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Yousif D, ElTantawi N, Badr A, Nurulhaque Z, Al-Jabri A, Haithm YM, Al- Meraikhi N, Chivese T, Rathnaiah Babu G. Gender-Specific Fat Distribution and Association with Type 2 Diabetes Mellitus: A Study of Adiposity Indicators (DEXA, BMI, Waist-to-Hip Ratio) in Adults from Qatar. Diabetes Metab Syndr Obes 2024; 17:1715-1724. [PMID: 38645657 PMCID: PMC11027926 DOI: 10.2147/dmso.s432331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/26/2024] [Indexed: 04/23/2024] Open
Abstract
Aim This study aimed to investigate the difference in adiposity measured by DEXA between people with type 2 diabetes mellitus (T2DM) and those without. Moreover, we investigated the most reliable adiposity measure for discriminating people with T2DM from those without in clinical settings. Methods A cross-sectional study was conducted from the database of Qatar Biobank (QBB), which comprised adults with a previous diagnosis of T2DM mellitus in Qatar. t-test and multivariable linear regression models were used to assess the association between T2DM and the difference in DEXA and BMI adiposity measures. Moreover, an evaluation of the odds of abnormal waist-hip ratio in participants with T2DM using an adjusted multivariable logistic regression was conducted. Results Among the participants with T2DM, males had less fat in the leg region, while females had less fat in the legs and gynoid regions, compared to individuals without T2DM. Females with T2DM had a higher average BMI. Moreover, the odds of having an abnormal waist-to-hip ratio were higher in males and females with T2DM compared to persons without T2DM. Conclusion There were different patterns of fat deposition in males and females with T2DM. T2DM was associated with a higher BMI in females only. The odds of abnormal waist-hip ratio were higher in individuals with T2DM of both genders. Waist-hip ratio showed reliable discrimination for T2DM and has implications for clinical practice.
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Affiliation(s)
- Duaa Yousif
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Ahmed Badr
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Almaha Al-Jabri
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Giridhara Rathnaiah Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Migliaccio S, Bimonte VM, Besharat ZM, Sabato C, Lenzi A, Crescioli C, Ferretti E. Environmental Contaminants Acting as Endocrine Disruptors Modulate Atherogenic Processes: New Risk Factors for Cardiovascular Diseases in Women? Biomolecules 2021; 12:biom12010044. [PMID: 35053192 PMCID: PMC8773563 DOI: 10.3390/biom12010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 12/04/2022] Open
Abstract
The number of aged individuals is increasing worldwide, rendering essential the comprehension of pathophysiological mechanisms of age-related alterations, which could facilitate the development of interventions contributing to “successful aging” and improving quality of life. Cardiovascular diseases (CVD) include pathologies affecting the heart or blood vessels, such as hypertension, peripheral artery disease and coronary heart disease. Indeed, age-associated modifications in body composition, hormonal, nutritional and metabolic factors, as well as a decline in physical activity are all involved in the increased risk of developing atherogenic alterations that raise the risk of CVD development. Several factors have been reported to play a role in the alterations observed in muscle and endothelial cells and that lead to increased CVD, such as genetic pattern, smoking and unhealthy lifestyle. Moreover, a difference in the risk of these diseases in women and men has been reported. Interestingly, in the past decades attention has been focused on a potential role of several pollutants that disrupt human health by interfering with hormonal pathways, and more specifically in non-communicable diseases such as obesity, diabetes and CVD. This review will focus on the potential alteration induced by Endocrine Disruptors (Eds) in the attempt to characterize a potential role in the cellular and molecular mechanisms involved in the atheromatous degeneration process and CVD progression.
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Affiliation(s)
- Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; (V.M.B.); (C.C.)
- Correspondence:
| | - Viviana M. Bimonte
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; (V.M.B.); (C.C.)
| | - Zein Mersini Besharat
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (Z.M.B.); (C.S.); (A.L.); (E.F.)
| | - Claudia Sabato
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (Z.M.B.); (C.S.); (A.L.); (E.F.)
