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Sowińska-Przepiera E, Krzyścin M, Syrenicz I, Ćwiertnia A, Orlińska A, Ćwiek D, Branecka-Woźniak D, Cymbaluk-Płoska A, Bumbulienė Ž, Syrenicz A. Evaluation of Trabecular Bone Microarchitecture and Bone Mineral Density in Young Women, Including Selected Hormonal Parameters. Biomedicines 2024; 12:758. [PMID: 38672114 PMCID: PMC11048270 DOI: 10.3390/biomedicines12040758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The absence of non-invasive methods for assessing bone material and structural changes is a significant diagnostic challenge. Dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) testing is the gold standard for osteoporosis diagnosis. BMD and the trabecular bone score (TBS) have facilitated targeted osteoporosis prevention and treatment in clinical settings. The findings from this study indicate that BMD modulation in young women is influenced by various hormones, potentially compromising the diagnostic precision of BMD for subclinical bone demineralization. A total of 205 women aged 19 to 37 underwent anthropometric measurements and hormonal tests. BMD was determined using DXA, and TBS values were computed from the lumbar spine L1-L4 segment. The multivariate analysis findings suggest that BMD might not be determined by hormones. The relationship between TBS and TSH was statistically significant in the univariate analysis, which indicates the efficacy of further studies to determine the link between TBS and specific hormones. Analyzing the strength of the correlation between TBS and hormones in the univariate analysis shows which factors are worth considering in further analyses. This makes it possible to create better techniques that will help identify young women who are at a higher risk of developing osteoporosis.
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Affiliation(s)
- Elżbieta Sowińska-Przepiera
- Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland;
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
| | - Mariola Krzyścin
- Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland;
| | - Igor Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
| | - Adrianna Ćwiertnia
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.Ć.); (A.O.); (A.C.-P.)
| | - Adrianna Orlińska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.Ć.); (A.O.); (A.C.-P.)
| | - Dorota Ćwiek
- Department of Obstetrics and Pathology of Pregnancy, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
| | - Dorota Branecka-Woźniak
- Department of Gynecology and Reproductive Health, Pomeranian Medical University of Szczecin, Żołnierska 48, 71-210 Szczecin, Poland;
| | - Aneta Cymbaluk-Płoska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.Ć.); (A.O.); (A.C.-P.)
| | - Žana Bumbulienė
- Clinic of Obstetrics and Gynecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-08661 Vilnius, Lithuania;
| | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
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Rouge M, Legendre F, Elkhatib R, Delalande C, Cognié J, Reigner F, Barrière P, Deleuze S, Hanoux V, Galéra P, Bouraïma-Lelong H. Early Castration in Horses Does Not Impact Osteoarticular Metabolism. Int J Mol Sci 2023; 24:16778. [PMID: 38069100 PMCID: PMC10706761 DOI: 10.3390/ijms242316778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
The castration of stallions is traditionally performed after puberty, at around the age of 2 years old. No studies have focused on the effects of early castration on osteoarticular metabolism. Thus, we aimed to compare early castration (3 days after birth) with traditional castration (18 months of age) in horses. Testosterone and estradiol levels were monitored from birth to 33 months in both groups. We quantified the levels of biomarkers of cartilage and bone anabolism (CPII and N-MID) and catabolism (CTX-I and CTX-II), as well as of osteoarthritis (HA and COMP) and inflammation (IL-6 and PGE2). We observed a lack of parallelism between testosterone and estradiol synthesis after birth and during puberty in both groups. The extra-gonadal synthesis of steroids was observed around the 28-month mark, regardless of the castration age. We found the expression of estrogen receptor (ESR1) in cartilage and bone, whereas androgen receptor (AR) expression appeared to be restricted to bone. Nevertheless, with respect to osteoarticular metabolism, steroid hormone deprivation resulting from early castration had no discernable impact on the levels of biomarkers related to bone and cartilage metabolism, nor on those associated with OA and inflammation. Consequently, our research demonstrated that early castration does not disrupt bone and cartilage homeostasis.
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Affiliation(s)
- Marion Rouge
- Université de Caen-Normandie, OeReCa, 14000 Caen, France; (M.R.); (R.E.); (C.D.); (V.H.)
| | - Florence Legendre
- Université de Caen Normandie BIOTARGEN, 14000 Caen, France; (F.L.); (P.G.)
| | - Razan Elkhatib
- Université de Caen-Normandie, OeReCa, 14000 Caen, France; (M.R.); (R.E.); (C.D.); (V.H.)
| | - Christelle Delalande
- Université de Caen-Normandie, OeReCa, 14000 Caen, France; (M.R.); (R.E.); (C.D.); (V.H.)
| | - Juliette Cognié
- INRAE, Université de Tours, Centre de Recherche de Tours, UMR PRC, 37380 Nouzilly, France;
| | - Fabrice Reigner
- INRAE, Université de Tours, Centre de Recherche de Tours, UEPAO, 37380 Nouzilly, France; (F.R.); (P.B.)
| | - Philippe Barrière
- INRAE, Université de Tours, Centre de Recherche de Tours, UEPAO, 37380 Nouzilly, France; (F.R.); (P.B.)
| | | | - Vincent Hanoux
- Université de Caen-Normandie, OeReCa, 14000 Caen, France; (M.R.); (R.E.); (C.D.); (V.H.)
| | - Philippe Galéra
- Université de Caen Normandie BIOTARGEN, 14000 Caen, France; (F.L.); (P.G.)
| | - Hélène Bouraïma-Lelong
- Université de Caen-Normandie, OeReCa, 14000 Caen, France; (M.R.); (R.E.); (C.D.); (V.H.)
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Rand MS, Diemar SS, Møllehave LT, Heidemann M, Thuesen BH, Petersen JH, Johannesen J, Schou AJ, Wedderkopp N, Mølgaard C, Jørgensen NR. Z-scores of bone turnover markers calculated from new established sex- and age-specific reference curves are associated to future change in BMD in children and adolescents. Bone 2023; 167:116641. [PMID: 36481707 DOI: 10.1016/j.bone.2022.116641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/01/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Michael Schønemann Rand
- Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark.
| | - Sarah Seberg Diemar
- Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark
| | - Line Tang Møllehave
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Malene Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense, Denmark
| | - Betina Heinsbæk Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Jørgen Holm Petersen
- Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark
| | - Jesper Johannesen
- Department of Children and Adolescents, Copenhagen University Hospital Herlev, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Steno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, 2730 Herlev, Denmark
| | - Anders J Schou
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense, Denmark
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5000 Odense, Denmark; Department of Orthopaedics, Hospital of Southwest Jutland, Finsensgade 35, 6700 Esbjerg, Denmark
| | - Christian Mølgaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense, Denmark; Clinical Institute, University of Southern Denmark, Campusvej 55, 5000 Odense, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
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Abstract
Peak bone mass (PBM) is a key determinant of bone mass and fragility fractures later in life. The increase in bone mass during childhood and adolescence is mainly related to an increase in bone size rather to changes in volumetric bone density. Race, gender, and genetic factors are the main determinants of PBM achievement. Nevertheless, environmental factors such as physical activity, calcium and protein intakes, weight and age at menarche, are also playing an important role in bone mass accrual during growth. Therefore, optimization of calcium and protein intakes and weight-bearing physical activity during growth is an important strategy for optimal acquisition of PBM and bone strength and for contributing to prevent fractures later in life.
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Affiliation(s)
- Thierry Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Abstract
The foundation of bone health is established in utero. Bone accrual starts from the developing fetus and continues throughout childhood and adolescence. This process is crucial to achieve peak bone mass. Understanding factors that influence bone accrual before attainment of peak bone mass is thus critical to improve bone health and prevent osteoporosis, thereby reducing the burden of osteoporotic fractures in older women. In this review, we broadly outline factors influencing peak bone mass from pregnancy to infancy, childhood and adolescence with potential diseases and medications that may affect the optimum trajectory to maximizing bone health. It is estimated that a 10% increase in peak bone mass will delay the onset of osteoporosis by 13 years in a woman.
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Affiliation(s)
- R F Vasanwala
- KK Women's and Children's Hospital, Singapore, Singapore
| | - L Gani
- Changi General Hospital, Singapore, Singapore
| | - S B Ang
- KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
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Rogers CW, Gee EK, Dittmer KE. Growth and Bone Development in the Horse: When Is a Horse Skeletally Mature? Animals (Basel) 2021; 11:ani11123402. [PMID: 34944179 PMCID: PMC8698045 DOI: 10.3390/ani11123402] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary A comparison of the pattern of growth in the horse with definitions used to describe growth and development in humans demonstrates the same general pattern of growth. In the horse, these development periods are completed very early in life, generally by 2 years of age. Using a variety of measures to define the completion of growth and bone development, the horse enters skeletal maturity by the time it is 2 years old. There is little variation in the age of maturity across different horse breeds. These data support the hypothesis that the horse evolved to be a precocious cursorial grazer and is capable of athletic activity, and used in sport, relatively early in life. Abstract Within the lay literature, and social media in particular, there is often debate about the age at which a horse should be started and introduced to racing or sport. To optimize the welfare and longevity of horses in racing and sport, it is important to match exercise with musculoskeletal development and the ability of the musculoskeletal system to respond to loading. The justification for not exercising horses at a certain age is often in contrast to the scientific literature and framed, with incorrect generalizations, with human growth. This review provides a relative comparison of the growth and development of the horse to the descriptors used to define growth and development in humans. Measures of physeal closure and somatic growth demonstrate that the horse completes the equivalent of rapid infant growth by weaning (4–6 months old). At approximately 11 months old, the horse completes the equivalent of the childhood phase of growth and enters puberty. At 2 years old, the horse has achieved most measures of maturity used within the human literature, including the plateauing of vertical height, closure of growth plates, and adult ratios of back length:wither height and limb length:wither height. These data support the hypothesis that the horse evolved to be a precocious cursorial grazer and is capable of athletic activity, and use in sport, relatively early in life.
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Affiliation(s)
- Chris W. Rogers
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand; (E.K.G.); (K.E.D.)
- School of Agriculture and Environment, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand
- Correspondence:
| | - Erica K. Gee
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand; (E.K.G.); (K.E.D.)
| | - Keren E. Dittmer
- School of Veterinary Science, Massey University, Private Bag 11-222, Palmerston North 4442, New Zealand; (E.K.G.); (K.E.D.)
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Impact of 1.0 mg/Day Dienogest Treatment on Bone Metabolism Markers in Young Women with Dysmenorrhea. ENDOCRINES 2021. [DOI: 10.3390/endocrines2030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
A low dose of dienogest (DNG) 1 mg/day is useful for treating dysmenorrhea in young women. However, the effect of DNG on bone turnover during bone growth and formation, rather than at maturity, is currently unknown even at low doses. We investigated change in bone turnover after 3 months of DNG 1 mg/day. This retrospective cohort study included young women aged 10–24 years with dysmenorrhea and irregular menstruation. Gonadotropins and the bone metabolism markers TRACP-5b and BAP were compared before and at 3 months after administration of DNG 1 mg/day. There were no significant changes in TRACP-5b (before, 455.6 ± 323.6 mU/dL; 3 months after, 462.1 ± 346.1 mU/dL), BAP (before, 24.7 ± 19.0 μg/L; 3 months after, 25.2 ± 22.3 μg/L), or the TRACP-5b/BAP ratio (before, 22.1 ± 7.0; 3 months after, 21.5 ± 6.3). Administration of DNG 1 mg/day had no significant effect on bone turnover after 3 months during the bone-growth phase in young women.
