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Critchley M, Toomey C, Gabel L, Kenny S, Emery CA. Differences in Bone Mineral Density and Associated Factors in Dancers and Other Female Athletes. Appl Physiol Nutr Metab 2024. [PMID: 38691851 DOI: 10.1139/apnm-2023-0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Dancers are susceptible to Relative Energy Deficiency in Sport (REDs), specifically low total body areal bone mineral density (aBMD). Little is known about how dancers' BMD compares to other athletic populations. The objective of this study was to examine the association between participant characteristics and aBMD among female pre-professional dancers compared to other female athletes. 269 females [132 dancers [17.6 (3.2) years] and 137 sport participants [22.8 (2.6) years] were included in this study. aBMD (g/cm2) was estimated using dual X-ray absorptiometry. Multivariable linear regression was used to examine the association between height adjusted z-scores of aBMD (aBMD-Z) and age (years), body mass index (BMI) (z-score), supplement intake, history of stress fracture, irregular menses, MRI/bone scan, one-year injury history, oral contraceptives, and activity (dance/sport). Total body aBMD and aBMD-Z were lower in dancers than athletes [dancers: aBMD=1.03 g/cm2 (95% CI: 1.01, 1.05); aBMD-Z=-0.28 (-0.43, -0.12)(p<0.001); athletes: aBMD=1.14 g/cm2 (95% CI: 1.12, 1.16); aBMD-Z= 0.41 (0.25, 0.57) (p<0.001)]. aBMD-Z increased with age (β=0.054, 95% CI: 0.017, 0.092; p=0.004) and BMI (β=0.221, 95% CI: 0.006, 0.415; p=0.043). Activity type modified the relationship between BMI and aBMD-Z (β=0.323, 95% CI: 0.025, 0.621; p<0.033) with a stronger positive association in dancers, compared to other female athletes. Dancers had lower total body aBMD and aBMD-Z than other female athletes. aBMD-Z increases with age in both groups. A stronger association exists between aBMD-Z and BMI in dancers than athletes. Future studies should consider changes in aBMD-Z during adolescence and associations with increased risk of bone injury.
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Affiliation(s)
- Meghan Critchley
- University of Calgary, 2129, Faculty of Kinesiology, Calgary, Alberta, Canada;
| | - Clodagh Toomey
- University of Limerick Faculty of Education and Health Sciences, 150229, Limerick, Ireland;
| | - Leigh Gabel
- University of Calgary, Calgary, Alberta, Canada;
| | - Sarah Kenny
- University of Calgary, 2129, Calgary, Alberta, Canada;
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Vasil E, M Nesbitt C, Toomey C, Kuntze G, Esau S, A Emery C, Gabel L. Bone health and physical activity in adolescents with juvenile idiopathic arthritis: a cross-sectional case-control study. Pediatr Rheumatol Online J 2024; 22:45. [PMID: 38641611 PMCID: PMC11031938 DOI: 10.1186/s12969-024-00982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/04/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Adolescents with juvenile idiopathic arthritis (JIA) tend to engage in less physical activity than their typically developing peers. Physical activity is essential for bone development and reduced physical activity may detrimentally effect bone health. Thus, we examined differences in total body bone mineral content (BMC) and areal bone mineral density (aBMD) between adolescents with JIA and adolescent controls without JIA. We also examined associations between moderate-to-vigorous physical activity (MVPA), lean mass, and bone outcomes. METHODS Participants included 21 adolescents with JIA (14 females, 7 males) and 21 sex- and age-matched controls aged 10-20 years. Assessments included: height; weight; triple-single-leg-hop distance (TSLH); MVPA by accelerometry; and total body BMC, aBMD, and lean mass measured using dual X-ray absorptiometry. Height-adjusted z-scores were calculated for BMC and aBMD and used for all analyses. Multiple linear mixed effects models examined group differences in BMC and aBMD, adjusting for sex, maturity, MVPA, TSLH, and lean mass. Participants clusters, based on sex and age (within 18 months), were considered random effects. RESULTS Adolescents with JIA had lower total body aBMD z-scores [β (95% CI); -0.58 (-1.10 to -0.07), p = 0.03] and BMC z-scores [-0.47 (-0.91 to -0.03), p = 0.04] compared with controls. Mean daily MVPA was 22.0 min/day lower in adolescents with JIA than controls; however, MVPA was not associated with aBMD [-0.01 (-0.01 to 0.01), p = 0.32] or BMC [0.00 (-0.01 to 0.00), p = 0.39]. Lean mass was positively associated with aBMD [0.05 (0.01 to 0.09) g/cm2, p = 0.03] and BMC [0.06 (0.03 to 0.10) g, p < 0.001]. CONCLUSION Adolescents with JIA had lower total body aBMD and BMC compared with sex- and age-matched controls without JIA. Group differences in bone outcomes were not associated with the lower MVPA participation of adolescents with JIA. Despite this, physical activity should still be encouraged as it promotes physical well-being.
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Affiliation(s)
- Egi Vasil
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N 1N4, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Colleen M Nesbitt
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Clodagh Toomey
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Gregor Kuntze
- Alberta Bone and Joint Health Institute, Calgary, AB, Canada
| | - Shane Esau
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Carolyn A Emery
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Departments of Community Health Sciences and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Leigh Gabel
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N 1N4, Calgary, AB, Canada.
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.
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Whittier DE, Bevers MSAM, Geusens PPMM, van den Bergh JP, Gabel L. Characterizing Bone Phenotypes Related to Skeletal Fragility Using Advanced Medical Imaging. Curr Osteoporos Rep 2023; 21:685-697. [PMID: 37884821 PMCID: PMC10724303 DOI: 10.1007/s11914-023-00830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Summarize the recent literature that investigates how advanced medical imaging has contributed to our understanding of skeletal phenotypes and fracture risk across the lifespan. RECENT FINDINGS Characterization of bone phenotypes on the macro-scale using advanced imaging has shown that while wide bones are generally stronger than narrow bones, they may be more susceptible to age-related declines in bone strength. On the micro-scale, HR-pQCT has been used to identify bone microarchitecture phenotypes that improve stratification of fracture risk based on phenotype-specific risk factors. Adolescence is a key phase for bone development, with distinct sex-specific growth patterns and significant within-sex bone property variability. However, longitudinal studies are needed to evaluate how early skeletal growth impacts adult bone phenotypes and fracture risk. Metabolic and rare bone diseases amplify fracture risk, but the interplay between bone phenotypes and disease remains unclear. Although bone phenotyping is a promising approach to improve fracture risk assessment, the clinical availability of advanced imaging is still limited. Consequently, alternative strategies for assessing and managing fracture risk include vertebral fracture assessment from clinically available medical imaging modalities/techniques or from fracture risk assessment tools based on clinical risk factors. Bone fragility is not solely determined by its density but by a combination of bone geometry, distribution of bone mass, microarchitecture, and the intrinsic material properties of bone tissue. As such, different individuals can exhibit distinct bone phenotypes, which may predispose them to be more vulnerable or resilient to certain perturbations that influence bone strength.
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Affiliation(s)
- Danielle E Whittier
- McCaig Institute for Bone and Joint Health and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.
