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Gao Y, Gao J, Wang Y, Gan H. Predicting Osteoporotic Fracture in Patients With Early-Stage Diabetic Kidney Disease Using a Radiomic Model: A Longitudinal Cohort Study. Endocr Pract 2024; 30:360-366. [PMID: 38185330 DOI: 10.1016/j.eprac.2024.01.005] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVE There is an urgent need for effective predictive strategies to accurately evaluate the risk of fragility fractures in elderly patients in the early stages of diabetic kidney disease (DKD). METHODS This longitudinal cohort study included 715 older patients in the early stages of DKD diagnosed between January 2015 and August 2019. Patients were randomly allocated to a training cohort (n = 499) and a validation cohort (n = 216). The least absolute shrinkage and selection operator method was used to select key features for dual-energy x-ray absorptiometry-based radiomic analysis. A radiomic model was constructed using Cox proportional hazards regression. The performance of the radiomic model was compared with that of traditional fracture assessment tools through a receiver operating characteristic curve, calibration curve, and decision curve analysis. RESULTS Over a mean follow-up period of 4.72 ± 1.60 years, 65 participants (9.09%) experienced incident fragility fractures. Seventeen features were ultimately selected to create the radiomic model. The calibration plots of this model demonstrated satisfactory agreement between the observed and predicted outcomes. Moreover, the radiomic model outperformed traditional fracture assessment tools in both the training and validation cohorts according to the area under the receiver operating characteristic curve and decision curve analysis. CONCLUSIONS The novel radiomic model has demonstrated a more effective prediction of fragility fracture in elderly patients in the early stages of DKDcompared to traditional fracture assessment tools.
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Affiliation(s)
- Youyuan Gao
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Nephrology, Chongqing University Fuling Hospital, Chongqing, China
| | - Jianya Gao
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunting Wang
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Gan
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Rodriguez C, Mota JD, Palmer TB, Heymsfield SB, Tinsley GM. Skeletal muscle estimation: A review of techniques and their applications. Clin Physiol Funct Imaging 2024. [PMID: 38426639 DOI: 10.1111/cpf.12874] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Quantifying skeletal muscle size is necessary to identify those at risk for conditions that increase frailty, morbidity, and mortality, as well as decrease quality of life. Although muscle strength, muscle quality, and physical performance have been suggested as important assessments in the screening, prevention, and management of sarcopenic and cachexic individuals, skeletal muscle size is still a critical objective marker. Several techniques exist for estimating skeletal muscle size; however, each technique presents with unique characteristics regarding simplicity/complexity, cost, radiation dose, accessibility, and portability that are important factors for assessors to consider before applying these modalities in practice. This narrative review presents a discussion centred on the theory and applications of current non-invasive techniques for estimating skeletal muscle size in diverse populations. Common instruments for skeletal muscle assessment include imaging techniques such as computed tomography, magnetic resonance imaging, peripheral quantitative computed tomography, dual-energy X-ray absorptiometry, and Brightness-mode ultrasound, and non-imaging techniques like bioelectrical impedance analysis and anthropometry. Skeletal muscle size can be acquired from these methods using whole-body and/or regional assessments, as well as prediction equations. Notable concerns when conducting assessments include the absence of standardised image acquisition/processing protocols and the variation in cut-off thresholds used to define low skeletal muscle size by clinicians and researchers, which could affect the accuracy and prevalence of diagnoses. Given the importance of evaluating skeletal muscle size, it is imperative practitioners are informed of each technique and their respective strengths and weaknesses.
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Affiliation(s)
- Christian Rodriguez
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob D Mota
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Ty B Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Steven B Heymsfield
- Metabolism and Body Composition Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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Küçükçiloğlu Y, Şekeroğlu B, Adalı T, Şentürk N. Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models. Diagn Interv Radiol 2024; 30:9-20. [PMID: 37309886 PMCID: PMC10773174 DOI: 10.4274/dir.2023.232116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/06/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Osteoporosis is the systematic degeneration of the human skeleton, with consequences ranging from a reduced quality of life to mortality. Therefore, the prediction of osteoporosis reduces risks and supports patients in taking precautions. Deep-learning and specific models achieve highly accurate results using different imaging modalities. The primary purpose of this research was to develop unimodal and multimodal deep-learning-based diagnostic models to predict bone mineral loss of the lumbar vertebrae using magnetic resonance (MR) and computed tomography (CT) imaging. METHODS Patients who received both lumbar dual-energy X-ray absorptiometry (DEXA) and MRI (n = 120) or CT (n = 100) examinations were included in this study. Unimodal and multimodal convolutional neural networks (CNNs) with dual blocks were proposed to predict osteoporosis using lumbar vertebrae MR and CT examinations in separate and combined datasets. Bone mineral density values obtained by DEXA were used as reference data. The proposed models were compared with a CNN model and six benchmark pre-trained deep-learning models. RESULTS The proposed unimodal model obtained 96.54%, 98.84%, and 96.76% balanced accuracy for MRI, CT, and combined datasets, respectively, while the multimodal model achieved 98.90% balanced accuracy in 5-fold cross-validation experiments. Furthermore, the models obtained 95.68%-97.91% accuracy with a hold-out validation dataset. In addition, comparative experiments demonstrated that the proposed models yielded superior results by providing more effective feature extraction in dual blocks to predict osteoporosis. CONCLUSION This study demonstrated that osteoporosis was accurately predicted by the proposed models using both MR and CT images, and a multimodal approach improved the prediction of osteoporosis. With further research involving prospective studies with a larger number of patients, there may be an opportunity to implement these technologies into clinical practice.
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Affiliation(s)
- Yasemin Küçükçiloğlu
- Near East University Faculty of Medicine, Department of Radiology, Nicosia, Cyprus
- Near East University, Center of Excellence, Tissue Engineering and Biomaterials Research Center, Nicosia, Cyprus
| | - Boran Şekeroğlu
- Near East University, Applied Artificial Intelligence Research Center, Nicosia, Cyprus
| | - Terin Adalı
- Near East University, Center of Excellence, Tissue Engineering and Biomaterials Research Center, Nicosia, Cyprus
- Near East University Faculty of Engineering, Department of Biomedical Engineering, Nicosia, Cyprus
- Sabancı University, Nanotechnology Research and Application Center, İstanbul, Turkey
| | - Niyazi Şentürk
- Near East University, Center of Excellence, Tissue Engineering and Biomaterials Research Center, Nicosia, Cyprus
- Near East University Faculty of Engineering, Department of Biomedical Engineering, Nicosia, Cyprus
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Pluimakers VG, van Atteveld JE, de Winter DTC, Bolier M, Fiocco M, Nievelstein RJAJ, Janssens GOR, Bresters D, van der Heiden-van der Loo M, de Vries ACH, Louwerens M, van der Pal HJ, Pluijm SMF, Ronckers CM, Versluijs AB, Kremer LCM, Loonen JJ, van Dulmen-den Broeder E, Tissing WJE, van Santen HM, van den Heuvel-Eibrink MM, Neggers SJCMM. Prevalence, risk factors, and optimal way to determine overweight, obesity, and morbid obesity in the first Dutch cohort of 2338 long-term survivors of childhood cancer: a DCCSS-LATER study. Eur J Endocrinol 2023; 189:495-507. [PMID: 37837608 DOI: 10.1093/ejendo/lvad139] [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: 04/21/2023] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Overweight and obesity are common challenges among childhood cancer survivors. Overweight may be disguised, as survivors can have normal weight but high fat percentage (fat%) on dual-energy X-ray absorptiometry (DXA). We aimed to assess prevalence, identify determinants and biomarkers, and assess which method captures overweight best, in a nationwide cohort. METHODS The prevalence of overweight and obesity, primarily defined by body mass index (BMI), was assessed in the DCCSS-LATER cohort of adult survivors treated from 1963-2002, with the LifeLines cohort as reference. The associations between risk factors and overweight metrics were investigated using logistic regression. Additional overweight metrics included DXA fat%, waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR), and high-molecular-weight (HMW) adiponectin. RESULTS A total of 2338 (mean age 35.5 years, follow-up 28.3 years) survivors participated. The overweight prevalence was 46.3% in men and 44.3% in women (obesity 11.2% and 15.9%, morbid obesity 2.4% and 5.4%), with highest rates among brain tumor survivors. Compared to controls, there was no overall increased overweight rate, but this was higher in women > 50 years, morbid obesity in men > 50 years. Overweight at cancer diagnosis (adjusted odds ratio [aOR] = 3.83, 95% CI 2.19-6.69), cranial radiotherapy (aOR = 3.21, 95% CI 1.99-5.18), and growth hormone deficiency (separate model, aOR = 1.61, 95% CI 1.00-2.59) were associated with overweight. Using BMI, WC, WHR, and WHtR, overweight prevalence was similar. Low HMW adiponectin, present in only 4.5% of survivors, was an insensitive overweight marker. Dual-energy X-ray absorptiometry-based classification identified overweight in an additional 30%, particularly after abdominal radiotherapy, total body irradiation, anthracyclines, and platinum. CONCLUSIONS Overweight occurs in almost half of long-term survivors. There was no overall increased incidence of overweight compared to controls. We identified factors associated with overweight, as well as subgroups of survivors in whom DXA can more reliably assess overweight.