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Han CS, Kim HK, Kim S. Effects of Adolescents' Lifestyle Habits and Body Composition on Bone Mineral Density. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116170. [PMID: 34200352 PMCID: PMC8201294 DOI: 10.3390/ijerph18116170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
The incidence of osteoporosis is increasing as the population ages, as is the need to manage and prevent it. Adolescence is the period when the fastest development of bone mass takes place. Increasing adolescents’ maximum bone mass and avoiding the risk factors for its loss are effective for preventing osteoporosis. This study investigated the factors influencing adolescents’ bone mineral density (BMD). The participants were 126 middle- and high-school students from Gangwon-do; 47.6% (n = 60) were male, with an average age of 15 (range 12–18) years of age. It was found that age, carbonated beverages, snacks, and calcium supplements were variables that showed significant differences in adolescents’ BMD. Additionally, through correlation analysis, it was found that height, weight, body mass index (BMI), body water, protein, minerals, body fat mass, and skeletal muscle mass were correlated with BMD. Multiple regression analysis identified age, calcium supplements, BMI, body fat mass, and skeletal muscle mass as BMD-associated factors. These results show that adolescents’ BMD is higher with lower body fat mass, higher BMI and skeletal muscle mass, and a higher intake of calcium supplements.
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Affiliation(s)
- Chang-Sook Han
- Division of Nursing, Graduate School, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 135-841, Gangwon-do, Korea; (C.-S.H.); (H.-K.K.)
| | - Hyo-Kyung Kim
- Division of Nursing, Graduate School, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 135-841, Gangwon-do, Korea; (C.-S.H.); (H.-K.K.)
| | - Suhee Kim
- School of Nursing and Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 135-841, Gangwon-do, Korea
- Correspondence: ; Tel.: +82-33-248-2718
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Kouda K, Iki M, Ohara K, Nakamura H, Fujita Y, Nishiyama T. Associations between serum levels of insulin-like growth factor-I and bone mineral acquisition in pubertal children: a 3-year follow-up study in Hamamatsu, Japan. J Physiol Anthropol 2019; 38:16. [PMID: 31806017 PMCID: PMC6896327 DOI: 10.1186/s40101-019-0210-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Epidemiological data regarding the association between serum levels of IGF-I and bone mineral acquisition during childhood are scarce. Here, we investigated the association between serum levels of IGF-I and bone status during puberty. METHODS We analyzed prospective 3-year follow-up data of 254 community-dwelling children who completed both baselines (at age 11.2 years) and follow-up (at age 14.2 years) surveys in Hamamatsu, Japan. Total body (TB) bone area and bone mineral parameters were assessed using dual-energy X-ray absorptiometry. RESULTS During the 3-year follow-up period, there were significant (P < 0.05) increases in total body less head (TBLH) areal bone mineral density (aBMD), TBLH bone mineral content (BMC), and TB bone area, and a significant decrease in TB bone mineral apparent density (BMAD, volumetric bone mineral density, vBMD). IGF-I levels showed significant positive relationships with TBLH BMC and TBLH aBMD at both baseline and follow-up. TBLH aBMD in boys and TB BMAD in girls at follow-up showed significant increases from the lowest to highest quartiles of baseline IGF-I levels after adjusting for confounding factors. Similarly, changes in TBLH aBMD in boys and TB BMAD in girls during the 3-year follow-up period showed significant increases from the lowest to highest quartiles of baseline IGF-I levels after adjusting for confounding factors. CONCLUSIONS These results suggest that pubertal children with high levels of serum IGF-I tended to have high bone mineral acquisition later on.
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Affiliation(s)
- Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka 573-1010,, Japan.
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka 589-8511,, Japan
| | - Kumiko Ohara
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka 589-8511,, Japan
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo 657-8501,, Japan
| | - Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka 589-8511,, Japan
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka 573-1010,, Japan
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11
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Abstract
Estrogens and progestogens influence the bone. The major physiological effect of estrogen is the inhibition of bone resorption whereas progestogens exert activity through binding to specific progesterone receptors. New estrogen-free contraceptive and its possible implication on bone turnover are discussed in this review. Insufficient bone acquisition during development and/or accelerated bone loss after attainment of peak bone mass (PBM) are 2 processes that may predispose to fragility fractures in later life. The relative importance of bone acquisition during growth versus bone loss during adulthood for fracture risk has been explored by examining the variability of areal bone mineral density (BMD) (aBMD) values in relation to age. Bone mass acquired at the end of the growth period appears to be more important than bone loss occurring during adult life. The major physiological effect of estrogen is the inhibition of bone resorption. When estrogen transcription possesses binds to the receptors, various genes are activated, and a variety modified. Interleukin 6 (IL-6) stimulates bone resorption, and estrogen blocks osteoblast synthesis of IL-6. Estrogen may also antagonize the IL-6 receptors. Additionally, estrogen inhibits bone resorption by inducing small but cumulative changes in multiple estrogen-dependent regulatory factors including TNF-α and the OPG/RANKL/RANK system. Review on existing data including information about new estrogen-free contraceptives. All progestins exert activity through binding to specific progesterone receptors; hereby, three different groups of progestins exist: pregnanes, gonanes, and estranges. Progestins also comprise specific glucocorticoid, androgen, or mineralocorticoid receptor interactions. Anabolic action of a progestogen may be affected via androgenic, anti-androgenic, or synadrogenic activity. The C 19 nortestosterone class of progestogens is known to bind with more affinity to androgen receptors than the C21 progestins. This article reviews the effect of estrogens and progestogens on bone and presents new data of the currently approved drospirenone-only pill. The use of progestin-only contraceptives leading to an estradiol level between 30 and 50 pg/ml does not seem to lead to an accelerate bone loss.
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Affiliation(s)
- P. Hadji
- Frankfurter Center of Bone Health, Goethestr. 23, 60313 Frankfurt/Main, Germany
- Philipps University of Marburg, Marburg, Germany
| | - E. Colli
- Exeltis HealthCare Madrid, C/ Manuel Pombo Angulo 28, 4th Floor, 28050 Madrid, Spain
| | - P.-A. Regidor
- Exeltis Europe, Adalperostr. 84, 85737 Ismaning, Germany
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Relationship between the changes over time of bone mass and muscle health in children and adults: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:429. [PMID: 31521141 PMCID: PMC6745072 DOI: 10.1186/s12891-019-2752-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background Various cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline – associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813). Methods We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI). Results Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23–0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value < 0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004). Conclusion Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the ‘muscle-bone unit’.
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Popović M, Matana A, Torlak V, Brdar D, Gunjača I, Boraska Perica V, Barbalić M, Kolčić I, Punda A, Polašek O, Hayward C, Zemunik T. The effect of multiple nutrients on plasma parathyroid hormone level in healthy individuals. Int J Food Sci Nutr 2019; 70:638-644. [PMID: 30614303 DOI: 10.1080/09637486.2018.1551335] [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
Although the effect of isolated nutrients on plasma parathyroid hormone (PTH) is somewhat familiar, the effect of multiple nutrients on plasma PTH level has not yet been studied. The aim of this study was to identify groups of food items that are associated with the plasma PTH level in healthy individuals. This cross-sectional study enrolled 1180 healthy individuals from Croatia with plasma PTH levels inside the referent values. A food frequency questionnaire containing 58 food items was completed to evaluate the dietary intake. We used principal component analysis to reduce food items into dietary groups, followed by linear regression analysis to test the association between dietary groups and the level of PTH. The results indicate that different sorts of vegetables (p = .006), sausages, salami, mushrooms, eggs (p = .033), as well as white bread (p = .009) are associated with the increase, while bran bread (p = .009) is associated with the decreased plasma PTH level.
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Affiliation(s)
- Marijana Popović
- a Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Antonela Matana
- a Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Vesela Torlak
- b Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Dubravka Brdar
- b Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Ivana Gunjača
- a Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Vesna Boraska Perica
- a Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Maja Barbalić
- a Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Ivana Kolčić
- c Department of Public Health , University of Split, School of Medicine Split , Split , Croatia
| | - Ante Punda
- b Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Ozren Polašek
- c Department of Public Health , University of Split, School of Medicine Split , Split , Croatia
| | - Caroline Hayward
- d MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine , University of Edinburgh, Western General Hospital , Edinburgh , United Kingdom
| | - Tatijana Zemunik
- a Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
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14
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Assessment of body weight, maternal dietary knowledge and lifestyle practices among children and adolescents in north Jordan. Public Health Nutr 2018; 21:2803-2810. [PMID: 29886853 DOI: 10.1017/s1368980018001489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To estimate the prevalence of overweight and obesity among children and adolescents in north Jordan and to evaluate the dietary knowledge of their mothers. DESIGN Cross-sectional study.SettingsSchools, Irbid, Jordan. SUBJECTS Male and female participants (n 516) aged 6-18 years. RESULTS Thirty per cent of our sample population was overweight or obese, and about 11 % was underweight. Males tend to have a higher BMI and waist circumference than females except in the age group ≥15 years. Children who ate in front of the television tended to have higher BMI and waist circumference. Forty per cent of the mothers answered four or more questions correctly out of six, which indicated a sufficient level of nutritional knowledge. CONCLUSIONS The study revealed that obesity is a growing health problem in children and adolescents in north Jordan. This finding is considered a serious concern for public health and calls for the creation of new prevention programmes at the individual, family and community level.
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15
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Wang X, Liu L, Li P, Ma J, Jiang R, Wang R, Li L, Guan H. Reference and Influential Factors of Serum Bone Markers in Chinese Adolescents. Sci Rep 2017; 7:17340. [PMID: 29229962 PMCID: PMC5725428 DOI: 10.1038/s41598-017-17670-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/29/2017] [Indexed: 11/09/2022] Open
Abstract
This study aimed to establish reference ranges of bone markers in Chinese adolescents between the age of 12 and 16, and to search these markers’ characteristics and influential factors. Personal information and fasting blood samples were collected from 174 healthy adolescents in Northeast China. Serum levels of PINP, ALP, β-CrossLaps, calcium, phosphate, PTH, 25(OH)D and TSH were measured. Reference ranges were established for PINP [(85.55–2,028.75)ng/ml], ALP [(53.88–463.63)U/L], β-CrossLaps [(0.16–1.19)ng/ml], calcium [(2.35–2.70)mmol/L], phosphate [(1.17–2.06)mmol/L] and PTH [(2.64–43.36)μg/L] in this population. We observed that bone formation markers PINP and ALP levels were evidently higher when compared to kit references for adults. Reference ranges for calcium, phosphate and PTH also differed from those provided by kit manuals. Serum ALP, PINP, phosphate and PTH changed with age (all P < 0.005), and were significantly higher in boys than in girls (all P < 0.05). Serum 25(OH)D and TSH levels didn’t correlate with PINP, ALP and β-CrossLaps (all P > 0.05). In conclusion, unique reference ranges should be provided for adolescents. BMI, sex and age independently influence certain serum bone markers in adolescents. Vitamin D deficiency is widespread. Serum levels of vitamin D and TSH may not influence bone turnover markers in this population.