- Department of Cell Biology and Anatomy, University of Calgary, Calgary, Canada.
| | - Melissa S A M Bevers
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Piet P M M Geusens
- Subdivision of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Joop P van den Bergh
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Subdivision of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
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Kemp TD, Besler BA, Gabel L, Boyd SK. Predicting Bone Adaptation in Astronauts during and after Spaceflight. Life (Basel) 2023; 13:2183. [PMID: 38004323 PMCID: PMC10672697 DOI: 10.3390/life13112183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
A method was previously developed to identify participant-specific parameters in a model of trabecular bone adaptation from longitudinal computed tomography (CT) imaging. In this study, we use these numerical methods to estimate changes in astronaut bone health during the distinct phases of spaceflight and recovery on Earth. Astronauts (N = 16) received high-resolution peripheral quantitative CT (HR-pQCT) scans of their distal tibia prior to launch (L), upon their return from an approximately six-month stay on the international space station (R+0), and after six (R+6) and 12 (R+12) months of recovery. To model trabecular bone adaptation, we determined participant-specific parameters at each time interval and estimated their bone structure at R+0, R+6, and R+12. To assess the fit of our model to this population, we compared static and dynamic bone morphometry as well as the Dice coefficient and symmetric distance at each measurement. In general, modeled and observed static morphometry were highly correlated (R2> 0.94) and statistically different (p < 0.0001) but with errors close to HR-pQCT precision limits. Dynamic morphometry, which captures rates of bone adaptation, was poorly estimated by our model (p < 0.0001). The Dice coefficient and symmetric distance indicated a reasonable local fit between observed and predicted bone volumes. This work applies a general and versatile computational framework to test bone adaptation models. Future work can explore and test increasingly sophisticated models (e.g., those including load or physiological factors) on a participant-specific basis.
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Affiliation(s)
- Tannis D. Kemp
- Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Bryce A. Besler
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Steven K. Boyd
- Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
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Gabel L, Kent K, Hosseinitabatabaei S, Burghardt AJ, Leonard MB, Rauch F, Willie BM. Recommendations for High-resolution Peripheral Quantitative Computed Tomography Assessment of Bone Density, Microarchitecture, and Strength in Pediatric Populations. Curr Osteoporos Rep 2023; 21:609-623. [PMID: 37428435 PMCID: PMC10543577 DOI: 10.1007/s11914-023-00811-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize current approaches and provide recommendations for imaging bone in pediatric populations using high-resolution peripheral quantitative computed tomography (HR-pQCT). RECENT FINDINGS Imaging the growing skeleton is challenging and HR-pQCT protocols are not standardized across centers. Adopting a single-imaging protocol for all studies is unrealistic; thus, we present three established protocols for HR-pQCT imaging in children and adolescents and share advantages and disadvantages of each. Limiting protocol variation will enhance the uniformity of results and increase our ability to compare study results between different research groups. We outline special cases along with tips and tricks for acquiring and processing scans to minimize motion artifacts and account for growing bone. The recommendations in this review are intended to help researchers perform HR-pQCT imaging in pediatric populations and extend our collective knowledge of bone structure, architecture, and strength during the growing years.
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Affiliation(s)
- L Gabel
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.
- McCaig Institute for Bone and Joint Health and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
| | - K Kent
- Department of Pediatrics, Stanford School of Medicine, Stanford, CA, USA
| | - S Hosseinitabatabaei
- Research Centre, Shriners Hospital for Children-Canada, Montreal, Canada
- Department of Biomedical Engineering, McGill University, Montreal, Canada
| | - A J Burghardt
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - M B Leonard
- Department of Pediatrics, Stanford School of Medicine, Stanford, CA, USA
| | - F Rauch
- Research Centre, Shriners Hospital for Children-Canada, Montreal, Canada
- Department of Pediatrics, McGill University, Montreal, Canada
| | - B M Willie
- Research Centre, Shriners Hospital for Children-Canada, Montreal, Canada
- Department of Biomedical Engineering, McGill University, Montreal, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
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Crack LE, Haider IT, Simonian N, Barroso J, Gabel L, Schnitzer TJ, Edwards WB. Zoledronic acid after spinal cord injury mitigates losses in proximal femoral strength independent of ambulation ability. Osteoporos Int 2023; 34:1637-1645. [PMID: 37289320 DOI: 10.1007/s00198-023-06811-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023]
Abstract
Rapid bone loss can occur after spinal cord injury (SCI) and a standard of care to prevent or treat this phenomenon is an active area of research. Using advanced analysis techniques, this study demonstrates that zoledronic acid, a possible treatment, prevented loss of bone strength at the hip following SCI. INTRODUCTION Bone loss below the level of neurological lesion is a well-known complication of spinal cord injury (SCI), and effective preventive treatment for this phenomenon is an active area of research. Zoledronic acid has demonstrated efficacy to attenuate bone loss at the hip after SCI, but previous studies relied on measurements from dual-energy X-ray absorptiometry. The purpose of this investigation was to more thoroughly characterize changes to bone mineral and strength at the proximal femur in individuals receiving zoledronic acid in the acute SCI stage; we also examined the influence of ambulatory ability on bone outcomes. METHODS Participants randomized to either zoledronic acid (n = 29) or placebo (n = 30) received computed tomography (CT) scans and ambulatory assessments at baseline and 6 and 12 months following drug infusion. CT-based finite element (FE) modeling was used to predict changes in proximal femoral strength associated with treatment. RESULTS After 12 months, FE-predicted bone strength was reduced by a mean (SD) of 9.6 (17.9)% in the zoledronic acid group versus 24.6 (24.5)% in the placebo group (p = 0.007). These differences in strength were explained by reductions in CT measurements of both trabecular (p < 0.001) and cortical (p ≤ 0.021) bone at the femoral neck and trochanteric region. Ambulation ability influenced select trabecular and cortical parameters, but we were unable to detect an impact on FE-predicted bone strength. CONCLUSION These findings demonstrate that treatment with zoledronic acid in acute SCI attenuates losses in proximal femoral strength, which may reduce the risk of hip fractures across patients with varying degrees of ambulatory abilities.
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Affiliation(s)
- Laura E Crack
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Alberta, Canada.
| | - Ifaz T Haider
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Narina Simonian
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joana Barroso
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leigh Gabel
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Thomas J Schnitzer
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - W Brent Edwards
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Alberta, Canada
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McConnell-Nzunga J, Gabel L, Macdonald HM, Rhodes RE, Hofer SM, Naylor PJ, McKay HA. A 4-Yr Mixed Longitudinal Study of Health Behaviors and Fat Mass Accrual during Adolescence and Early Adulthood. Med Sci Sports Exerc 2022; 54:2178-2187. [PMID: 35868009 DOI: 10.1249/mss.0000000000003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Physical activity (PA), sedentary time (SED), and energy intake (EI) are associated with fat mass accrual in children and youth. Previous studies relied primarily on cross-sectional designs and proxy measures of body composition such as body mass index. We aimed to prospectively investigate associations between PA, SED, EI, and total body fat mass accrual using dual-energy x-ray absorptiometry. METHODS This analysis of the mixed longitudinal Healthy Bones III Study included data from 312 participants (138 boys age 9 to 21 yr at baseline). For each participant, we acquired a maximum of four annual total body dual-energy x-ray absorptiometry scans from which we determined fat mass (in kilograms; n = 748 observations). We assessed total PA, moderate-to-vigorous PA (MVPA) and SED with accelerometers (ActiGraph GT1M) and measured EI via 24-h dietary recall. We fit sex-specific multilevel models adjusting for maturity (years from age at peak height velocity (APHV)), weight status, ethnicity, total PA, MVPA, SED, and EI. RESULTS Boys and girls demonstrated divergent trajectories of fat mass accrual; rate of fat mass accrual in girls was four times greater than boys at APHV and increased across adolescence, whereas boys' fat mass plateaued after APHV. In boys, within-person change in MVPA negatively predicted fat mass independent of SED; each annual increase in MVPA of 6 min·d -1 was associated with a 0.21-kg lower fat mass. In girls, between-person average MVPA negatively predicted fat mass accrual independent of SED; greater MVPA of 4 min·d -1 across adolescence was associated with a 0.31-kg lower fat mass. CONCLUSIONS MVPA demonstrates an independent and negative effect on fat mass in boys and girls. Given different trajectories of fat mass accrual and movement behaviors between boys and girls, PA interventions aimed at preventing obesity in youth may benefit from a sex and gendered approach.
