economos
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Kenneth Chui
- Tufts University School of Medicine, Boston, MA USA
| | - Johanna Dwyer
- Frances Stern Nutrition Center, Tufts Medical Center, Boston, MA USA
- Jean Mayer USDA Human Nutrition Research Center on Aging and Tufts University School of Medicine, Boston, MA USA
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD USA
| | | | - Aviva Must
- Tufts University School of Medicine, Boston, MA USA
| | - Elena N. Naumova
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Jeanne Goldberg
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
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Nishimura T, Arima K, Abe Y, Kanagae M, Mizukami S, Okabe T, Tomita Y, Goto H, Hasegawa M, Sou Y, Horiguchi I, Aoyagi K. Relationship between bone turnover markers and the heel stiffness index measured by quantitative ultrasound in post-menopausal Japanese women. Ann Hum Biol 2019; 46:330-334. [PMID: 30995879 DOI: 10.1080/03014460.2019.1607552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Osteoporosis in women is a serious health problem. The relationships between biochemical markers of bone turnover and bone mineral density (BMD) in women have been reported, but no study has examined relationships between tartrate-resistant acid phosphatase-5b (TRACP-5b) or bone-specific alkaline phosphatase (BAP) and bone mass measured by quantitative ultrasound (QUS) in Japanese post-menopausal women. Aim: To investigate the serum TRACP-5b and BAP levels and to determine their associations with the heel stiffness index measured by QUS in post-menopausal women. Subjects and methods: The subjects were 510 post-menopausal women who were invited to participate in periodic health examinations in 2011-2013 (the Unzen Study). The heel stiffness index (bone mass) was measured by QUS. Serum samples were collected and TRACP-5b and BAP levels were measured. Results: Multiple regression analysis showed that a higher log (TRACP-5b) was correlated with a lower stiffness index (p = 0.014) and log (BAP) was not correlated with stiffness index after adjusting for covariates (p = 0.136). Conclusion: Higher rates of bone resorption are associated with a lower stiffness index in Japanese post-menopausal women. These results may indicate that high bone resorption affects bone mass more than bone formation, resulting in a low bone mass.
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Affiliation(s)
- Takayuki Nishimura
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Yasuyo Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Mitsuo Kanagae
- Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | - Satoshi Mizukami
- Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | - Takuhiro Okabe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | - Yoshihito Tomita
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | | | - Maiko Hasegawa
- Medical Policy Division, Nagasaki Prefectural Government , Nagasaki , Japan
| | - Yoko Sou
- Ken-Nan Health Care Office , Nagasaki , Japan
| | - Itsuko Horiguchi
- Center for Public Relations Strategy, Nagasaki University , Nagasaki , Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
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10
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Hervás G, Ruiz-Litago F, Irazusta J, Fernández-Atutxa A, Fraile-Bermúdez AB, Zarrazquin I. Physical Activity, Physical Fitness, Body Composition, and Nutrition Are Associated with Bone Status in University Students. Nutrients 2018; 10:nu10010061. [PMID: 29320446 PMCID: PMC5793289 DOI: 10.3390/nu10010061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/27/2017] [Accepted: 01/05/2018] [Indexed: 12/13/2022] Open
Abstract
Understanding the modifiable factors that improve and maximize peak bone mass at an early age is necessary to design more effective intervention programs to prevent osteoporosis. To identify these modifiable factors, we analyzed the relationship of physical activity (PA), physical fitness, body composition, and dietary intake with bone stiffness index (SI), measured by quantitative ultrasonometry in young university students (18–21 years). Moderate-to-vigorous PA (MVPA) was the strongest predictor of SI (β = 0.184; p = 0.035). SI was most closely related with very vigorous PA in males (β = 0.288; p = 0.040) and with the number of steps/day in females (β = 0.319; p = 0.002). An association between thigh muscle and SI was consistent in both sexes (β = 0.328; p < 0.001). Additionally, extension maximal force was a bone SI predictor factor in females (β = 0.263; p = 0.016) independent of thigh muscle perimeter. Calcium intake was the only nutrition parameter that had a positive relationship with SI (R = 0.217; p = 0.022). However, it was not included as a predictor for SI in our regression models. This study identifies predictors of bone status in each sex and indicates that muscle and bone interrelate with PA and fitness in young adults.
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Affiliation(s)
- Gotzone Hervás
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bo Sarriena s/n, Leioa, 48940 Bizkaia, Spain; (F.R.-L.); (J.I.)
