Age-related changes of bone strength phenotypes: observational follow-up study of hand bone mineral density

Muscle, Fat, Bone, and Lungs: Unlocking the Fitness and Health Equation of Firefighters in Porto, Portugal

BACKGROUND

Firefighters face significant physical demands, necessitating optimal fitness and health monitoring. This study examined the relationships between body composition, bone mineral density, handgrip strength, and pulmonary function in professional firefighters in Porto, Portugal.

METHODS

Sixty-eight firefighters underwent assessments, including anthropometry, dual-energy X-ray absorptiometry (DEXA) for body composition and bone density, handgrip dynamometry, and spirometry for lung function.

RESULTS

36.5% of participants were overweight, and 33.3% had obesity (Grade 1). Men exhibited greater muscle mass, bone density, and handgrip strength (48.7 ± 7.8 kg vs. 31.6 ± 3.6 kg) compared to women. Spirometry revealed normal lung function in 95.2% of participants, though 20.6% demonstrated handgrip strength values below the risk threshold, indicating vulnerability to reduced physical fitness and an increased risk of injury. Significant correlations were observed between lean mass and both handgrip strength (ρ = 0.551, p < 0.001) and pulmonary function, including forced vital capacity (ρ = 0.465, p < 0.001).

CONCLUSIONS

This study underscores the role of body composition, muscle strength, and pulmonary function in firefighters' health and safety. These findings suggest that these factors are linked to physical fitness and may influence overall health outcomes. Interventions focusing on improving strength and managing body weight could help to reduce health risks and enhance firefighter well-being.

Exploring Age-Related Variations in Carpal Bone Volume: Implications for Clinical Practice and Anatomical Understanding

BACKGROUND

Clinically recognizing the changes in carpal bone volumes and understanding their implications in predicting osteoarthritis (OA) is crucial in clinical practice This study aimed to explore age-related differences in carpal bone volumes across genders, leveraging computed tomography (CT) wrist scans to create 3D surface models of these bones.

METHODS

Carpal bone volumes were calculated using the 3D Slicer software from CT scans obtained from Frankston Hospital and additional datasets from Brown and Auckland Universities. The data were statistically processed using Stata V13. Double-sided P-values < .05 were considered statistically significant. The study was conducted in accordance with the ethical standards laid out in the Declaration of Helsinki.

RESULTS

A total of 181 patients were analyzed, and 48% of whom were female. A statistically significant positive Spearman correlation (rho = 0.37-0.611, P <.05) was observed between increasing age and the volume of all surveyed carpal bones (scaphoid, lunate, triquetrum, pisiform, hamate, capitate, and trapezium) across genders. Intrauser and interuser reliabilities for 3D Slicer-generated volumes of trapezium and pisiform bones were statistically significant, with Interclass Correlation Coefficient (ICC) values of 0.86 and 0.95, respectively.

CONCLUSION

Trapezial volumes increase with age, potentially due to the presence of OA and consequent osteophyte formation. This pattern is more prevalent among older individuals and women. However, the positive correlation between carpal bone volume and age was consistent across all carpal bones and both genders, regardless of OA presence. These findings suggest that carpal bone volume may naturally increase with age, independent of OA-related changes.

LEVEL OF EVIDENCE

III, cohort study.

Bone Organic-Inorganic Phase Ratio Is a Fundamental Determinant of Bone Material Quality

Background

Bone mineral density is widely used by clinicians for screening osteoporosis and assessing bone strength. However, its effectiveness has been reported unsatisfactory. In this study, it is demonstrated that bone organic-inorganic phase ratio is a fundamental determinant of bone material quality measured by stiffness, strength, and toughness.

Methods and Results

Two-hundred standard bone specimens were fabricated from bovine legs, with a specialized manufacturing method that was designed to reduce the effect of bone anisotropy. Bone mechanical properties of the specimens, including Young's modulus, yield stress, peak stress, and energy-to-failure, were measured by mechanical testing. Organic and inorganic mass contents of the specimens were then determined by bone ashing. Bone density and organic-inorganic phase ratio in the specimens were calculated. Statistical methods were applied to study relationships between the measured mechanical properties and the organic-inorganic phase ratios. Statistical characteristics of organic-inorganic phase ratios in the specimens with top material quality were investigated. Bone organic-inorganic phase ratio had strong Spearman correlation with bone material properties. Bone specimens that had the highest material quality had a very narrow scope of organic-inorganic phase ratio, which could be considered as the “optimal” ratio among the tested specimens.

