Bone mineral density and body composition in normal weight, overweight and obese children

Enhancing Akkermansia growth via phytohormones: a strategy to modulate the gut-bone axis in postmenopausal osteoporosis therapy

BACKGROUND

Phytohormones have garnered considerable interest as potential modulators of the gut-bone axis. Denosumab (Deno), a widely utilized therapeutic agent for postmenopausal osteoporosis, has not been previously investigated for its effects on gut health. The objective of this study was to assess the efficacy of isoflavones (SI), naringin (Nar), and Deno in the management of postmenopausal osteoporosis by targeting the gut-bone axis.

METHODS

The postmenopausal osteoporosis model in mice was established via bilateral oophorectomy. Subsequently, mice in the Deno group received subcutaneous injections of Deno at a dosage of 10 mg/kg, administered twice weekly. In contrast, mice in the SI and Nar groups were subjected to oral gavage with 200 mg/kg/day of SI and Nar, respectively. The treatment period for all groups lasted for 8 weeks. Upon the conclusion of the experiment, a thorough evaluation of the effects of SI, Nar, and Deno on bone and gut health in mice was conducted through immunological, pathological, imaging, and multi-omics methodologies.

RESULTS

Deno, SI, and Nar significantly alleviated the physical symptoms in postmenopausal mice. However, only SI and Nar significantly modulated the gut microbiota. Akkermansia was significantly enriched after the gavage of SI and Nar. Akkermansia has the capacity to not only augment bone mass and alleviate strength deterioration via extracellular vesicles, but it also influences bone metabolism by diminishing inflammation and modulating lipid metabolism. Notably, no significant changes in the gut microbiota were observed in the Deno group, which may be attributed to the differences in the method of administration, as Deno was administered via subcutaneous injection rather than gavage.

CONCLUSION

SI and Nar may influence the gut-bone axis through Akkermansia and have the potential of alternative treatment options for postmenopausal osteoporosis. Although the gut microbiota is not significantly affected by the subcutaneous administration of Deno, the long-term management of postmenopausal osteoporosis and the exploration of various management models warrant additional scrutiny. Furthermore, this study has yet to establish a dose-response relationship, indicating that further research is essential to clarify the regulatory effects of varying doses of SI and Nar on postmenopausal osteoporosis especially the modulation of gut microbiota.

Association between handgrip strength and muscle mass in children 6 to 10 years old

BACKGROUND AND AIMS

Sarcopenia, defined as a muscle mass loss and function, is increasingly recognized in pediatric populations, particularly in childhood obesity. Therefore, it is necessary to have measurements that can distinguish between muscle and fat mass. Methods of body composition such as Dual Energy X-ray Absorptiometry (DEXA) provide accurate assessments of body composition, but they are resource-intensive and impractical for routine monitoring in clinical or community settings. To address this, handgrip strength (HGS) may be used for assessing muscle mass. This study investigates the association between muscle mass and HGS in children aged 6-10 years.

METHODS

A cross-sectional study of 110 participants was conducted with children aged 6-10 years who could follow instructions in English, lay still for 6-7 min, and had not entered puberty. Children with disabilities that affected muscle mass or hand strength were excluded. Height, weight, mid-upper arm circumference, lean body mass (LBM), fat mass (FM), fat-free mass (FFM), and bone mineral density (BMD) were measured. Pearson correlations between all body composition measurements and HGS were conducted. The best predictors of muscle mass were determined using stepwise analysis.

RESULTS

A significant correlation between HGS and fat-free mass index (FFMI) (R = 0.39) (p < 0.001) among children aged 6-10 years and lean body mass index (LBMI) (R = 0.42) (p = 0.005) in children aged 8-10 years old was found. HGS with BMI (p < 0.0001) were the best predictors of FFMI and LBMI.

CONCLUSION

HGS was associated with muscle mass and may provide insight on body composition changes in children. Integrating HGS with BMI into routine clinical practice could enhance comprehensive evaluation of body composition.

The role of trunk region body composition in lumbar spine bone mineral content and density

BACKGROUND

The aim of this study was to investigate the differential effects of trunk region body composition-specifically fat mass (FM) and lean mass (LM)-on lumbar spine bone mineral density (BMD) and bone mineral content (BMC), with a focus on variations by gender and menopausal status.

MATERIALS AND METHODS

We identified 331 adult patients (69 men, 161 premenopausal women, and 101 postmenopausal women) who underwent dual-energy X-ray absorptiometry (DXA) to simultaneously measure trunk body composition and lumbar spine BMD (L2-L4). The Pearson correlation coefficient was used to assess the linear relationships between body composition components and lumbar spine BMD and BMC, stratified by gender and menopausal status. Additionally, multiple linear regression analysis with the forward stepwise elimination procedure was applied to find a reasonable subset of predictor variables.

