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Labayen I, Cadenas-Sánchez C, Idoate F, Medrano M, Tobalina I, Villanueva A, Rodríguez-Vigil B, Álvarez de Eulate N, Osés M, Cabeza R. Liver Fat, Bone Marrow Adipose Tissue, and Bone Mineral Density in Children With Overweight. J Clin Endocrinol Metab 2023; 109:e253-e258. [PMID: 37490040 DOI: 10.1210/clinem/dgad429] [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: 03/26/2023] [Revised: 05/21/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023]
Abstract
CONTEXT Hepatic steatosis is associated with decreased bone mineral density (BMD). Bone marrow fat fraction (BMFF) could play a role in this relationship in children with obesity. OBJECTIVE The objectives of this work were (i) to examine the relationship between the lumbar spine (LS) BMFF and BMD, and (ii) to explore the mediating role of LS-BMFF on the relationship between percentage hepatic fat with LS-BMD in preadolescent children with overweight/obesity. METHODS Hepatic fat and LS-BMFF (magnetic resonance imaging) and areal LS-BMD (LS-aBMD, dual-energy x-ray absorptiometry) were measured in 106 children (aged 10.6 ± 1.1 years, 53.8% girls) with overweight/obesity. RESULTS LS-BMFF was inversely associated with LS-aBMD (r = -0.313; P = .001) and directly related with percentage hepatic fat (r = 0.276; P = .005). LS-BMFF was significantly greater in children with than without hepatic steatosis (P = .003; Cohen's d: 0.61; 95% CI, -0.21 to 1.0), while no significant difference was seen between children with overweight and those with obesity (P = .604; Cohen's d: 0.16; 95% CI, -0.21-0.55). Mediating analysis indicated that LS-BMFF is an important mediator (50%) in the association of hepatic fat with lower LS-aBMD (indirect effect: β = -.076; 95% CI, -0.143 to -0.015). CONCLUSION These findings suggest that hepatic steatosis, rather than overall excess adiposity, is associated with greater bone marrow adipose tissue in preadolescent children with overweight/obesity, which in turn, is related to lower BMD. Hepatic steatosis could be a potential biomarker of osteoporosis risk, and a therapeutic target for interventions that aim to reduce not only hepatic steatosis, but for those designed to improve bone health in such children.
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Affiliation(s)
- Idoia Labayen
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina Cadenas-Sánchez
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada 18071, Spain
| | - Fernando Idoate
- Radiology Department, Mutua Navarra, Department of Health Sciences, Public University of Navarre, 31012 Pamplona, Navarre, Spain
| | - María Medrano
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ignacio Tobalina
- Department of Nuclear Medicine, University Hospital of Araba (HUA), Bioaraba Health Research Institute, 01004 Vitoria-Gasteiz, Alava, Spain
- Department of Medicine, University of the Basque Country, UPV/EHU, 01006 Vitoria-Gasteiz, Spain
| | - Arantxa Villanueva
- Department of Electrical, Electronic and Communications Engineering, Smart Cities Institute, Public University of Navarre, 31006 Pamplona, Spain
| | - Beatriz Rodríguez-Vigil
- Department of Magnetic Resonance Imaging, University Hospital of Araba (HUA), Osakidetza Basque Health Service, Osatek, Bioaraba Health Research Institute, 01004 Vitoria-Gasteiz, Alava, Spain
| | | | - Maddi Osés
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Smart Cities Institute, Public University of Navarre, 31006 Pamplona, Spain
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Amasene M, Besga A, Medrano M, Urquiza M, Rodriguez-Larrad A, Tobalina I, Barroso J, Irazusta J, Labayen I. Nutritional status and physical performance using handgrip and SPPB tests in hospitalized older adults. Clin Nutr 2021; 40:5547-5555. [PMID: 34656951 DOI: 10.1016/j.clnu.2021.09.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 07/09/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Malnutrition and poor physical performance are highly prevalent within hospitalized older adults, and both have in common the loss of muscle mass. Likewise, there is growing interest in identifying markers of physical performance, other than just measuring muscle mass, that might be useful for managing malnutrition. This study aimed to (i) characterize the physical condition of hospitalized older adults in comparison to previously published reference percentile values of same age adults and (ii) to examine the association between the nutritional status and physical performance of older inpatients. METHODS A total of 604 inpatients (age 84.3 ± 6.8 years, 50.3% women) participated in this cross-sectional study. Patients were assessed for nutritional status (Mini Nutritional Assessment-Short Form (MNA-SF)) and physical performance (handgrip strength and the Short Physical Performance Battery (SPPB)). RESULTS During hospitalization, 65.7% of the inpatients were at risk of malnutrition or malnourished. More than a half of the older inpatients were unfit (≤P25) for handgrip strength (52.0%) and SPPB total score (86.3%) as well as for two of its subtests, gait speed (86.7%) and 5 times sit-to-stand (91.1%) tests. Patients' nutritional status was significantly associated with better physical performance within all tests (all p < 0.001), as their nutritional status improved so did their physical performance (all p for trend <0.001). Hence, being at risk of malnutrition or malnourished significantly increased the likelihood for being classified as unfit according to handgrip strength (OR: 1.466, 95% CI: 1.045-2.056), SPPB total score (OR: 2.553, 95% CI: 1.592-4.094) and 4-m walking test (OR: 4.049, 95% CI: 2.469-6.640) (all p < 0.05), and as frail (OR: 4.675, 95% CI: 2.812-7.772) according to the SPPB frailty threshold (p < 0.001). CONCLUSIONS This study reinforces the use of handgrip strength and SPPB, as well as its subtests (gait speed and 5 times sit-to-stand tests), in hospitalized older adults as alternative measures of muscle mass for malnutrition management. Hence, it seems that risk of malnutrition or malnutrition assessed by MNA-SF might help to predict poor physical performance in older inpatients.