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Affiliation(s)
- Jennifer McConnell-Nzunga
- Social Dimensions of Health, University of Victoria, Interdisciplinary Programs, Victoria, BC, CANADA
| | - Leigh Gabel
- Faculty of Kinesiology, University of Calgary, Calgary, AB, CANADA
| | | | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, CANADA
| | - Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC, CANADA
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, CANADA
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Gabel L, Liphardt AM, Hulme PA, Heer M, Zwart SR, Sibonga JD, Smith SM, Boyd SK. Incomplete recovery of bone strength and trabecular microarchitecture at the distal tibia 1 year after return from long duration spaceflight. Sci Rep 2022; 12:9446. [PMID: 35773442 PMCID: PMC9247070 DOI: 10.1038/s41598-022-13461-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Determining the extent of bone recovery after prolonged spaceflight is important for understanding risks to astronaut long-term skeletal health. We examined bone strength, density, and microarchitecture in seventeen astronauts (14 males; mean 47 years) using high-resolution peripheral quantitative computed tomography (HR-pQCT; 61 μm). We imaged the tibia and radius before spaceflight, at return to Earth, and after 6- and 12-months recovery and assessed biomarkers of bone turnover and exercise. Twelve months after flight, group median tibia bone strength (F.Load), total, cortical, and trabecular bone mineral density (BMD), trabecular bone volume fraction and thickness remained − 0.9% to − 2.1% reduced compared with pre-flight (p ≤ 0.001). Astronauts on longer missions (> 6-months) had poorer bone recovery. For example, F.Load recovered by 12-months post-flight in astronauts on shorter (< 6-months; − 0.4% median deficit) but not longer (− 3.9%) missions. Similar disparities were noted for total, trabecular, and cortical BMD. Altogether, nine of 17 astronauts did not fully recover tibia total BMD after 12-months. Astronauts with incomplete recovery had higher biomarkers of bone turnover compared with astronauts whose bone recovered. Study findings suggest incomplete recovery of bone strength, density, and trabecular microarchitecture at the weight-bearing tibia, commensurate with a decade or more of terrestrial age-related bone loss.
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Affiliation(s)
- Leigh Gabel
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Anna-Maria Liphardt
- Department of Internal Medicine, Rheumatology and Immunology, German Centre for Immune Therapy, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Paul A Hulme
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Martina Heer
- IU International University of Applied Sciences Erfurt and Department of Nutrition and Food Science, Nutritional Physiology, University of Bonn, Bonn, Germany
| | - Sara R Zwart
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Jean D Sibonga
- Human Heath and Performance Directorate, NASA Lyndon B. Johnson Space Center, Houston, USA
| | - Scott M Smith
- Human Heath and Performance Directorate, NASA Lyndon B. Johnson Space Center, Houston, USA
| | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. .,Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
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Burt LA, Gabel L, Billington EO, Hanley DA, Boyd SK. Response to High-Dose Vitamin D Supplementation Is Specific to Imaging Modality and Skeletal Site. JBMR Plus 2022; 6:e10615. [PMID: 35509634 PMCID: PMC9059471 DOI: 10.1002/jbm4.10615] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/15/2022] [Indexed: 12/02/2022] Open
Abstract
High-dose vitamin D supplementation (4000 or 10,000 IU/d) in vitamin D-sufficient individuals results in a dose-dependent decrease in radius and tibia total bone mineral density (Tt.BMD) compared with 400 IU/d. This exploratory analysis examined whether the response to high-dose vitamin D supplementation depends on imaging modality and skeletal site. Participants were aged 55 to 70 years, not osteoporotic, with serum 25(OH)D 30 to 125 nM. Participants' radius and tibia were scanned on high-resolution peripheral quantitative computed tomography (HR-pQCT) to measure Tt.BMD, trabecular bone volume fraction (Tb.BV/TV), trabecular separation (Tb.Sp), cortical thickness (Ct.Th), and finite element analysis (FEA) estimated failure load. Three-dimensional image registration was used. Dual-energy X-ray absorptiometry (DXA) scans of the hip, spine, and radius measured areal BMD (aBMD) and trabecular bone score (TBS). Constrained linear mixed-effects models determined treatment group-by-time and treatment group-by-time-by-sex interactions. The treatment group-by-time interaction previously observed for radial Tt.BMD was observed at both ultradistal (UD, p < 0.001) and 33% (p < 0.001) aBMD sites. However, the treatment group-by-time-by-sex interaction observed for radial Tt.BMD was not observed with aBMD at either the UD or 33% site, and the 4000 and 400 groups did not differ. Registered radial FEA results mirrored Tt.BMD. An increase in Tb.Sp and decrease in Ct.Th underpinned dose-dependent changes in radial BMD and strength. We observed no effects in DXA-based aBMD at the hip or spine or TBS. At the tibia, we observed a time-by-treatment group effect for Tb.BV/TV. Given that DXA measures at the radius did not detect sex differences or differences between the 4000 and 400 groups, HR-pQCT at the radius may be more sensitive for examining bone changes after vitamin D supplementation. Although DXA did not reveal treatment effects at the hip or spine, whether that is a true skeletal site difference or a lack of modality sensitivity remains unclear. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Lauren A Burt
- McCaig Institute for Bone and Joint Health, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Emma O Billington
- McCaig Institute for Bone and Joint Health, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - David A Hanley
- McCaig Institute for Bone and Joint Health, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
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Hildebrand KN, Sidhu K, Gabel L, Besler BA, Burt LA, Boyd SK. The Assessment of Skeletal Muscle and Cortical Bone by Second-generation HR-pQCT at the Tibial Midshaft. J Clin Densitom 2021; 24:465-473. [PMID: 33257203 DOI: 10.1016/j.jocd.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Peripheral quantitative computed tomography (pQCT) is the current densitometric gold-standard for assessing skeletal muscle at the 66% proximal tibia site. High resolution peripheral quantitative computed tomography (HR-pQCT) is a leading technology for quantifying bone microarchitecture at the distal extremities, and with the second-generation HR-pQCT it is possible to measure proximal limb sites. Therefore, the objectives of this study were to: (1) assess the feasibility of using HR-pQCT to assess skeletal muscle parameters at the 66% proximal tibia site, and (2) test HR-pQCT skeletal muscle measurement reproducibility at this site. METHODS Adult participants (9 males; 7 females; ages 31-75) received 1 pQCT scan and 2 HR-pQCT scans at the 66% proximal site of the nondominant tibia. Participants were repositioned between HR-pQCT scans to test reproducibility. HR-pQCT and pQCT scans were analyzed to quantify muscle cross-sectional area (CSA) and muscle density. Coefficients of determination and Bland-Altman plots compared muscle parameters between pQCT and HR-pQCT. For short-term reproducibility, root-mean-square of coefficient of variance and least significant change were calculated. RESULTS HR-pQCT and pQCT measured muscle density and muscle CSA were positively correlated (R2 = 0.66, R2 = 0.95, p < 0.001, respectively). Muscle density was equivalent between HR-pQCT and pQCT; however, there was systematic and directional bias for muscle CSA, such that muscle CSA was 11% lower with HR-pQCT and bias increased with larger muscle CSA. Root-mean-square of coefficient of variance was 0.67% and 0.92% for HR-pQCT measured muscle density and muscle CSA, respectively, while least significant change was 1.4 mg/cm3 and 174.0 mm2 for muscle density and muscle CSA, respectively. CONCLUSION HR-pQCT is capable of assessing skeletal muscle at the 66% site of the tibia with good precision. Measures of muscle density are comparable between HR-pQCT and pQCT.