- Correspondence: ; Tel.: +34-946-012-900
| | - Fátima Ruiz-Litago
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bo Sarriena s/n, Leioa, 48940 Bizkaia, Spain; (F.R.-L.); (J.I.)
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bo Sarriena s/n, Leioa, 48940 Bizkaia, Spain; (F.R.-L.); (J.I.)
| | - Ainhoa Fernández-Atutxa
- Department of Nursing I, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bo Sarriena s/n, Leioa, 48940 Bizkaia, Spain; (A.F.-A.); (A.B.F.-B.); (I.Z.)
| | - Ana Belen Fraile-Bermúdez
- Department of Nursing I, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bo Sarriena s/n, Leioa, 48940 Bizkaia, Spain; (A.F.-A.); (A.B.F.-B.); (I.Z.)
| | - Idoia Zarrazquin
- Department of Nursing I, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Bo Sarriena s/n, Leioa, 48940 Bizkaia, Spain; (A.F.-A.); (A.B.F.-B.); (I.Z.)
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11
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Urinary Mineral Concentrations in European Pre-Adolescent Children and Their Association with Calcaneal Bone Quantitative Ultrasound Measurements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050471. [PMID: 27164120 PMCID: PMC4881096 DOI: 10.3390/ijerph13050471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 11/26/2022]
Abstract
This study investigates differences and associations between urinary mineral concentrations and calcaneal bone measures assessed by quantitative ultrasonography (QUS) in 4322 children (3.1–11.9 years, 50.6% boys) from seven European countries. Urinary mineral concentrations and calcaneal QUS parameters differed significantly across countries. Clustering revealed a lower stiffness index (SI) in children with low and medium urinary mineral concentrations, and a higher SI in children with high urinary mineral concentrations. Urinary sodium (uNa) was positively correlated with urinary calcium (uCa), and was positively associated with broadband ultrasound attenuation and SI after adjustment for age, sex and fat-free mass. Urinary potassium (uK) was negatively correlated with uCa but positively associated with speed of sound after adjustment. No association was found between uCa and QUS parameters after adjustment, but when additionally adjusting for uNa, uCa was negatively associated with SI. Our findings suggest that urinary mineral concentrations are associated with calcaneal QUS parameters and may therefore implicate bone properties. These findings should be confirmed in longitudinal studies that include the food intake and repeated measurement of urinary mineral concentrations to better estimate usual intake and minimize bias.
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12
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Qin L, Pan Y, Zhang M, Xu M, Lao H, O'Laughlin MC, Tong S, Zhao Y, Hung VWY, Cheng JCY, Guo X. Lifelong bound feet in China: a quantitative ultrasound and lifestyle questionnaire study in postmenopausal women. BMJ Open 2015; 5:e006521. [PMID: 25783423 PMCID: PMC4368908 DOI: 10.1136/bmjopen-2014-006521] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The phenomenon of foot binding, also known as 'lotus feet', has an enduring and influential history in China. To achieve a man-made smaller foot size, lifelong foot binding may have had adverse effects on the skeleton. We investigated bone properties in postmenopausal women with bound feet, which may provide new information for developing countermeasures for prevention of fragility fractures. DESIGN Population-based cohort study. PARTICIPANTS This study involved 254 postmenopausal women aged 65-80, including 172 with bound feet and 82 age- and gender-matched control subjects, living in a remote region of China. OUTCOMES Anthropometric, SF-36 Lifestyle Questionnaire and heel quantitative ultrasound (QUS) data were collected for the whole study population. A small subset of two cases was also invited for assessment of bone mineral density and microarchitecture at the distal tibia using high-resolution peripheral quantitative CT (HR-pQCT) and gait and balance tests. RESULTS Women with bound feet had significantly lower QUS values than age-matched women with normal feet; this was supported by HR-pQCT data. However, SF-36 Questionnaire results did not reveal any statistically significant differences in any categorical responses, including physical functioning, general health vitality and physical component summary score, and number of previous fractures. No impairment of body balance was found in the small subset. CONCLUSIONS The man-made changes caused by foot binding led to reduced physical activity, making the subjects prone to osteoporosis. Women with bound feet and osteoporosis did not have a higher incidence of fragility fractures than controls. This might be explained by compensation in physical activity to improve body balance, implying the importance of improving or maintaining body balance in overall prevention strategies against fragility fractures.