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (Z.M.B.); (C.S.); (A.L.); (E.F.)
| | - Clara Crescioli
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy; (V.M.B.); (C.C.)
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (Z.M.B.); (C.S.); (A.L.); (E.F.)
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Dance and Music for Improving Health among Patients with Breast Cancer and Parkinson’s Disease: A Narrative Review. ENDOCRINES 2021. [DOI: 10.3390/endocrines2040042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although a longer life may bring new opportunities for older people and society, advancing age is a leading risk factor for developing several chronic diseases, consequently limiting the health span. During the ageing process, changes in the activity of several endocrine glands may occur, leading to different clinical conditions. Being physically active becomes fundamental for healthy ageing. Despite regular physical activity being shown to have many health benefits, patients with cancer and neurodegenerative diseases remain physically inactive. Over the past two decades, there has been a major increase in arts engagement (e.g., dance and music) on health and well-being in both clinical and non-clinical contexts. Dance and music have been shown to induce positive effects on hormonal glands, patients’ sociality, and self-confidence. Therefore, this review aims to highlight evidence regarding the effects of music and dance on hormonal responses and as preventive and compliance tools for heathy ageing in breast cancer and Parkinson’s disease patients.
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Determination of Cutoff Values for the Screening of Osteosarcopenia in Obese Postmenopausal Women. Curr Gerontol Geriatr Res 2021; 2021:6634474. [PMID: 33790963 PMCID: PMC7997768 DOI: 10.1155/2021/6634474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022] Open
Abstract
Osteosarcopenic obesity (OSO) describes the concurrent presence of obesity, low bone mass, and low muscle mass in an individual. Currently, no established criteria exist to diagnose OSO. We hypothesized that obese individuals require different cut-points from standard cut-points to define low bone mass and low muscle mass due to their higher weight load. In this study, we determined cutoff values for the screening of osteosarcopenia (OS) in obese postmenopausal Malaysian women based on the measurements of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and functional performance test. Then, we compared the cutoff values derived by 3 different statistical modeling methods, (1) receiver operating characteristic (ROC) curve, (2) lowest quintile of the study population, and (3) 2 standard deviations (SD) below the mean value of a young reference group, and discussed the most suitable method to screen for the presence of OS in obese population. One hundred and forty-one (n = 141) postmenopausal Malaysian women participated in the study. Bone density was assessed using calcaneal quantitative ultrasound. Body composition was assessed using bioelectrical impedance analyzer. Handgrip strength was assessed using a handgrip dynamometer, and physical performance was assessed using a modified Short Physical Performance Battery test. ROC curve was determined to be the most suitable statistical modeling method to derive the cutoffs for the presence of OS in obese population. From the ROC curve method, the final model to estimate the probability of OS in obese postmenopausal women is comprised of five variables: handgrip strength (HGS, with area under the curve (AUC) = 0.698 and threshold ≤ 16.5 kg), skeletal muscle mass index (SMMI, AUC = 0.966 and threshold ≤ 8.2 kg/m2), fat-free mass index (FFMI, AUC = 0.946 and threshold ≤ 15.2 kg/m2), broadband ultrasonic attenuation (BUA, AUC = 0.987 and threshold ≤ 52.85 dB/MHz), and speed of sound (SOS, AUC = 0.991 and threshold ≤ 1492.15 m/s). Portable equipment may be used to screen for OS in obese women. Early identification of OS can help lower the risk of advanced functional impairment that can lead to physical disability in obese postmenopausal women.
