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Strässle M, Grossmann J, Eppenberger P, Faas A, Jerkovic I, Floris J, Öhrström L, Akgül G, Aldakak L, Rühli F, Bender N, Staub K. Short-termed changes in quantitative ultrasound estimated bone density among young men in an 18-weeks follow-up during their basic training for the Swiss Armed Forces. PeerJ 2023; 11:e15205. [PMID: 37041974 PMCID: PMC10083003 DOI: 10.7717/peerj.15205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/19/2023] [Indexed: 04/13/2023] Open
Abstract
Background Quantitative Ultrasound (QUS) methods have been widely used to assess estimated bone density. This study aimed to assess changes in estimated bone density in association with changes in body composition, physical activity, and anthropometry. Methods We examined changes in anthropometry, body composition, and physical activity associated with changes in estimated bone mineral density (measured using quantitative ultrasound with a heel ultrasound device indicating broadband ultrasound attenuation BUA and speed of sound SOS) in a follow-up sample of n = 73 young men at the beginning and again 18 weeks later at the end of basic military training. Results At the end of the basic training, the subjects were on average significantly heavier (+1.0%), slightly taller (+0.5%) and had a higher fat mass (+6.6%) and grip strength (+8.6%). A significant decrease in mean physical activity (-49.5%) and mean estimated bone density calculated with BUA (-7.5%) was observed in the paired t-test. The results of the multivariable linear regressions (backward selection) show that changes in skeletal muscle mass (delta = 2nd measurement minus 1st measurement) have negative and body weight (delta) have positive association with the speed of sound SOS (delta), while fat mass (delta) and physical activity (delta) had the strongest negative associations with estimated bone mineral density (delta). In particular, we found a negative association between fat mass (delta) and estimated bone mineral density (delta, estimated with BUA). Conclusion Our study suggests that estimated bone density from the calcaneus can change within a few months even in young and mostly healthy individuals, depending upon physical activity levels and other co-factors. Further studies including other troop types as control groups as well as on women should follow in order to investigate this public health relevant topic in more depth. To what extent the estimated bone density measurement with quantitative ultrasound is clinically relevant needs to be investigated in further studies.
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Affiliation(s)
- Michael Strässle
- Kantonsspital St. Gallen, St. Gallen, Switzerland
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Medical Faculty, University of Zürich, Zurich, Switzerland
| | - Jonas Grossmann
- Functional Genomics Center Zurich, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Patrick Eppenberger
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | | | | | - Joël Floris
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Lena Öhrström
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Gülfirde Akgül
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Lafi Aldakak
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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Roberts JA, Shen Y, Strehlau R, Patel F, Kuhn L, Coovadia A, Kaufman JJ, Shiau S, Arpadi SM, Yin MT. Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV. PLoS One 2022; 17:e0276290. [PMID: 36251674 PMCID: PMC9576091 DOI: 10.1371/journal.pone.0276290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Children living with HIV (CLHIV) have decreased bone mineral content (BMC) and density (BMD), increasing risk for fracture and future osteoporosis. While DXA is the gold-standard for bone assessments, it lacks availability in resource-constrained settings (RCS). Quantitative ultrasound (QUS) offers an alternative owing to its portability, low cost, ease of handling, and lack of ionizing radiation. While QUS has detected reduced bone quality in CLHIV, the relationship between QUS and DXA in this population remains unexplored. At baseline and 12 months, BMC and BMD of the whole body, lumbar spine, and radius were measured by DXA in a longitudinal cohort of CLHIV in Johannesburg, South Africa. Calcaneal speed of sound (SOS) and broadband ultrasound attenuation (BUA) and radius SOS were obtained by QUS, and calcaneal stiffness index (SI) was calculated. Spearman correlations, with and without HIV stratification, were performed between QUS and DXA measurements at each visit and for absolute difference in measurements between visits. At baseline and 12-months, calcaneal BUA and SI displayed strong positive correlations with DXA, with only modest correlations between radial QUS and DXA at baseline. Longitudinal measures of QUS did not correlate with DXA. At both baseline and 12-months, individuals with DXA whole-body BMD z-score < -1 displayed significantly lower calcaneal BUA and SI. Cross-sectionally, calcaneal QUS correlates strongly with whole body DXA and may represent a viable diagnostic alternative in RCS. Longitudinally, the two methods do not correlate well, possibly reflecting that each method assesses distinct aspects of bone architecture.