Conclusion

Bone organic-inorganic phase ratio is a fundamental determinant of bone material quality. There may exist an “optimal” ratio for the bone to achieve top material quality. Deviation from the “optimal” ratio is probably the fundamental cause of various bone diseases. This study suggests that bone organic-inorganic phase ratio should be considered in clinical assessment of fracture risk.

Lifetime depression and age-related changes in body composition, cardiovascular function, grip strength and lung function: sex-specific analyses in the UK Biobank

Individuals with depression, on average, die prematurely, have high levels of physical comorbidities and may experience accelerated biological ageing. A greater understanding of age-related changes in physiology could provide novel biological insights that may help inform strategies to mitigate excess mortality in depression. We used generalised additive models to examine age-related changes in 15 cardiovascular, body composition, grip strength and lung function measures, comparing males and females with a lifetime history of depression to healthy controls. The main dataset included 342,393 adults (mean age = 55.87 years, SD = 8.09; 52.61% females). We found statistically significant case-control differences for most physiological measures. There was some evidence that age-related changes in body composition, cardiovascular function, lung function and heel bone mineral density followed different trajectories in depression. These differences did not uniformly narrow or widen with age and differed by sex. For example, BMI in female cases was 1.1 kg/m2 higher at age 40 and this difference narrowed to 0.4 kg/m2 at age 70. In males, systolic blood pressure was 1 mmHg lower in depression cases at age 45 and this difference widened to 2.5 mmHg at age 65. These findings suggest that targeted screening for physiological function in middle-aged and older adults with depression is warranted to potentially mitigate excess mortality.

Common FSNP variants of fourteen Bardet-Biedl syndrome genes and adult body mass

OBJECTIVE

Bardet-Biedl syndrome (BBS) is a rare monogenic multi-systemic disorder manifesting with marked obesity. Fourteen BBS genes have been identified to date and additional loci are expected. Mutations of several BBS genes were shown to affect fat cell differentiation. The purpose was to Investigate the association between common polymorphisms in all 14 genes as a group and body weight.

DESIGN AND METHODS

We investigated association between tagging single nucleotide polymorphisms (tSNPs) located between 10 kb upstream and downstream from the transcribed sequences of each of 14 BBS genes, and body weight and fat in 2462 adult women from the UK Twins study. Significant results were further tested in a confirmation sample of 2003 women from the same cohort and additionally in the GIANT consortium population (n = 123,865).

RESULTS

105 SNPs in 14 BBS genes were selected and tested in the first cohort of women for association with the body weight and fat related phenotypes, i.e. weight, body mass index (BMI), total body fat (assessed by DEXA), total fat/height(2), and total fat/weight. We used principal component (PC) derived using the latter five traits as a primary phenotype for this study. Of the 105 SNPs, 3 variants in BBS9 and BBS11 showed evidence of nominally significant association with elevated body weight and fat. However, none of the associations survived multiple-testing correction.

CONCLUSIONS

The results suggest that common variation in 14 BBS genes (within or adjacent to the genes) are unlikely to have a substantial effect on body weight and fat in the European population.

Significant association between body composition phenotypes and the osteocalcin genomic region in normative human population

Osteocalcin, a major inorganic component of bone matrix and marker of bone formation, is also involved in regulation of glucose and fat mass metabolism. However, much uncertainty remains about whether the above effect on fat mass has a genetic component. Our main aim was to test whether a variation of body composition phenotypes is associated with BGLAP genomic region variants. To achieve this aim, we used an ethnically homogeneous discovery sample of 230 families consisting of 1112 apparently healthy individuals (561 males and 551 females) of European origin. We conducted association analysis between six SNPs and five obesity-related phenotypes: plasma levels of leptin, anthropometrical fat mass (FM), principal component scores of eight skinfold (SK_PC) and nine circumference (CR_PC) measurements, and body mass index (BMI). Two powerful and robust tools were applied: the pedigree disequilibrium test and variance component models, taking into account both familial and genetic effects. Significant association results were observed for all phenotypes. The most significant results were observed between the haplotype composed of three SNPs (rs2758605-rs1543294-rs2241106) and BMI (p=8.07(-7)), and CR_PC (p=5.29(-5)). The association with BMI was tested and confirmed in our replication study, including 2244 unrelated adult US Caucasians, who were previously assessed for whole genome SNP data. In addition, we obtained an evidence of potential non-additive interactions between the above three SNPs concerning their association with BMI. Bioinformatics sources suggest that the aforementioned interaction could originate from different genetic loci in this region; however, ascertaining the exact circumstances requires a detailed molecular-genetic study.