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Affiliation(s)
- Ling Qin
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yi Pan
- Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Ming Zhang
- Department of Mechanical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Mian Xu
- Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Hanchang Lao
- Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Michael C O'Laughlin
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Shan Tong
- Department of Mechanical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Yanling Zhao
- Training Department of International Osteoporosis Diagnosis and Treatment, Health Promotion Foundation of China, Beijing, China
| | - VWY Hung
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - JCY Cheng
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Xia Guo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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13
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De Smet S, Michels N, Polfliet C, D'Haese S, Roggen I, De Henauw S, Sioen I. The influence of dairy consumption and physical activity on ultrasound bone measurements in Flemish children. J Bone Miner Metab 2015; 33:192-200. [PMID: 24633491 DOI: 10.1007/s00774-014-0577-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 02/04/2014] [Indexed: 10/25/2022]
Abstract
The study's aim was to analyse whether children's bone status, assessed by calcaneal ultrasound measurements, is influenced by dairy consumption and objectively measured physical activity (PA). Moreover, the interaction between dairy consumption and PA on bone mass was studied. Participants of this cross-sectional study were 306 Flemish children (6-12 years). Body composition was measured with air displacement plethysmography (BodPod), dairy consumption with a Food Frequency Questionnaire, PA with an accelerometer (only in 234 of the 306 children) and bone mass with quantitative ultrasound, quantifying speed of sound (SOS), broadband ultrasound attenuation (BUA) and Stiffness Index (SI). Regression analyses were used to study the associations between dairy consumption, PA, SOS, BUA and SI. Total dairy consumption and non-cheese dairy consumption were positively associated with SOS and SI, but no significant association could be demonstrated with BUA. In contrast, milk consumption, disregarding other dairy products, had no significant effect on calcaneal bone measurements. PA [vigorous PA, moderate to vigorous physical activity (MVPA) and counts per minute] was positively associated and sedentary time was negatively associated with BUA and SI, but no significant influence on SOS could be detected. Dairy consumption and PA (sedentary time and MVPA) did not show any interaction influencing bone measurements. In conclusion, even at young age, PA and dairy consumption positively influence bone mass. Promoting PA and dairy consumption in young children may, therefore, maximize peak bone mass, an important protective factor against osteoporosis later in life.
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Affiliation(s)
- Stephanie De Smet
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ 2 Blok A, De Pintelaan 185, 9000, Ghent, Belgium,
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14
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Hermans H, Evenhuis HM. Multimorbidity in older adults with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:776-783. [PMID: 24529858 DOI: 10.1016/j.ridd.2014.01.022] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/21/2014] [Accepted: 01/22/2014] [Indexed: 05/28/2023]
Abstract
Multimorbidity may be related to the supposed early aging of people with intellectual disabilities (ID). This group may suffer more often from multimorbidity, because of ID-related physical health conditions, unhealthy lifestyle and metabolic effects of antipsychotic drug use. Multimorbidity has been defined as two or more chronic conditions. Data on chronic conditions have been collected through physical assessment, questionnaires, and medical files. Prevalence, associated factors and clusters of multimorbidity have been studied in 1047 older adults (≥ 50 years) with ID. Multimorbidity was prevalent in 79.8% and associated with age and severe/profound ID. Four or more conditions were prevalent in 46.8% and associated with age, severe/profound ID and Down syndrome. Factor analyses did not reveal a model for disease-clusters with good fit. Multimorbidity is highly prevalent in older adults with ID. Multimorbidity should receive more attention in research and clinical practice for targeted pro-active prevention and treatment.
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Affiliation(s)
- Heidi Hermans
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Amarant Groep, P.O. Box 715, 5000 AS Tilburg, The Netherlands.