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Affiliation(s)
- Jackson A. Roberts
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America
| | - Yanhan Shen
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Renate Strehlau
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Ashraf Coovadia
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonathan J. Kaufman
- Cyberlogic, Inc., New York, New York, United States of America
- Department of Orthopedics, The Mount Sinai Medical Center, New York, New York, United States of America
| | - Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Stephen M. Arpadi
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Michael T. Yin
- Division of Infectious Disease, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
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Chang CY, Arasu K, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM, Chee WSS. Factors associated with bone health status of Malaysian pre-adolescent children in the PREBONE-Kids Study. BMC Pediatr 2021; 21:382. [PMID: 34479539 PMCID: PMC8414720 DOI: 10.1186/s12887-021-02842-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent (N = 243) Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ physical activity questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results The mean calcium intake was 349 ± 180 mg/day and mean serum 25(OH)D level was 43.9 ± 14.5 nmol/L. In boys, lean mass (LM) was a significant predictor of LSBMC (β = 0.539, p < 0.001), LSBMD (β = 0.607, p < 0.001), TBBMC (β = 0.675, p < 0.001) and TBBMD (β = 0.481, p < 0.01). Height was a significant predictor of LSBMC (β = 0.346, p < 0.001) and TBBMC (β = 0.282, p < 0.001) while fat mass (FM) (β = 0.261, p = 0.034) and physical activity measured as MET scores (β = 0.163, p = 0.026) were significant predictors of TBBMD in boys. Among girls, LM was also a significant predictor of LSBMC (β = 0.620, p < 0.001), LSBMD (β = 0.700, p < 0.001), TBBMC (β = 0.542, p < 0.001) and TBBMD (β = 0.747, p < 0.001). Calcium intake was a significant predictor of LSBMC (β = 0.102, p = 0.034), TBBMC (β = 0.122, p < 0.001) and TBBMD (β = 0.196, p = 0.002) in girls. Conclusions LM was the major determinant of BMC and BMD among pre-adolescent Malaysian children alongside other modifiable lifestyle factors such as physical activity and calcium intake.
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Affiliation(s)
- Chung Yuan Chang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Kanimolli Arasu
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Soon Yee Wong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Shu Hwa Ong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Wai Yew Yang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Megan Hueh Zan Chong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Negeri Sembilan, 70300, Seremban, Malaysia
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Negeri Sembilan, 70300, Seremban, Malaysia
| | - Karuthan Chinna
- Faculty of Health & Medical Sciences, School of Medicine, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
| | | | - Winnie Siew Swee Chee
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Shalof H, Dimitri P, Shuweihdi F, Offiah AC. "Which skeletal imaging modality is best for assessing bone health in children and young adults compared to DXA? A systematic review and meta-analysis". Bone 2021; 150:116013. [PMID: 34029779 DOI: 10.1016/j.bone.2021.116013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skeletal imaging techniques have become clinically valuable methods for measuring and assessing bone mineral density in children and young people. Dual-energy X-ray absorptiometry (DXA) is the current reference standard for evaluating bone density, as recommended by the International Society for Clinical Densitometry (ISCD). Various bone imaging modalities, such as quantitative ultrasound (QUS), peripheral quantitative computed tomography (pQCT), high-resolution peripheral quantitative computed tomography (HR-pQCT), magnetic resonance imaging (MRI), and digital X-ray radiogrammetry (DXR) have been developed to further quantify bone health in children and adults. The purpose of this review, with meta-analysis, was to systematically research the literature to compare the various imaging methods and identify the best modality for assessing bone status in healthy papulations and children and young people with chronic disease (up to 18 years). METHODS A systematic computerized search of Medline, PubMed, and Web of Science databases was conducted to identify English-only studies published between 1st January 1990 and 1st December 2019. In this review, clinical studies comparing imaging modalities with DXA were chosen according to the inclusion criteria. The risk of bias and quality of articles was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The meta-analysis to estimate the overall correlation was performed using a Fisher Z transformation of the correlation coefficient. Additionally, the diagnostic accuracy measures of different imaging methods compared with DXA were calculated. RESULTS The initial search strategy identified 13,412 papers, 29 of which matched the inclusion and exclusion criteria. Of these, twenty-two papers were included in the meta-analysis. DXA was compared to QUS in 17 papers, to DXR in 7 and to pQCT in 4 papers. A single paper compared DXA, DXR, and pQCT. The meta-analysis demonstrated that the strongest correlation was between DXR and DXA, with a coefficient of 0.71 [95%CI: 0.43; 1.00, p-value < 0.001], while the correlation coefficients between QUS and DXA, and pQCT and DXA were 0.57 [95%CI: 0.25; 0.90, p-value < 0.001] and 0.57 [95%CI: 0.46; 0.67, p-value < 0.001], respectively. The overall sensitivity and specificity were statistically significant 0.71 and 0.80, respectively. CONCLUSION No current imaging modality provides a full evaluation of bone health in children and young adults, with each method having some limitations. Compared to QUS and pQCT, DXR achieved the strongest positive relationship with DXA. DXR should be further evaluated as a reliable method for assessing bone health and as a predictor of fractures in children and young people.