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Affiliation(s)
- Kurt N Hildebrand
- Faculty of Kinesiology, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Karamjot Sidhu
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Bryce A Besler
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lauren A Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Steven K Boyd
- Faculty of Kinesiology, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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11
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Gabel L, Liphardt AM, Hulme PA, Heer M, Zwart SR, Sibonga JD, Smith SM, Boyd SK. Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight. Br J Sports Med 2021; 56:196-203. [PMID: 33597120 PMCID: PMC8862023 DOI: 10.1136/bjsports-2020-103602] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 02/02/2023]
Abstract
ObjectivesBone loss remains a primary health concern for astronauts, despite in-flight exercise. We examined changes in bone microarchitecture, density and strength before and after long-duration spaceflight in relation to biochemical markers of bone turnover and exercise.MethodsSeventeen astronauts had their distal tibiae and radii imaged before and after space missions to the International Space Station using high-resolution peripheral quantitative CT. We estimated bone strength using finite element analysis and acquired blood and urine biochemical markers of bone turnover before, during and after spaceflight. Pre-flight exercise history and in-flight exercise logs were obtained. Mixed effects models examined changes in bone and biochemical variables and their relationship with mission duration and exercise.ResultsAt the distal tibia, median cumulative losses after spaceflight were −2.9% to −4.3% for bone strength and total volumetric bone mineral density (vBMD) and −0.8% to −2.6% for trabecular vBMD, bone volume fraction, thickness and cortical vBMD. Mission duration (range 3.5–7 months) significantly predicted bone loss and crewmembers with higher concentrations of biomarkers of bone turnover before spaceflight experienced greater losses in tibia bone strength and density. Lower body resistance training volume (repetitions per week) increased 3–6 times in-flight compared with pre-spaceflight. Increases in training volume predicted preservation of tibia bone strength and trabecular vBMD and thickness.ConclusionsFindings highlight the fundamental relationship between mission duration and bone loss. Pre-flight markers of bone turnover and exercise history may identify crewmembers at greatest risk of bone loss due to unloading and may focus preventative measures.
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Affiliation(s)
- Leigh Gabel
- Department of Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Anna-Maria Liphardt
- Department of Internal Medicine, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Bavaria, Germany
| | - Paul A Hulme
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Martina Heer
- Department of Nutrition and Food Science, University of Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Sara R Zwart
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Jean D Sibonga
- Human Health and Performance Directorate, NASA Lyndon B Johnson Space Center, Houston, Texas, USA
| | - Scott M Smith
- Human Health and Performance Directorate, NASA Lyndon B Johnson Space Center, Houston, Texas, USA
| | - Steven K Boyd
- Department of Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
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de Bakker CMJ, Burt LA, Gabel L, Hanley DA, Boyd SK. Parity, Breastfeeding, and Osteoporosis-Authors' Response. Calcif Tissue Int 2021; 108:279-280. [PMID: 33057761 DOI: 10.1007/s00223-020-00767-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Chantal M J de Bakker
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lauren A Burt
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Leigh Gabel
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - David A Hanley
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Steven K Boyd
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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13
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Kemp TD, de Bakker CMJ, Gabel L, Hanley DA, Billington EO, Burt LA, Boyd SK. Longitudinal bone microarchitectural changes are best detected using image registration. Osteoporos Int 2020; 31:1995-2005. [PMID: 32430614 DOI: 10.1007/s00198-020-05449-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022]
Abstract
UNLABELLED Longitudinal studies of bone using high-resolution medical imaging may result in non-physiological measurements of longitudinal changes. In this study, we determined that three-dimensional image processing techniques best capture realistic longitudinal changes in bone density and should therefore be used with high-resolution imaging when studying bone changes over time. INTRODUCTION The purpose of this study was to determine which longitudinal analysis technique (no registration (NR), slice-match (SM) registration, or three-dimensional registration (3DR)) produced the most realistic longitudinal changes in a 3-year study of bone density and structure using high-resolution peripheral quantitative computed tomography (HR-pQCT). METHODS We assessed HR-pQCT scans of the distal radius and tibia for men and women (N = 40) aged 55-70 years at baseline and 6, 12, 24, and 36 months. To evaluate which longitudinal analysis technique (NR, SM, or 3DR) best captured physiologically reasonable 3-year changes, we calculated the standard deviation of the absolute rate of change in each bone parameter. The data were compared between longitudinal analysis techniques using repeated measures ANOVA and post hoc analysis. RESULTS As expected, both SM and 3DR better captured physiological longitudinal changes than NR. At the tibia, there were no differences between SM and 3DR; however, at the radius where precision was lower, 3DR produced better results for total bone mineral density. CONCLUSIONS At least SM or 3DR should be implemented in longitudinal studies using HR-pQCT. 3DR is preferable, particularly at the radius, to ensure that physiological changes in bone density are observed.
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Affiliation(s)
- T D Kemp
- Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - C M J de Bakker
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - L Gabel
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - D A Hanley
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - E O Billington
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - L A Burt
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - S K Boyd
- Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, Canada.
- McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
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14
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de Bakker CMJ, Burt LA, Gabel L, Hanley DA, Boyd SK. Associations Between Breastfeeding History and Early Postmenopausal Bone Loss. Calcif Tissue Int 2020; 106:264-273. [PMID: 31786624 DOI: 10.1007/s00223-019-00638-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022]
Abstract
This study aimed to evaluate associations of parity and breastfeeding history with postmenopausal bone loss. Early postmenopausal women from the Canadian Multicentre Osteoporosis Study were divided into three groups based on their reproductive histories: nulliparous (NP, n = 10), parous with < 6 months breastfeeding (P-NBF, n = 14), and parous with > 6 months breastfeeding (P-BF, n = 21). Women underwent dual X-ray absorptiometry and high-resolution peripheral quantitative computed tomography imaging at baseline and after 6 years to evaluate bone mineral density (BMD), bone microstructure, and finite element-estimated failure load. Average age at baseline was 57 years. Baseline density, microstructure, and failure load were not different among groups. In all women, total and cortical BMD decreased significantly at the tibia and radius. P-BF women only experienced a significant decline in tibial trabecular BMD, with a greater magnitude of change for P-BF than NP women (p = 0.002). Overall, results suggest that early postmenopausal bone health did not differ based on parity or breastfeeding history. Over the 6-year follow-up period, postmenopausal bone loss was evident in all women, with subtle differences in the rate of postmenopausal change among women with varying breastfeeding histories. Parous women who had breastfed for at least 6 months showed an elevated rate of trabecular BMD loss at the tibia. Meanwhile, correlation analyses suggest that longer durations of breastfeeding may be associated with reduced cortical bone loss at the radius. The lack of differences among groups in FE-derived failure load suggests that parity and breastfeeding history is unlikely to significantly affect postmenopausal risk of fracture.
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Affiliation(s)
- Chantal M J de Bakker
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lauren A Burt
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Leigh Gabel
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - David A Hanley
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Steven K Boyd
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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15
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Burt LA, Gabel L, Billington EO, Hanley DA, Boyd SK. Postural Balance Effects Associated with 400, 4000 or 10,000 IU Vitamin D 3 Daily for Three Years: A Secondary Analysis of a Randomized Clinical Trial. Nutrients 2020; 12:nu12020527. [PMID: 32092887 PMCID: PMC7071365 DOI: 10.3390/nu12020527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 12/22/2022] Open
Abstract
Vitamin D supplementation is proposed as a fall prevention strategy, as it may improve neuromuscular function. We examined whether three years of vitamin D supplementation (400, 4000 or 10,000 IU daily) affects postural sway in older adults. Three hundred and seventy-three non-osteoporotic, vitamin D-sufficient, community-dwelling healthy adults, aged 55–70 years, were randomized to 400 (n = 124), 4000 (n = 125) or 10,000 (n = 124) IU daily vitamin D3 for three years. Sway index was assessed at baseline, 12-, 24- and 36-months using the Biosway machine. We tested participants under four conditions: eyes open or eyes closed with firm (EOFI, ECFI) or foam (EOFO, ECFO) surfaces. Secondary assessments examined sway in the anterior-posterior (AP) and medio-lateral (ML) directions. Linear mixed effects models compared sway between supplementation groups across time. Postural sway under EOFO and ECFO conditions significantly improved in all supplementation groups over time. Postural sway did not differ between supplementation groups at any time under any testing conditions in normal, AP or ML directions (p > 0.05 for all). Our findings suggest that high dose (4000 or 10,000 IU) vitamin D supplementation neither benefit nor impair balance compared with 400 IU daily in non-osteoporotic, vitamin D-sufficient, healthy older adults.