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Affiliation(s)
- Xinyi Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, Shenyang, China.,Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Lichao Liu
- Department of Endocrinology and Metabolism, The Second Hospital of Dalian Medical University, Dalian, China
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jie Ma
- Department of Endocrinology, Cangzhou Central Hospital, Changzhou, China
| | | | - Renee Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, Shenyang, China
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Haixia Guan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, Shenyang, China.
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16
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Ha AS, Ng JYY. Rope skipping increases bone mineral density at calcanei of pubertal girls in Hong Kong: A quasi-experimental investigation. PLoS One 2017; 12:e0189085. [PMID: 29220384 PMCID: PMC5722366 DOI: 10.1371/journal.pone.0189085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 10/07/2017] [Indexed: 11/18/2022] Open
Abstract
Bone mineral accrual during puberty is important, especially in girls, because it is related to reduced risks of osteoporosis in adulthood. Previous research has shown that jumping or plyometric exercises may be effective in increasing bone mineral density in adolescents. Rope skipping is a form of activity that involves jumping, thus regular skipping may also increase bone mineral density in pubertal girls. To this end, we conducted a quasi-experimental to examine the effects of rope skipping on girls' bone mineral density and cardiovascular fitness. 176 Hong Kong girls (age = 12.23 ± 1.80 years at baseline) were recruited to take part in the study. Bone density at their forearms and calcanei were measured twice over two academic years (mean time between visits was 10.3 months). Using multilevel modeling analyses and adjusting for participants' height and physical activity, we found that girls who participated in weekly rope skipping activities, compared to those who did not, had higher levels of bone density at the calcanei (B = 0.023, p < .01). However, no differences were found for bone density at forearms or participants' cardiovascular fitness. The rates of change of these variables across time were also not significantly different. Results suggest that regular rope skipping may increase girls' bone density at the lower extremities, irrespective of the amount of self-report physical activity. However, further research is required to examine the potential dose-response relation between skipping behaviors and the measured outcomes.
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Affiliation(s)
- Amy S. Ha
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
- * E-mail:
| | - Johan Y. Y. Ng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
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17
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Kouda K, Ohara K, Nakamura H, Fujita Y, Iki M. Predicting bone mineral acquisition during puberty: data from a 3-year follow-up study in Hamamatsu, Japan. J Bone Miner Metab 2017; 35:185-191. [PMID: 26969393 DOI: 10.1007/s00774-016-0740-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
Although most adult bone mass is acquired before adolescence, only a few studies have assessed bone turnover markers in children. Thus, the utility of bone markers to evaluate and predict bone mineral accrual in children is unclear. The present study assessed the association between serum bone markers at 11 years of age and subsequent changes in bone gain. Information on bone minerals and bone markers at baseline and at the 3-year follow-up were obtained from 121 children who registered as fifth-grade students in 2010, in Hamamatsu, Japan. Whole-body bone mineral content (WBBMC) and whole-body bone mineral density (WBBMD) were measured using dual-energy X-ray absorptiometry. Boys showed significant (P < 0.05) positive relationships between intact osteocalcin at baseline and WBBMC at follow-up (β = 0.24), between tartrate-resistant acid phosphatase isoenzyme 5b (TRAP5b) and WBBMC (β = 0.34), and between TRAP5b and WBBMD (β = 0.34), after adjusting for potential confounding factors. In girls, adjusted means of 3-year gain in both WBBMC and WBBMD significantly increased from the lowest to highest quartiles of type 1 collagen cross-linked C-terminal telopeptide. In boys, adjusted means of 3-year gain in both WBBMC and WBBMD significantly increased from the lowest to highest quartiles of TRAP5b. Children with a high concentration of bone turnover markers tended to exhibit substantial accrual of bone minerals. These results suggest that serum levels of circulating biomarkers at age 11 predict subsequent bone mineral accrual.
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Affiliation(s)
- Katsuyasu Kouda
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, 589-8511, Japan.
| | - Kumiko Ohara
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
| | - Yuki Fujita
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, 589-8511, Japan
| | - Masayuki Iki
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, 589-8511, Japan
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18
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Larijani B, Hossein-Nezhad A, Feizabad E, Maghbooli Z, Adibi H, Ramezani M, Taheri E. Vitamin D deficiency, bone turnover markers and causative factors among adolescents: a cross-sectional study. J Diabetes Metab Disord 2016; 15:46. [PMID: 27752482 PMCID: PMC5062858 DOI: 10.1186/s40200-016-0266-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/01/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND This cross-sectional population-based study was conducted to elucidate the prevalence of vitamin D deficiency, bone turnover marker's variation and its influencing factors among adolescents of Tehran. METHODS Totally 444 middle and high school (53.6 % in high school) students (both girls and boys) were recruited. A short food frequency questionnaire designed to estimate dietary calcium and vitamin D consumption. Serum levels of calcium, phosphorus, parathyroid hormone (PTH), bone specific alkaline phosphates, 25 (OH) vitamin D, osteocalcin, cross-linked C-telopeptide (CTX), total protein, albumin and creatinine were determined. RESULTS Vitamin D deficiency was prevalent in adolescents and only 22.4 % of students had normal serum vitamin D. Results revealed that vitamin D insufficiency reported in 34.2 % of students and vitamin D deficiency was in 43.3 % of them. Serum vitamin D, osteocalcin, CTX and bone specific alkaline phosphates were significantly higher in boys in all different ages. Serum levels of 25 (OH) vitamin D had positive influences on bone turnover markers and had negative correlation with PTH. CONCLUSIONS Vitamin D deficiency and insufficiency is common among healthy adolescents of Tehran. There is a pressing need to improve vitamin D status among adolescents. Increasing vitamin D fortification of dairy products can be considered as a population-wide public health strategy in Iran.
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Affiliation(s)
- Bagher Larijani
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
| | - Arash Hossein-Nezhad
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
| | - Elham Feizabad
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
| | - Zhila Maghbooli
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
| | - Hossein Adibi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
| | - Majid Ramezani
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
| | - Eghbal Taheri
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 5th floor, shariati Hospital, North Kargar, Tehran, 141142386 Iran
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19
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Tsugawa N, Uenishi K, Ishida H, Ozaki R, Takase T, Minekami T, Uchino Y, Kamao M, Okano T. Association between vitamin D status and serum parathyroid hormone concentration and calcaneal stiffness in Japanese adolescents: sex differences in susceptibility to vitamin D deficiency. J Bone Miner Metab 2016; 34:464-74. [PMID: 26260151 DOI: 10.1007/s00774-015-0694-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 05/19/2015] [Indexed: 01/02/2023]
Abstract
There is currently insufficient information on serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) concentrations, and bone mineral status in healthy adolescents to allow reference values to be set. This study aimed to provide comparable data on vitamin D status in Japanese adolescents and to assess sex differences in susceptibility to vitamin D insufficiency. Serum 25OHD and PTH concentrations were measured in 1,380 healthy adolescents (aged 12-18 years). Subjects completed a questionnaire on exercise history, diet, and lifestyle factors. Calcaneal stiffness was evaluated by quantitative ultrasound. Serum 25OHD concentrations in boys and girls were 60.8 ± 18.3 and 52.8 ± 17.0 nmol/L, respectively. Approximately 30 % of boys and 47 % of girls had suboptimal 25OHD concentrations (<50 nmol/L). Serum PTH concentration was negatively correlated with serum 25OHD concentration in boys, but negatively correlated with calcium intake rather than serum 25OHD in girls. In contrast, the increment in calcaneal stiffness as a result of elevation of serum 25OHD was higher in girls than in boys. As vitamin D deficiency is common in Japanese adolescents, it was estimated that intakes of ≥12 and ≥14 μg/day vitamin D would be required to reach 25OHD concentrations of 50 nmol/L in boys and girls, respectively. Moreover, the results of the present study indicate that vitamin D deficiency has a greater association with calcaneal stiffness in girls than in boys.
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Affiliation(s)
- Naoko Tsugawa
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan.
- Laboratory of Public Health, Faculty of Health and Nutrition, Osaka Shoin Women's University, 4-2-26, Hishiya-nishi, Higashiosaka, Osaka, 577-8550, Japan.
| | - Kazuhiro Uenishi
- Laboratory of Physiological Nutrition, Kagawa Nutrition University, Sakado, Japan
| | - Hiromi Ishida
- Laboratory of Administrative Dietetics, Kagawa Nutrition University, Sakado, Japan
| | - Reo Ozaki
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan
| | - Tomoki Takase
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan
| | - Takuya Minekami
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan
| | - Yuri Uchino
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan
| | - Maya Kamao
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan
| | - Toshio Okano
- Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan
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20
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Scerpella TA, Bernardoni B, Wang S, Rathouz PJ, Li Q, Dowthwaite JN. Site-specific, adult bone benefits attributed to loading during youth: A preliminary longitudinal analysis. Bone 2016; 85:148-59. [PMID: 26826335 PMCID: PMC4947934 DOI: 10.1016/j.bone.2016.01.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/21/2015] [Accepted: 01/24/2016] [Indexed: 11/28/2022]
Abstract
We examined site-specific bone development in relation to childhood and adolescent artistic gymnastics exposure, comparing up to 10years of prospectively acquired longitudinal data in 44 subjects, including 31 non-gymnasts (NON) and 13 gymnasts (GYM) who participated in gymnastics from pre-menarche to ≥1.9years post-menarche. Subjects underwent annual regional and whole-body DXA scans; indices of bone geometry and strength were calculated. Anthropometrics, physical activity, and maturity were assessed annually, coincident with DXA scans. Non-linear mixed effect models centered growth in bone outcomes at menarche and adjusted for menarcheal age, height, and non-bone fat-free mass to evaluate GYM-NON differences. A POST-QUIT variable assessed the withdrawal effect of quitting gymnastics. Curves for bone area, mass (BMC), and strength indices were higher in GYM than NON at both distal radius metaphysis and diaphysis (p<0.0001). At the femoral neck, greater GYM BMC (p<0.01), narrower GYM endosteal diameter (p<0.02), and similar periosteal width (p=0.09) yielded GYM advantages in narrow neck cortical thickness and buckling ratio (both p<0.001; lower BR indicates lower fracture risk). Lumbar spine and sub-head BMC were greater in GYM than NON (p<0.036). Following gymnastics cessation, GYM slopes increased for distal radius diaphysis parameters (p≤0.01) and for narrow neck BR (p=0.02). At the distal radius metaphysis, GYM BMC and compressive strength slopes decreased, as did slopes for lumbar spine BMC, femoral neck BMC, and narrow neck cortical thickness (p<0.02). In conclusion, advantages in bone mass, geometry, and strength at multiple skeletal sites were noted across growth and into young adulthood in girls who participated in gymnastics loading to at least 1.9years post-menarche. Following gymnastics cessation, advantages at cortical bone sites improved or stabilized, while advantages at corticocancellous sites stabilized or diminished. Additional longitudinal observation is necessary to determine whether residual loading benefits enhance lifelong skeletal strength.