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Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009-2010 Korean National Health and Nutrition Examination Survey. J Clin Med 2020; 9:jcm9082415. [PMID: 32731479 PMCID: PMC7466128 DOI: 10.3390/jcm9082415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
Osteoporosis contributes to the occurrence of falling and vestibular problems, particularly in elderly patients. This study aimed to investigate the association between bone metabolism with vestibular problems and falling. A total of 4054 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) from 2009 to 2010 aged ≥50 years old were surveyed on their history of falling, vestibular problems evaluated by the modified Romberg test, variables involving bone metabolism, and serum levels of vitamin D and alkaline phosphatase. They also underwent dual energy X-ray absorptiometry. The crude (simple) and adjusted odd ratios (ORs) of variables involving bone metabolism for vestibular problems in the modified Romberg test and falling were analyzed using a logistic regression model. A subgroup analysis was performed according to sex and the presence of menopause in females. Vestibular problems in the modified Romberg test group but not the falling group were associated with decreased serum vitamin D levels (p < 0.001; odds ratio (OR) = 0.951; 95% confidence interval (CI), 0.926-0.976). In subgroup analysis according to sex, the post-menopause group showed a higher rate of vestibular problems in the modified Romberg test compared to the pre-menopause group (4.5% vs. 0.7%, p = 0.019). In the post-menopause group, osteoporosis was positively associated with vestibular problems in the modified Romberg test (p = 0.001, OR = 10.971, 95% CI = 2.650-45.414). On the other hand, a history of hormone replacement therapy was negatively related with vestibular problems in this subgroup (p = 0.035; OR = 0.473; 95% CI = 0.239-0.948). A decrease in serum vitamin D levels may impact the vestibular system through neural signaling or by osteoporotic changes of the otic capsule, as well as otolith particles. Decreased estrogen levels in postmenopausal women may make them more prone to osteoporotic changes, which were associated with vestibular problems in the modified Romberg test. Because this is a cross-sectional study, the causal relationship of bone metabolism with vestibular function needs to be investigated.
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Molecular and Lifestyle Factors Modulating Obesity Disease. Biomedicines 2020; 8:biomedicines8030046. [PMID: 32121611 PMCID: PMC7148479 DOI: 10.3390/biomedicines8030046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity adversely affects bone health by means of multiple mechanisms, e.g., alterations in bone-regulating hormones, inflammation, and oxidative stress. Substantial evidence supports the relationship between adiposity and bone disorders in overweight/obese individuals. It is well known that the balance between mutually exclusive differentiation of progenitor cells into osteoblasts or adipocytes is controlled by different agents, including growth factors, hormones, genetic and epigenetic factors. Furthermore, an association between vitamin D deficiency and obesity has been reported. On the other hand, regular physical activity plays a key role in weight control, in the reduction of obesity-associated risks and promotes osteogenesis. The aim of this review is to highlight relevant cellular and molecular aspects for over-weight containment. In this context, the modulation of progenitor cells during differentiation as well as the role of epigenetics and microbiota in obesity disease will be discussed. Furthermore, lifestyle changes including an optimized diet as well as targeted physical activity will be suggested as strategies for the treatment of obesity disease.
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Meng J, Sun N, Chen Y, Li Z, Cui X, Fan J, Cao H, Zheng W, Jin Q, Jiang L, Zhu W. Artificial neural network optimizes self-examination of osteoporosis risk in women. J Int Med Res 2019; 47:3088-3098. [PMID: 31179797 PMCID: PMC6683875 DOI: 10.1177/0300060519850648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective This study aimed to investigate the application of an artificial neural network (ANN) in optimizing the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods OSTA score was calculated for each female participant that underwent dual-energy X-ray absorptiometry examination in two hospitals (one in each of two Chinese cities, Harbin and Ningbo). An ANN model was built using age and weight as input and femoral neck T-score as output. Osteoporosis risk screening by joint application of ANN and OSTA score was evaluated by receiver operating characteristic curve analysis. Results Nearly 90% of women with dual-energy X-ray absorptiometry-determined femoral neck osteoporosis were ≥60 years old. The ANN with age and weight as input and OSTA score both identified osteoporosis, with respective accuracy rates of 78.8% and 78.3%. However, both methods failed to identify osteoporosis in women < 60 years old. Compared with OSTA score alone, combined use of the two tools increased the rate of osteoporosis recognition among women > 80 years old. Conclusions OSTA score-mediated osteoporosis risk screening should be restricted to women ≥60 years old. Joint application of ANN and OSTA improved osteoporosis risk screening among Chinese women > 80 years old.