Depression, fracture risk, and bone loss: a meta-analysis of cohort studies

Whether depression can increase the risk of bone fractures is uncertain. This meta-analysis, which pooled results from 14 qualifying individual cohort studies, found that depression was associated with a significantly increased risk of fractures and bone loss.

INTRODUCTION

The effect of depression on the risk of bone fractures is controversial. We conducted a meta-analysis of prospective studies that examined the risk of osteoporotic fractures and bone loss associated with depression.

METHODS

We searched databases and reviewed citations in relevant articles to identify cohort studies that met prestated inclusion criteria; 14 studies were identified. Information on study design, participant characteristics, exposure and outcome measures, control for potential confounders, and risk estimates was abstracted independently by two investigators using a standardized protocol. Data were pooled by use of a random-effects model.

RESULTS

In studies that reported fracture outcomes as hazard ratios (HRs) (six studies [n = 108,157]), depression was associated with a 17% increase in fracture risk (HR = 1.17; 95% confidence interval [CI], 1.00-1.36; P = 0.05); in studies that reported risk ratios as fracture outcomes (four studies [n = 33,428]), depression was associated with a 52% increase in risk (risk ratio, 1.52; 95% CI, 1.26-1.85; P < 0.001). In studies that reported bone mineral density as an outcome (five studies [n = 8,931]), depression was associated with a reduced annualized bone loss rate of 0.25% (0.05-0.45%; P = 0.02) at the hip and 0.29% (-0.07-0.64%; P = 0.11) at the spine. The HR for the three studies (n = 14,777) that did not adjust for antidepressant treatment was 1.30 (95% CI, 1.11-1.52; P = 0.01), and the HR for the three studies (n = 93,380) that did adjust for antidepressant treatment was 1.05 (95% CI, 0.86-1.29; P = 0.6).

CONCLUSION

Evidence supports an association between depression and increased risk of fracture and bone loss that may be mediated by antidepressants.

Association of ALPL and ENPP1 gene polymorphisms with bone strength related skeletal traits in a Chuvashian population

Mineralization of the extracellular matrix of bone is an essential element of bone development, maintenance and repair. ALPL and ENPP1 genes and their products are known to be central in local regulation of bone mineralization. The present study investigates potential associations of ENPP1 and ALPL polymorphisms with several phenotypes reflecting bone size and hand BMD. The study sample included 310 Caucasian nuclear families. Forty SNPs in ALPL and 14 SNPs in ENPP1 genetic loci as well as pairwise haplotypes were tested for association with bone strength related traits. Our findings suggest that the region corresponding to exons 7 through 9 of the ALPL gene harbors functional polymorphism affecting both bone size at various skeletal sites (p-value ranged from 0.01 to 0.0001) and hand bone mineral density (p-value=0.0007). The other important finding of consistent association between bone size phenotypes and the 3' untranslated region of ENPP1 gene (p-value ranged from 0.01 to 0.001) imply functional significance of this region to bone growth. The considered anthropometric and radiographic bone phenotypes are closely related to bone fragility thus suggesting a role for both genes in osteoporosis. Further research is required to validate the relevancy of the potentially functional regions identified by our and other studies to normal and pathologic bone development as well as to determine the relevancy of the polymorphisms in ALPL and ENPP1 gene loci to clinical practice.

Morphological and biochemical features of obesity are associated with mineralization genes' polymorphisms

BACKGROUND

Ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) was recently extensively studied as a candidate gene for obesity phenotypes. As the human homologue of the mouse progressive ankylosis (ANKH) and alkaline phosphatase (ALPL) are known functional partners of ENPP1 in bone mineralization, we hypothesized that these genes may also be jointly involved in determining obesity features.