RESULT

The highest correlation coefficients between body composition and BMD were seen for men and post- and premenopausal individuals in the following areas: pelvic fat mass (r = 0.325; P < 0.01), chest lean mass (r = 0.260; P < 0.01), and total lean mass (r = 0.312; P < 0.01), respectively. Additionally, total lean mass (r = 0.477; P < 0.01), chest lean mass (r = 0.360; P < 0.01), and total lean mass (r = 0.459; P < 0.01) had the strongest correlation coefficients between body composition and BMC. Forward stepwise regression identified age, chest lean mass, and midriff fat mass as predictors of BMC in postmenopausal women; BMI and total lean mass in premenopausal women; and total lean mass in men. For BMD, chest lean mass (postmenopausal), total lean mass (premenopausal), and BMI (men) were significant predictors.

CONCLUSIONS

Fat mass does not affect BMD or BMC, while lean mass, strongly predicts bone health. Trunk body composition showed varying relationships with BMD and BMC, making it challenging to pinpoint how lean mass distribution in the chest and midriff specifically impacts bone health.

Effect of nutritional status on dental maturation and mandibular bone density among Indonesian children aged 6-9 Years in Yogyakarta

Introduction

Growth and development in children depend significantly on their nutritional status; therefore, nutritional deficiencies can greatly influence dental and bone maturity. The level of dental maturation can be used to measure dental development. Mandibular bone density (MBD) can directly impact certain invasive procedures, such as extractions and dental trauma management. This study aimed to determine the influence of nutritional status on dental maturation and MBD in children aged 6-9 years.

Materials and methods

The study used 108 panoramic radiographs from children in this age and divided them into three groups: low, moderate, and high nutritional status. The nutritional status was determined on the basis of height-for-age (H/A) z-scores using the WHO H/A chart. The dental maturity score was calculated as the total score of the seven mandibular teeth in the left region using the Nolla method. Using fractal analysis, MBD was measured as the average fractal dimension values from three regions of interest (ROI): the condyle, angle, and below the second premolar and first permanent molar of the left mandible. Data were analyzed using one-way ANOVA for dental maturation levels and the Kruskal-Wallis test for MBD (95 % CI).

Results

The results showed significant differences in dental maturation levels between the nutritional status groups, with dental maturation in the low-nutrition group being significantly slower than in the other groups. The MBD showed no significant differences between the nutritional status groups.

Conclusion

This study concluded that nutritional status influences the level of dental maturation, but not MBD.

Sex-specific effects of a Mediterranean diet on lower limb bone strength in Polish children

Lifestyle factors have the potential to influence bone health in various ways, whether positively or negatively. As osteoporosis is believed to originate in early years, it is therefore essential to indicate factors that may positively affect bone health during childhood. The aim of our study was to investigate the effects of early and current diet, vitamin D supplementation, and BMI z-score on bone properties in a group of children aged 3-7 years. A cross-sectional sample of 205 preschoolers and their parents participated in the study. Dietary assessment was made using a modified version of the Polish-adapted Mediterranean Diet score (MVP-aMED) on the basis of the data from food frequency questionnaire (FFQ), filled out by the parents. Quantitative ultrasound (QUS) was used in the assessment of bone properties. In the sex-stratified analysis, significant associations were observed between MVP-aMED score (β = 0.193, 95 % CI: 0.005, 0.237; p = 0.04), BMI z-score (β = -0.318, 95 % CI: -1.455, -0.039; p = 0.04) and QUS z-score, exclusively among girls. After adjustment, only the relationship with diet remained significant (β = 0.209, 95 % CI: 0.007, 0.255; p = 0.04), suggesting that a higher adherence to the Mediterranean Diet may be associated with better bone properties in girls aged 3-7 years old. Our results emphasize the importance of fostering healthy dietary habits and maintaining proper weight in children in order to promote optimal bone development.

Behavioral Counseling for Weight Management by Pediatric Nurse Practitioners: A Quantitative Cross-Sectional Study

INTRODUCTION

This study assessed counseling by pediatric nurse practitioners (PNPs) for management of overweight and obesity.

METHOD

Using a cross-sectional design, 1,058 PNPs completed a one-time survey regarding counseling for healthy body weight, physical activity, and consumption of protein, fruits and vegetables.