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Affiliation(s)
- Tamara A Scerpella
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, 6th floor, Madison, WI 53705, USA; Musculoskeletal Science Research Center, Institute for Human Performance, SUNY Upstate Medical University, Rm. 3202, 505 Irving Ave., Syracuse, NY 13210, USA.
| | - Brittney Bernardoni
- University of Wisconsin School of Medicine and Public Health, 750 Highland Ave, Madison, WI 53726, USA
| | - Sijian Wang
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA
| | - Paul J Rathouz
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA
| | - Quefeng Li
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, USA
| | - Jodi N Dowthwaite
- Musculoskeletal Science Research Center, Institute for Human Performance, SUNY Upstate Medical University, Rm. 3202, 505 Irving Ave., Syracuse, NY 13210, USA; Department of Exercise Science, Syracuse University, 201 Women's Building, Syracuse, NY 13244, USA
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21
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Mitchell DM, Tuck P, Ackerman KE, Cano Sokoloff N, Woolley R, Slattery M, Lee H, Bouxsein ML, Misra M. Altered trabecular bone morphology in adolescent and young adult athletes with menstrual dysfunction. Bone 2015; 81:24-30. [PMID: 26123592 PMCID: PMC4745258 DOI: 10.1016/j.bone.2015.06.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/15/2015] [Accepted: 06/18/2015] [Indexed: 01/25/2023]
Abstract
CONTEXT Young amenorrheic athletes (AA) have lower bone mineral density (BMD) and an increased prevalence of fracture compared with eumenorrheic athletes (EA) and non-athletes. Trabecular morphology is a determinant of skeletal strength and may contribute to fracture risk. OBJECTIVES To determine the variation in trabecular morphology among AA, EA, and non-athletes and to determine the association of trabecular morphology with fracture among AA. DESIGN AND SETTING A cross-sectional study performed at an academic clinical research center. PARTICIPANTS 161 girls and young women aged 14-26 years (97 AA, 32 EA, and 32 non-athletes). MAIN OUTCOME MEASURE We measured volumetric BMD (vBMD) and skeletal microarchitecture using high-resolution peripheral quantitative computed tomography. We evaluated trabecular morphology (plate-like vs. rod-like), orientation, and connectivity by individual trabecula segmentation. RESULTS At the non-weight-bearing distal radius, the groups did not differ for trabecular vBMD. However, plate-like trabecular bone volume fraction (pBV/TV) was lower in AA vs. EA (p=0.03), as were plate number (p=0.03) and connectivity (p=0.03). At the weight-bearing distal tibia, trabecular vBMD was higher in athletes vs. non-athletes (p=0.05 for AA and p=0.009 for EA vs. non-athletes, respectively). pBV/TV was higher in athletes vs. non-athletes (p=0.04 AA and p=0.005 EA vs. non-athletes), as were axially-aligned trabeculae, plate number, and connectivity. Among AA, those with a history of recurrent stress fracture had lower pBV/TV, axially-aligned trabeculae, plate number, plate thickness, and connectivity at the distal radius. CONCLUSIONS Trabecular morphology and alignment differ among AA, EA, and non-athletes. These differences may be associated with increased fracture risk.
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Affiliation(s)
- Deborah M Mitchell
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Padrig Tuck
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Kathryn E Ackerman
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA 02116, USA
| | - Natalia Cano Sokoloff
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Ryan Woolley
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hang Lee
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Madhusmita Misra
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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22
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Shagina NB, Tolstykh EI, Degteva MO, Anspaugh LR, Napier BA. Age and gender specific biokinetic model for strontium in humans. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2015; 35:87-127. [PMID: 25574605 DOI: 10.1088/0952-4746/35/1/87] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A biokinetic model for strontium in humans is necessary for quantification of internal doses due to strontium radioisotopes. The ICRP-recommended biokinetic model for strontium has limitations for use in a population study, because it is not gender specific and does not cover all age ranges. The extensive Techa River data set on (90)Sr in humans (tens of thousands of measurements) is a unique source of data on long-term strontium retention for men and women of all ages at intake. These, as well as published data, were used for evaluation of age- and gender-specific parameters for a new compartment biokinetic model for strontium (Sr-AGe model). The Sr-AGe model has a similar structure to the ICRP model for the alkaline earth elements. The following parameters were mainly re-evaluated: gastrointestinal absorption and parameters related to the processes of bone formation and resorption defining calcium and strontium transfers in skeletal compartments. The Sr-AGe model satisfactorily describes available data sets on strontium retention for different kinds of intake (dietary and intravenous) at different ages (0-80 years old) and demonstrates good agreement with data sets for different ethnic groups. The Sr-AGe model can be used for dose assessment in epidemiological studies of general populations exposed to ingested strontium radioisotopes.
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Affiliation(s)
- N B Shagina
- Urals Research Center for Radiation Medicine, Chelyabinsk 454076, Russia
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23
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Viguet-Carrin S, Hoppler M, Membrez Scalfo F, Vuichoud J, Vigo M, Offord EA, Ammann P. Peak bone strength is influenced by calcium intake in growing rats. Bone 2014; 68:85-91. [PMID: 25102437 DOI: 10.1016/j.bone.2014.07.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 07/21/2014] [Accepted: 07/25/2014] [Indexed: 01/20/2023]
Abstract
In this study we investigated the effect of supplementing the diet of the growing male rat with different levels of calcium (from low to higher than recommended intakes at constant Ca/P ratio), on multiple factors (bone mass, strength, size, geometry, material properties, turnover) influencing bone strength during the bone accrual period. Rats, age 28days were supplemented for 4weeks with high Ca (1.2%), adequate Ca (0.5%) or low Ca level (0.2%). Bone metabolism and structural parameters were measured. No changes in body weight or food intake were observed among the groups. As anticipated, compared to the adequate Ca intake, low-Ca intake had a detrimental impact on bone growth (33.63 vs. 33.68mm), bone strength (-19.7% for failure load), bone architecture (-58% for BV/TV) and peak bone mass accrual (-29% for BMD) due to the hormonal disruption implied in Ca metabolism. In contrast, novel, surprising results were observed in that higher than adequate Ca intake resulted in improved peak bone strength (106 vs. 184N/mm for the stiffness and 61 vs. 89N for the failure load) and bone material properties (467 vs. 514mPa for tissue hardness) but these effects were not accompanied by changes in bone mass, size, microarchitecture or bone turnover. Hormonal factors, IGF-I and bone modeling were also evaluated. Compared to the adequate level of Ca, IGF-I level was significantly lower in the low-Ca intake group and significantly higher in the high-Ca intake group. No detrimental effects of high Ca were observed on bone modeling (assessed by histomorphometry and bone markers), at least in this short-term intervention. In conclusion, the decrease in failure load in the low calcium group can be explained by the change in bone geometry and bone mass parameters. Thus, improvements in mechanical properties can be explained by the improved quality of intrinsic bone tissue as shown by nanoindentation. These results suggest that supplemental Ca may be beneficial for the attainment of peak bone strength and that multiple factors linked to bone mass and strength should be taken into account when setting dietary levels of adequate mineral intake to support optimal peak bone mass acquisition.
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Affiliation(s)
- S Viguet-Carrin
- Centre de Recherche Nestlé, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - M Hoppler
- Centre de Recherche Nestlé, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - F Membrez Scalfo
- Centre de Recherche Nestlé, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - J Vuichoud
- Centre de Recherche Nestlé, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - M Vigo
- Centre de Recherche Nestlé, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - E A Offord
- Centre de Recherche Nestlé, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - P Ammann
- Service des Maladies Osseuses, Hôpital Universitaire de Genève, Genève, Switzerland
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24
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Abstract
Pubertal maturation plays a fundamental role in bone acquisition. In retrospective epidemiological surveys in pre- and postmenopausal women, relatively later menarcheal age was associated with low bone mineral mass and increased risk of osteoporotic fracture. This association was usually ascribed to shorter time exposure to estrogen from the onset of pubertal maturation to peak bone mass attainment. Recent prospective studies in healthy children and adolescents do not corroborate the limited estrogen exposure hypothesis. In prepubertal girls who will experience later menarche, a reduced bone mineral density was observed before the onset of pubertal maturation, with no further accumulated deficit until peak bone mass attainment. In young adulthood, later menarche is associated with impaired microstructural bone components and reduced mechanical resistance. This intrinsic bone deficit can explain the fact that later menarche increases fracture risk during childhood and adolescence. In healthy individuals, both pubertal timing and bone development share several similar characteristics including wide physiological variability and strong effect of heritable factors but moderate influence of environmental determinants such as nutrition and physical activity. Several conditions modify pubertal timing and bone acquisition, a certain number of them acting in concert on both traits. Taken together, these facts should prompt the search for common genetic regulators of pubertal timing and bone acquisition. It should also open epigenetic investigation avenues to pinpoint which environmental exposure in fetal and infancy life, such as vitamin D, calcium, and/or protein supplies, influences both pubertal timing and bone acquisition.
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Affiliation(s)
- Jean-Philippe Bonjour
- Division of Bone Diseases, University Hospitals and Faculty of Medicine, CH-1211 Geneva, Switzerland
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Changes in serum RANKL and OPG with sexual development and their associations with bone turnover and bone mineral density in a cohort of girls. Clin Biochem 2014; 47:1040-6. [DOI: 10.1016/j.clinbiochem.2014.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/21/2014] [Accepted: 04/11/2014] [Indexed: 01/30/2023]
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Roende G, Petersen J, Ravn K, Fuglsang K, Andersen H, Nielsen JB, Brøndum-Nielsen K, Jensen JEB. Low bone turnover phenotype in Rett syndrome: results of biochemical bone marker analysis. Pediatr Res 2014; 75:551-8. [PMID: 24375084 DOI: 10.1038/pr.2013.252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 09/19/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients with Rett syndrome (RTT) are at risk of having low bone mass and low-energy fractures. METHODS We characterized bone metabolism by both bone formation and resorption markers in blood in a RTT population of 61 girls and women and 122 well-matched healthy controls. Levels of N-terminal propeptides of collagen type 1 (P1NP), C-terminal telopeptide cross links (CTX), osteocalcin (OC), and bone-specific alkaline phosphatase (B-ALP) were compared between RTT patients and controls in regression models adjusted for BMI, vitamin D status, volumetric bone mineral apparent density of the lumbar spine (vBMAD spine), and femoral neck (vBMAD neck). We examined biochemical bone marker levels overall and stratified to persons younger than age 25 y or equal to or older than age 25 y. RESULTS The RTT patients had reduced levels of all biochemical bone markers (P < 0.05), which remained significant in persons younger than 25 y (P ≤ 0.001) regarding P1NP, CTX, and OC. Bone marker levels were not significantly associated to methyl-CpG-binding protein 2 (MECP2) mutation group, walking ability, or previous low-energy fractures. CONCLUSION Our findings of a low bone turnover state in girls with RTT suggest critical attention to medical treatment of low bone mass in young RTT patients.