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Affiliation(s)
- Jia Meng
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ning Sun
- 2 Office of Academic Research, Ningbo Health Career Technical College, Ningbo, China
| | - Yali Chen
- 3 Department of Spine Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | | | - Xiaomeng Cui
- 5 School of Measurement-Control Tech & Communications Engineering, Harbin University of Science and Technology, Harbin, China
| | - Jingxue Fan
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hailing Cao
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wangping Zheng
- 3 Department of Spine Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Qiying Jin
- 3 Department of Spine Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Lihong Jiang
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenliang Zhu
- 6 Department of Pharmacy, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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8
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Kelly OJ, Gilman JC, Boschiero D, Ilich JZ. Osteosarcopenic Obesity: Current Knowledge, Revised Identification Criteria and Treatment Principles. Nutrients 2019; 11:E747. [PMID: 30935031 PMCID: PMC6520721 DOI: 10.3390/nu11040747] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 02/06/2023] Open
Abstract
Osteosarcopenic obesity (OSO) syndrome describes the simultaneous deterioration of bone, muscle and excess fat, resulting in reduced functionality and systemic metabolic dysregulation. The key component contributing to this may be ectopic fat in the viscera, bone and muscle. OSO research to date is summarized, and the revised criteria for its identification for research purposes are reviewed and proposed, including new criteria to assess visceral fat in males and females. Finally, nutritional and physical activity recommendations are consolidated into a treatment algorithm, which can be validated in future studies and which may also be applied to preventative management.
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Affiliation(s)
| | | | | | - Jasminka Z Ilich
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32306, USA.
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Urano T, Shiraki M, Kuroda T, Tanaka S, Urano F, Uenishi K, Inoue S. Bisphosphonates prevent age-related weight loss in Japanese postmenopausal women. J Bone Miner Metab 2018; 36:734-740. [PMID: 29236162 DOI: 10.1007/s00774-017-0891-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/16/2017] [Indexed: 12/22/2022]
Abstract
Decline of body weight with aging is a major risk factor for frailty, osteoporosis and fracture, suggesting that treatment for osteoporosis may affect body composition. Recently, we have shown that 5-year treatment with raloxifene prevented age-related weight loss, suggesting some other drugs for osteoporosis may also prevent a decrease in body weight with aging. The present study aimed to identify the relationship between bisphosphonate treatment and body composition markers. We measured bone mineral density (BMD), body composition, and bone remodeling markers in 551 Japanese postmenopausal women with bisphosphonate treatment, which included risedronate or alendronate treatment (BP-treatment group; N = 193) and without treatment by any osteoporosis drug (no-treatment group; N = 358) for 4-7 years (mean observation periods; 5.5 years) and analyzed the relationship of these with BMD, body mass index (BMI), body weight, and biochemical markers. The mean (SD) age of the participants was 68.6 (9.8) years in the BP-treatment group and 63.7 (10.6) years in the no-treatment group. Percent changes in body weight and BMI were significantly different between the BP-treatment and no-treatment groups (P < 0.01 and P < 0.01, respectively). In multiple linear regression analysis, bisphosphonate treatment was a significant independent determinant of percent changes in body weight and BMI (P < 0.01 and P = 0.01, respectively). Long-term use of bisphosphonates prevented reductions in BMI and body weight, usually observed in elderly women. Our results suggest that bisphosphonate treatment not only reduces the risk for incident osteoporotic fractures but also for frailty in the elderly.
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Affiliation(s)
- Tomohiko Urano
- Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bumkyo-ku, Tokyo, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Nagano, Japan
| | | | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Fumihiko Urano
- Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Kazuhiro Uenishi
- Division of Nutritional Physiology, Kagawa Nutrition University, Saitama, Japan
| | - Satoshi Inoue
- Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bumkyo-ku, Tokyo, Japan.