RESULTS

Study findings suggest PNPs are using behavioral counseling for weight management in pediatric patients. Counseling was more frequent for healthy body weight, fruit and vegetable intake, and physical activity than for protein consumption and muscle strengthening. Furthermore, when PNPs counseled for healthy body weight they were also more likely to counsel for physical activity (OR = 25.99 [95% CI: 19.25, 35.11]), fruit and vegetable intake (OR = 22.35 [95% CI: 16.71, 29.88]), protein intake (OR = 9.82 [95% CI: 7.60, 12.69]), and muscle strengthening (OR = 6.41 [95% CI: 4.98, 8.24]).

DISCUSSION

PNPs are counseling for healthy body weight and necessary behavioral tools, but increased emphasis on muscle strengthening may benefit overweight and obese youth.

Selenoprotein-p and insulin resistance in children and adolescents with obesity

BACKGROUND

Insulin resistance and obesity present significant challenges in pediatric populations. Selenoprotein P1 (SEPP1) serves as a biomarker for assessing selenium levels in the body. While its association with metabolic syndrome is established in adults, its relevance in children remains underexplored.

AIM

To ascertain SEPP1 blood levels in children and adolescents diagnosed with obesity and to assess its correlation with insulin resistance and adiposity indices.

METHODS

170 children participated in this study, including 85 diagnosed with obesity and an equal number of healthy counterparts matched for age and sex. Each participant underwent a comprehensive medical evaluation, encompassing a detailed medical history, clinical examination, and anthropometric measurements like waist circumference and waist-to-height ratio. Furthermore, routine blood tests were conducted, including serum SEPP1, visceral adiposity index (VAI), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) level.

RESULTS

Our findings revealed significantly lower serum SEPP1 levels in children with obesity compared to their healthy peers. Moreover, notable negative correlations were observed between serum SEPP1 levels and body mass index, VAI, and HOMA-IR.

CONCLUSION

The study suggests that SEPP1 could serve as a valuable predictor for insulin resistance among children and adolescents diagnosed with obesity. This highlights the potential utility of SEPP1 in pediatric metabolic health assessment and warrants further investigation.

Longitudinal associations of an exposome score with serum metabolites from childhood to adolescence

Environmental and lifestyle factors, including air pollution, impaired diet, and low physical activity, have been associated with cardiometabolic risk factors in childhood and adolescence. However, environmental and lifestyle exposures do not exert their physiological effects in isolation. This study investigated associations between an exposome score to measure the impact of multiple exposures, including diet, physical activity, sleep duration, air pollution, and socioeconomic status, and serum metabolites measured using LC-MS and NMR, compared to the individual components of the score. A general population of 504 children aged 6-9 years at baseline was followed up for eight years. Data were analysed with linear mixed-effects models using the R software. The exposome score was associated with 31 metabolites, of which 12 metabolites were not associated with any individual exposure category. These findings highlight the value of a composite score to predict metabolic changes associated with multiple environmental and lifestyle exposures since childhood.

Occurrence of Body Posture Abnormalities in Overweight and Obese Children Aged 5-6 Years-Pilot Study

OBJECTIVES

The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight.

METHODS

In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture.

RESULTS

A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups.

CONCLUSIONS

There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5-6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity.

Correlation of body composition metrics with bone mineral density and computed tomography-based trabecular attenuation

PURPOSE

To investigate the relationship of body composition metrics with bone mineral density (BMD) and trabecular attenuation in a cohort of healthy individuals.

METHODS

We retrospectively analyzed data of consecutively evaluated individuals who underwent dual-energy X-ray absorptiometry (DXA) and abdominopelvic computed tomography (CT) on the same day during routine medical check-ups between January 2021 and December 2021. Trabecular attenuation was measured at L1 level, while body composition metrics, including skeletal muscle index (SMI), skeletal muscle attenuation (SMA), visceral fat index (VFI), and subcutaneous fat index (SFI), were measured at L3 level. The association of body composition metrics with BMD and trabecular attenuation was analyzed using partial correlation analysis.

RESULTS

A total of 634 patients (median age, 56 years; range 50-62 years; 392 men) were included. In men, the SMI and SMA were positively correlated with BMD and trabecular attenuation, both before (r, 0.157-0.344; p < 0.05) and after (r, 0.103-0.246; p < 0.05) adjusting for age and body mass index. The VFI showed negative correlations with trabecular attenuation in both men (r, -0.170; p = 0.001) and women (r, -0.394; p < 0.001), which remained significant after adjusting for age and body mass index (r, -0.181 to -0.122; p < 0.05).