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16
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Gomez-Bruton A, Gabel L, Nettlefold L, Macdonald H, Race D, McKay H. Estimation of Peak Muscle Power From a Countermovement Vertical Jump in Children and Adolescents. J Strength Cond Res 2019; 33:390-398. [PMID: 28570492 DOI: 10.1519/jsc.0000000000002002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gomez-Bruton, A, Gabel, L, Nettlefold, L, Macdonald, H, Race, D, and McKay, H. Estimation of peak muscle power from a countermovement vertical jump in children and adolescents. J Strength Cond Res 33(2): 390-398, 2019-Several equations to predict muscle power (MP) from vertical jump height (VJH) have been developed in adults. However, few have been derived in children. We therefore aimed to: (a) evaluate the validity of existing MP estimation equations from a vertical countermovement jump (CMJ) in children and adolescents and (b) develop and validate a new MP estimation equation for use in children and adolescents. We measured peak MP (in watts) and VJH (in centimeters) during a CMJ using a force platform in 249 children and adolescents (9-17 years; 119 boys and 130 girls). We compared actual (force platform) with predicted (12 existing prediction equations) MP using repeated-measures analysis of variance and estimated bias using modified Bland-Altman plots. We developed a new prediction equation using stepwise linear regression, assessed predictive error using leave-one-out and 10-fold cross-validation, and externally validated the equation in an independent sample (n = 100). All existing prediction equations demonstrated some degree of bias, either systematic bias (mean differences ranging 178-1,377 W; 8-64%) or bias at the extremes or interactions with sex. Our new prediction equation estimates MP from VJH and body mass: Power (W) = 54.2 × VJH (cm) + 34.4 × body mass (kg) - 1,520.4. With this new equation, there was no difference between actual and predicted MP (0%) and negligible differences (0.2-0.9%) in R and root mean square error between our observed and cross-validated sets. Actual and predicted MP were not different in our external validation (p = 0.12). The new equation demonstrates excellent validity and can be used to predict MP from a CMJ in children and adolescents.
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Affiliation(s)
- Alejandro Gomez-Bruton
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Leigh Gabel
- Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Lindsay Nettlefold
- Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Heather Macdonald
- Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.,Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Douglas Race
- Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Heather McKay
- Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.,Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
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17
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Gabel L, Macdonald HM, Nettlefold LA, McKay HA. Sex-, Ethnic-, and Age-Specific Centile Curves for pQCT- and HR-pQCT-Derived Measures of Bone Structure and Strength in Adolescents and Young Adults. J Bone Miner Res 2018; 33:987-1000. [PMID: 29394462 DOI: 10.1002/jbmr.3399] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/18/2018] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
Abstract
There are presently no adolescent centile curves for bone parameters at the tibial midshaft using peripheral quantitative computed tomography (pQCT) or at the distal radius and tibia using high-resolution pQCT (HR-pQCT). Thus, we aimed to develop sex-, ethnic-, site-, and age-specific centile curves for pQCT and HR-pQCT-derived bone outcomes for youth and young adults aged 10 to 21 years. We acquired pQCT scans (XCT3000 or XCT2000) at the tibial midshaft (50% site) and HR-pQCT scans (XtremeCT) at the distal radius (7% site) and tibia (8% site) in a convenience sample of participants in the mixed-longitudinal University of British Columbia Healthy Bones III Study. We scanned 778 10- to 21-year-olds annually for a maximum of 11 years using pQCT (413 girls, 56% Asian; 365 boys, 54% Asian; n = 3160 observations) and 349 10- to 21-year-olds annually for a maximum of 4 years using HR-pQCT (189 girls, 51% Asian; 165 boys, 50% Asian; n = 1090 observations). For pQCT, we report cortical bone mineral density (BMD), total bone cross-sectional area, and polar strength-strain index. For HR-pQCT, we report standard measures (total BMD, trabecular number, thickness, and bone volume fraction) and automated segmentation measures (total bone cross-sectional area, cortical BMD, porosity, and thickness). We applied finite element analysis to estimate failure load. We applied the lamda, mu, sigma (LMS) method using LMS ChartMaker Light (version 2.5, The Institute of Child Health, London, UK) to construct LMS tables and centile plots. We report sex- and age-specific centiles (3rd, 10th, 25th, 50th, 75th, and 97th) for whites and Asians for pQCT bone parameters at the tibial midshaft and HR-pQCT bone parameters at the distal radius and tibia. These centile curves might be used by clinicians and scientists to interpret values or better understand trajectories of bone parameters in clinical populations, those from different geographic regions or of different ethnic origins. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Lindsay A Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, University of British Columbia, Vancouver, Canada
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18
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Tan VP, Macdonald HM, Gabel L, McKay HA. Physical activity, but not sedentary time, influences bone strength in late adolescence. Arch Osteoporos 2018; 13:31. [PMID: 29556801 DOI: 10.1007/s11657-018-0441-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 02/28/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Physical activity is essential for optimal bone strength accrual, but we know little about interactions between physical activity, sedentary time, and bone outcomes in older adolescents. Physical activity (by accelerometer and self-report) positively predicted bone strength and the distal and midshaft tibia in 15-year-old boys and girls. Lean body mass mediated the relationship between physical activity and bone strength in adolescents. PURPOSE To examine the influence of physical activity (PA) and sedentary time on bone strength, structure, and density in older adolescents. METHODS We used peripheral quantitative computed tomography to estimate bone strength at the distal tibia (8% site; bone strength index, BSI) and tibial midshaft (50% site; polar strength strain index, SSIp) in adolescent boys (n = 86; 15.3 ± 0.4 years) and girls (n = 106; 15.3 ± 0.4 years). Using accelerometers (GT1M, Actigraph), we measured moderate-to-vigorous PA (MVPAAccel), vigorous PA (VPAAccel), and sedentary time in addition to self-reported MVPA (MVPAPAQ-A) and impact PA (ImpactPAPAQ-A). We examined relations between PA and sedentary time and bone outcomes, adjusting for ethnicity, maturity, tibial length, and total body lean mass. RESULTS At the distal tibia, MVPAAccel and VPAAccel positively predicted BSI (explained 6-7% of the variance, p < 0.05). After adjusting for lean mass, only VPAAccel explained residual variance in BSI. At the tibial midshaft, MVPAAccel, but not VPAAccel, positively predicted SSIp (explained 3% of the variance, p = 0.01). Lean mass attenuated this association. MVPAPAQ-A and ImpactPAPAQ-A also positively predicted BSI and SSIp (explained 2-4% of the variance, p < 0.05), but only ImpactPAPAQ-A explained residual variance in BSI after accounting for lean mass. Sedentary time did not independently predict bone strength at either site. CONCLUSION Greater tibial bone strength in active adolescents is mediated, in part, by lean mass. Despite spending most of their day in sedentary pursuits, adolescents' bone strength was not negatively influenced by sedentary time.