- Department of Functional Biogerontology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
- Research Center for Genomic Medicine, Saitama Medical School, Saitama, Japan.
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Fornari R, Marocco C, Francomano D, Fittipaldi S, Lubrano C, Bimonte VM, Donini LM, Nicolai E, Aversa A, Lenzi A, Greco EA, Migliaccio S. Insulin growth factor-1 correlates with higher bone mineral density and lower inflammation status in obese adult subjects. Eat Weight Disord 2018; 23:375-381. [PMID: 28271457 DOI: 10.1007/s40519-017-0362-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 01/10/2017] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Obesity is a severe public health problem worldwide, leading to an insulin-resistant state in liver, adipose, and muscle tissue, representing a risk factor for type 2 diabetes mellitus, cardiovascular diseases, and cancer. We have shown that abdominal obesity is associated with homeostasis derangement, linked to several hormonal and paracrine factors. Data regarding potential link between GH/IGF1 axis, bone mineral density, and inflammation in obesity are lacking. Thus, aim of this study was to evaluate correlation among IGF-1, BMD, and inflammation in obese individuals. METHODS The study included 426 obese subjects, mean age 44.8 ± 14 years; BMI 34.9 ± 6.1. Exclusion criteria were chronic medical conditions, use of medications affecting bone metabolism, hormonal and nutritional status, recent weight loss, and prior bariatric surgery. Patients underwent measurements of BMD and body composition by DEXA and were evaluated for hormonal, metabolic profile, and inflammatory markers. RESULTS In this population, IGF-1 was inversely correlated with abdominal FM% (p < 0.001, r 2 = 0.12) and directly correlated with osteocalcin (OSCA) (p < 0.002, r 2 = 0.14). A negative correlation was demonstrated between IGF-1 levels and nonspecific inflammatory index, such as fibrinogen (p < 0.01, r 2 = 0.04) and erythrocyte sedimentation rate (p < 0.0001, r 2 = 0.03). IGF-1 was directly correlated with higher BMD, at both lumbar (p < 0.02, r 2 = 0.03) and femoral site (p < 0.04, r 2 = 0.03). CONCLUSIONS In conclusion, our results show that higher levels of serum IGF-1 in obese patients correlate with lower inflammatory pattern and better skeletal health, as demonstrated by higher BMD and osteocalcin levels. These results lead to speculate the existence of a bone-adipose-muscle interplay modulating energy homeostasis, glucose, bone metabolism, and chronic inflammation in individuals affected by abdominal obesity.
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Affiliation(s)
- Rachele Fornari
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | - Chiara Marocco
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | - Davide Francomano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | | | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | - Viviana M Bimonte
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University "Foro Italico", Largo Lauro De Bosis 6, 00135, Rome, Italy
| | - Lorenzo M Donini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | | | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | - Emanuela A Greco
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, University "Sapienza", Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University "Foro Italico", Largo Lauro De Bosis 6, 00135, Rome, Italy.
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Hoffmann MR, Senior PA, Jackson ST, Jindal K, Mager DR. Vitamin D status, body composition and glycemic control in an ambulatory population with diabetes and chronic kidney disease. Eur J Clin Nutr 2015; 70:743-9. [PMID: 26530927 DOI: 10.1038/ejcn.2015.185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/26/2015] [Accepted: 09/29/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES To determine the interrelationships between body composition, glycemic control and vitamin D status in an ambulatory population with diabetes (DM) and chronic kidney disease (CKD). SUBJECTS/METHODS Adult (18-80 years) patients (n=60) with DM and stage 1-4 CKD were recruited from the Northern Alberta Renal Program. Outcome variables included body composition (absolute/regional fat (FM)/lean soft tissue/total mass, percent fat/lean/fat-free (FFM) mass), glycemic control (glycated hemoglobin (HbA1c)), vitamin D intake (dietary/supplemental) and vitamin D status (25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D)) measured by validated methodologies. Sarcopenia was determined as an appendicular skeletal mass/height(2) less than 7.26 kg/m(2) (males) and 5.45 kg/m(2) (females). RESULTS Suboptimal HbA1c (>7%), 25(OH)D (<50 nmol/l) and 1,25(OH)2D (<43 pmol/l) concentrations were present in 57, 8 and 11% of participants. Ten percent of subjects had sarcopenia. Gender/age/DM type, not CKD, significantly influenced regional/whole body composition. Females, older participants and those with type 2 DM had higher %FM. No significant interrelationships between vitamin D status and glycemic control were observed (P>0.05). Serum 25(OH)D concentrations were inversely associated with arm lean soft tissue/FFM/total mass, weight, appendicular skeletal mass, lean soft tissue/height(2), FFM/height(2), appendicular skeletal mass/height(2) and body mass index (P<0.05). Sarcopenia occurred more frequently in patients with 25(OH)D concentrations ⩾100 nmol/l. Regional/whole body %FM was inversely related to 1,25(OH)2D, not 25(OH)D. CONCLUSIONS Body composition, not glycemic control, is associated with vitamin D status in an ambulatory population of adults with DM and CKD.