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Affiliation(s)
| | | | - Demi T C de Winter
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Melissa Bolier
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Medical Statistics, Department of Biomedical Data Science, Leiden UMC, Leiden 2333 ZA, The Netherlands
- Mathematical Institute Leiden University, Leiden 2333 ZA, The Netherlands
| | - Rutger Jan A J Nievelstein
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Radiology & Nuclear Medicine, UMC Utrecht, Utrecht 3584 CX, The Netherlands
| | - Geert O R Janssens
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Radiation Oncology, UMC Utrecht, Utrecht 3584 CX, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | | | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Pediatric Oncology/Hematology, Sophia Children's Hospital/Erasmus MC, Rotterdam 3015 CN, The Netherlands
| | - Marloes Louwerens
- Department of Internal Medicine, Leiden UMC, Leiden 2333 ZA, The Netherlands
| | | | - Saskia M F Pluijm
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Cecile M Ronckers
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg 26129, Germany
| | - Andrica B Versluijs
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Pediatric Oncology and Hematology, Wilhelmina Children's Hospital/UMC Utrecht, Utrecht 3584 EA, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital/Amsterdam UMC, Amsterdam 1105 AZ, The Netherlands
| | | | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Pediatric Oncology/Hematology, University of Groningen, UMC Groningen, Groningen 9713 GZ, The Netherlands
| | - Hanneke M van Santen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital/UMC Utrecht, Utrecht 3584 EA, The Netherlands
| | | | - Sebastian J C M M Neggers
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Department of Medicine, Section Endocrinology, Erasmus MC, Rotterdam 3015 GD, The Netherlands
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Luo X, Zhang J, Dai Z, Gong X, Qu G, Li J, Zhang Z. Hounsfield units on abdominal computed tomography: a new tool for predicting osteoporosis. Acta Radiol 2023; 64:2841-2848. [PMID: 37644799 DOI: 10.1177/02841851231190795] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Osteoporosis can cause bone fractures and disability, but early diagnosis faces challenges. Our proposed diagnostic indicators offer a new approach for early detection, which benefits early identification. PURPOSE To determine the most appropriate threshold for predicting osteoporosis in patients with each section of vertebral body. MATERIAL AND METHODS A retrospective analysis of 210 patients, including 646 vertebrae, who had both abdominal computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) within six months. The correlation between DXA T-score and CT Hounsfield units (HU) values was tested by Pearson. The area under the curve (AUC) was calculated using the threshold obtained from the regression equation. RESULTS The thresholds matching the T-score of -2.5 were 85, 95, 85, and 90 HU for the upper axial plane of the vertebral body (Lau), the middle axial plane of the vertebral body (Lam), the lower axial plane of the vertebral body (Lad), and the mid-sagittal plane of the vertebral body (Lsm), respectively. Defining osteoporosis using CT as Lau ≤ 85, Lam ≤ 95, Lad ≤ 85, or Lsm ≤ 90 HU had a specificity of 88.1% (116/134) and sensitivity of 90.8% (69/76) for distinguishing DXA osteoporosis of the lumbar spine in 210 patients. T-score ≤-2.5 defined as Lau ≤85 or Lam ≤95 or Lad ≤85 or Lsm ≤90 HU had a specificity of 85.9% (275/320) and sensitivity of 82.8% (270/326) for DXA T-score ≤-2.5 in 646 lumbar vertebrae. CONCLUSION CT HU values obtained based on different sections of the vertebral body in abdominal CT can be used as a supplementary measure to assess osteoporosis.
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Affiliation(s)
- Xiaohui Luo
- Department of Orthopedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Nanchang Key Laboratory of Orthopaedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Medical Department of Graduate School, Nanchang University, Nanchang, PR China
| | - Jiongfeng Zhang
- Department of Orthopedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Nanchang Key Laboratory of Orthopaedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Medical Department of Graduate School, Nanchang University, Nanchang, PR China
| | - Zhengzai Dai
- Department of Orthopedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Nanchang Key Laboratory of Orthopaedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Medical Department of Graduate School, Nanchang University, Nanchang, PR China
| | - Xiang Gong
- Graduate School, Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Gaoyang Qu
- Medical Department of Graduate School, Nanchang University, Nanchang, PR China
| | - Juncheng Li
- Department of Orthopedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Medical Department of Graduate School, Nanchang University, Nanchang, PR China
| | - Zhiping Zhang
- Department of Orthopedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Nanchang Key Laboratory of Orthopaedics, The Third Affiliated Hospital of Nanchang University, Nanchang, PR China
- Medical Department of Graduate School, Nanchang University, Nanchang, PR China
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Gao L, Moodie M, Watts JJ, Wang L. Cost-Effectiveness of Osteoporosis Opportunistic Screening Using Computed Tomography in China. Value Health Reg Issues 2023; 38:38-44. [PMID: 37454646 DOI: 10.1016/j.vhri.2023.06.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Underutilization and insufficient availability of dual-energy X-ray absorptiometry (DXA) in diagnosing osteoporosis in China could be changed by adopting unindicated quantitative computed tomography. We aimed to assess the cost-effectiveness of quantitative computed tomography (QCT) as a screening tool for osteoporosis in China. METHODS A Markov microsimulation model was developed to assess the long-term costs and quality-adjusted life-years (QALYs) saved associated with 2 examinations as opportunistic screening for osteoporosis in a general population without prior histories of fracture. The diagnostic performance of both examinations was incorporated into the model. In lifetime modeling, opportunistically screened people may face the risk of experiencing hip, vertebral, and wrist fractures depending on their osteoporosis, age, and sex. Model parameters were informed by published literature. RESULTS The base-case result showed that QCT was associated with higher costs ($6054 vs $5883) and higher benefits (10.081 vs 10.071 QALYs) in comparison with DXA, making QCT a cost-effective option for opportunistic screening (incremental cost-effectiveness ratio of US $16 430/QALY). Screening with QCT led to fewer fractures over the lifetime simulation: for every 10 000 people screened, 129 fractures (32 hip, 78 vertebral, and 19 wrist fractures) could be avoided because of the early initiation of antiosteoporotic treatment. CONCLUSIONS Using QCT to screen people for osteoporosis is more cost-effective than standard practice in China, where access to DXA is minimal. This finding could support opportunistic osteoporosis screening using QCT in other countries with similar status.
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Affiliation(s)
- Lan Gao
- Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Marj Moodie
- Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Jennifer J Watts
- Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
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Willems S, David K, Decallonne B, Marcq P, Antonio L, Vanderschueren D. The effect of testosterone treatment on bone mineral density in Klinefelter syndrome: A retrospective cohort study. Andrology 2023; 11:1295-1302. [PMID: 36792918 DOI: 10.1111/andr.13411] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/03/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Although Klinefelter syndrome (KS) is the most frequent sex-hormone disorder, there is ongoing uncertainty about the often associated sex-hormone deficiency, its impact on common comorbidities, and therefore about prevention and treatment. In this study, we focus on bone loss, reported to occur in over 40% of KS patients, and the impact of testosterone replacement therapy (TRT) on this comorbidity. OBJECTIVES This single-center retrospective cohort study in a tertiary hospital compared the effect of treatment with TRT to no TRT on evolution of bone mineral density (BMD) in KS patients. METHODS After a medical chart review, a total of 52 KS subjects were included in this study. BMD was measured by dual-energy X-ray absorptiometry (DXA) and expressed as T-scores. RESULTS The subjects were divided into three groups, according to TRT. In the subgroup that only started TRT after baseline measurements (mean age 31 years), we observed significant gain in BMD T-score at the lumbar spine (0.58 ± 0.60, p = 0.003; mean gain of 0.62% areal BMD per year) and total femur T-score (0.24 ± 0.39, p = 0.041; mean gain of 0.25% areal BMD per year) after a mean follow-up period of 7.5 years. Compared to untreated subjects, a significant difference in evolution was demonstrated at the lumbar level (+0.58 ± 0.60 vs. -0.14 ± 0.42, p = 0.007). In untreated subjects with normal testosterone levels, a loss of BMD (-0.27 ± 0.37, p = 0.029; mean loss of 0.49% areal BMD per year) at the femoral neck was measured. This decline was equal to the predicted loss seen in the general male population. CONCLUSION TRT results in BMD gain in patients with KS with testosterone deficiency, mainly at the lumbar spine. However, this effect is limited (0.62% per year). Patients who were not treated with TRT because of sufficient endogenous testosterone levels, showed only the predicted age-related bone loss during follow-up. The need for TRT in maintaining bone health in KS should be evaluated on an individual basis according to the degree of sex steroid deficiency.