| | - Heleen M Evenhuis
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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15
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Xu Y, Guo B, Gong J, Xu H, Bai Z. The correlation between calcaneus stiffness index calculated by QUS and total body BMD assessed by DXA in Chinese children and adolescents. J Bone Miner Metab 2014; 32:159-66. [PMID: 23695447 DOI: 10.1007/s00774-013-0474-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/14/2013] [Indexed: 12/31/2022]
Abstract
Few studies have shown comparison data between calcaneus stiffness index (SI) calculated by quantitative ultrasound (QUS) and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) in the Chinese population. This study was aimed to examine the correlations between calcaneus SI calculated by QUS and total body BMD and bone mineral content (BMC) measured by DXA in Chinese children and adolescents. We measured the total body BMD and BMC using Lunar Prodigy (GE Healthcare), and speed of sound (SOS), broadband ultrasound attenuation (BUA), and a calculated SI of the left os calcis using Lunar Achilles Express (GE Healthcare) in 392 healthy Chinese schoolchildren and adolescents aged 5-19 years. The short-term precision for DXA was 0.5 % for total body BMD. The precision for QUS was 1.8 % for SI, 2.9 % for BUA, and 0.4 % for SOS. Pearson's correlation coefficients (r) were calculated to assess the possible correlations between the total body BMC by DXA and SI calculated by QUS. There were significantly positive correlations between SI of the left os calcis and total body BMD (r = 0.693, p < 0.001, n = 392) and BMC (r = 0.690, p < 0.001, n = 392). For all the subjects, significant positive correlations were observed between the calcaneal SI and the age, weight, height, BMI, total body BMD, total body BMC, total body lean mass, and total body fat mass, with r ranging from 0.310 (total body fat mass) to 0.693 (total body BMD) (p < 0.001, n = 392). In conclusion, QUS bone densitometry is a useful measuring method showing the physiological bone development in childhood and adolescence.
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Affiliation(s)
- Yi Xu
- Department of Clinical Medicine, Medical College, Jinan University, No. 601 West Huangpu Road, Guangzhou, 510632, China
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16
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Gianfagna F, Cugino D, Ahrens W, Bailey MES, Bammann K, Herrmann D, Koni AC, Kourides Y, Marild S, Molnár D, Moreno LA, Pitsiladis YP, Russo P, Siani A, Sieri S, Sioen I, Veidebaum T, Iacoviello L. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children. PLoS One 2013; 8:e70632. [PMID: 23936460 PMCID: PMC3731254 DOI: 10.1371/journal.pone.0070632] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/20/2013] [Indexed: 01/08/2023] Open
Abstract
Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs) and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2±1.8 years) from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet) and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714), was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ = −1.8, p = 0.006). Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0–43.9%), the CCT haplotype (frequency = 39.7%) was associated with lower SI values (dominant model, Δ = −1.0, p = 0.04) as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4%) showed much lower SI than non-carriers (Δ = −3.9, p<0.0001; p for interaction = 0.025). The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p = 0.01). This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls.
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Affiliation(s)
- Francesco Gianfagna
- Research Laboratories, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso, Italy
| | | | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Department of Mathematics and Computer Sciences, University of Bremen, Bremen, Germany
| | - Mark E. S. Bailey
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karin Bammann
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Diana Herrmann
- Department of Epidemiological Methods and Etiologic Research, Leibniz-Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - Anna C. Koni
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Yiannis Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Staffan Marild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Dénes Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Luis A. Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis P. Pitsiladis
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paola Russo
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - Alfonso Siani
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - Sabina Sieri
- Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Isabelle Sioen
- Department of Public Health, Ghent University, Ghent, Belgium
- FWO, Research Foundation Flanders, Brussels, Belgium
| | - Toomas Veidebaum
- Center of Health and Behavioral Science, National Institute for Health Development, Tallinn, Estonia
| | - Licia Iacoviello
- Casa di Cura Montevergine, Mercogliano (AV), Italy
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy
- * E-mail:
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Beerhorst K, Tan J, Tan IY, Verschuure P, Aldenkamp AP. Dual-energy X-ray absorptiometry versus quantitative ultrasonography in diagnosing osteoporosis in patients with refractory epilepsy and chronic antiepileptic drug use. Ther Adv Musculoskelet Dis 2013; 5:59-66. [PMID: 23641257 DOI: 10.1177/1759720x13475851] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the feasibility of calcaneal quantitative ultrasonography (QUS) as a screening method for increased risk of osteoporosis in a unique population of people with chronic epilepsy, intellectual disability (ID), and chronic use of antiepileptic drugs. METHODS A total of 205 patients from a long-stay care facility for people with epilepsy underwent dual-energy X-ray absorptiometry (DXA) and QUS of the calcaneus. T-scores for both DXA and QUS were calculated and correlated. RESULTS A total of 195 patients (95.1%) were successfully measured with DXA and 204 (99.5%) with QUS. High correlations were found between DXA and QUS T-scores: r = 0.666 (QUS versus T-score total femur), r = 0.631 (QUS versus T-score femur neck) and r = 0.485 (QUS versus T-score lumbar spine). All correlations were statistically significant (p = 0.01). CONCLUSION QUS showed a strong correlation with DXA and proved to be a feasible measuring method in a population with ID and epilepsy. Including osteopenia in the screening process increases the sensitivity of QUS to identify those patients at risk for the development of bone diseases.