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Affiliation(s)
- Vina Ps Tan
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Heather M Macdonald
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Leigh Gabel
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Heather A McKay
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada. .,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada. .,Department of Orthopedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Macdonald HM, Määttä M, Gabel L, Mulpuri K, McKay HA. Bone Strength in Girls and Boys After a Distal Radius Fracture: A 2-Year HR-pQCT Double Cohort Study. J Bone Miner Res 2018; 33:229-240. [PMID: 29024249 DOI: 10.1002/jbmr.3307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/05/2017] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Abstract
We recently reported impaired bone strength in girls with low- to moderate-energy distal radius fractures (Fx) compared with girls with no history of forearm fractures (Non-Fx). We aimed to determine whether bone strength deficits observed at baseline were still present after 2 years. We assessed bone strength, microarchitecture, and bone mineral density (BMD) of the non-fractured (Fx) and non-dominant (Non-Fx) distal radius (7% site) at baseline, 12, and 24 months using high-resolution pQCT (Scanco Medical, Brüttisellen, Switzerland) in 104 girls (aged 11.0 ± 1.7 years; 47 Fx, 57 Non-Fx) and 157 boys (aged 12.7 ± 1.7 years; 86 Fx, 71 Non-Fx). Bone outcomes included total area (Tt.Ar) and bone mineral density (Tt.BMD), trabecular bone volume ratio (BV/TV), thickness (Tb.Th), separation (Tb.Sp), and number (Tb.N), and cortical BMD (Ct.BMD), thickness (Ct.Th), and porosity (Ct.Po). We used finite element analysis to estimate bone strength (failure load [F.Load]; ultimate stress [U.Stress]; load-to-strength ratio). We used sex-specific mixed-effects models to compare bone outcomes between Fx and Non-Fx over 2 years. In girls, those with fractures had 18% to 24% lower U.Stress and 5% to 9% lower Tt.BMD than Non-Fx at all time points (p < 0.017). In secondary analysis by fracture degree, girls with low-energy (LE) fractures had 19% to 21% lower F.Load, 25% to 47% lower U.Stress, 11% to 14% lower Tt.BMD, and 11% to 15% lower BV/TV than Non-Fx at all time points (p < 0.017). In contrast, boys' bone outcomes were similar between Fx and Non-Fx at all time points. In secondary analysis by fracture degree, boys with LE fractures had 10% lower Tt.BMD and 10% lower Ct.Th compared with Non-Fx at 12 months only. Deficits in distal radius bone strength and trabecular bone microarchitecture appear to track across 2 years after a forearm fracture in girls but not in boys. Longer follow-up is needed to determine whether deficits persist into adulthood in women and how they may influence future risk of fragility fracture. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Mikko Määttä
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Orthopedics, University of British Columbia, Vancouver, Canada
| | - Leigh Gabel
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Kishore Mulpuri
- Department of Orthopedics, University of British Columbia, Vancouver, Canada.,Department of Orthopedic Surgery, British Columbia Children's Hospital, Vancouver, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada.,Department of Orthopedics, University of British Columbia, Vancouver, Canada
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Gabel L, Macdonald HM, Nettlefold L, McKay HA. Physical Activity, Sedentary Time, and Bone Strength From Childhood to Early Adulthood: A Mixed Longitudinal HR-pQCT study. J Bone Miner Res 2017; 32:1525-1536. [PMID: 28326606 DOI: 10.1002/jbmr.3115] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 11/08/2022]
Abstract
Bone strength is influenced by bone geometry, density, and bone microarchitecture, which adapt to increased mechanical loads during growth. Physical activity (PA) is essential for optimal bone strength accrual; however, less is known about how sedentary time influences bone strength and its determinants. Thus, our aim was to investigate the prospective associations between PA, sedentary time, and bone strength and its determinants during adolescence. We used HR-pQCT at distal tibia (8% site) and radius (7% site) in 173 girls and 136 boys (aged 9 to 20 years at baseline). We conducted a maximum of four annual measurements at the tibia (n = 785 observations) and radius (n = 582 observations). We assessed moderate-to-vigorous PA (MVPA) and sedentary time with accelerometers (ActiGraph GT1M). We aligned participants on maturity (years from age at peak height velocity) and fit a mixed-effects model adjusting for maturity, sex, ethnicity, leg muscle power, lean mass, limb length, dietary calcium, and MVPA in sedentary time models. MVPA was a positive independent predictor of bone strength (failure load [F.Load]) and bone volume fraction (BV/TV) at the tibia and radius, total area (Tt.Ar) and cortical porosity (Ct.Po) at the tibia, and negative predictor of load-to-strength ratio at the radius. Sedentary time was a negative independent predictor of Tt.Ar at both sites and Ct.Po at the tibia and a positive predictor of cortical thickness (Ct.Th), trabecular thickness (Tb.Th), and cortical bone mineral density (Ct.BMD) at the tibia. Bone parameters demonstrated maturity-specific associations with MVPA and sedentary time, whereby associations were strongest during early and mid-puberty. Our findings support the importance of PA for bone strength accrual and its determinants across adolescent growth and provide new evidence of a detrimental association of sedentary time with bone geometry but positive associations with microarchitecture. This study highlights maturity-specific relationships of bone strength and its determinants with loading and unloading. Future studies should evaluate the dose-response relationship and whether associations persist into adulthood. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
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Gabel L, Macdonald HM, McKay HA. Sex Differences and Growth-Related Adaptations in Bone Microarchitecture, Geometry, Density, and Strength From Childhood to Early Adulthood: A Mixed Longitudinal HR-pQCT Study. J Bone Miner Res 2017; 32:250-263. [PMID: 27556581 PMCID: PMC5233447 DOI: 10.1002/jbmr.2982] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/10/2016] [Accepted: 08/22/2016] [Indexed: 11/09/2022]
Abstract
Sex differences in bone strength and fracture risk are well documented. However, we know little about bone strength accrual during growth and adaptations in bone microstructure, density, and geometry that accompany gains in bone strength. Thus, our objectives were to (1) describe growth related adaptations in bone microarchitecture, geometry, density, and strength at the distal tibia and radius in boys and girls; and (2) compare differences in adaptations in bone microarchitecture, geometry, density, and strength between boys and girls. We used HR-pQCT at the distal tibia (8% site) and radius (7% site) in 184 boys and 209 girls (9 to 20 years old at baseline). We aligned boys and girls on a common maturational landmark (age at peak height velocity [APHV]) and fit a mixed effects model to these longitudinal data. Importantly, boys showed 28% to 63% greater estimated bone strength across 12 years of longitudinal growth. Boys showed 28% to 80% more porous cortices compared with girls at both sites across all biological ages, except at the radius at 9 years post-APHV. However, cortical density was similar between boys and girls at all ages at both sites, except at 9 years post-APHV at the tibia when girls' values were 2% greater than boys'. Boys showed 13% to 48% greater cortical and total bone area across growth. Load-to-strength ratio was 26% to 27% lower in boys at all ages, indicating lower risk of distal forearm fracture compared with girls. Contrary to previous HR-pQCT studies that did not align boys and girls at the same biological age, we did not observe sex differences in Ct.BMD. Boys' superior bone size and strength compared with girls may confer them a protective advantage. However, boys' consistently more porous cortices may contribute to their higher fracture incidence during adolescence. Large prospective studies using HR-pQCT that target boys and girls who have sustained a fracture are needed to verify this. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M. Macdonald
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Heather A. McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Department of Family Practice, University of British Columbia, Vancouver, Canada
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Gabel L, Macdonald H, Nettlefold L, Race D, McKay H. Reference data for jumping mechanography in Canadian children, adolescents and young adults. J Musculoskelet Neuronal Interact 2016; 16:283-295. [PMID: 27973380 PMCID: PMC5259569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To provide age- and sex-specific reference data for mechanography-derived parameters of muscle function in Canadian children and youth using the single two-legged jump (S2LJ) with hands-on-waist. METHODS Our sample included 2017 observations from 715 participants (9-21 years; 338 girls). Participants performed three S2LJ with hands-on-waist on a force platform (Leonardo Mechanograph, Novotec). Outcomes were maximum peak power (Pmax), Pmax/mass, peak force/body weight (Fmax/BW), force efficiency, maximum jump height (Hmax), and velocity (Vmax). We used the LMS method to construct age- and sex-specific percentile curves and mixed effects models to examine sex and ethnic differences. RESULTS With the exception of Efficiency, mechanography outcomes were greater in girls (4-40%, p<0.05) than boys at age 9. Boys' advantage in mechanography parameters emerged in adolescence (age 11-13 years; 3-65%, p<0.05) and persisted into young adulthood, except for Fmax/BW which was not greater in boys until age 17 (4-10%, p<0.05). Mechanography outcomes were 3-9% (p<0.05) greater in Asian compared with white participants. CONCLUSIONS We provide the first reference data for the S2LJ using the hands-on-waist protocol in children, youth and young adults. These data support previous findings using freely moving arms and can be used when evaluating muscle function in pediatric studies.