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Affiliation(s)
- Heba Shalof
- Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Damer Street Building, Western Bank, Sheffield S10 2TH, United Kingdom; Faculty of Medicine, Omar Al-Mukhtar University, Bayda, Libya.
| | - Paul Dimitri
- Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Damer Street Building, Western Bank, Sheffield S10 2TH, United Kingdom; Department of Pediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, United Kingdom
| | - Farag Shuweihdi
- Leeds Institute of Health Sciences, School of medicine, University of Leeds, Leeds, United Kingdom
| | - Amaka C Offiah
- Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Damer Street Building, Western Bank, Sheffield S10 2TH, United Kingdom; Radiology Department, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, United Kingdom
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Koo HC, Lim GP, Kaur S, Chan KQ, Chan KE, Chung C, Wong M, Danaselvam U. Bone Health and Its Positive Relationships with Body Composition in Malaysian Schoolchildren: Findings from a Cross-Sectional Study. CHILDREN-BASEL 2021; 8:children8070569. [PMID: 34356548 PMCID: PMC8303397 DOI: 10.3390/children8070569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/14/2021] [Accepted: 06/30/2021] [Indexed: 01/02/2023]
Abstract
Background: Optimal bone health is vital in children to prevent osteoporosis later in life, and body composition plays a crucial role in it. However, the literature reports contradictory results when considering the relationship between body composition and bone health in children. This study aimed to examine the bone health and its relationship with body composition in Malaysian schoolchildren. Methods: In this cross sectional study, body composition data (weight, height, body fat percentage [% fat], fat mass, fat free mass, visceral fat, waist circumference [WC] and body mass index-for-age [BMI z-score]) and bone health data (Z-score and broadband ultrasound attenuation [BUA]) were collected from 415 schoolchildren aged 9–12 years, cluster sampled from randomly selected primary schools in Kuala Lumpur, Malaysia. Results: Girls generally had significantly higher height, body fat percentage, fat mass, visceral fat and Z-score as compared to boys. A steady increase of the mean BUA value was observed with increasing age in both sexes. The mean BUA value of the present study across the population was significantly higher than that of schoolchildren from Nigeria (p < 0.001), Colombia (p < 0.001) and Spain (p = 0.002). Significant positive correlations were found between all the body composition variables and bone outcome variables across the population. Further, BUA was significantly correlated with weight (β = 0.172; p = 0.001), height (β = 0.299; p < 0.001), % fat (β = 0.131; p = 0.007), fat mass (β = 0.130; p = 0.007), fat free mass (β = 0.209; p < 0.001), visceral fat (β = 0.127, p = 0.008), WC (β = 0.165; p = 0.001) and BMI z-score (β = 0.162; p = 0.001), after controlling for sex, age and ethnicity. Similarly, after confounders adjusted, Z-score was significantly predicted by weight (β = 0.160; p = 0.001), height (β = 0.310; p < 0.001), % fat (β = 0.104; p = 0.032), fat mass (β = 0.107; p = 0.026), fat free mass (β = 0.218; p < 0.001), visceral fat (β = 0.107, p = 0.026), WC (β = 0.145; p = 0.002) and BMI z-score (β = 0.150; p = 0.002). Conclusions: Our findings have revealed that body composition variables were positive correlated with bone outcome variables, suggesting that adipose tissue acts to stimulate bone growth. Further clinical and molecular studies in the future is recommended to fully illustrate the complex interactions between adiposity and bone health.