AIM

To examine the effects of the three genes, possible gene-sex and gene-gene interactions on variability of four obesity phenotypes: the body mass index (BMI), the waist-hip ratio (WHR), the epidermal growth factor receptor (EGFR), and leptin.

SUBJECTS AND METHODS

In all, 962 healthy individuals from 230 families were genotyped for 45 single nucleotide polymorphisms (SNPs). The association analysis was performed using two family based association tests (family based association test and pedigree disequilibrium test). The combined P-values of the two tests were estimated by Monte-Carlo simulations. Relative magnitude of the genetic and familial effects, gene-sex and gene-gene interactions were assessed using variance component models.

RESULTS

Associations were observed between ENPP1 polymorphisms and BMI (P=0.0037) and leptin (P=0.0068). ALPL markers were associated with WHR (P=0.0026) and EGFR (P=0.0001). The ANKH gene was associated with all four studied obesity-related traits (P<0.0184), and its effects were modulated by sex. Gene-gene interactions were not detected.

CONCLUSION

The observed pattern of association signals indicates that ANKH may have a generalized effect on adipose tissue physiology, whereas ENPP1 and ALPL affect distinct obesity features. The joint analysis of related genes and integration of the results obtained by different methods used in this research should benefit other studies of similar design.

Depression and low bone mineral density: a meta-analysis of epidemiologic studies

SUMMARY

The association between depression and loss of bone mineral density (BMD) has been reported inconsistently. This meta-analysis, which pooled results from 14 qualifying individual studies, found that depression was associated with a significantly decreased BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression.

INTRODUCTION

The reported association between depression and loss of BMD has been controversial. This meta-analysis was conducted to determine whether depression and BMD are associated and to identify the variation in some subgroups.

METHODS

English-language articles published before October 2008 were used as the data source. A total of six case-controlled and eight cross-sectional studies met prestated inclusion criteria (N = 10,523). Information on study design, participant characteristics, measurements of BMD and depression, and control for potential confounders was abstracted independently by two investigators using a standardized protocol.

RESULTS

Overall, depression was associated with a significant decrease in mean BMD of spine (-0.053 g/cm(2) [95% confidence interval {CI} -0.087 to -0.018 g/cm(2)]) and hip (-0.052 g/cm(2) [95% CI -0.083 to -0.022 g/cm(2)]). A substantially greater BMD decrease was observed in depressed women (-0.076 g/cm(2) in spine; -0.059 g/cm(2) in hip) and in cases of clinical depression (-0.074 g/cm(2) in spine; -0.080 g/cm(2) in hip).

CONCLUSION

Depression is associated with low BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.

Epiphyseal expansion in hand bones: association with age, sex, and hand osteoarthritis

OBJECTIVES

Previous studies showed increased femoral, neck, and tibial plateau with age in individuals with and without osteoarthritis (OA) at adjacent joints. However, the question whether epiphyseal bone enlargement is a natural phenomenon of aging or associated with OA remains open. The aim of the present study was to evaluate age- and sex-related changes in the relative size of epiphyses of long hand bones and their association with radiographic OA.

DESIGN

The data were collected from a population-based European sample in 1994 (557 individuals) and in 2002 (513 individuals). The latter sample included 253 individuals who were previously investigated in 1994. The epiphyseal index (EI), reflecting the relative size of bone epiphyses and hand OA, was evaluated from hand radiographs. Statistical analyses included multiple regression analyses and a maximum likelihood-based model-fitting technique.

RESULTS

Hand bone epiphyses increased with age and with OA. In males, the EI gradually increased during their entire life span. In females, the EI remained almost unchanged up to the age of 40, after which, it increased more rapidly than in males. Individuals with OA had higher values of EI at any age. In both sexes, epiphyseal enlargement is a predisposing factor for hand OA progression in adjacent joints. This was clearly seen in males, where old individuals with high EI values had much higher OA scores in comparison with age-matched individuals.

CONCLUSIONS

Enlargement of long bone epiphyses with age appears to be a general tendency in the human skeleton. Our study shows that the enlargement of epiphyses may also be related to OA.