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Affiliation(s)
- Stien Willems
- Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Karel David
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Clinical and Experimental Medicine, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Brigitte Decallonne
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Clinical and Experimental Medicine, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Philippe Marcq
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Leen Antonio
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Clinical and Experimental Medicine, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Clinical and Experimental Medicine, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
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Kuang YX, Cheng H, Zheng YY, Chen WY, Ma ZX, Zou GY, Zeng D, Mi J, Liu L. [Comparison on Performance of Quantitative Ultrasound and Dual-Energy X-ray Absorptiometry in Evaluating Bone Health of Adults Aged 18-40 Years]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2023; 45:737-742. [PMID: 37927014 DOI: 10.3881/j.issn.1000-503x.15695] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Objective To compare the consistency of quantitative ultrasound(QUS)and dual-energy X-ray absorptiometry(DXA)in measuring bone mineral density(BMD)of adults aged 18-40 years in Guangzhou and evaluate the diagnostic value of QUS for identifying low bone mass.Methods DXA was employed to measure the BMD and QUS to measure the speed of sound(SOS)in 731 participants.The Bland-Altman analysis was performed to evaluate the consistency of Z scores between SOS and BMD.With the BMD Z ≤-2.00 as the diagnostic criterion for low bone mass,the receiver operating characteristics curve of QUS was established,and the area under the curve(AUC)and the sensitivity,specificity,and correct diagnostic index for the optimal cut-off of SOS Z score were calculated.Results The results of Bland-Altman analysis showed that the mean differences in the Z scores of SOS and BMD in males and females were 1.27(-0.94 to 3.47)and 0.93(-1.33 to 3.18),respectively.The AUC of SOS Z score in the diagnosis of low bone mass in males and females was 0.734(95%CI=0.380-0.788)and 0.679(95%CI=0.625-0.732),respectively.In males,the optimal cut-off of SOS Z score for low bone mass was -0.35,with the sensitivity,specificity,and correct diagnostic index of 64.1%,68.6%,and 0.327,respectively.In females,the optimal cut-off value of SOS Z scores for low bone mass was -1.14,with the sensitivity,specificity,and correct index of 73.9%,54.8%,and 0.285,respectively.Conclusion QUS and DXA show poor consistency in the diagnosis of BMD in the adults aged 18-40 years in Guangzhou,while QUS demonstrates an acceptable value in identifying low bone mass.
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Affiliation(s)
- Yu-Xian Kuang
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
| | - Hong Cheng
- Department of Epidemiology,Capital Institute of Pediatrics,Beijing 100020,China
| | - Yi-Ying Zheng
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
| | - Wei-Ye Chen
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
| | - Zhen-Xin Ma
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
| | - Gao-Yong Zou
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
| | - Ding Zeng
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
| | - Jie Mi
- Center for Non-Communicable Disease Management,Beijing Children's Hospital,Capital Medical University, National Center for Children's Health,Beijing 100045,China
| | - Li Liu
- Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China
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Munhoz L, Santos MAL, Vincentin Junior CA, Mendonça RP, Watanabe PCA, Arita ES. Assessment of the correlation between mandibular radiomorphometric patterns and dual-energy X-ray absorptiometry measurements for screening bone mineral density. Gen Dent 2023; 71:11-16. [PMID: 37595077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
The objective of this study was to investigate the correlation between scores for femoral and lumbar spine bone mineral density (dual-energy X-ray absorptiometry [DXA]) and visual, qualitative mandibular bone pattern assess¬ments (mandibular cortical index, trabecular bone pattern, and visual mandibular cortical width) as well as age and body mass index. Three trained observers evaluated 200 panoramic radiographs and 200 femoral and lumbar spine DXA measurements from 100 male and 100 female participants. The κ test showed an acceptable agreement among observers (0.73; P = 0.003). The Shapiro-Wilk test revealed that the variables were not normally distributed, so the Spearman correlation test was used. The mean age of the sample was 60.7 (13.9) years, and 86.0% of the patients were White. There were inverse correlations between the mandibular cortical index and the spine T-score in men, women, and the total sample as well as between the spine Z-score in the total sample. An inverse correlation was observed between the trabecular bone pattern and the spine T- and Z-scores in women and the total sample. The results also showed inverse correlations between the visual mandibular cortical width and all parameters analyzed in men, women, and the total sample except for the femur T-score and spine T- and Z-scores in men. Body mass index was correlated with all DXA parameters. Age was inversely correlated with femur T-scores in men and women but not with spine DXA values in men. The results suggest that qualitative assessments of radiomorphometric patterns on panoramic radiographs correlate with DXA values and therefore are suitable for screening patients at risk of developing low bone mineral density.
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Lin M, Ridley L, Seibel MJ. Prediction of low DEXA T-scores by routine computed tomography body scans at different kilovoltage peaks. J Med Imaging Radiat Oncol 2023; 67:602-608. [PMID: 37199007 DOI: 10.1111/1754-9485.13537] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/22/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Previous studies have demonstrated positive correlations between computed tomography (CT) attenuation of lumbar spine vertebrae and their bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DEXA). However, these studies were performed using a standard 120 kilovoltage peak (kVp) setting. As radiation attenuation in mineralised tissues varies by the tube voltage applied, we determined the diagnostic accuracy of CT attenuation at identifying individuals with low BMD at different kVp settings. METHODS Single centre retrospective study of adults who had CT and DEXA scans within 6 months of each other. CT scans were performed at either 100 kVp, 120 kVp or dual energy (80 kVp/140 kVp). Attenuation was measured in axial cross-sections of L1-4 vertebrae and correlated with the results of DEXA. Receiver operated characteristic (ROC) curves were generated to determine diagnostic cut-off thresholds. RESULTS Analysis included 268 subjects (169 females; mean age: 70, range: 20-94 years). CT attenuation values at L1 or mean L1-4 correlated positively with DEXA-derived T-scores. At L1, the optimal Hounsfield units (HU) thresholds for predicting DEXA T-scores of -2.5 or less at 100 kVp, 120 kVp and dual-energy scans were <170, <128 and <164, with corresponding AUCs of 0.925, 0.814 and 0.743 respectively. For mean L1-4, the HU thresholds were <173, <134 and <151, with corresponding AUCs of 0.933, 0.824 and 0.707 respectively. CONCLUSION CT attenuation thresholds differ depending on the tube voltage used. We provide voltage-specific, probability-optimised thresholds for the identification of persons likely to have low BMD on DEXA scanning.
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Affiliation(s)
- Mike Lin
- Department of Endocrinology and Metabolism, Concord Hospital, Sydney, New South Wales, Australia
| | - Lloyd Ridley
- Department of Radiology|, Concord Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Markus J Seibel
- Department of Endocrinology and Metabolism, Concord Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Ong JN, Ducker KJ, Furzer BJ, Dymock M, Landers GJ. Acute exercise affects dual-energy X-ray absorptiometry body composition estimates but not standardised ultrasound measurements of subcutaneous adipose tissue. Clin Physiol Funct Imaging 2023; 43:345-353. [PMID: 37191158 DOI: 10.1111/cpf.12832] [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] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/17/2023]
Abstract
Ultrasound has been demonstrated to be a highly accurate and reliable tool for measuring subcutaneous adipose tissue thickness and is robust against changes in hydration status or acute food or fluid intake. However, the effect of prior acute exercise is unexamined. This study examined the impact of an acute endurance exercise and resistance exercise session on standardised brightness-mode ultrasound measurements of subcutaneous adipose tissue thickness compared to skinfolds and dual-energy X-ray absorptiometry body composition estimates. In a randomised cross-over design, 30 active adults (24.2 ± 4.9 years) undertook physique assessment via standardised brightness-mode ultrasound, skinfolds and dual-energy X-ray absorptiometry before, immediately and 45 min after an acute endurance or resistance exercise session. The mean sum of eight subcutaneous adipose tissue thickness measured via standardised brightness-mode ultrasound increased (0.6 mm, p = 0.04) immediately postendurance exercise but was not meaningful when evaluated against the technical error of measurement of the investigator. A significant (p = 0.01) but not meaningful decrease in the sum of eight skinfolds occurred immediately (-1.1 ± 0.4 mm) and 45 min (-1.3 ± 0.4 mm) postresistance exercise. Comparatively, endurance exercise elicited a meaningful decrease of total mass (460 ± 30 g) and trunk lean mass (680 ± 90 g) dual-energy X-ray absorptiometry estimates. Findings from this study indicate standardised client presentation may be unnecessary when employing either standardised brightness-mode ultrasound or skinfolds for body composition assessment unlike dual-energy X-ray absorptiometry.