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Affiliation(s)
- Gitte Roende
- Center for Rett Syndrome, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Janne Petersen
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Kirstine Ravn
- Center for Rett Syndrome, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Kathrine Fuglsang
- Center for Rett Syndrome, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Henrik Andersen
- Department of Exercise and Sports Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jytte B Nielsen
- Center for Rett Syndrome, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Karen Brøndum-Nielsen
- Genetic Counseling Clinic, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Jens-Erik B Jensen
- Department of Endocrinology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
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Maïmoun L, Guillaume S, Lefebvre P, Philibert P, Bertet H, Picot MC, Gaspari L, Paris F, Courtet P, Thomas E, Mariano-Goulart D, Bringer J, Renard E, Sultan C. Role of sclerostin and dickkopf-1 in the dramatic alteration in bone mass acquisition in adolescents and young women with recent anorexia nervosa. J Clin Endocrinol Metab 2014; 99:E582-90. [PMID: 24471564 DOI: 10.1210/jc.2013-2565] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND The nutritional deprivation of adolescent girls with anorexia nervosa (AN) reduces bone mass acquisition. A better understanding of this process would improve the medical treatment of bone alteration and its long-term consequences. OBJECTIVE The first aim was to model the bone mass acquisition in young women with AN. The second aim was to identify the clinical and biological factors associated with bone demineralization and investigate the potential role of sclerostin and dickkopf-1 protein (DKK-1). POPULATION AND METHODS Ninety-eight AN patients (mean age 18.2 ± 2.6 years) and 63 age-matched controls were enrolled in this study. Areal bone mineral density (aBMD) was determined by dual-energy x-ray absorptiometry. Calciotropic hormones, bone turnover markers, sclerostin, DKK-1, and growth factors were concomitantly evaluated. RESULTS The aBMD was significantly reduced at all bone sites in AN patients vs controls (range, -3.3% at the radius to -12.1% for total proximal femur). Bone formation markers IGF-1 and DKK-1 were significantly decreased in AN patients, whereas PTH, sclerostin, and the bone resorption markers were increased. In patients, the AN duration, amenorrhea, weight, body mass index, fat mass, and fat-free soft tissue were negatively correlated with aBMD, whereas the age of AN onset was positively correlated. Multiple regression analysis revealed that the duration of amenorrhea was the independent factor most negatively associated with aBMD at all bone sites except the radius. CONCLUSION This case-control study demonstrated a dramatic reduction in aBMD, reinforced for the first time by our models, and indicates the need for early, systematic, and adapted bone mass monitoring. Moreover, appropriate treatment should be started early in patients with AN. Increased secretion of sclerostin suggests that it may be a target for pharmacological action.
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Affiliation(s)
- Laurent Maïmoun
- Service de Médecine Nucléaire (L.M., D.M.-G.), Hôpital Lapeyronie, Centre Hospitalier Regional Universitaire (CHRU) Montpellier et Université Montpellier 1 (UMI); Service d'Hormonologie (L.M., P.P., F.P., C.S.) et Service de Rhumatologie (E.T.), Departement d'Endocrinologie, Diabète, Nutrition (P.L., J.B., E.R.), and Unité de Recherche Clinique et Epidémiologie (H.B., M.-C.P.), Hôpital Lapeyronie, CHRU Montpellier; Département d'Urgence et Post-Urgence Psychiatrique (S.G., P.C.), Hôpital Lapeyronie, CHRU Montpellier and UM1, Inserm Unité (U) 1061; Physiologie et Médecine Expérimentale du Cœur et des Muscles (L.M.), Inserm U1046, UM1 and UM2; Centre d'Investigation Clinique (CIC) Inserm 1411 (M.-C.P., E.R.), Hôpital Gui de Chauliac, CHRU Montpellier; Unité d'Endocrinologie et Gynécologie Pédiatrique (F.P., C.S.), Département de Pédiatrie, Hôpital Arnaud de Villeneuve, CHRU Montpellier et UM1; and Institut de Génomique Fonctionnelle (E.R.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5203/Inserm U661/UM1 and UM2, 34295 Montpellier, France; and Département de Pédiatrie (L.G.), Hôpital Caremeau, CHRU Nîmes, 30000 Nîmes, France
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Bernardoni B, Thein-Nissenbaum J, Fast J, Day M, Li Q, Wang S, Scerpella T. A school-based resistance intervention improves skeletal growth in adolescent females. Osteoporos Int 2014; 25:1025-32. [PMID: 24114402 PMCID: PMC4118457 DOI: 10.1007/s00198-013-2535-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 09/24/2013] [Indexed: 10/26/2022]
Abstract
SUMMARY Twenty-two sixth-grade girls who participated in a 7-month school-based resistance-training program were compared to 22 controls. In a subanalysis of Tanner breast II (T2) and III (T3) subjects (n = 21 controls subjects (CON), n = 17 subjects in the high-intervention (INT)-dose group (HI)), T2 HI had greater narrow neck (NN) width gains than T2 CON (p < 0.05) and T3 HI had greater L3 bone mineral density (BMD) gains than T3 CON (p < 0.05). INTRODUCTION Physical activity modulates bone growth during adolescence, but an effective activity has not been identified for general use. The purpose of this study was to examine the effect of a school-based resistance-training program on skeletal growth in pre-menarcheal females. METHODS Sixth-grade girls participated in a 7-month, resistance-training program (INT) embedded in physical education (PE) classes. Age- and maturity-matched CON from a neighboring school participated in the standard PE classes. INT dose defined high (HI) and low (LO) groups. At baseline (BL) and follow-up (FU), non-INT organized physical activity (PA, hours per week) and maturity status were recorded; DXA scans assessed total body, distal radius, proximal femur, and lumbar spine. Regression models analyzed growth in bone outcomes for HI versus CON, accounting for age, Tanner stage, height, and PA. RESULTS Forty-four girls (22 HI, 22 CON) were 11.7 ± 0.3 years of age at BL; all were ≤6 months postmenarche and did not differ in bone growth over the course of the intervention (p > 0.05). However, in a subanalysis limited to subjects who were T2 or T3 at BL (n = 21 CON, n = 17 HI), T2 HI had greater gains in NN width (p = 0.01) compared to T2 CON, while T3 HI had greater gains in L3 BMD (p = 0.03) compared to T3 CON. CONCLUSIONS In a group of T2 and T3 sixth-grade girls, a school-based resistance-training intervention produced maturity-specific differential gains for HI versus CON at the hip and spine.
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Affiliation(s)
- B Bernardoni
- University of Wisconsin School of Medicine and Public Health, Madison, USA,
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Maïmoun L, Coste O, Philibert P, Briot K, Mura T, Galtier F, Mariano-Goulart D, Paris F, Sultan C. Peripubertal female athletes in high-impact sports show improved bone mass acquisition and bone geometry. Metabolism 2013; 62:1088-98. [PMID: 23490587 DOI: 10.1016/j.metabol.2012.11.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 11/20/2012] [Accepted: 11/29/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Intensive physical training may have a sport-dependent effect on bone mass acquisition. This cross-sectional study evaluated bone mass acquisition in girls practicing sports that put different mechanical loads on bone. MATERIALS/METHODS Eighty girls from 10.7 to 18.0 years old (mean 13.83 ± 1.97) were recruited: 20 artistic gymnasts (AG; high-impact activity), 20 rhythmic gymnasts (RG; medium-impact activity), 20 swimmers (SW, no-impact activity), and 20 age-matched controls (CON; leisure physical activity <3h/wk). Areal bone mineral density (aBMD) was determined using DEXA. Hip structural analysis applied at the femur evaluated cross-sectional area (CSA, cm(2)), section modulus (Z, cm(3)), and buckling ratio. Bone turnover markers and OPG/RANKL levels were analyzed. RESULTS AG had higher aBMD than SW and CON at all bone sites and higher values than RG in the lumbar spine and radius. RG had higher aBMD than SW and CON only in the femoral region. CSA and mean cortical thickness were significantly higher and the buckling ratio was significantly lower in both gymnast groups compared with SW and CON. In RG only, endocortical diameter and width were reduced, while Z was only increased in AG compared with SW and CON. Reduced bone remodeling was observed in RG compared with AG only when groups were subdivided according to menarcheal status. All groups showed similar OPG concentrations, while RANKL concentrations increased with age and were decreased in SW. CONCLUSION High-impact activity clearly had a favorable effect on aBMD and bone geometry during the growth period, although the bone health benefits seem to be more marked after menarche.
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Affiliation(s)
- Laurent Maïmoun
- Département d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, 191 avenue Doyen Gaston Giraud, 34295 Montpellier, France.
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Maïmoun L, Coste O, Mura T, Philibert P, Galtier F, Mariano-Goulart D, Paris F, Sultan C. Specific bone mass acquisition in elite female athletes. J Clin Endocrinol Metab 2013; 98:2844-53. [PMID: 23666974 DOI: 10.1210/jc.2013-1070] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Cross-sectional studies have demonstrated that physical activity can improve bone mass acquisition. However, this design is not adequate to describe the specific kinetics of bone mass gain during pubertal development. OBJECTIVE To compare the kinetics of bone mass acquisition in female adolescent athletes of sports that impose different mechanical loads and untrained controls throughout puberty. STUDY PARTICIPANTS A total of 72 girls with ages ranging from 10.8 to 18.0 years were recruited: 24 rhythmic gymnasts (RG, impact activity group), 24 swimmers (SW, no-impact activity), and 24 age-matched controls (CON). MAIN OUTCOME MEASURES Areal bone mineral density (aBMD) was determined using dual-energy x-ray absorptiometry and bone turnover markers were analyzed. All the investigations were performed at baseline and after 1 year. RESULTS At baseline and after 1 year of follow-up, RG presented significantly greater aBMD adjusted for age, fat-free soft tissue, and fat mass compared with CON and SW, only at the femoral region. When aBMD variation throughout the pubertal period was modeled for each group from individual values, the aBMD at the femoral region was significantly higher in RG compared with the other 2 groups from 12.5 to 14 years, and this difference lasted up to 18 years. Moreover, the mean annual aBMD gain tended to be higher in RG compared with SW and CON only at the femoral region and this gain lasted longer in RG. Bone remodeling markers decreased similarly with age in the 3 groups. CONCLUSIONS This study, which was based on linear mixed models for longitudinal data, demonstrated that the osteogenic effect of gymnastics is characterized by greater bone mass gain localized at mechanically loaded bone (ie, the proximal femur) principally around the menarcheal period. Moreover, the bone mass gain lasts longer in gymnasts, which may be explained by the delay in sexual maturation.