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Affiliation(s)
- Maria Amasene
- Department of Pharmacy and Food Science, University of the Basque Country UPV/EHU, 01006, Vitoria-Gasteiz, Spain.
| | - Ariadna Besga
- Department of Internal Medicine, Araba University Hospital, OSI Araba, Bioaraba Research Institute, CIBERSAM, University of the Basque Country, UPV/EHU, 01004, Vitoria-Gasteiz, Spain.
| | - María Medrano
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, 31006, Pamplona, Spain.
| | - Miriam Urquiza
- Department of Physiology, University of the Basque Country UPV/EHU, 48940, Leioa, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, University of the Basque Country UPV/EHU, 48940, Leioa, Spain.
| | - Ignacio Tobalina
- Department of Nuclear Medicine, Araba University Hospital, 01004, Vitoria-Gasteiz, Spain; Department of Surgery Radiology and Physical Medicine, Faculty of Medicine, University of the Basque Country, UPV/EHU, 01009, Vitoria-Gasteiz, Spain.
| | - Julia Barroso
- Department of Internal Medicine, Araba University Hospital, OSI Araba, Bioaraba Research Institute, CIBERSAM, University of the Basque Country, UPV/EHU, 01004, Vitoria-Gasteiz, Spain.
| | - Jon Irazusta
- Department of Physiology, University of the Basque Country UPV/EHU, 48940, Leioa, Spain.
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, 31006, Pamplona, Spain.
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Amasene M, Besga A, Medrano M, Urquiza M, Rodriguez-Larrad A, Tobalina I, Barroso J, Irazusta J, Labayen I. Nutritional status and physical performance within handgrip and SPPB tests in hospitalized elderly adults. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.837] [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: 10/23/2022]
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Arenaza L, Medrano M, Amasene M, Rodríguez-Vigil B, Díez I, Graña M, Tobalina I, Maiz E, Arteche E, Larrarte E, Huybrechts I, Davis CL, Ruiz JR, Ortega FB, Margareto J, Labayen I. Prevention of diabetes in overweight/obese children through a family based intervention program including supervised exercise (PREDIKID project): study protocol for a randomized controlled trial. Trials 2017; 18:372. [PMID: 28793919 PMCID: PMC5551009 DOI: 10.1186/s13063-017-2117-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 07/26/2017] [Indexed: 12/11/2022] Open
Abstract
Background The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise. Methods A total of 84 children, aged 8–12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry). Discussion Prevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity. Trial registration ClinicalTrials.gov, ID: NCT03027726. Registered on 16 January 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2117-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lide Arenaza
- Nutrition, Exercise and Health Research group, Elikadura, Ariketa Fisikoa eta Osasuna, ELIKOS group, Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain
| | - María Medrano
- Nutrition, Exercise and Health Research group, Elikadura, Ariketa Fisikoa eta Osasuna, ELIKOS group, Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain
| | - María Amasene
- Nutrition, Exercise and Health Research group, Elikadura, Ariketa Fisikoa eta Osasuna, ELIKOS group, Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain
| | - Beatriz Rodríguez-Vigil
- Department of Magnetic Resonance Imaging, Osatek, University Hospital of Alava (HUA), Vitoria-Gasteiz, Spain
| | - Ignacio Díez
- Paediatric Endocrinology Unit, University Hospital of Araba (HUA), Vitoria-Gasteiz, Spain
| | - Manuel Graña
- Computational Intelligence Group, University of the Basque Country, UPV/EHU, Donostia, Spain
| | - Ignacio Tobalina
- Department of Nuclear Medicine, University Hospital of Araba (HUA), Vitoria-Gasteiz, Spain
| | - Edurne Maiz
- Department of Personality, Assessment and Psychological Treatment, University of the Basque Country, UPV/EHU, San Sebastián-Donostia, Spain
| | - Edurne Arteche
- Department of Radiology, University Hospital of Araba (HUA), Vitoria-Gasteiz, Spain
| | - Eider Larrarte
- Technological Services Division, Health and quality of life, TECNALIA, Miñano, Spain
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Catherine L Davis
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Jonatan R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Grenada, Spain
| | - Francisco B Ortega
- PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Grenada, Spain
| | - Javier Margareto
- Technological Services Division, Health and quality of life, TECNALIA, Miñano, Spain
| | - Idoia Labayen
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain.