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Affiliation(s)
- Jun N Ong
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, Australia
| | - Kagan J Ducker
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Bonnie J Furzer
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Dymock
- Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia, Australia
| | - Grant J Landers
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, Australia
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Stokar J, Ben-Porat T, Kaluti D, Abu-Gazala M, Weiss R, Mintz Y, Elazari R, Szalat A. Trabecular Bone Score Preceding and during a 2-Year Follow-Up after Sleeve Gastrectomy: Pitfalls and New Insights. Nutrients 2023; 15:3481. [PMID: 37571418 PMCID: PMC10421136 DOI: 10.3390/nu15153481] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Bariatric surgery (BS) can have negative effects on bone health. Bone microarchitecture quality evaluation using the trabecular bone score (TBS) has not been described in patients after sleeve gastrectomy (SG). To test the hypothesis that the TBS is clinically useful for this population, we evaluated changes in bone mineral density (BMD) and the TBS in a longitudinal cohort study following SG. The measurements before surgery and after 12 and 24 postoperative months were as follows: weight, height, BMI, waist circumference (WC), BMD and TBS. The results at baseline showed the following: a mean BMI of 43 ± 0.56, TBS of 1.25 ± 0.02, lumbar spine BMD T-score of -0.4 ± 0.93, TBS T-score of -2.30 ± 0.21, significantly lower than BMD-T-score, and associated with a BMD-T-TBS-T gap (T-gap) of -2.05 ± 1.26 (-0.24 ± 0.13). One year after surgery, the TBS had significantly improved (+12.12% ± 1.5), leading to a T-gap of -0.296 ± 0.14, which remained stable at 2 years post-surgery. A correlation analysis revealed a significant negative correlation between the T-gap and WC (r = -0.43 p = 0.004). Our interpretation is that abdominal fat may interfere with image acquisition via increased tissue thickness, leading to a false low TBS at baseline. In conclusion, TBS should be interpreted with caution in patients with obesity and elevated WC. Additionally, we show that after SG, the LS microarchitecture measured using the TBS is partially degraded in up to 25% of patients. Further studies are warranted to assess hip bone microarchitecture changes after bariatric surgery.
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Affiliation(s)
- Joshua Stokar
- Osteoporosis Center, Endocrinology and Metabolism Service, Internal Medicine Ward, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
| | - Tair Ben-Porat
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem 9124001, Israel; (T.B.-P.); (D.K.)
- Department of Nutrition, Hadassah-Hebrew University Medical Center, Jerusalem 9124001, Israel
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada
| | - Donia Kaluti
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem 9124001, Israel; (T.B.-P.); (D.K.)
| | - Mahmud Abu-Gazala
- Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel; (M.A.-G.); (Y.M.); (R.E.)
| | - Ram Weiss
- Department of Pediatrics, Rambam Medical Center, Technion School of Medicine, Haifa 3200003, Israel;
| | - Yoav Mintz
- Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel; (M.A.-G.); (Y.M.); (R.E.)
| | - Ram Elazari
- Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel; (M.A.-G.); (Y.M.); (R.E.)
| | - Auryan Szalat
- Osteoporosis Center, Endocrinology and Metabolism Service, Internal Medicine Ward, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
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Wang GX, Han JH, Zhou RZ, Gao CP. Response of vertebral fractures to treatment with denosumab in a patient with postpartum osteoporosis: a case report and literature review. J Int Med Res 2023; 51:3000605231187951. [PMID: 37523158 PMCID: PMC10392288 DOI: 10.1177/03000605231187951] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Postpartum osteoporosis (PO) is a rare condition characterized by low bone mineral density (BMD) and an increased risk of vertebral fragility fracture. We encountered a 34-year-old woman who developed back pain 1 week after delivery. Magnetic resonance imaging of the lumbar spine revealed three vertebral compression fractures. Pretreatment BMD evaluation by dual-energy X-ray absorptiometry revealed a low T-score and Z-score (-2.0 and -2.0, respectively; BMD, 0.876 g/cm2) in the affected region of the spine. The patient was diagnosed with PO and treated with subcutaneous injection of denosumab 60 mg (Prolia; Amgen, Inc., Thousand Oaks, CA, USA) every 6 months. After two treatments, the BMD had significantly increased and the back pain was improved; the patient therefore decided to terminate the treatment. Two months later, her back pain worsened and BMD decreased as measured by dual-energy X-ray absorptiometry examination of the lumbar spine. Therefore, the patient resumed treatment with denosumab, and the BMD of the lumbar spine increased after another two treatments. Therefore, we consider denosumab to be promising in the management of PO with respect to increased BMD and decreased pain.
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Affiliation(s)
- Guan-Xi Wang
- Department of Radiology, Songshan Hospital of Qingdao University Medical College, Qingdao, China
| | - Jin-Hua Han
- Department of Radiology, Qingdao Central Hospital, Qingdao, China
| | - Rui-Zhi Zhou
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chuan-Ping Gao
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, China
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Palmas F, Ciudin A, Guerra R, Eiroa D, Espinet C, Roson N, Burgos R, Simó R. Comparison of computed tomography and dual-energy X-ray absorptiometry in the evaluation of body composition in patients with obesity. Front Endocrinol (Lausanne) 2023; 14:1161116. [PMID: 37455915 PMCID: PMC10345841 DOI: 10.3389/fendo.2023.1161116] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/17/2023] [Indexed: 07/18/2023] Open
Abstract
Objective a) To evaluate the accuracy of the pre-existing equations (based on cm2 provided by CT images), to estimate in kilograms (Kg) the body composition (BC) in patients with obesity (PwO), by comparison with Dual-energy X-ray absorptiometry (DXA). b) To evaluate the accuracy of a new approach (based on both cm2 and Hounsfield Unit parameters provided by CT images), using an automatic software and artificial intelligence to estimate the BC in PwO, by comparison with DXA. Methods Single-centre cross-sectional study including consecutive PwO, matched by gender with subjects with normal BMI. All the subjects underwent BC assessment by Dual-energy X-ray absorptiometry (DXA) and skeletal-CT at L3 vertebrae. CT images were processed using FocusedON-BC software. Three different models were tested. Model 1 and 2, based on the already existing equations, estimate the BC in Kg based on the tissue area (cm2) in the CT images. Model 3, developed in this study, includes as additional variables, the tissue percentage and its average Hounsfield unit. Results 70 subjects (46 PwO and 24 with normal BMI) were recruited. Significant correlations for BC were obtained between the three models and DXA. Model 3 showed the strongest correlation with DXA (r= 0.926, CI95% [0.835-0.968], p<0.001) as well as the best agreement based on Bland - Altman plots. Conclusion This is the first study showing that the BC assessment based on skeletal CT images analyzed by automatic software coupled with artificial intelligence, is accurate in PwO, by comparison with DXA. Furthermore, we propose a new equation that estimates both the tissue quantity and quality, that showed higher accuracy compared with those currently used, both in PwO and subjects with normal BMI.
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Affiliation(s)
- Fiorella Palmas
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
| | - Andreea Ciudin
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut De Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
- Centro De Investigación Biomédica En Red De Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto De Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Daniel Eiroa
- Department of Radiology, Institut De Diagnòstic Per La Imatge (IDI), Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Carina Espinet
- Nuclear Medicine Deparment, Vall Hebron Hospital, Barcelona, Spain
| | - Nuria Roson
- Department of Radiology, Institut De Diagnòstic Per La Imatge (IDI), Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Rosa Burgos
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut De Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
| | - Rafael Simó
- Endocrinology and Nutrition Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
- Diabetes and Metabolism Research Unit, Vall d’Hebron Institut De Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
- Centro De Investigación Biomédica En Red De Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto De Salud Carlos III (ISCIII), Madrid, Spain
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Alizadeh LS, Vogl TJ, Waldeck SS, Overhoff D, D'Angelo T, Martin SS, Yel I, Gruenewald LD, Koch V, Fulisch F, Booz C. Dual-Energy CT in Cardiothoracic Imaging: Current Developments. Diagnostics (Basel) 2023; 13:2116. [PMID: 37371011 DOI: 10.3390/diagnostics13122116] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This article describes the technical principles and clinical applications of dual-energy computed tomography (DECT) in the context of cardiothoracic imaging with a focus on current developments and techniques. Since the introduction of DECT, different vendors developed distinct hard and software approaches for generating multi-energy datasets and multiple DECT applications that were developed and clinically investigated for different fields of interest. Benefits for various clinical settings, such as oncology, trauma and emergency radiology, as well as musculoskeletal and cardiovascular imaging, were recently reported in the literature. State-of-the-art applications, such as virtual monoenergetic imaging (VMI), material decomposition, perfused blood volume imaging, virtual non-contrast imaging (VNC), plaque removal, and virtual non-calcium (VNCa) imaging, can significantly improve cardiothoracic CT image workflows and have a high potential for improvement of diagnostic accuracy and patient safety.