CONCLUSION

Low skeletal muscle mass and attenuation were significantly correlated with low BMD and trabecular attenuation in men. Visceral adiposity was associated with reduced BMD and trabecular attenuation in both men and women, demonstrating a stronger correlation with trabecular attenuation.

Association between urinary glyphosate exposure and bone mineral density in adults

There is very limited evidence linking glyphosate exposure to bone mineral density in adults aged 20 to 59 years in the National Health and Nutrition Examination Survey database. Hence, this study aimed to investigate the correlation between urinary glyphosate concentrations and total bone mineral density (BMD) in adults aged 20 to 59 years. A cross-sectional study was conducted using data from the 2013 to 2016 National Health and Nutrition Examination Survey, which included 594 men (mean age 39.1 years) and 610 women (mean age 40.0 years). In our study, we utilized a weighted multiple regression equation model to investigate the potential correlation between urinary glyphosate concentration and total BMD. Additionally, we conducted a stratified analysis to differentiate between various special populations. Our findings revealed a significant negative association between urinary glyphosate concentration and total BMD across 3 different regression models (Model 1, β [95% CI]: -0.0160 [-0.0200, -0.0120]; Model 2, β [95% CI]: -0.0135 [-0.0172, -0.0098]; Model 3, β [95% CI]: -0.0141 [-0.0178, -0.0104]). However, after stratifying by gender, age, and race, we observed varying conclusions. This study found that urinary glyphosate concentration was negatively associated with total BMD in both men and women when stratified by sex. Additionally, when stratified by age, the negative association was more significant in the 20 to 29 and 50 to 59 year age groups. When stratified by race, a significant negative association was found in races other than Hispanic. Therefore, the impact of glyphosate exposure on BMD should attract more people's attention.

Association of TNF-α, IGF-1, and IGFBP-1 levels with the severity of osteopenia in mice with nonalcoholic fatty liver disease

BACKGROUNDS

Nonalcoholic fatty liver disease (NAFLD) exhibits a close association with osteoporosis. This work aims to assess the potential effects of NAFLD on the progression of osteopenia in animal models.

METHODS

Forty-eight C57BL/6 female mice were randomly divided to wild-type (WT) group and high-fat diet (HFD) group. The corresponding detections were performed after sacrifice at 16, 24 and 32 weeks, respectively.

RESULTS

At 16 weeks, an remarkable increase in body weight and lipid aggregation in the hepatocytes of HFD group was observed compared to the WT group, while the bone structure parameters showed no significant difference. At 24 weeks, the levels of TNF-α and IL-6 in NAFLD mice were significantly increased, while the level of osteoprotegerin mRNA in bone tissue was decreased, and the level of receptor activator of nuclear factor Kappa-B ligand mRNA was increased. Meanwhile, the function of osteoclasts was increased, and the bone microstructure parameters showed significant changes. At 32 weeks, in the HFD mice, the mRNA levels of insulin-like growth factor-1 (IGF-1), runt-related transcription factor 2, and osterix mRNA were reduced, while the insulin-like growth factor binding protein-1 (IGFBP-1) level was increased. Simultaneously, the osteoblast function was decreased, and the differences of bone structure parameters were more significant, showing obvious osteoporosis.

CONCLUSIONS

The bone loss in HFD mice is pronounced as NAFLD progresses, and the changes of the TNF-α, IL-6, IGF-1, and IGFBP-1 levels may play critical roles at the different stages of NAFLD in HFD.

Effects of time-restricted feeding and walking exercise on the physical health of female college students with hidden obesity: a randomized trial

Purpose

Time-restricted feeding (TRF) is an emerging dietary pattern with many potential effects. This study focused on the effects of TRF and walking on the physical health of female college students with hidden obesity.

Methods

A total of 77 female college students with hidden obesity, aged 18-22 years, were randomly assigned to a control group (CON, N = 19), time-restricted feeding group (TRF, N = 19), exercise group (EXE, N = 20), and TRF combined with exercise group (TRF + EXE, N = 19). The interventions lasted for 8 weeks. Tests assessing body shape, body composition, bone mineral density, blood lipid levels, and blood pressure were performed before and after the intervention.