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Affiliation(s)
- Laurent Maïmoun
- Département d'Hormonologie, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire Montpellier et Université Montpellier I, Montpellier, 34295 Montpellier, France
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Effect of gender, season, and vitamin D status on bone biochemical markers in Saudi diabetes patients. Molecules 2012; 17:8408-18. [PMID: 22785268 PMCID: PMC6268078 DOI: 10.3390/molecules17078408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/04/2012] [Accepted: 07/05/2012] [Indexed: 11/24/2022] Open
Abstract
Biochemical bone turnover markers (BTMs) provide important information on the diagnosis, therapy and monitoring of metabolic bone diseases. They are evident before measurable changes in bone mineral density (BMD) take place. A total of 35 adult Saudi patients (23 males; 12 females) with type 2 diabetes and diagnosed to be vitamin D deficient were recruited in this prospective study. Here we investigated the effects of gender, season, and vitamin D status on bone biochemical markers of bone remodeling. Anthropometry and blood samples were collected at different intervals. Metabolic parameters and bone biomarkers were measured routinely and by ELISA. Both males and females had a significant increase in their vitamin D status over time, but no significant changes in the bone biomarkers were observed in females. In males there was a significant increase in circulating levels of corrected calcium and OPN (p = 0.004 and 0.01 respectively) and a significant decrease in crosslaps (p = 0.005). In all subjects there was a modest but significant positive relationship between vitamin D status and OC (R = 0.34; p = 0.04). In conclusion, our study demonstrates that changes in bone remodeling markers are affected by season, gender, and possibly vitamin D status. This gender difference may well reflect the physiologic pathway responsible for the higher peak bone mass achieved in males compared to females.
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Dowthwaite JN, Rosenbaum PF, Scerpella TA. Site-specific advantages in skeletal geometry and strength at the proximal femur and forearm in young female gymnasts. Bone 2012; 50:1173-83. [PMID: 22342799 PMCID: PMC3340420 DOI: 10.1016/j.bone.2012.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 01/15/2012] [Accepted: 01/20/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE We evaluated site-specific skeletal adaptation to loading during growth, comparing radius (RAD) and femoral neck (FN) DXA scans in young female gymnasts (GYM) and non-gymnasts (NON). METHODS Subjects from an ongoing longitudinal study (8-26yr old) underwent annual DXA scans (proximal femur, forearm, total body) and anthropometry, completing maturity and physical activity questionnaires. This cross-sectional analysis used the most recent data meeting the following criteria: gynecological age ≤2.5yr post-menarche; and GYM annual mean gymnastic exposure ≥5.0h/wk in the prior year. Bone geometric and strength indices were derived from scans for 173 subjects (8-17yr old) via hip structural analysis (femoral narrow neck, NN) and similar radius formulae (1/3 and Ultradistal (UD)). Maturity was coded as M1 (Tanner I breast), M2 (pre-menarche, ≥Tanner II breast) or M3 (post-menarche). ANOVA and chi square compared descriptive data. Two factor ANCOVA adjusted for age, height, total body non-bone lean mass and percent body fat; significance was tested for main effects and interactions between gymnastic exposure and maturity. RESULTS At the distal radius, GYM means were significantly greater than NON means for all variables (p<0.05). At the proximal femur, GYM exhibited narrower periosteal and endosteal dimensions, but greater indices of cortical thickness, BMC, aBMD and section modulus, with lower buckling ratio (p<0.05). However, significant interactions between maturity and loading were detected for the following: 1) FN bone mineral content (BMC) and NN buckling ratio (GYM BMC advantages only in M1 and M3; for BMC and buckling ratio, M1 advantages were greatest); 2) 1/3 radius BMC, width, endosteal diameter, cortical cross-sectional area, and section modulus (GYM advantages primarily post-menarche); and 3) UD radius BMC and axial compressive strength (GYM advantages were larger with greater maturity, greatest post-menarche). CONCLUSIONS Maturity-specific comparisons suggested site-specific skeletal adaptation to loading during growth, with greater advantages at the radius versus the proximal femur. At the radius, GYM advantages included greater bone width, cortical cross-sectional area and cortical thickness; in contrast, at the femoral neck, GYM bone tissue cross-sectional area and cortical thickness were greater, but bone width was narrower than in NON. Future longitudinal analyses will evaluate putative maturity-specific differences.
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Affiliation(s)
- Jodi N. Dowthwaite
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, U.S.A. Phone: 001-315-464-9981; Fax: 001-315-464-6638,
| | - Paula F. Rosenbaum
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, U.S.A. Phone: 001-315-464-4430; Fax: 001-315-464-4429,
| | - Tamara A. Scerpella
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, U.S.A. Phone: 001-315-464-9981; Fax: 001-315-464-6638,
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Abstract
Patterns of variation in bone size and shape provide crucial data for reconstructing hominin paleobiology, including ecogeographic adaptation, life history, and functional morphology. Measures of bone strength, including robusticity (diaphyseal thickness relative to length) and cross-sectional geometric properties such as moments of area, are particularly useful for inferring behavior because bone tissue adapts to its mechanical environment. Particularly during skeletal growth, exercise-induced strains can stimulate periosteal modeling so that, to some extent, bone thickness reflects individual behavior. Thus, patterns of skeletal robusticity have been used to identify gender-based activity differences, temporal shifts in mobility, and changing subsistence strategies. Although there is no doubt that mechanical loading leaves its mark on the skeleton, less is known about whether individuals differ in their skeletal responses to exercise. For example, the potential effects of hormones or growth factors on bone-strain interactions are largely unexplored. If the hormonal background can increase or decrease the effects of exercise on skeletal robusticity, then the same mechanical loads might cause different degrees of bone response in different individuals. Here I focus on the role of the hormone estrogen in modulating exercise-induced changes in human bone thickness.
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Affiliation(s)
- Maureen J Devlin
- Orthopedic Biomechanics Laboratory of Beth Israel Deaconess Medical Center, USA.
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Nishiyama KK, Macdonald HM, Moore SA, Fung T, Boyd SK, McKay HA. Cortical porosity is higher in boys compared with girls at the distal radius and distal tibia during pubertal growth: an HR-pQCT study. J Bone Miner Res 2012; 27:273-82. [PMID: 22028110 DOI: 10.1002/jbmr.552] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study was to determine the sex- and maturity-related differences in bone microstructure and estimated bone strength at the distal radius and distal tibia in children and adolescents. We used high-resolution pQCT to measure standard morphological parameters in addition to cortical porosity (Ct.Po) and estimated bone strength by finite element analysis. Participants ranged in age from 9 to 22 years (n = 212 girls and n = 186 boys) who were scanned annually for either one (11%) or two (89%) years at the radius and for one (15%), two (39%), or three (46%) years at the tibia. Participants were grouped by the method of Tanner into prepubertal, early pubertal, peripubertal, and postpubertal groups. At the radius, peri- and postpubertal girls had higher cortical density (Ct.BMD; 9.4% and 7.4%, respectively) and lower Ct.Po (-118% and -56%, respectively) compared with peri- and postpubertal boys (all p < 0.001). Peri- and postpubertal boys had higher trabecular bone volume ratios (p < 0.001) and larger cortical cross-sectional areas (p < 0.05, p < 0.001) when compared with girls. Based upon the load-to-strength ratio (failure load/estimated fall force), boys had lower risk of fracture than girls at every stage except during early puberty. Trends at the tibia were similar to the radius with differences between boys and girls in Ct.Po (p < 0.01) and failure load (p < 0.01) at early puberty. Across pubertal groups, within sex, the most mature girls and boys had higher Ct.BMD and lower Ct.Po than their less mature peers (prepuberty) at both the radius and tibia. Girls in early, peri-, and postpubertal groups and boys in peri- and postpubertal groups had higher estimates of bone strength compared with their same-sex prepubertal peers (p < 0.001). These results provide insight into the sex- and maturity-related differences in bone microstructure and estimated bone strength.
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Affiliation(s)
- Kyle K Nishiyama
- Schulich School of Engineering, University of Calgary, Calgary, Canada
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Dimitri P, Bishop N, Walsh JS, Eastell R. Obesity is a risk factor for fracture in children but is protective against fracture in adults: a paradox. Bone 2012; 50:457-66. [PMID: 21619952 DOI: 10.1016/j.bone.2011.05.011] [Citation(s) in RCA: 168] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 04/14/2011] [Accepted: 05/09/2011] [Indexed: 01/19/2023]
Abstract
With the rise in obesity worldwide, an important debate has developed as to whether excess fat has a detrimental or protective effect on skeletal health in children and adults. Obese children appear to be over represented in fracture groups and recent evidence suggests that fat may be detrimental to bone accrual in children, although this effect may be confined to adolescence during rapid skeletal growth. Fat induced alterations in hormonal factors and cytokines during growth may play a pivotal role in disturbing bone accrual. In contrast, the widely accepted opinion is that fat appears to be protective of bone in adults and minimises bone loss in postmenopausal women. Recent evidence suggests that in adults, site specific fat depots may exert differing effects on bone (with visceral fat acting as a pathogenic fat depot and subcutaneous fat exerting protective effects), and that the effects of fat mass on bone and fracture risk may vary by skeletal site; obesity protects against hip and vertebral fractures but is a risk factor for fractures of the humerus and ankle. The incidence of fracture during adolescence is rising and osteoporosis remains a considerable health burden in older adults. Understanding the effects of fat mass on bone during growth and early adulthood is vital in informing future health strategies and pharmacotherapies to optimise peak bone mass and prevent fracture.
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Affiliation(s)
- P Dimitri
- The NIHR Bone Biomedical Research Unit, Sheffield, UK.
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Zhang Q, Wastney ME, Rosen CJ, Beamer WG, Weaver CM. Insulin-like growth factor-1 increases bone calcium accumulation only during rapid growth in female rats. J Nutr 2011; 141:2010-6. [PMID: 21956958 PMCID: PMC3192459 DOI: 10.3945/jn.111.142679] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Calcium retention varies with developmental state, which may be partially under the control of insulin-like growth factor 1 (IGF-1). IGF-1 levels can be manipulated through dietary and therapeutic interventions. We investigated the relationship between IGF-1 endogenous production and calcium utilization and bone accretion during growth as well as the effects of IGF-1 treatment on calcium utilization during rapid and slowed growth in intact female Sprague-Dawley rats. In 33 rats killed at 11 time points (n = 3 each) from age 4 to 24 wk, femoral and vertebral bone mass were paralleled by plasma IGF-1 up to 9 wk. Fractional calcium absorption was maximal at 9 wk, reduced by one-half at 12 wk, and there was no further change at 20 wk. From this study, we selected 2 stages of growth, rapid and slow, for a subsequent intervention study. A 4-wk intervention was initiated at 6 or 8 wk when rats (n = 15/group) received either continuous rhIGF-1/IGF binding protein 3 (IGFBP3) infusion (0.3 mg/d) or vehicle (control) by osmotic mini-pumps. In rapidly growing IGF-1/IGFBP3-treated rats compared to controls, but not in slowly growing treated compared to control rats, IGF-1 treatment increased (P < 0.05) calcium absorption (35 vs. 21%), bone calcium balance (0.55 vs. 0.3 mmol/d), and femoral calcium content (31 vs. 24% of dry weight). Exogenous IGF-1/IGFBP3 treatment increased calcium accretion during rapid growth, but rats past rapid growth were no longer as sensitive to this dose of IGF-1/IGFBP3. Thus, interventions designed to improve bone mass through increased IGF-1 will have the greatest impact during rapid growth.