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Affiliation(s)
- M R Hoffmann
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - P A Senior
- Department of Endocrinology, University of Alberta, Edmonton, Alberta, Canada.,Diabetic Nephropathy Prevention Clinic, Alberta Health Services, Edmonton, Alberta, Canada
| | - S T Jackson
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - K Jindal
- Diabetic Nephropathy Prevention Clinic, Alberta Health Services, Edmonton, Alberta, Canada.,Northern Alberta Renal Program, Edmonton, Alberta, Canada.,Department of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - D R Mager
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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12
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Poiana C, Carsote M, Radoi V, Mihai A, Capatina C. Prevalent osteoporotic fractures in 622 obese and non- obese menopausal women. J Med Life 2015; 8:462-6. [PMID: 26664471 PMCID: PMC4656953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hypothesis. The osteoporotic fractures represent a worldwide economical issue. In order to prevent them, we need to understand the risk factors constellation. Although obesity was traditionally considered as protective against osteoporosis, recent data exposed an increased risk of falling and thus a high risk of some fractures. Objective. We aimed to analyze the body mass index (BMI) in relationship with the bone mineral density (BMD) and the prevalent fractures. Methods and Results. Between 2008 and 2014, a cross-sectional observational study included Romanian menopausal Caucasian women without a previous diagnosis of bone maladies, or specific anti-osteoporotic therapy. Prevalent fragility fractures were both self-declared and incidental vertebral. All the subjects had lumbar BMD (GE Lunar Prodigy DXA machine). Out of 622 females (mean age of 58.65 years, mean BMI of 30.30 kg/ m2), 39.22% were obese (BMI ≥ 30kg/ m2). The fracture prevalence was 1.35% versus 1.67% in obese versus non-obese patients. The correlation coefficient between lumbar BMD and BMI was r=0.165, p<0.005. BMI in the fracture group was 31.68 kg/ m2 vs. 30.04 kg/ m2 in the non-fracture group (p=0.08). 15.91% of the entire cohort had prevalent fractures. Obesity prevalence among females with fractures was 30.3% versus 40.73% in the non-fracture group. The most frequent sites were distal forearm (42.42%) and vertebral (21.21%). Discussions & Conclusions. Although the vertebral fractures might be underdiagnosed in our study and despite the fact that we enrolled a relatively young menopausal population, BMI positively correlated with BMD, regardless of the fractures’ prevalence. In early menopause, the most frequent fracture is distal forearm. BMI is higher in patients with prevalent fractures vs. non-fractures (borderline significance). Obesity might not protect from any type of fracture but future evidence is necessary since one third of osteoporotic fractures are met in women with a BMI ≥ 30kg/ m2.
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Affiliation(s)
- C Poiana
- "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania ; Department of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M Carsote
- "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania ; Department of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - V Radoi
- Obregia Hospital, Bucharest, Romania
| | - A Mihai
- "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - C Capatina
- "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania ; Department of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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