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Affiliation(s)
- L. Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - H.M. Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - L. Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - D. Race
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - H.A. McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada,Department of Family Practice, University of British Columbia, Vancouver, Canada,Corresponding author: Heather McKay, PhD, Centre for Hip Health and Mobility, 7/F-2635 Laurel St, Vancouver, BC V5Z 1M9, Canada E-mail:
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Gabel L, Macdonald HM, McKay HA. Reply to: Challenges in the Acquisition and Analysis of Bone Microstructure During Growth. J Bone Miner Res 2016; 31:2242-2243. [PMID: 27704623 DOI: 10.1002/jbmr.3010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
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Gabel L, Ridgers ND, Della Gatta PA, Arundell L, Cerin E, Robinson S, Daly RM, Dunstan DW, Salmon J. Associations of sedentary time patterns and TV viewing time with inflammatory and endothelial function biomarkers in children. Pediatr Obes 2016; 11:194-201. [PMID: 26097139 PMCID: PMC5054926 DOI: 10.1111/ijpo.12045] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 04/28/2015] [Accepted: 05/01/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Investigate associations of TV viewing time and accelerometry-derived sedentary time with inflammatory and endothelial function biomarkers in children. METHODS Cross-sectional analysis of 164 7-10-year-old children. TV viewing time was assessed by parental proxy report and total and patterns of sedentary time accumulation (e.g. prolonged bouts) were assessed by accelerometry. C-reactive protein (CRP), homeostasis model assessment of insulin resistance, interleukin-2, -6, -8, -10, tumour necrosis factor alpha, adiponectin, resistin, brain-derived neurotrophic factor, soluble intercellular and vascular adhesion molecule 1, plasminogen activator inhibitor 1 and soluble E-selectin were assessed. Generalised linear models assessed the associations of TV viewing and sedentary time with biomarkers, adjusting for sex, waist circumference, moderate- to vigorous-intensity physical activity and diet density. RESULTS Each additional h week(-1) of TV viewing was associated with 4.4% (95% CI: 2.1, 6.7) greater CRP and 0.6% (0.2, 1.0) greater sVCAM-1 in the fully adjusted model. The association between frequency and duration of 5-10 min bouts of sedentary time and CRP was positive after adjustment for sex and waist circumference but attenuated after adjustment for diet density. CONCLUSIONS This study suggests that TV viewing was unfavourably associated with several markers of inflammation and endothelial dysfunction. The detrimental association between 5 and 10 min bouts of sedentary time and CRP approached significance, suggesting that further research with a stronger study design (longitudinal and/or experimental) is needed to better understand how the accumulation of sedentary time early in life may influence short and longer term health.
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Affiliation(s)
- L. Gabel
- Experimental Medicine ProgramFaculty of Medicine & Child and Family Research InstituteUniversity of British ColumbiaVancouverBritish ColumbiaCanada,Centre for Hip Health and MobilityVancouver Coastal Research InstituteVancouverBritish ColumbiaCanada
| | - N. D. Ridgers
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
| | - P. A. Della Gatta
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
| | - L. Arundell
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
| | - E. Cerin
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
| | - S. Robinson
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
| | - R. M. Daly
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
| | - D. W. Dunstan
- Physical Activity and Behavioural Epidemiology LaboratoriesBaker IDI Heart and Diabetes InstituteMelbourneVictoriaAustralia,School of Exercise and Nutrition SciencesDeakin UniversityBurwoodVictoriaAustralia,School of Population HealthThe University of QueenslandBrisbaneQueenslandAustralia,Department of Epidemiology and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia,School of Sport Science, Exercise and HealthThe University of Western AustraliaPerthWestern AustraliaAustralia,Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - J. Salmon
- Center for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
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Gabel L, Nettlefold L, Brasher PM, Moore SA, Ahamed Y, Macdonald HM, McKay HA. Reexamining the Surfaces of Bone in Boys and Girls During Adolescent Growth: A 12-Year Mixed Longitudinal pQCT Study. J Bone Miner Res 2015; 30:2158-67. [PMID: 26058373 PMCID: PMC5059154 DOI: 10.1002/jbmr.2570] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 06/01/2015] [Accepted: 06/04/2015] [Indexed: 11/09/2022]
Abstract
We revisit Stanley Garn's theory related to sex differences in endocortical and periosteal apposition during adolescence using a 12-year mixed longitudinal study design. We used peripheral quantitative computed tomography to examine bone parameters in 230 participants (110 boys, 120 girls; aged 11.0 years at baseline). We assessed total (Tt.Ar, mm(2)), cortical (Ct.Ar, mm(2)), and medullary canal area (Me.Ar, mm(2)), Ct.Ar/Tt.Ar, cortical bone mineral density (Ct.BMD, mg/cm(3)), and polar strength-strain index (SSIp , mm(3)) at the tibial midshaft (50% site). We used annual measures of height and chronological age to identify age at peak height velocity (APHV) for each participant. We compared annual accrual rates of bone parameters between boys and girls, aligned on APHV using a linear mixed effects model. At APHV, boys demonstrated greater Tt.Ar (ratio = 1.27; 95% confidence interval [CI] 1.21, 1.32), Ct.Ar (1.24 [1.18, 1.30]), Me.Ar (1.31 [1.22, 1.40]), and SSIp (1.36 [1.28, 1.45]) and less Ct.Ar/Tt.Ar (0.98 [0.96, 1.00]) and Ct.BMD (0.97 [0.96, 0.97]) compared with girls. Boys and girls demonstrated periosteal bone formation and net bone loss at the endocortical surface. Compared with girls, boys demonstrated greater annual accrual rates pre-APHV for Tt.Ar (1.18 [1.02, 1.34]) and Me.Ar (1.34 [1.11, 1.57]), lower annual accrual rates pre-APHV for Ct.Ar/Tt.Ar (0.56 [0.29, 0.83]) and Ct.BMD (-0.07 [-0.17, 0.04]), and similar annual accrual rates pre-APHV for Ct.Ar (1.10 [0.94, 1.26]) and SSIp (1.14 [0.98, 1.30]). Post-APHV, boys demonstrated similar annual accrual rates for Ct.Ar/Tt.Ar (1.01 [0.71, 1.31]) and greater annual accrual rates for all other bone parameters compared with girls (ratio = 1.23 to 2.63; 95% CI 1.11 to 3.45). Our findings support those of Garn and others of accelerated periosteal apposition during adolescence, more evident in boys than girls. However, our findings challenge the notion of greater endocortical apposition in girls, suggesting instead that girls experience diminished endocortical resorption compared with boys.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Penelope M Brasher
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Sarah A Moore
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Yasmin Ahamed
- Centre of Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Heather M Macdonald
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Tan VPS, Macdonald HM, Kim S, Nettlefold L, Gabel L, Ashe MC, McKay HA. Influence of physical activity on bone strength in children and adolescents: a systematic review and narrative synthesis. J Bone Miner Res 2014; 29:2161-81. [PMID: 24737388 DOI: 10.1002/jbmr.2254] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 04/04/2014] [Accepted: 04/09/2014] [Indexed: 11/08/2022]
Abstract
A preponderance of evidence from systematic reviews supports the effectiveness of weight-bearing exercises on bone mass accrual, especially during the growing years. However, only one systematic review (limited to randomized controlled trials) examined the role of physical activity (PA) on bone strength. Thus, our systematic review extended the scope of the previous review by including all PA intervention and observational studies, including organized sports participation studies, with child or adolescent bone strength as the main outcome. We also sought to discern the skeletal elements (eg, mass, structure, density) that accompanied significant bone strength changes. Our electronic-database, forward, and reference searches yielded 14 intervention and 23 observational studies that met our inclusion criteria. We used the Effective Public Health Practice Project (EPHPP) tool to assess the quality of studies. Due to heterogeneity across studies, we adopted a narrative synthesis for our analysis and found that bone strength adaptations to PA were related to maturity level, sex, and study quality. Three (of five) weight-bearing PA intervention studies with a strong rating reported significantly greater gains in bone strength for the intervention group (3% to 4%) compared with only three significant (of nine) moderate intervention studies. Changes in bone structure (eg, bone cross-sectional area, cortical thickness, alone or in combination) rather than bone mass most often accompanied significant bone strength outcomes. Prepuberty and peripuberty may be the most opportune time for boys and girls to enhance bone strength through PA, although this finding is tempered by the few available studies in more mature groups. Despite the central role that muscle plays in bones' response to loading, few studies discerned the specific contribution of muscle function (or surrogates) to bone strength. Although not the focus of the current review, this seems an important consideration for future studies.