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Affiliation(s)
- Qinmin Zhang
- Department of Foods and Nutrition, Purdue University, West Lafayette, IN
| | | | - Clifford J. Rosen
- The Jackson Laboratory, Bar Harbor, ME; and,Maine Medical Center Research Institute, Scarborough, ME
| | | | - Connie M. Weaver
- Department of Foods and Nutrition, Purdue University, West Lafayette, IN,To whom correspondence should be addressed. E-mail:
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Klentrou P, Ludwa IA, Falk B. Factors associated with bone turnover and speed of sound in early and late-pubertal females. Appl Physiol Nutr Metab 2011; 36:707-14. [PMID: 21980959 DOI: 10.1139/h11-085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This cross-sectional study examines whether maturity, body composition, physical activity, dietary intake, and hormonal concentrations are related to markers of bone turnover and tibial speed of sound (tSOS) in premenarcheal (n = 20, 10.1 ± 1.1 years) and postmenarcheal girls (n = 28, aged 15.0 ± 1.4 years). Somatic maturity was evaluated using years from age of peak height velocity (aPHV). Daily dietary intake was assessed with a 24-h recall interview, and moderate to very vigorous physical activity (MVPA) was measured using accelerometry. Plasma levels of 25-OH vitamin D, serum levels of insulin-like growth-factor 1 (IGF-1) and leptin, and serum levels of bone turnover markers including osteocalcin (OC), bone-specific alkaline phosphatase (BAP) and cross-linked N-teleopeptide of type I collagen (NTX) were measured using ELISA. OC, BAP, and NTX were significantly higher while IGF-1 and tSOS were lower in the premenarcheal group. The premenarcheal girls were more active and had higher daily energy intake relative to their body mass but there were no group differences in body mass index percentile. Maturity predicted 40%-57% of the variance in bone turnover markers. Additionally, daily energy intake was a significant predictor of OC, especially in the postmenarcheal group. IGF-1 and MVPA were significant predictors of BAP in the group as a whole. However, examined separately, IGF-1 was a predictor of BAP in the premenarcheal group while MVPA was a predictor in the postmenarcheal group. Adiposity and leptin were both negative predictors of tSOS, with leptin being specifically predictive in the postmenarcheal group. In conclusion, while maturity was the strongest predictor of bone markers and tSOS, dietary intake, physical activity, body composition, and hormonal factors further contribute to the variance in bone turnover and bone SOS in young Caucasian females. Further, the predicting factors of bone turnover and tSOS were different within each maturity group.
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Affiliation(s)
- Panagiota Klentrou
- Department of Physical Education and Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada.
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Klentrou P, Ludwa IA. Quantitative Bone Ultrasound Measurements in Young Females 14–23 Years of Age. J Womens Health (Larchmt) 2011; 20:677-83. [DOI: 10.1089/jwh.2010.2214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Panagiota Klentrou
- Department of Physical Education and Kinesiology, Brock University, Ontario, Canada
| | - Izabella A. Ludwa
- Department of Physical Education and Kinesiology, Brock University, Ontario, Canada
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Gracia-Marco L, Ortega FB, Jiménez-Pavón D, Rodríguez G, Valtueña J, Díaz-Martínez AE, González-Gross M, Castillo MJ, Vicente-Rodríguez G, Moreno LA. Contribution of bone turnover markers to bone mass in pubertal boys and girls. J Pediatr Endocrinol Metab 2011; 24:971-4. [PMID: 22308850 DOI: 10.1515/jpem.2011.326] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS The association between bone turnover markers and bone mass in adolescence is not clear. We aimed to evaluate the associations between bone turnover markers and bone mineral content (BMC), density (BMD) and area (BMA). SUBJECTS A total of 56 adolescents (25 boys, 12.5-17.5 years) participated in the study. METHODS Bone mass and physical activity (PA) were measured using dual energy X-ray absorptiometry and accelerometers. Osteocalcin and amino-terminal propeptide of type I procollagen (PINP), as markers of bone formation, and beta-isomer of the C-terminal telopeptide of type I collagen, as marker of bone resorption were also measured. Sexual maturation, weight, height and average PA were considered as confounders. RESULTS Positive correlations (Pearson) were observed among the three bone turnover markers (r = 0.7-0.9). Stepwise multiple linear regression analyses showed that PINP was strong and negatively associated with BMC, BMD and BMA in girls, explaining 24.9% of the variance in BMC, 25.6% in BMD and 16.3% in BMA. CONCLUSION PINP is a strong predictor of bone related variables in pubertal girls.
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Affiliation(s)
- Luis Gracia-Marco
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
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Assa A, Weiss M, Aharoni D, Mor A, Rachmiel M, Bistritzer T. Evaluation of bone density in girls with precocious and early puberty during treatment with GnRH agonist. J Pediatr Endocrinol Metab 2011; 24:505-10. [PMID: 21932589 DOI: 10.1515/jpem.2011.170] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Major changes in bone status occur during puberty. Most longitudinal studies have shown no impairment in bone mineral density (BMD) in girls with precocious (PP) and early puberty (EP) during and after GnRH agonist therapy. METHODS In the present study we evaluated BMD, bone strength (BS) and bone metabolism in 26 girls with PP and with EP before and during treatment with GnRH agonist. BMD was measured by dual energy X-ray absorptiometry and BS was measured using the quantitative high frequency ultrasound technique at baseline, after 6 and 12 months from onset of therapy. Variables were compared with age- and sex-matched values of the same population. Biochemical markers of bone turnover were measured at the same intervals. RESULTS Mean lumbar spine (LS) and femoral neck (FN) BMD were significantly lower at baseline (LS: p < 0.0001, FN: p < 0.0017) compared with age-matched reference values. Bone strength was significantly lower at the radius (p < 0.0001) and normal at the tibia. A non-significant increase in BMD and a significant increase in BS were observed throughout the first year of therapy with GnRH agonist. Serum bone specific alkaline phosphatase measurements were normal at baseline and remained stable. Urinary deoxypyridinoline\creatinine measurements were significantly higher (p < 0.0001) at baseline and decreased significantly (p < 0.001) during treatment. CONCLUSIONS Girls with central idiopathic PP and EP have lower BMD and BS for chronological age and increased bone resorption markers. These parameters show a trend of normalization during the first year of therapy with GnRH agonist.
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Affiliation(s)
- Amit Assa
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel-Aviv, Israel.
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Breen ME, Laing EM, Hall DB, Hausman DB, Taylor RG, Isales CM, Ding KH, Pollock NK, Hamrick MW, Baile CA, Lewis RD. 25-hydroxyvitamin D, insulin-like growth factor-I, and bone mineral accrual during growth. J Clin Endocrinol Metab 2011; 96:E89-98. [PMID: 20962027 PMCID: PMC3038478 DOI: 10.1210/jc.2010-0595] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The extent to which 25-hydroxyvitamin D [25(OH)D] and IGF-I influence bone mineral content (BMC) accrual from early to mid-puberty is unclear. OBJECTIVE, SETTING, AND PARTICIPANTS: This study sought to determine relationships among 25(OH)D, IGF-I, and BMC in community-dwelling prepubertal females (n = 76; aged 4-8 yr at baseline) over a period of up to 9 yr. DESIGN The hypothesis that changes in IGF-I vs. 25(OH)D are more strongly associated with BMC accrual was formulated after data collection. 25(OH)D and IGF-I were log-transformed and further adjusted using two-way ANOVA for differences in season and race. Linear mixed modeling (including a random subject-specific intercept and a random subject-specific slope on age) was employed to analyze the proportion of variance the transformed 25(OH)D and IGF-I variables explained for the bone outcomes. RESULTS IGF-I was more strongly associated with BMC accrual than 25(OH)D at the total body (R(2) = 0.874 vs. 0.809), proximal femur (R(2) = 0.847 vs. 0.771), radius (R(2) = 0.812 vs. 0.759), and lumbar spine (R(2) = 0.759 vs. 0.698). The rate of BMC accrual was positively associated with changes in IGF-I but negatively associated with 25(OH)D. When IGF-I and 25(OH)D were included in the same regression equation, 25(OH)D did not have a significant predictive effect on BMC accrual above and beyond that of IGF-I. CONCLUSIONS These prospective data in early adolescent females indicate that both 25(OH)D and IGF-I have a significant impact on bone mineral accrual; however, the positive association of IGF-I and BMC accrual is greater than the negative association of 25(OH)D and BMC accrual.
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Affiliation(s)
- M E Breen
- Department of Foods and Nutrition, The University of Georgia, Athens, Georgia 30602, USA
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Maïmoun L, Coste O, Galtier F, Mura T, Mariano-Goulart D, Paris F, Sultan C. Bone mineral density acquisition in peripubertal female rhythmic gymnasts is directly associated with plasma IGF1/IGF-binding protein 3 ratio. Eur J Endocrinol 2010; 163:157-64. [PMID: 20423985 DOI: 10.1530/eje-10-0315] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Intense physical activity in peripubertal girls may delay menarche and cause menstrual disorders and estrogen deficiency, particularly in sport disciplines that require strict weight control. It may also have a deleterious effect on bone mass acquisition. The aim of this study was to determine the time-course of bone mass accretion in peripubertal elite female rhythmic gymnasts (FRGs) over a 1-year period, as well as the anthropometric and hormone parameters that could be helpful for predicting bone mineral density (BMD) gain. METHODS AND DESIGN We conducted a 1-year follow-up study in 29 FRGs (10.7-16.1 years old). Whole body composition and BMD of the whole body, proximal femur, lumbar spine, mid-radius, and skull were measured by dual energy X-ray absorptiometry (DXA). Moreover, baseline growth- and bone metabolism-related hormones such as IGF1, IGF-binding protein 3 (IGFBP3), leptin, and bone markers were measured. RESULTS BMD increased significantly at all bone sites throughout puberty, particularly between Tanner stages II and IV-V (P=0.025 to P<0.001). The IGF1 level, IGF1/IGFBP3 ratio, and leptin level were higher in late pubertal stages (i.e. IV-V) compared with early stage (i.e. I). In simple and multivariate analyses, only the IGF1/IGFBP3 ratio was strongly correlated with the BMD change at all bone sites (r=0.49, P=0.02 to r=0.77, P<0.0001). CONCLUSION This 1-year follow-up study of peripubertal FRGs showed that BMD gain was maximal around Tanner stage III. The plasma IGF1/IGFBP3 ratio was associated with bone mass acquisition in this period, and it may thus serve as a surrogate marker of bone mass gain in this population.