Results

(1) Intragroup comparison before and after the intervention revealed that the TRF, EXE, and TRF + EXE groups had significantly reduced body weight (p < 0.01), body mass index (BMI) (p < 0.05), and lean tissue mass (LTM) (p < 0.01) but increased total cholesterol (TC) levels (p < 0.05) after the intervention. Body fat percentage (BF%) increased considerably in the EXE and TRF + EXE groups (p < 0.01). (2) Post-intervention comparisons of body weight, BMI, LTM, adipose tissue mass (ATM), total bone mineral density (TBMD), blood lipid levels, and blood pressure between the intervention groups (TRF, EXE, and TRF + EXE) and the CON group showed no significant differences (p > 0.05). (3) A comparison of the changes between the groups before and after the intervention showed significant decreases in body weight in the TRF and TRF + EXE groups (p < 0.05) and in both BMI and LTM in the TRF, EXE, and TRF + EXE groups (p < 0.05) compared to those in the CON group. The BF% change in the EXE and TRF + EXE groups were significantly greater than that in the TRF group (p < 0.01).

Conclusion

TRF effectively decreased body weight and BMI in female college students with hidden obesity. However, increased blood lipid levels and decreased LTM levels were also observed. The effects of TRF combined with exercise were not superior to those of TRF or walking alone in terms of body weight, body mass index, body composition, TBMD, or blood lipid levels. Therefore, TRF cannot be considered the best option for fat reduction in female college students with hidden obesity.

Circulating Extracellular Vesicles Impair Mesenchymal Stromal Cell Differentiation Favoring Adipogenic Rather than Osteogenic Differentiation in Adolescents with Obesity

Excess body weight has been considered beneficial to bone health because of its anabolic effect on bone formation; however, this results in a poor quality bone structure. In this context, we evaluated the involvement of circulating extracellular vesicles in the impairment of the bone phenotype associated with obesity. Circulating extracellular vesicles were collected from the plasma of participants with normal weight, as well as overweight and obese participants, quantified by flow cytometry analysis and used to treat mesenchymal stromal cells and osteoblasts to assess their effect on cell differentiation and activity. Children with obesity had the highest amount of circulating extracellular vesicles compared to controls. The treatment of mesenchymal stromal cells with extracellular vesicles from obese participants led to an adipogenic differentiation in comparison to vesicles from controls. Mature osteoblasts treated with extracellular vesicles from obese participants showed a reduction in differentiation markers in comparison to controls. Children with obesity who regularly performed physical exercise had a lower circulating extracellular vesicle amount in comparison to those with a sedentary lifestyle. This pilot study demonstrates how the high amount of circulating extracellular vesicles in children with obesity affects the bone phenotype and that physical activity can partially rescue this phenotype.

Higher serum apolipoprotein B level will reduce the bone mineral density and increase the risk of osteopenia or osteoporosis in adults

Objective: There is very limited evidence in the NHANES database linking serum apolipoprotein B and lumbar bone mineral density (BMD) in adults aged 20-59 years. There are few studies associating apolipoprotein B concentrations with BMD, and there is some debate about the association between obesity and BMD. Therefore, the purpose of this study was to determine the association between serum apolipoprotein B concentrations and lumbar spine BMD in adults aged 20-59 years and to predict its association with risk of osteopenia or osteoporosis. Methods: A cross-sectional study of the entire US ambulatory population was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database. Weighted multiple regression equation models were used to assess the association between serum apolipoprotein B and lumbar BMD. A logistic weighted regression model was used to assess the association between serum apolipoprotein B concentrations and risk of osteopenia or osteoporosis. Subsequent stratified analyses were performed to refine the primary population of association. Results: Our study showed a significant negative association between serum apolipoprotein B concentration and lumbar BMD and a significant positive association with the risk of osteoporosis or osteopenia in the total population. After stratifying by sex, age and race, we concluded differently. The association of serum apolipoprotein B concentration with lumbar spine BMD and risk of osteopenia or osteoporosis was significant in male, but not in female. After stratification by age, the negative association between serum apolipoprotein B concentrations and lumbar BMD and the positive association with risk of osteopenia or osteoporosis was more significant in the 30-39 and 50-59 years age groups. When stratified by race, serum apolipoprotein B concentrations were significantly negatively associated with lumbar BMD and positively associated with risk of osteopenia or osteoporosis in Mexican American and non-Hispanic black populations. Thus, these findings suggest that these associations are influenced by sex, age, and race, respectively. Conclusion: Our results suggest that the association between serum apolipoprotein B levels and the risk of lumbar BMD and osteopenia or osteoporosis varies by sex, age, and race. In men, elevated serum apolipoprotein B levels were negative for bone quality. Elevated serum apolipoprotein B levels in the age groups 30-39 and 50-59 years also had a negative effect on bone quality. In the Mexican American and Non-Hispanic Black populations, elevated serum apolipoprotein B levels also had a significant negative effect on bone quality.