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Affiliation(s)
- Vina P S Tan
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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Gabel L, Proudfoot NA, Obeid J, MacDonald MJ, Bray SR, Cairney J, Timmons BW. Step count targets corresponding to new physical activity guidelines for the early years. Med Sci Sports Exerc 2013; 45:314-8. [PMID: 22968313 DOI: 10.1249/mss.0b013e318271765a] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE New physical activity guidelines recommend that children age 3–4 yr should accumulate at least 180 min of physical activity at any intensity spread throughout the day, including progression toward at least 60 min of energetic play by 5 yr of age. Step count targets corresponding to these recommendations will help practitioners and researchers monitor physical activity. METHODS One hundred thirty-three preschoolers were instructed to wear accelerometers for seven consecutive days. Activity and step count data were recorded in 3-s epochs. Step count targets equivalent to physical activity recommendations were derived using prediction equations from regression analyses. Receiver operating curve analyses were conducted to compare the sensitivity and specificity of the derived thresholds as well as a range of other targets. RESULTS The daily step count target derived for 180 min of physical activity of any intensity was 6013 +/- 88, whereas the target for 180 min of physical activity of any intensity including at least 60 min of moderate-to-vigorous physical activity was 6191 +/- 103. The smallest discrepancy between days meeting physical activity guidelines and step count targets was found with a 6000-step-per-day target. Receiver operating curves confirmed a balanced sensitivity and specificity of this target. CONCLUSIONS On the basis of our data, we suggest that a new step count target of 6000 steps per day should be used to determine whether 3- to 5-yr-old children are meeting physical activity recommendations.
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Affiliation(s)
- Leigh Gabel
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Gabel L, Proudfoot NA, MacDonald MJ, Timmons BW. Relationships Between Physical Activity and Health Measures in Preschool Children. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.suppl_a.25ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gabel L, Obeid J, Nguyen T, Proudfoot NA, Timmons BW. Short-term muscle power and speed in preschoolers exhibit stronger tracking than physical activity. Appl Physiol Nutr Metab 2011; 36:939-45. [DOI: 10.1139/h11-118] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine the tracking of short-term muscle power, speed, and physical activity over a 15-month period in a sample of healthy Canadian preschool-aged children. Seventeen preschoolers (age, 4.4 ± 0.8 years) completed exercise testing and physical activity monitoring at baseline and follow-up separated by 14.6 ± 4.1 months. Short-term muscle power was measured using a modified 10-s Wingate test with peak power and mean power normalized to body mass. Speed was assessed with a 25-m dash. Physical activity was measured by accelerometry (Actigraph GT1M) using a 3-s epoch over 7 consecutive days. Total physical activity and moderate-to-vigorous physical activity, expressed as a percentage of accelerometer wear time, were examined. Tracking of the variables between year 1 and year 2 was analyzed using Spearman rank order correlations and Kappa statistics. Paired t-tests were used to assess differences in performance and physical activity between year 1 and year 2. Total physical activity was not significantly different at year 2 (p > 0.05) and showed fair tracking (r = 0.51, p = 0.05; ĸ = 0.30). Moderate-to-vigorous physical activity was increased at year 2 (p = 0.03) and exhibited poor tracking (r = 0.29, p = 0.28; ĸ = 0.00). Short-term muscle power and speed was increased at year 2 (p < 0.0001) and exhibited significant tracking: peak power (r = 0.72, p = 0.001; ĸ = 0.46), mean power (r = 0.83, p = 0.00004; ĸ = 0.82), and 25-m dash (r = 0.82, p = 0.0001; ĸ = 0.47). Moderate-to-vigorous physical activity increased in this sample of boys and girls during the preschool years, and short-term muscle power and speed exhibited stronger tracking than physical activity.
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Affiliation(s)
- Leigh Gabel
- Child Health and Exercise Medicine Program, McMaster University, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Joyce Obeid
- Child Health and Exercise Medicine Program, McMaster University, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Thanh Nguyen
- Child Health and Exercise Medicine Program, McMaster University, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Nicole A. Proudfoot
- Child Health and Exercise Medicine Program, McMaster University, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Brian W. Timmons
- Child Health and Exercise Medicine Program, McMaster University, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
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Wang Y, Yin X, Rosen G, Gabel L, Guadiana SM, Sarkisian MR, Galaburda AM, Loturco JJ. Dcdc2 knockout mice display exacerbated developmental disruptions following knockdown of doublecortin. Neuroscience 2011; 190:398-408. [PMID: 21689730 DOI: 10.1016/j.neuroscience.2011.06.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 05/27/2011] [Accepted: 06/01/2011] [Indexed: 12/12/2022]
Abstract
The dyslexia-associated gene DCDC2 is a member of the DCX family of genes known to play roles in neurogenesis, neuronal migration, and differentiation. Here we report the first phenotypic analysis of a Dcdc2 knockout mouse. Comparisons between Dcdc2 knockout mice and wild-type (wt) littermates revealed no significant differences in neuronal migration, neocortical lamination, neuronal cilliogenesis or dendritic differentiation. Considering previous studies showing genetic interactions and potential functional redundancy among members of the DCX family, we tested whether decreasing Dcx expression by RNAi would differentially impair neurodevelopment in Dcdc2 knockouts and wild-type mice. Consistent with this hypothesis, we found that deficits in neuronal migration, and dendritic growth caused by RNAi of Dcx were more severe in Dcdc2 knockouts than in wild-type mice with the same transfection. These results indicate that Dcdc2 is not required for neurogenesis, neuronal migration or differentiation in mice, but may have partial functional redundancy with Dcx.
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Affiliation(s)
- Y Wang
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT 06269, USA
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Obeid J, Nguyen T, Gabel L, Timmons BW. Physical activity in Ontario preschoolers: prevalence and measurement issues. Appl Physiol Nutr Metab 2011; 36:291-7. [DOI: 10.1139/h11-002] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Joyce Obeid
- Child Health and Exercise Program, McMaster University and McMaster Children’s Hospital, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Thanh Nguyen
- Child Health and Exercise Program, McMaster University and McMaster Children’s Hospital, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Leigh Gabel
- Child Health and Exercise Program, McMaster University and McMaster Children’s Hospital, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
| | - Brian W. Timmons
- Child Health and Exercise Program, McMaster University and McMaster Children’s Hospital, Chedoke Site, Evel Building, Room 469, 555 Sanatorium Road, Hamilton, ON L8N 3Z5, Canada
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