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Medrano M, Maiz E, Maldonado-Martín S, Arenaza L, Rodríguez-Vigil B, Ortega F, Ruiz J, Larrarte E, Diez-López I, Sarasúa-Miranda A, Tobalina I, Barrenechea L, Pérez-Asenjo J, Kannengiesser S, Manhães-Savio A, Echaniz O, Labayen I. The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: protocol of the EFIGRO study. Contemp Clin Trials 2015; 45:346-355. [DOI: 10.1016/j.cct.2015.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/14/2015] [Accepted: 09/21/2015] [Indexed: 02/07/2023]
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Lizarralde E, Martínez Odriozola P, Tobalina I, Maniega R, Miguel F. [Intra-abdominal abscess as presentation of colonic cancer]. An Med Interna 2000; 17:32-4. [PMID: 10730403] [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] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Splenic abscess and retroperitoneal abscess are uncommon, although severe diseases, with a high mortality rate that has been attributed to delayed diagnosis, due to the unspecificity of clinical symptoms. We report two patients with a splenic and a retroperitoneal abscess, respectively, in both cases as an onset of colon cancer. The two patients complained of abdominal pain and fever as onset symptoms. Abdominal ultrasonography was normal in the case of retroperitoneal abscess and abnormal in the case of splenic abscess. CT Scan was diagnostic in both cases. In the patient with splenic abscess. CT Scan established a further diagnostic suspect of colon cancer, which was confirmed by colonoscopy. In the patient with retroperitoneal abscess, diagnosis of colon carcinoma was made during the surgical act. In spite of an adequate, combined medical and surgical therapy, both patients died within a short time after surgery.
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Affiliation(s)
- E Lizarralde
- Servicio de Medicina Interna Hospital de Basurto, Bilbao
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Tobalina I, Alvaro-González LC, García-Andrade L. [Arterial thoracic outlet syndrome and diagnostic angioresonance]. Rev Neurol 1996; 24:1541-2. [PMID: 9064172] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The anatomy of the upper cervical region, in the presence of structural anomalies favours the compression of the brachial plexus and/or subclavian vessels, giving rise to the thoracic inlet syndrome (SATS). Neurological involvement is more common than vascular involvement (95 and 5% respectively); the latter is known as the arterial SATS. The forms of clinical presentation of arterial SATS are very variable and have different prognoses: it may present as acute distal ischaemia with a variable course, peripheral embolism or as a non-serious condition such as Raynaud's phenomenon. CLINICAL CASE We present a case with arterial involvement only, associated with a clavicular osteophyte, in a patient with episodes of acute, transient weakness of the arm which were initially thought to be transient strokes with brachial monoparesis. CONCLUSION Classically, the basic examination to diagnose arterial SATS has been conventional angiography, an invasive test which is not without complications; in our case it was magnetic angioresonance which showed changes in blood flow on forced arm movement. This avoided having to do a conventional angiogram. Angioresonance, rarely cited in this syndrome, is worthy of study and comparison with the 'standard' diagnostic method of conventional angiography.
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Affiliation(s)
- I Tobalina
- Sección de Neurología, Hospital de Basurto, Bilbao, España
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