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Affiliation(s)
- Leona S Alizadeh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Stephan S Waldeck
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Mainz, 55131 Mainz, Germany
| | - Daniel Overhoff
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Mannheim, 68167 Mannheim, Germany
| | - Tommaso D'Angelo
- Diagnostic and Interventional Radiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, 98124 Messina, Italy
| | - Simon S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Leon D Gruenewald
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Florian Fulisch
- Department of Diagnostic and Interventional Radiology, Bundeswehrzentralkrankenhaus Koblenz, 56072 Koblenz, Germany
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
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Foulis SA, Friedl KE, Spiering BA, Walker LA, Guerriere KI, Pecorelli VP, Zeppetelli DJ, Reynoso MC, Taylor KM, Hughes JM. Body composition changes during 8 weeks of military training are not accurately captured by circumference-based assessments. Front Physiol 2023; 14:1183836. [PMID: 37351259 PMCID: PMC10282178 DOI: 10.3389/fphys.2023.1183836] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
In 1981, the US military adopted body fat standards to promote physical readiness and prevent obesity. Separate circumference-based equations were developed for women and men. Both predictive equations were known to underestimate %BF. However, it was not known how well these abdominal circumference-based methods tracked changes in %BF. This study examined the validity of the circumference-based %BF equations for assessing changes in %BF in young adult recruits during Army Basic Combat Training (BCT). Dual-energy X-ray absorptiometry (DXA) and circumference-based measures of %BF were obtained in women (n = 481) and men (n = 926) at the start (pre-BCT) and end (post-BCT) of 8 weeks of BCT. Repeated-measure ANOVAs were used to assess differences between DXA and circumference pre-BCT and for the change during BCT. Pre-BCT, circumferences underestimated %BF relative to DXA, with mean errors of -6.0% ± 4.4% for women and -6.0% ± 3.5% for men (both p < 0.01), and no difference between sexes was observed (p = 0.77). DXA detected a -4.0% ± 2.4% and -3.3% ± 2.8% change in %BF for women and men in response to BCT, respectively (both p < 0.01), whereas circumference estimates of %BF indicated a 0.0% ± 3.3% (p = 0.86) change in women and a -2.2% ± 3.3% (p < 0.01) change in men (sex difference by technique p < 0.01). In conclusion, circumference-based measures underestimated %BF at the start of BCT in both sexes as compared to DXA. Circumference measures underestimated changes in %BF during BCT in men and did not detect changes in women. These findings suggest that circumference-based %BF metrics may not be an appropriate tool to track changes in body composition during short duration training.
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Yang L, Huang H, Liu Z, Ruan J, Xu C. Association of the android to gynoid fat ratio with nonalcoholic fatty liver disease: a cross-sectional study. Front Nutr 2023; 10:1162079. [PMID: 37255941 PMCID: PMC10226647 DOI: 10.3389/fnut.2023.1162079] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is becoming a severe global public health problem, and can developed into fibrotic nonalcoholic steatohepatitis (NASH), but its risk factors have not been fully identified. The objective of this study was to investigate the association between the android-to-gynoid fat ratio (A/G ratio) and the prevalence of NAFLD. Methods This cross-sectional study is based on the 2003-2006 and 2011-2018 cycles of the National Health and Nutrition Examination Survey and included 10,989 participants. Participants aged 20 and older without viral hepatitis or significant alcohol consumption were included. Dual-energy X-ray absorptiometry was used to assess body composition. NAFLD was diagnosed using the United States fatty liver index (US FLI). Multivariable logistic regression models were used to evaluate the association between the A/G ratio and NAFLD. Results The prevalence of NAFLD was 32.15% among the study population. Android percent fat and the A/G ratio were significantly higher in patients with NAFLD than in those without NAFLD [41.68% (0.25) vs. 32.80% (0.27), p < 0.001; 1.14 ± 0.01 vs. 0.94 ± 0.00, p < 0.001, respectively]. Logistic regression analysis showed that android percent fat was positively correlated to NAFLD (OR: 1.15, 95% CI: 1.11-1.18), while gynoid percent fat was negatively correlated to NAFLD (OR: 0.92, 95% CI: 0.90-0.94), and the A/G ratio was significantly associated with the prevalence of NAFLD (OR: 1.59, 95% CI: 1.38-1.82) and fibrotic NASH (OR: 2.01, 95% CI: 1.71-2.38). We also found that females had a notably diminished A/G ratio compared with males (0.91 vs. 1.12, p < 0.001). In addition, the female population proportion was negatively correlated with the A/G ratio, which may partly explain the lower prevalence of NAFLD in females. What is more, the OR value of the A/G ratio in the female subgroup was much higher than that in the male subgroup in all adjusted models. Conclusion A/G ratio is significantly associated with NAFLD and fibrotic NASH. Women have a lower A/G ratio than men, which may explain the sex difference in NAFLD prevalence. Furthermore, with a higher A/G ratio, the association between females and NAFLD are greatly elevated.
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Affiliation(s)
- Ling Yang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hangkai Huang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhening Liu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Ruan
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengfu Xu
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Clinical Research Center for Digestive Diseases, Hangzhou, China
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Roy R, Hazra A, Ghosh S. An Observational Study on Response to Growth Hormone Therapy in Indian Patients of Short Stature with Special Emphasis on Biochemical Parameters and Bone Biomarkers. Indian J Endocrinol Metab 2023; 27:260-269. [PMID: 37583404 PMCID: PMC10424109 DOI: 10.4103/ijem.ijem_303_22] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction There is a lack of Indian data on short stature treatment using recombinant human growth hormone (rhGH). We explored the effects of such treatment in eastern Indian patients, with emphasis on biochemical parameters and bone biomarkers in addition to basic anthropometry. Methods Our descriptive study covered 50 short stature patients of varied aetiology attending endocrine outpatient department (OPD) of a tertiary care teaching hospital. Patients were followed up for 1 year after the index visit, and prospective data were reconciled with past medical records. A dose of rhGH used was 0.18-0.375 mg/kg as standard, starting dose mostly being 0.2 mg/kg. Dosing was adjusted if the physician judged the clinical outcome to be less favourable than expected. Anthropometric parameters (height, weight, body mass index (BMI) and skeletal age) were recorded clinically, and various biochemical parameters and bone biomarkers were estimated from blood. Results Among 50 subjects, 60% had idiopathic growth hormone (GH) deficiency and 26% had Turner's syndrome. The median age at treatment start was 10 years, and the median treatment duration was 25.5 months. The height increased more in the first year of therapy. In the last 6 months, the height velocity was approximately 0.5 cm/month. Although the weight increased significantly, the increment slowed down in the last 6 months. Both remained less than age- and gender-matched references throughout. The skeletal age was on average 2 years behind chronological age (CA)-being 8.7, 9.6 and 11.3 years, respectively, at therapy start, after one year and at study end. Fasting blood glucose (FBG), total cholesterol and calcium level changes were not statistically significant. Serum cortisol and phosphate showed a modest but statistically significant rise, while thyroid-stimulating hormone (TSH) level declined. Insulin-like growth factor 1 (IGF-1) increase was relatively pronounced. Among bone biomarkers, a decrease in CTx and an increase in vitamin D were significant. Dual-energy X-ray absorptiometry (DEXA) data indicated that bone mineral density was less than that of age-matched controls despite treatment. The therapy was well tolerated. Conclusions rhGH treatment leads to significant improvement in anthropometry in Indian children comparable with Western data. Bone biomarker changes indicate decreased bone resorption and increased bone formation although bone mineral density still lags behind age-matched controls.
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Affiliation(s)
- Ritam Roy
- Department of Pharmacology, IPGME&R, Kolkata, West Bengal, India
| | - Avijit Hazra
- Department of Pharmacology, IPGME&R, Kolkata, West Bengal, India
- Dean, IPGME&R, Kolkata, West Bengal, India
| | - Sujoy Ghosh
- Department of Endocrinology, IPGME&R, Kolkata, West Bengal, India
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Radecka A, Lubkowska A. The Significance of Dual-Energy X-ray Absorptiometry (DXA) Examination in Cushing's Syndrome-A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13091576. [PMID: 37174967 PMCID: PMC10178172 DOI: 10.3390/diagnostics13091576] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/13/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
In recent years, the usefulness of dual-energy X-ray absorptiometry (DXA) as a valuable complementary method of assessing the content and distribution of adipose and lean tissue as well as bone mineral density and estimating the risk of fractures has been increasingly confirmed. The diagnosis and treatment of Cushing's syndrome remain challenging, and monitoring the effects of treatment is often necessary. DXA tests offer a potential solution to many problems related to the availability of a quick, detailed, and reliable analysis of changes in the content and distribution of individual body composition components. The article discusses total body DXA scans (FMI, VAT, ALMI), lumbar spine scans (VFA, TBS), and osteoporosis scans (BMD, T-score, Z-score)-all are of potential interest in Cushing's syndrome. The article discusses the use of the most important indicators obtained from a DXA test (FMI, VAT, ALMI, BMD, T-score, Z-score, VFA, TBS) and their clinical significance in Cushing's syndrome was verified. The literature from the last decade was used for the study, available in MEDLINE, Web of Science, and ScienceDirect.
