Relationships between longitudinal changes in body composition and bone mineral density in middle-to-older aged Australians

Osteosarcopenic adiposity and its relation to cancer and chronic diseases: Implications for research to delineate mechanisms and improve clinical outcomes

This is the third review in our series examining the connection between osteosarcopenic adiposity/obesity (OSA/OSO) syndrome and health impairments. The objective here was to examine whether there is a causal and/or bidirectional relationship between OSA and some chronic diseases. The search (in PubMed, Scopus, and WoS), screened for articles from their inception to the end of February 2024. Of n=859 articles retrieved, eleven met the eligibility criteria (having all three body composition compartments measured-bone, muscle, adipose tissue and being conducted in adult humans with chronic disease). The selected articles included four assessing OSA and cancers, one each assessing OSA and HIV, Cushing's disease (CD), chronic kidney disease (CKD), pulmonary function, and two for alcohol abuse-caused liver disease, as well as one 6-year study showing the progression to OSA over time. There was a positive relationship between OSA and each of the chronic diseases, as well as a possible bidirectional relationship between OSA and cancers. The evidence linking OSA with HIV, CD, CKD, liver disease, and pulmonary function, was insufficient to derive firm conclusions about their causal/bidirectional relations. This review emphasizes the need for a multidisciplinary approach in the management and treatment of chronic diseases where body composition assessment should get full attention. To close the knowledge gap, more studies about the role of OSA in chronic diseases are needed.

Twelve-month resistance and impact exercise program or risedronate provides a relative benefit to hip bone structure in postmenopausal women: results from a randomized controlled trial

Bone strength estimates are important for fracture prevention. This study compared bone strength changes in postmenopausal women with low bone mass who were assigned to 12 months of exercise, a bone medication, or control. Exercise and bone medications benefited structure at the hip. Structure should be considered in fracture prevention research.

PURPOSE

Exercise and bisphosphonates reduce fracture risk, but their impact on estimates of bone strength remains uncertain. This study compared changes in tibial bone strength using peripheral quantitative computed tomography (pQCT) and hip structure analysis (HSA) outcomes from dual-energy X-ray absorptiometry (DXA) scans in postmenopausal women with low bone mass assigned to 12 months of exercise, risedronate, or control.

METHODS

In this RCT, 276 postmenopausal women within 6 years of menopause were randomly assigned to three groups: exercise (92), risedronate (91), or control (93). Exercise included weighted jogging and progressive resistance exercises; risedronate treatment was 150 mg monthly; all groups received calcium and vitamin D. pQCT and DXA images were obtained at baseline and 6 and 12 months and compared between groups over time.

RESULTS

Participants had a mean (± SD) age of 54.5 (± 3.2) years with an average of 36.7 (± 40.7) months postmenopause. No significant differences were found between groups for the change in pQCT outcomes (volumetric bone mineral density, area, and strength estimates). At 12 months, mean percent differences (95% CI) in HSA measures between exercise and controls were as follows: intertrochanteric, cross-sectional area 2.25% (0.28, 4.12) (p = .03), cross-sectional moment of inertia (CSMI) 5.67% (1.47, 9.87) (p < .01), and section modulus (SM) 4.38% (1.02, 7.74) (p = .01), and narrow neck, average cortical thickness 2.37% (-0.08, 4.83) (p = .031). Mean percent differences (95% CI) in HSA measures between risedronate and control were as follows: intertrochanteric, CSMI 4.28% (-0.24, 8.81) (p = .03) and SM 3.35% (-0.21, 6.91) (p = .03), and shaft, subperiosteal width 0.82% (0.05, 1.58) (p = .047), CSMI 2.53% (0.88, 4.18) (p = .004), and SM 1.57% (0.34, 2.8) (p = .008). Exercise maintained neck-shaft angle compared to both control 1.27% (0.13, 2.41) (p = .04) and risedronate 1.31% (0.23, 2.39) (p = .03). All other differences for changes in HSA outcomes over time were not significantly different between the exercise and risedronate groups.

CONCLUSION

Exercise and bisphosphonates may influence structural and strength estimates at the hip, but not at peripheral sites (tibia). Neither exercise nor bisphosphonates were found to be superior in improving estimates of hip bone strength.