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Affiliation(s)
- Laurent Maïmoun
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier et UMI, 34295 Montpellier, France
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Schoenmakers I, Ginty F, Jarjou LMA, Nigdikar S, Bennett J, Laidlaw A, Prentice A. Interrelation of parathyroid hormone and vitamin D metabolites in adolescents from the UK and The Gambia. J Steroid Biochem Mol Biol 2010; 121:217-20. [PMID: 20214991 DOI: 10.1016/j.jsbmb.2010.03.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 02/15/2010] [Accepted: 03/01/2010] [Indexed: 11/20/2022]
Abstract
Parathyroid hormone (PTH) is used as a marker of vitamin D (VD) status. However, PTH depends on many other factors. The 24,25-dihydroxy VD (24,25VD) concentration may be a sensitive marker because its production is reduced in VD deficiency. The relationship between VD metabolites, their ratio and PTH was investigated in adolescents from the UK and The Gambia with different calcium intakes and VD status. In the UK, there was a significant positive (+ve) association between 25VD and both 1,25-dihydroxy VD (1,25VD) and 24,25VD and a negative (-ve) association with PTH. The 24,25:25VD ratio was consistent across the 25VD concentration range. There was a +ve association between PTH and 1,25:25VD, (1,25+24,25):25VD or 1,25:24,25VD, a -ve association with 24,25VD and none with 1,25VD or 24,25:25VD. Using LnPTH and 1,25:25VD ratio (but not 1,25VD:24,25VD or 25VD:24,25VD) increased uniformity between groups and strength of relationships compared to PTH and 1,25 or 25VD alone. In The Gambia, there was a significant -ve relationship between 25VD and PTH and none with 1,25VD. There was a +ve association between 1,25VD or 1,25:25VD and PTH. The more uniform prediction of PTH by the 1,25VD:25VD ratio may be because this better reflects the extent to which PTH-induced 1,25VD production can be met by VD supply. Further validation is needed.
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Alpert PT. Bone Health: How to Maximize Bone Mineral Density. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2010. [DOI: 10.1177/1084822309349020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hill TR, Cotter AA, Mitchell S, Boreham CA, Dubitzky W, Murray L, Strain JJ, Flynn A, Robson PJ, Wallace JMW, Kiely M, Cashman KD. Vitamin D status and parathyroid hormone relationship in adolescents and its association with bone health parameters: analysis of the Northern Ireland Young Heart's Project. Osteoporos Int 2010; 21:695-700. [PMID: 19436930 DOI: 10.1007/s00198-009-0959-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 04/09/2009] [Indexed: 12/15/2022]
Abstract
UNLABELLED In girls, a plateau in parathyroid hormone (PTH) was observed at a 25-hydroxyvitamin D (25(OH)D) concentration of approximately 60 nmol/l. In boys, there was no plateau in PTH concentrations as 25(OH)D concentration increased. A 25(OH)D threshold of 60 nmol/l appears to have implications for bone health outcomes in both girls and boys. INTRODUCTION Our objective was to investigate if there is a threshold 25(OH)D concentration where a plateau in PTH concentration is evident and to examine the impact of this relationship on bone mineral density (BMD) and bone turnover in a representative sample of adolescents. METHODS We conducted a cross-sectional analysis among 1,015 Northern Irish adolescents aged 12 and 15 years. Serum 25(OH)D, PTH, osteocalcin, type 1 collagen cross-linked C-telopeptide (CTx), and BMD of the nondominant forearm and heel were measured. Nonlinear regression analysis was used to model the association between 25(OH)D and PTH. RESULTS In girls, a plateau in PTH was observed at a 25(OH)D concentration of approximately 60 nmol/l (PTH = 47.146 + 370.314 x exp((-0.092 x 25(OH)D))) while no plateau in PTH was observed in boys (PTH = 42.144 + 56.366 x exp((-0.022 x 25(OH)D))). Subjects with 25(OH)D levels <60 nmol/l had significantly higher osteocalcin concentrations (P < 0.05) compared with those who had >or=60 nmol/l, while no significant (P > 0.05) differences were noted for CTx concentrations. In girls only, nondominant forearm BMD but not heel BMD was significantly higher (P = 0.046) in those with 25(OH)D concentrations >or= 60 nmol/l. CONCLUSIONS Serum 25(OH)D levels above 60 nmol/l in Northern Irish adolescent girls prevent an increase in serum PTH levels and maintaining 25(OH)D >60 nmol/l in both girls and boys may lead to improved bone health outcomes.
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Affiliation(s)
- T R Hill
- Department of Food and Nutritional Sciences, University College, Cork, Ireland.
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Pérez-López FR, Pérez-Roncero G, López-Baena MT. Vitamin D and adolescent health. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2010; 1:1-8. [PMID: 28028383 PMCID: PMC5175574 DOI: 10.2147/ahmt.s7472] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Vitamin D is a hormone sequentially produced at different body sites, and which plays a significant role in human health, particularly bone health. However, other roles are emerging. When the serum concentration of vitamin D is very low, the risk of rickets, osteomalacia and osteoporosis is increased. In children and adolescents there is a high prevalence of low vitamin D status, especially in females and during the winter–the prevalence being lower than during the summer. Although there is no unanimous agreement over the minimum values necessary for good health, serum 25-hydroxyvitamin D [25(OH)D] levels below 20 ng/mL may be regarded as a vitamin D-deficient condition, and levels between 20–30 ng/mL may be the range of vitamin D insufficiency. Mild low levels have been associated with bone mass accrual alterations in children and adolescents, diminished muscle strength, negative cardiovascular outcomes, insulin resistance and obesity, and neurological disorders. Effective preventive strategies are needed to guarantee adequate vitamin D levels throughout childhood and adolescence, taking into account the geographical setting, season of the year, the level of environmental pollution, skin characteristics, eating habits and body weight, with a view to securing optimum health during these phases, and the prevention of complications in adulthood. There needs to be a renewed appreciation of the beneficial effect of moderate sunlight for providing all humans with the vitamin D needed for ensuring good health. Prolonged sun exposure is not advised, however, due to the risk of skin cancer. In addition, a balanced diet is indicated, since vitamin D-rich foods are better assimilated than supplements. When such conditions cannot be met, then the supplementation of 400 IU/day of vitamin D is advised in children and adolescents–though correcting vitamin D insufficiency or deficiency may require 1000 IU/day or more. High-dose calcifediol depots are an alternative for guaranteeing treatment adherence and in patients with liver disease.
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Affiliation(s)
- Faustino R Pérez-López
- Grupo de Investigación sobre Salud de la Mujer en Aragón (GRISAMAR), Universidad de Zaragoza, Hospital Clínico Zaragoza, Spain
| | - Gonzalo Pérez-Roncero
- Grupo de Investigación sobre Salud de la Mujer en Aragón (GRISAMAR), Universidad de Zaragoza, Hospital Clínico Zaragoza, Spain
| | - María T López-Baena
- Grupo de Investigación sobre Salud de la Mujer en Aragón (GRISAMAR), Universidad de Zaragoza, Hospital Clínico Zaragoza, Spain
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Abstract
The incidence of distal forearm fractures peaks during the adolescent growth spurt, but the structural basis for this is unclear. Thus, we studied healthy 6- to 21-yr-old girls (n = 66) and boys (n = 61) using high-resolution pQCT (voxel size, 82 microm) at the distal radius. Subjects were classified into five groups by bone-age: group I (prepuberty, 6-8 yr), group II (early puberty, 9-11 yr), group III (midpuberty, 12-14 yr), group IV (late puberty, 15-17 yr), and group V (postpuberty, 18-21 yr). Compared with group I, trabecular parameters (bone volume fraction, trabecular number, and thickness) did not change in girls but increased in boys from late puberty onward. Cortical thickness and density decreased from pre- to midpuberty in girls but were unchanged in boys, before rising to higher levels at the end of puberty in both sexes. Total bone strength, assessed using microfinite element models, increased linearly across bone age groups in both sexes, with boys showing greater bone strength than girls after midpuberty. The proportion of load borne by cortical bone, and the ratio of cortical to trabecular bone volume, decreased transiently during mid- to late puberty in both sexes, with apparent cortical porosity peaking during this time. This mirrors the incidence of distal forearm fractures in prior studies. We conclude that regional deficits in cortical bone may underlie the adolescent peak in forearm fractures. Whether these deficits are more severe in children who sustain forearm fractures or persist into later life warrants further study.
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Walsh JS, Henry YM, Fatayerji D, Eastell R. Lumbar spine peak bone mass and bone turnover in men and women: a longitudinal study. Osteoporos Int 2009; 20:355-62. [PMID: 18629566 DOI: 10.1007/s00198-008-0672-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2008] [Accepted: 05/28/2008] [Indexed: 10/21/2022]
Abstract
UNLABELLED Peak bone mass is an important determinant of bone mass in later life, but the age of peak bone mass is still unclear. We found that bone size and density increase and bone turnover decreases until age 25. It may be possible to influence bone accrual into the third decade. INTRODUCTION Peak bone mass is a major determinant of bone mass in later life. Bone growth and maturation is site-specific, and the age of peak bone mass is still unclear. It is important to know the age to which bone accrual continues so strategies to maximise bone mass can be targeted appropriately. This study aims to ascertain the age of lumbar spine peak bone mass. METHODS We measured lumbar spine BMC, estimated volume and BMAD by DXA and biochemical markers of bone turnover in 116 healthy males and females ages 11 to 40, followed up at an interval of five to nine years. RESULTS The majority of peak bone mass was attained by the mid-twenties. Increases in BMC in adolescents and young adults were mostly due to increases in bone size. Bone turnover markers decreased through adolescence and the third decade and the decreasing rate of change in bone turnover corresponded with the decreasing rate of change in lumbar spine measurements. CONCLUSIONS Skeletal maturation and bone mineral accrual at the lumbar spine continues into the third decade.
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Affiliation(s)
- J S Walsh
- Academic Unit of Bone Metabolism, University of Sheffield, Northern General Hospital, Herries Road, Sheffield S57AU, UK.
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Hill KM, Braun M, Kern M, Martin BR, Navalta JW, Sedlock DA, McCabe L, McCabe GP, Peacock M, Weaver CM. Predictors of calcium retention in adolescent boys. J Clin Endocrinol Metab 2008; 93:4743-8. [PMID: 18840643 PMCID: PMC2626439 DOI: 10.1210/jc.2008-0957] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The relationship between calcium (Ca) intake and Ca retention in adolescent boys was recently reported. OBJECTIVE This study evaluated the influence of Ca intake, serum hormone levels, biomarkers of bone metabolism, habitual physical activity, habitual Ca intake, and physical fitness on Ca retention in the same sample. DESIGN This study was a randomized, cross-over design that consisted of two 3-wk metabolic balance periods. SETTING The study took place on a university campus as a summer camp. PATIENTS OR OTHER PARTICIPANTS A total of 31 American white boys (13-15 yr) participated in the study. INTERVENTIONS Each subject consumed a controlled diet with one of five high-low Ca intake pairs that ranged from 670-2003 mg/d, which was manipulated utilizing a fortified beverage. MAIN OUTCOME MEASURES Ca retention was determined by Ca intake minus urinary and fecal Ca excretion during each balance period. RESULTS Ca intake explained 21.7% of the variability in Ca retention, and serum IGF-I concentration explained an additional 11.5%. Other serum hormone levels did not significantly add to the model. Biomarkers of bone metabolism, habitual physical activity, habitual Ca intake, and physical fitness were not significant predictors of Ca retention in adolescent boys. CONCLUSIONS IGF-I, a regulator of growth during puberty, is an important predictor of Ca retention in adolescent boys. However, dietary Ca intake is an even greater predictor of Ca retention during this period of growth.
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Affiliation(s)
- Kathleen M Hill
- Purdue University, Foods and Nutrition, 700 W State Street, West Lafayette, Indiana 47907-2059, USA
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