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Affiliation(s)
- Aleksandra Radecka
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland
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20
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Gieng J, Field KD, Pignotti GAP. Healthy Eating Index and Dietary Inflammatory Index are not correlated with body composition in female collegiate athletes. J Am Coll Health 2023:1-7. [PMID: 37094286 DOI: 10.1080/07448481.2023.2201858] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE This cross-sectional study investigated associations among the Healthy Eating Index (HEI)-2015, Dietary Inflammatory Index (DII), and body composition in female collegiate athletes. PARTICIPANTS Female NCAA Division I student-athletes (n = 41, 18-21 years old) were included from various sports and did not report any diagnosed chronic diseases. METHODS Demographics, dietary intake, anthropometrics, and body composition, including bone mineral density, were collected utilizing a questionnaire, three interview-based multiple-pass 24-h dietary recalls, and dual-energy X-ray absorptiometry. RESULTS Mean HEI-2015 and DII scores (using 39 of 45 components) were 56.2 ± 13.5 and -0.1 ± 1.9, respectively. Athletes did not meet recommended intake levels for servings of fruit, vegetables, fiber, calcium, vitamin D, omega-3, and omega-6. Saturated fat and added sugar intake exceeded the recommended intakes. Diet quality indices and body composition measures were not correlated. CONCLUSIONS Although female collegiate athletes consumed poor-quality diets, this was not associated with body composition or bone health.
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Affiliation(s)
- John Gieng
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, California, USA
| | - Kiley D Field
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, California, USA
| | - Giselle A P Pignotti
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, California, USA
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Noordwijk KJ, Chen L, Ruspi BD, Schurer S, Papa B, Fasanello DC, McDonough SP, Palmer SE, Porter IR, Basran PS, Donnelly E, Reesink HL. Metacarpophalangeal Joint Pathology and Bone Mineral Density Increase with Exercise but Not with Incidence of Proximal Sesamoid Bone Fracture in Thoroughbred Racehorses. Animals (Basel) 2023; 13:ani13050827. [PMID: 36899684 PMCID: PMC10000193 DOI: 10.3390/ani13050827] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/31/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Proximal sesamoid bone (PSB) fracture is the leading cause of fatal musculoskeletal injury in Thoroughbred racehorses in Hong Kong and the US. Efforts are underway to investigate diagnostic modalities that could help identify racehorses at increased risk of fracture; however, features associated with PSB fracture risk are still poorly understood. The objectives of this study were to (1) investigate third metacarpal (MC3) and PSB density and mineral content using dual-energy X-ray absorptiometry (DXA), computed tomography (CT), Raman spectroscopy, and ash fraction measurements, and (2) investigate PSB quality and metacarpophalangeal joint (MCPJ) pathology using Raman spectroscopy and CT. Forelimbs were collected from 29 Thoroughbred racehorse cadavers (n = 14 PSB fracture, n = 15 control) for DXA and CT imaging, and PSBs were sectioned for Raman spectroscopy and ash fraction measurements. Bone mineral density (BMD) was greater in MC3 condyles and PSBs of horses with more high-speed furlongs. MCPJ pathology, including palmar osteochondral disease (POD), MC3 condylar sclerosis, and MC3 subchondral lysis were greater in horses with more high-speed furlongs. There were no differences in BMD or Raman parameters between fracture and control groups; however, Raman spectroscopy and ash fraction measurements revealed regional differences in PSB BMD and tissue composition. Many parameters, including MC3 and PSB bone mineral density, were strongly correlated with total high-speed furlongs.
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Affiliation(s)
- Kira J. Noordwijk
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Leyi Chen
- Department of Materials Science and Engineering, College of Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Bianca D. Ruspi
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Sydney Schurer
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Brittany Papa
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Diana C. Fasanello
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Sean P. McDonough
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Scott E. Palmer
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Ian R. Porter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Parminder S. Basran
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, College of Engineering, Cornell University, Ithaca, NY 14853, USA
- Correspondence: (E.D.); (H.L.R.)
| | - Heidi L. Reesink
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
- Correspondence: (E.D.); (H.L.R.)
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Huang Y, Wang X, Cheng H, Dong H, Shan X, Zhao X, Wang X, Xie X, Mi J. Differences in air displacement plethysmography, bioelectrical impedance analysis and dual-energy X-ray absorptiometry for estimating body composition in Chinese children and adolescents. J Paediatr Child Health 2023; 59:470-479. [PMID: 36661380 DOI: 10.1111/jpc.16327] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/08/2022] [Accepted: 12/23/2022] [Indexed: 01/21/2023]
Abstract
AIM This study aimed to compare body composition (BC) measurements obtained by three widely used BC measuring methods, air displacement plethysmography (ADP), bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), in Chinese children and adolescents by sex and different BMI categories. METHODS We used three BC measuring methods to evaluate healthy Chinese children and adolescents aged 5-17 years with BMI categories ranging from underweight to obese. Fat mass (FM, kg), fat mass percentage (FMP, %), fat-free mass (FFM, kg) and appendicular skeletal muscle mass (ASM, kg) were measured by DXA, BIA and ADP on the same day within 1 h. RESULTS A total of 172 Chinese children and adolescents were included in this study. The agreements for FM, FFM and ASM estimated by the three methods were excellent or good at the population level (intraclass correlation coefficient > 0.850, P < 0.05). However, ADP or BIA estimated lower body fat content and higher FFM than DXA (P < 0.001 for all). Moreover, the precise estimates significantly varied across BMI categories. In addition, the limit of agreements was wide, and the differences might not be clinically acceptable at the individual level. CONCLUSIONS Body fat and FFM obtained by the three commonly used methods were highly correlated, but systematically different and influenced by BMI. This study provided a basis for mutual reference of measurements between three widely used methods.
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Affiliation(s)
- Yiwen Huang
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xi Wang
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Hongbo Dong
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xinying Shan
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xia Wang
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | | | - Jie Mi
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
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23
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Ishimoto R, Mutsuzaki H, Shimizu Y, Kishimoto H, Takeuchi R, Hada Y. Prevalence of Sarcopenic Obesity and Factors Influencing Body Composition in Persons with Spinal Cord Injury in Japan. Nutrients 2023; 15. [PMID: 36678344 DOI: 10.3390/nu15020473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
This study aims to investigate the prevalence of sarcopenic obesity and factors influencing body composition in persons with spinal cord injury (SCI) in Japan. Adults with SCI aged ≥ 20 years who underwent whole-body dual-energy X-ray absorptiometry between 2016 and 2022 were retrospectively analyzed. Data from 97 patients were examined. The primary outcome was appendicular skeletal muscle mass (ASM). Multiple linear regression analysis was conducted to assess factors influencing the lean and adipose indices in persons with SCI. Sarcopenia, obesity, and sarcopenic obesity were prevalent in 76%, 85%, and 64% of patients, respectively. Multivariate linear regression analysis revealed that sex (β = 0.34, p < 0.001), lesion level (β = 0.25, p = 0.007), severity (β = 0.20, p = 0.043), and ability to walk (β = 0.29, p = 0.006) were independently associated with ASM. Sex (β = −0.63, p < 0.001) was independently associated with percent body fat. In conclusion, sarcopenia, obesity, and sarcopenic obesity were prevalent among patients with SCI in Japan. Female sex, tetraplegia, motor-complete injury, and inability to walk were risk factors for sarcopenia, whereas female sex was a risk factor for obesity in persons with SCI. A routine monitoring of body composition is necessary, especially among those with multiple risk factors, to identify individuals in need of preventive and therapeutic interventions.