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Affiliation(s)
- Kim Beerhorst
- Department of Neurology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
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18
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Williams LJ, Pasco JA, Jacka FN, Hodge JM, Kotowicz MA, Berk M. Quantitative Heel Ultrasound (QUS) measures of bone quality in association with mood and anxiety disorders. J Affect Disord 2013; 146:395-400. [PMID: 23122528 DOI: 10.1016/j.jad.2012.09.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 09/26/2012] [Accepted: 09/26/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The common mental disorders are potential risk factors for low bone mass as a result of disease and/or medication-related processes. Quantitative heel ultrasound (QUS) is a portable and relatively cheap screening tool for determining fracture risk. Thus, we investigated the association between QUS parameters, mood and anxiety disorders in a population-based sample of 745 men and 897 women. METHODS Using a clinical interview (SCID-I/NP), mood and anxiety disorders were identified. Bone quality was established using QUS and included the following parameters: Broadband Ultrasound Attenuation (BUA), Speed of Sound (SOS) and Stiffness Index (SI). Anthropometry, socio-economic status (SES), medication use and lifestyle factors were determined. RESULTS In men, mood and anxiety disorders were associated with lower age-weight- and smoking-adjusted SOS, BUA and SI. In women, age was an effect modifier. Among younger women (≤ 40yr), mood disorders were associated with lower age-weight- and smoking-adjusted SOS and SI but not BUA. No differences were detected in older women or women with anxiety disorders. These patterns persisted after adjustment for activity, alcohol, calcium intake, SES and medications. LIMITATIONS Cross-sectional study design, and possible residual or unrecognised confounding. CONCLUSION Our data suggest that bone quality, as measured by QUS, is reduced among men and younger women with a history of mood disorders. Furthermore, an inverse association between anxiety disorders and bone quality was evident for men. Thus, QUS may be a useful screening tool for determining fracture risk within these populations.
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Van den Bussche K, Michels N, Gracia-Marco L, Herrmann D, Eiben G, De Henauw S, Sioen I. Influence of birth weight on calcaneal bone stiffness in Belgian preadolescent children. Calcif Tissue Int 2012; 91:267-75. [PMID: 22911000 DOI: 10.1007/s00223-012-9636-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 07/03/2012] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the relation between birth weight and calcaneal bone stiffness in a large sample of Belgian, healthy, preadolescent children. Participants were 827 children (3.6-11.2 years, 51.6 % boys) from the Belgian cohort of the IDEFICS study. Birth weight was obtained using a parental questionnaire, and quantitative ultrasound (QUS) measurements were performed to determine calcaneal broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) using the Lunar Achilles device. Average birth weights were 3435.7 ± 512.0 g for boys and 3256.9 ± 471.1 g for girls. Average calcaneal QUS measurements were 89.6 ± 24.0 (23.3-153.9) dB/MHz for BUA, 1621.4 ± 49.6 (1516.3-1776.5) m/s for SOS, and 92.8 ± 15.6 (49.0-163.0) for SI. Birth weight was positively associated with BUA (r = 0.13, p = 0.002) and SOS (r = -0.16, p < 0.001). The associations remained after correcting for age and sex in multiple regression analyses but disappeared after correcting for anthropometric covariates. Our findings suggest that birth weight, as a rough proxy indicator for genetic and environmental influences during intrauterine life, is associated with BUA and SOS in preadolescent children and may therefore influence the risk of osteoporosis later in life. Further studies using QUS are needed to investigate the consistency of the results of this study.