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Affiliation(s)
- Hui Chin Koo
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
- Correspondence:
| | - Geok Pei Lim
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur 56000, Malaysia;
| | - Kai Quin Chan
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Keh En Chan
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Casey Chung
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Michelle Wong
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Ugunesh Danaselvam
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
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Kang YE, Kang YM, Park B, Shong M, Yi HS. Type 2 deiodinase Thr92Ala polymorphism is associated with a reduction in bone mineral density: A community-based korean genome and epidemiology study. Clin Endocrinol (Oxf) 2020; 93:238-247. [PMID: 32324283 DOI: 10.1111/cen.14206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/09/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Type 2 deiodinase (DIO2)-mediated thyroid hormone synthesis stimulates osteoblast activity and increases the expression of osteoblast differentiation markers, but there are no large cohort studies to identify the role of the DIO2 polymorphism in bone mineral density in humans. METHODS To investigate the hypothesis that individuals with the DIO2 gene polymorphism are susceptible to osteoporosis, we assessed the polymorphism of the DIO2 gene in 7,524 Koreans drawn from the large-scale Ansan-Anseong cohort of the Korean Genome and Epidemiology Study. All of the participants underwent genotyping of the DIO2 Thr92Ala polymorphism (rs225014). RESULTS A total of 6,022 participants were recruited; 1991 (33.0%) were homozygous for the Thr allele, 2,967 (49.3%) were heterozygous (Thr/Ala), and 1064 (17.7%) were homozygous for the Ala allele. The effects of the DIO2 Thr92Ala polymorphism on axial speed of sound (SOS) and the T-score in the tibia and radius were assessed, with age, gender, oestrogen status, body mass index (BMI), serum calcium, 25-hydroxyvitamin D, and parathyroid hormone (PTH) included as covariables. Female subjects carrying the DIO2 Thr92Ala polymorphism had significantly lower SOS and T-scores than control participants. Cox regression analysis revealed a significant relationship between the DIO2 polymorphism and diagnosis of osteoporosis in female participants. CONCLUSION DIO2 Thr92Ala polymorphism is associated with decreased SOS and T-scores in the tibia of female subjects independent of other clinical parameters, where this indicates a potential functional role of DIO2 in the maintenance of bone mineral density.
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Affiliation(s)
- Yea Eun Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young Mi Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
| | - Boyoung Park
- Department of Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Minho Shong
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyon-Seung Yi
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
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Delshad M, Beck KL, Conlon CA, Mugridge O, Kruger MC, von Hurst PR. Validity of quantitative ultrasound and bioelectrical impedance analysis for measuring bone density and body composition in children. Eur J Clin Nutr 2020; 75:66-72. [PMID: 32814858 DOI: 10.1038/s41430-020-00711-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/21/2020] [Accepted: 08/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Using dual X-ray absorptiometry (DXA) to assess body composition in children has limitations including expense, lack of portability, and exposure to radiation. The aims of this study were to examine: (1) validity of quantitative ultrasound (QUS) against DXA for measuring bone density and (2) the validity of in-built algorithm of bioelectrical impedance analysis (BIA) for measuring body composition in children (8-13 years) living in New Zealand. SUBJECTS/METHODS Total body less head (TBLH), bone mineral content (BMC), bone mineral density (BMD), and body composition were measured with DXA (QDR Discovery A, Hologic, USA); calcaneal BMD and stiffness index (SI) with QUS (Sahara QUS, Hologic, USA), and BIA on the InBody 230 (Biospace Ltd., Seoul, Korea). Relative validity was assessed using Pearson's and Lin's concordance correlation coefficients (CCC), and Bland-Altman plots. RESULTS In 124 healthy children, positive correlations between QUS SI and DXA (BMC and BMD) were observed (range = 0.30-0.45, P < 0.01). Results from Lin's CCC test showed almost perfect correlations between BIA and DXA fat free mass (0.96), fat mass (0.92), and substantial correlation for percentage of fat mass (0.75) (P < 0.05). CONCLUSION Although BIA results were not as accurate as DXA and DXA remains the gold standard method for clinical assessment, BIA can be an alternative method for investigating body composition among children in large cohort field studies. Calcaneal QUS and DXA are not interchangeable methods for measuring bone density in children similar to our study population.