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24
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Li S, Mao J, Zhou W. Prediabetes is associated with loss of appendicular skeletal muscle mass and sarcopenia. Front Nutr 2023; 10:1109824. [PMID: 36937340 PMCID: PMC10014813 DOI: 10.3389/fnut.2023.1109824] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/15/2023] [Indexed: 03/05/2023] Open
Abstract
Background Decreasing mass and metabolism in skeletal muscle are associated with increasing insulin resistance (IR) and type 2 diabetes mellitus (T2DM). The causal relation between sarcopenia and abnormal glucose metabolism may be bidirectional. This investigation is aimed to explore the detailed correlation between pre-diabetes and sarcopenia in United States (US) adults. Methods A total of 22,482 adults aged ≥20 years in the National Health and Nutrition Examination Survey (NHANES) were included. Generalized linear models were conducted to examine associations between diabetes status, serum glucose, glycohemoglobin (HbA1c), and sarcopenia. Generalized additive models and smooth fitting curves were used to examine the non-linear relationship between HbA1c and ASMBMI. Sarcopenia was defined as ASMBMI (appendicular skeletal muscle mass/body mass index) < 0.789 for males, and <0.512 for females based on the cut-off values of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. Results After fully adjusting for multiple covariates, sarcopenia was directly correlated with pre-diabetes [OR (95%CI) = 1.230 (1.057, 1.431), p = 0.008] and T2DM [OR (95%CI) = 2.106 (1.625, 2.729), p < 0.001]. In non-T2DM population, HbA1c was negatively correlated with ASMBMI [β (95%CI) = -0.009 (-0.013, -0.005), p < 0.001]. The correlations only persisted in males. Furthermore, in male non-T2DM population, the association of HbA1c and ASMBMI presents an inverted U-shape curve with an inflection point of HbA1c 5.2%. Conclusion Pre-diabetes is associated with increased risk of sarcopenia. HbA1c is an independent risk factor for loss of appendicular skeletal muscle mass and sarcopenia when HbA1c greater than 5.2% in the male non-T2DM population.
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Affiliation(s)
- Shuying Li
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Jiangfeng Mao
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- *Correspondence: Jiangfeng Mao,
| | - Weihong Zhou
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
- Weihong Zhou,
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25
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Yang S, Luo C, Zheng W, Li X, Zhang X, Jiang Y, Xiao F. Patterns of body composition and alteration after treatment in patients with newly diagnosed idiopathic inflammatory myopathies. Rheumatology (Oxford) 2022; 62:270-280. [PMID: 35552653 DOI: 10.1093/rheumatology/keac286] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/24/2022] [Accepted: 04/29/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To define the pattern of body composition and alteration after treatment of patients with newly diagnosed idiopathic inflammatory myopathies (IIMs) using DXA. METHODS DXA was used to obtain regional and whole-body measurements of fat mass and lean tissue mass (LTM) in 50 patients with newly diagnosed IIM and matched controls. The DXA indices of fat mass and LTM were calculated. The analyses included correlations between DXA indices and clinical parameters [manual muscle test (MMT), Myositis Damage Index (MDI), Myositis Intention-to-Treat Activities Index (MITAX), handgrip, percentage forced vital capacity (%FVC) and creatine kinase level], comparison between patients with IIM and controls, comparison between IIM subgroups, receiver operating characteristic (ROC) analysis, and comparison of body composition before and after treatment. RESULTS DXA LTM measurements were significantly correlated with MMT, MDI-muscle, handgrip strength, and %FVC. Patients with IIM had decreased LTM of the upper limbs and appendicular region. Male patients with IIM had significantly decreased LTM in the upper and lower limbs, whereas female patients with IIM had significantly decreased LTM in the upper limbs. Patients with IIM with anti-SRP seropositivity had lower LTM than patients with anti-SRP seronegativity. In ROC analysis, the DXA LTM indices presented good diagnostic values for distinguishing patients with newly diagnosed IIM from healthy controls. After treatment, the LTM of the upper limbs and appendicular region significantly increased. CONCLUSION DXA is an attractive method for the evaluation of patients with newly diagnosed IIM as well as a new way of monitoring disease conditions.
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Affiliation(s)
- Shiyi Yang
- Department of Neurology, Chongqing Key Laboratory of Neurology
| | | | - Wei Zheng
- Department of Neurology, Chongqing Key Laboratory of Neurology
| | - Xue Li
- Department of Neurology, Chongqing Key Laboratory of Neurology
| | - Xu Zhang
- Department of Neurology, Chongqing Key Laboratory of Neurology
| | - Ying Jiang
- Department of Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fei Xiao
- Department of Neurology, Chongqing Key Laboratory of Neurology
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26
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Watanabe N, Miyatake K, Takada R, Ogawa T, Amano Y, Jinno T, Koga H, Yoshii T, Okawa A. The prevalence and treatment of osteoporosis in patients undergoing total hip arthroplasty and the levels of biochemical markers of bone turnover. Bone Joint Res 2022; 11:873-880. [PMID: 36464500 PMCID: PMC9792872 DOI: 10.1302/2046-3758.1112.bjr-2022-0252.r1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
AIMS Osteoporosis is common in total hip arthroplasty (THA) patients. It plays a substantial factor in the surgery's outcome, and previous studies have revealed that pharmacological treatment for osteoporosis influences implant survival rate. The purpose of this study was to examine the prevalence of and treatment rates for osteoporosis prior to THA, and to explore differences in osteoporosis-related biomarkers between patients treated and untreated for osteoporosis. METHODS This single-centre retrospective study included 398 hip joints of patients who underwent THA. Using medical records, we examined preoperative bone mineral density measures of the hip and lumbar spine using dual energy X-ray absorptiometry (DXA) scans and the medications used to treat osteoporosis at the time of admission. We also assessed the following osteoporosis-related biomarkers: tartrate-resistant acid phosphatase 5b (TRACP-5b); total procollagen type 1 amino-terminal propeptide (total P1NP); intact parathyroid hormone; and homocysteine. RESULTS The prevalence of DXA-proven hip osteoporosis (T-score ≤ -2.5) among THA patients was 8.8% (35 of 398). The spinal osteoporosis prevalence rate was 4.5% (18 of 398), and 244 patients (61.3%; 244 of 398) had osteopenia (-2.5 < T-score ≤ -1) or osteoporosis of either the hip or spine. The rate of pharmacological osteoporosis treatment was 22.1% (88 of 398). TRACP-5b was significantly lower in the osteoporosis-treated group than in the untreated group (p < 0.001). CONCLUSION Osteoporosis is common in patients undergoing THA, but the diagnosis and treatment for osteoporosis were insufficient. The lower TRACP-5b levels in the osteoporosis-treated group - that is, osteoclast suppression - may contribute to the reduction of the postoperative revision rate after THA.Cite this article: Bone Joint Res 2022;11(12):873-880.
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Affiliation(s)
- Naoto Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan, Naoto Watanabe. E-mail:
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryohei Takada
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahisa Ogawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Amano
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan,Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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Blais K, Doyon M, Arguin M, Bouchard L, Perron P, Hivert MF. Associations between Cord Blood Leptin Levels and Childhood Adiposity Differ by Sex and Age at Adiposity Assessment. Life (Basel) 2022; 12. [PMID: 36556424 DOI: 10.3390/life12122060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Lower cord blood leptin levels have been associated with lower and higher adiposity in childhood and associations seem to differ according to the child’s age, methods of adiposity assessment and sex. Our aim was to investigate sex-specific associations of cord blood leptinemia with childhood adiposity at birth, 3 and 5 years of age. We measured cord blood leptin using Luminex immunoassays in 520 offspring from the Gen3G cohort. We tested associations between cord blood leptin and body mass index (BMI) z-score, skinfolds thicknesses (SFT), and body composition using dual-energy X-ray absorptiometry, adjusted for confounders. At birth, girls had almost twice as much leptin in cord blood as boys (15.5 [8.9; 25.6] vs. 8.6 [4.9; 15.0] ng/mL; p < 0.0001) as well as significantly greater adiposity. Lower levels of cord blood leptin were associated with higher sum of SFT (β = −0.05 ± 0.02; p = 0.03) and higher BMI z-score (β= −0.22 ± 0.08; p = 0.01) in 3-year-old boys only. We did not observe these associations at age 5, or in girls. Our results suggest a sexual dimorphism in the programming of leptin sensitivity and childhood adiposity, but further observational and functional studies are needed to better understand the role of leptin in early life.