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Sioen I, Mouratidou T, Herrmann D, De Henauw S, Kaufman JM, Molnár D, Moreno LA, Marild S, Barba G, Siani A, Gianfagna F, Tornaritis M, Veidebaum T, Ahrens W. Relationship between markers of body fat and calcaneal bone stiffness differs between preschool and primary school children: results from the IDEFICS baseline survey. Calcif Tissue Int 2012; 91:276-85. [PMID: 22907129 DOI: 10.1007/s00223-012-9640-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 07/27/2012] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the relationship between markers of body fat and bone status assessed as calcaneal bone stiffness in a large sample of European healthy pre- and primary school children. Participants were 7,447 children from the IDEFICS study (spread over eight different European countries), age 6.1 ± 1.8 years (range 2.1-9.9), 50.5 % boys. Anthropometric measurements (weight, height, bioelectrical impedance, waist and hip circumference, and tricipital and subscapular skinfold thickness) as well as quantitative ultrasonographic measurements to determine calcaneal stiffness index (SI) were performed. Partial correlation analysis, linear regression analysis, and ANCOVA were stratified by sex and age group: preschool boys (n = 1,699) and girls (n = 1,599) and primary school boys (n = 2,062) and girls (n = 2,087). In the overall study population, the average calcaneal SI was equal to 80.2 ± 14.0, ranging 42.4-153. The results showed that preschool children with higher body fat had lower calcaneal SI (significant correlation coefficients between -0.05 and -0.20), while primary school children with higher body fat had higher calcaneal SI (significant correlation coefficients between 0.05 and 0.13). After adjusting for fat-free mass, both preschool and primary school children showed an inverse relationship between body fat and calcaneal stiffness. To conclude, body fat is negatively associated with calcaneal bone stiffness in children after adjustment for fat-free mass. Fat-free mass may confound the association in primary school children but not in preschool children. Muscle mass may therefore be an important determinant of bone stiffness.
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Affiliation(s)
- Isabelle Sioen
- Department of Public Health, Ghent University, Ghent, Belgium.
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Abstract
BACKGROUND During the preparatory phase of the baseline survey of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study, standardised survey procedures including instruments, examinations, methods, biological sampling and software tools were developed and pretested for their feasibility, robustness and acceptability. METHODS A pretest was conducted of full survey procedures in 119 children aged 2-9 years in nine European survey centres (N(per centre)=4-27, mean 13.22). Novel techniques such as ultrasound measurements to assess subcutaneous fat and bone health, heart rate monitors combined with accelerometers and sensory taste perception tests were used. RESULTS Biological sampling, physical examinations, sensory taste perception tests, parental questionnaire and medical interview required only minor amendments, whereas physical fitness tests required major adaptations. Callipers for skinfold measurements were favoured over ultrasonography, as the latter showed only a low-to-modest agreement with calliper measurements (correlation coefficients of r=-0.22 and r=0.67 for all children). The combination of accelerometers with heart rate monitors was feasible in school children only. Implementation of the computer-based 24-h dietary recall required a complex and intensive developmental stage. It was combined with the assessment of school meals, which was changed after the pretest from portion weighing to the more feasible observation of the consumed portion size per child. The inclusion of heel ultrasonometry as an indicator of bone stiffness was the most important amendment after the pretest. DISCUSSION Feasibility and acceptability of all procedures had to be balanced against their scientific value. Extensive pretesting, training and subsequent refinement of the methods were necessary to assess the feasibility of all instruments and procedures in routine fieldwork and to exchange or modify procedures that would otherwise give invalid or misleading results.
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Mergler S, Löbker B, Evenhuis HM, Penning C. Feasibility of quantitative ultrasound measurement of the heel bone in people with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2010; 31:1283-1290. [PMID: 20800437 DOI: 10.1016/j.ridd.2010.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 07/12/2010] [Accepted: 07/16/2010] [Indexed: 05/29/2023]
Abstract
Low bone mineral density (BMD) and fractures are common in people with intellectual disabilities (ID). Reduced mobility in case of motor impairment and the use of anti-epileptic drugs contribute to the development of low BMD. Quantitative ultrasound (QUS) measurement of the heel bone is a non-invasive and radiation-free method for measuring bone status that can be used outside the hospital. QUS might be used for screening purposes to identify people with intellectual disability with poor bone status, who are in need of supplementary examination and treatment. To investigate feasibility of QUS in this group, QUS of the heel bone was performed on-site in 151 people with ID living in residential care. Measurements were successfully performed in at least one foot in 94.7%, were interpretable (resulting in a stiffness index) in 91.6%, and induced barely or no stress in 90.4% of the study population. Measurements generally took less than 10 min. In 93 persons bone status of both feet had been measured. The "mean percentage of the absolute difference" between outcomes of both feet was 15.5% (±15.3% SD, range 0-76.5%). Ultrasound measurement of the heel bone is a feasible and non-stressful method for measuring bone status in people with ID. Since the mean difference between outcomes of the left and right foot were large, measurement of both feet is recommended to prevent inaccurate interpretation.
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Affiliation(s)
- S Mergler
- Erasmus MC, Intellectual Disability Medicine/Department of General Practice, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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