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Affiliation(s)
- Maryam Delshad
- College of Health, Massey University, Auckland, New Zealand
| | - Kathryn L Beck
- College of Health, Massey University, Auckland, New Zealand
| | | | - Owen Mugridge
- College of Health, Massey University, Auckland, New Zealand
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Liu J, Lan L, Zhou J, Yang Y. Influence of cancellous bone microstructure on ultrasonic attenuation: a theoretical prediction. Biomed Eng Online 2019; 18:103. [PMID: 31653267 PMCID: PMC6815062 DOI: 10.1186/s12938-019-0724-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023] Open
Abstract
Background Quantitative ultrasound has been used for the assessment of cancellous bone status. The attenuation mechanisms of cancellous bone, however, have not been well understood, because the microstructure of cancellous bone is significantly inhomogeneous and the interaction between ultrasound and the microstructure of cancellous bone is complex. In this study, a theoretical approach was applied to investigate the influence of the microstructure of cancellous bone on ultrasonic attenuation. Results The scattering from a trabecular cylinder was significantly angle dependent. The dependencies of the ultrasonic attenuation on frequency, scatterer size, and porosity were explored from the theoretical calculation. Prediction results showed that the ultrasonic attenuation increased with the increase of frequency and decreased linearly with the increase in porosity, and the broadband ultrasound attenuation decreased with the increase in porosity. All these predicted trends were consistent with published experimental data. In addition, our model successfully explained the principle of broadband ultrasound attenuation measurement (i.e., the attenuation over the frequency range 0.3–0.65 MHz was approximately linearly proportional to frequency) by considering the contributions of scattering and absorption to attenuation. Conclusion The proposed theoretical model may be a potentially valuable tool for understanding the interaction of ultrasound with cancellous bone.
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Affiliation(s)
- Jinjin Liu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Ouhai Qu, Wenzhou, 325000, Zhejiang, China
| | - Li Lan
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiafeng Zhou
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Ouhai Qu, Wenzhou, 325000, Zhejiang, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Ouhai Qu, Wenzhou, 325000, Zhejiang, China.
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Kanta P, Gopinathan NR. Idiopathic Growing Pains in Pediatric Patients: Review of Literature. Clin Pediatr (Phila) 2019; 58:5-9. [PMID: 29962219 DOI: 10.1177/0009922818784956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Poonam Kanta
- 1 Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Safety of Tenofovir Disoproxil Fumarate-Based Antiretroviral Therapy Regimens in Pregnancy for HIV-Infected Women and Their Infants: A Systematic Review and Meta-Analysis. J Acquir Immune Defic Syndr 2017; 76:1-12. [PMID: 28291053 PMCID: PMC5553236 DOI: 10.1097/qai.0000000000001359] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Supplemental Digital Content is Available in the Text. Background: There are limited data on adverse effects of tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART) on pregnant women and their infants. Methods: We conducted a systematic review of studies published between January 1980 and January 2017 that compared adverse outcomes in HIV-infected women receiving TDF- vs. non–TDF-based ART during pregnancy. The risk ratio (RR) for associations was pooled using a fixed-effects model. Results: Seventeen studies met the study inclusion criteria. We found that the rate of preterm (<37 weeks gestation) delivery (RR = 0.90, 95% confidence interval [CI]: 0.81 to 0.99, I2 = 59%) and stillbirth (RR = 0.60, 95% CI: 0.43 to 0.84, I2 = 72.0%) were significantly lower in women exposed (vs. not) to TDF-based ART regimen. We found no increased risk in maternal severe (grade 3) or potentially life-threatening (grade 4) adverse events (RR = 0.62; 95% CI: 0.30 to 1.29), miscarriage (RR = 1.09; 95% CI: 0.80 to 1.48), very preterm (<34 weeks gestation) delivery (RR = 1.08, 95% CI: 0.72 to 1.62), small for gestational age (RR = 0.87, 95% CI: 0.67 to 1.13), low birth weight (RR = 0.91; 95% CI: 0.80 to 1.04), very low birth weight (RR = 3.18; 95% CI: 0.65 to 15.63), congenital anomalies (RR = 1.03; 95% CI: 0.83 to 1.28), infant adverse outcomes or infant mortality (age >14 days) (RR = 0.65; 95% CI: 0.23 to 1.85), but increased neonatal mortality (age <14 days) risk (RR = 5.64, 95% CI: 1.70 to 18.79) with TDR-based ART exposure. No differences were found for anthropomorphic parameters at birth; one study reported minor differences in z-scores for length and head circumference at age 1 year. Conclusions: TDF-based ART in pregnancy seems generally safe for women and their infants. However, data remain limited and further studies are needed, particularly to assess neonatal mortality and infant growth/bone effects.
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