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Senkus KE, Crowe-White KM, Locher JL, Ard JD. Relative fat mass assessment estimates changes in adiposity among female older adults with obesity after a 12-month exercise and diet intervention. Ann Med 2022; 54:1160-1166. [PMID: 35471192 PMCID: PMC9126590 DOI: 10.1080/07853890.2022.2067352] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/24/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVES/INTRODUCTION It is imperative to accurately estimate whole body fat percentage (%fat) to understand the deleterious nature of excess adiposity on cardiometabolic disease risk. Cost and accessibility often preclude the use of advanced imaging methods like dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). Relative fat mass (RFM) is an emerging estimator of whole body %fat based on waist circumference, height, and biological sex. The purpose of this ancillary study was to examine the relationship between RFM and gold-standard measures of adiposity among community-dwelling older adults with obesity and to evaluate if changes in RFM reflect changes in %fat following a 12-month lifestyle intervention (clinicaltrials.gov #NCT00955903). PATIENTS/MATERIALS AND METHODS Participants (N = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to the exercise only group, exercise + nutrient-dense weight maintenance group, or exercise + nutrient-dense energy restriction of 500 kcal/d group. Total and regional adiposity assessed by DXA and MRI, as well as anthropometrics, were evaluated at baseline and 12 months. RESULTS RFM was significantly positively correlated with DXA whole body %fat and DXA trunk %fat at baseline. Equivalence testing revealed that RFM was considered equivalent to DXA whole body %fat for females only. Additionally, from baseline to 12 months, a significant reduction in RFM was observed among female participants in the exercise + energy restriction group only. Changes in RFM were significantly correlated with changes in DXA whole body %fat, DXA trunk fat, and total abdominal fat tissue determined by MRI. CONCLUSION Results support the use of RFM as an estimate of whole body %fat where advanced imaging techniques are not feasible. Furthermore, results suggest that this index is sensitive to changes in fat mass over 12 months in female older adults with obesity. KEY MESSAGESRelative fat mass (RFM), an emerging estimator of whole body %fat based on waist circumference, height, and biological sex, was intentionally developed to be a simple estimate of adiposity that overcomes limitations of measures like body mass index.In the current study, results from correlations and agreement analyses support the use of RFM to estimate whole-body fat percentage in a community-dwelling older adult population with obesity when advanced methods, namely dual-energy X-ray absorptiometry, are not feasible.Significant reductions in RFM were also observed over a 12-month period that was significantly correlated with changes in whole body fat percentage; thus, supporting the sensitivity of RFM to lifestyle changes.
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Affiliation(s)
- Katelyn E. Senkus
- Department of Human Nutrition, The University of Alabama, Tuscaloosa, AL, USA
| | | | - Julie L. Locher
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jamy D. Ard
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Abstract
Osteoporosis is a common condition in which deteriorating bone tissue results in an increased risk of low trauma fracture. Influenced by the role of estrogen in building and maintaining bone mineral density, women have different patterns of bone accrual and loss compared with men, resulting in a lower peak bone mass and a greater lifetime fracture risk. Moreover, fracture risk increases significantly in postmenopausal women who have depleted estrogen levels. Osteoporotic fractures pose serious consequences-ranging from an inability to perform basic tasks and an increased risk of repeat fracture to the need for assisted living and even death. There is also a large economic toll associated with the health care costs required for post-fracture care. The Society for Women's Health Research (SWHR) convened an interdisciplinary Bone Health Working Group to review the current state of science and practice concerning women's bone health and osteoporosis care and to explore strategies to address gaps in screening, diagnosis, and treatment of bone disease in women. Women's bone health care must shift its paradigm from one of postmenopausal and post-fracture care to a preventive model that engages touchpoints throughout the lifespan. To achieve this paradigm shift, the Working Group recommends prioritizing efforts to build public awareness and clinical education of preventive bone health care for women, increase access to screening tools, improve patient-provider communication, and treat osteoporosis using a broader risk stratification approach.
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Affiliation(s)
- Carolyn McPhee
- Society for Women's Health Research, Washington, District of Columbia, USA
| | - Irene O. Aninye
- Society for Women's Health Research, Washington, District of Columbia, USA.,Address correspondence to: Irene O. Aninye, PhD, Society for Women's Health Research, 1025 Connecticut Avenue, NW, Suite 1104, Washington, DC 20036, USA
| | - Lindsey Horan
- Society for Women's Health Research, Washington, District of Columbia, USA
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Dawra S, Gupta P, Yadav N, Singh AK, Samanta J, Sinha SK, Sandhu MS, Kochhar R. Association between the Distribution of Adipose Tissue and Outcomes in Acute Pancreatitis: A Comparison of Methods of Fat Estimation. Indian J Radiol Imaging 2022; 33:12-18. [PMID: 36855725 PMCID: PMC9968522 DOI: 10.1055/s-0042-1758201] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose To assess the correlation between abdominal fat measured at computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) and association with clinical outcomes in patients with acute pancreatitis (AP). Methods This prospective study comprised consecutive patients with AP who underwent abdominal CT and DXA. Fat estimation was done on whole-body DXA and abdominal CT. Correlations among body mass index (BMI), waist circumference (WC), DXA, and CT fat measurements were determined. The association between fat measurements and clinical outcomes was assessed. Results Fifty-nine patients (mean age 38.2 years, 48 males) were included. There was a strong correlation ( r = 0.691-0.799) between DXA and CT fat estimation. In addition, there was a significant association of the visceral adipose tissue (VAT) on DXA and CT with the severity of AP ( p = 0.039 and 0.021, respectively) and the need for drainage of collections ( p = 0.026 and 0.008, respectively). There was a weak correlation of the BMI and WC with the length of hospitalization (LOH) ( r = 0.121, 0.190, respectively) and length of intensive care unit stay (LOICU) ( r = 0.211, 0.197), while there was a moderate to strong correlation of the truncal fat and visceral fat on DXA and total adipose tissue and VAT on CT with LOH ( r = 0.562, 0.532, 0.602 and 0.614, respectively) and LOICU ( r = 0.591, 0.577, 0.636, and 0.676, respectively). Conclusion In conclusion, fat indices measured on DXA and CT are associated with the severity of AP. In addition, the fat measurements at DXA are strongly correlated with those obtained at CT.
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Affiliation(s)
- Saurabh Dawra
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pankaj Gupta
- Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India,Address for correspondence Pankaj Gupta, MD Department of Radiodiagnosis and ImagingPostgraduate Institute of Medical Education and Research, Chandigarh 160012India
| | - Neha Yadav
- Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Anupam K Singh
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Jayanta Samanta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Saroj K Sinha
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Manavjit Singh Sandhu
- Departments of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rakesh Kochhar
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Wang W, Feng Y, Long Q, Chen F, Chen Y, Ma M, Mao S. A comparative analysis of body composition assessment by BIA and DXA in children with type II and III spinal muscular atrophy. Front Neurol 2022; 13:1034894. [PMID: 36468044 PMCID: PMC9715747 DOI: 10.3389/fneur.2022.1034894] [Citation(s) in RCA: 2] [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: 09/02/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Body composition analysis is a valuable tool for assessing and monitoring the nutritional status of children with spinal muscular atrophy (SMA). This study was designed to compare the consistency of bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), as the gold standard method for assessing body composition in clinical practice when treating children with type II and III SMA. METHODS From 2019 to 2021, we performed a retrospective analysis of body composition by DXA and BIA measurement methods in patients with type II and III SMA treated at a Chinese tertiary children's hospital. Fat mass (FM), muscle mass (MM), bone mineral content (BMC), and visceral fat area (VFA) were compared using paired sample t-tests. We calculated Lin's concordance correlation coefficient (CCC) and Spearman correlation coefficient to verify the correlation between DXA and BIA measurements. Bland-Altman analysis was used to assess the consistency of the two methods. RESULTS Fifty-seven children with type II and III SMA were recruited. Compared with body composition measured by DXA, the average FM measured by BIA is significantly lower (P <0.001), whereas the average MM, BMC, and VFA measured by BIA are significantly higher (P < 0.001) in children with SMA. Overall, the difference between MM (Delta [BIA-DAX] = 1.6 kg) and FM (Delta [BIA-DAX] = -1.6 kg) measured by DXA and BIA was minor, whereas the difference of VFA (Delta [BIA-DAX] = -43.5 cm) was significantly large. Correlation analysis indicated a substantial correlation of MM (CCC = 0.96 [95% confidence interval (CI) = 0.93-0.98], r = 0.967 [P < 0.0001]) and FM (CCC = 0.95 [95% CI = 0.92-0.97], r = 0.953 [P < 0.0001]), and poor correlation of BMC (CCC = 0.61 [95% CI = 0.42-0.75], r = 0.612 [P < 0.0001]) and VFA (CCC = 0.54 [95% CI = 0.33-0.70], r = 0.689 [P < 0.0001]) measurements between the two methods. The Bland-Altman analysis suggests that the majority of participants were within LOA. In addition, differences in MM and VFA measurements between BIA and DAX increased according to patients' increasing height, whereas differences in FM and BMC did not differ with height. CONCLUSION BIA overestimates MM and underestimates the FM, BMC, and VFA in children with SMA compared with DXA measurements. Overall, the non-invasive, easy-to-use, and repeatable BIA measurements were found to be in good agreement with DXA measurements, especially for FM and MM, which are essential parameters for the nutritional evaluation of children with SMA.
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Affiliation(s)
- Wenqiao Wang
- Department of Clinical Nutrition, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yijie Feng
- Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Qi Long
- Department of Clinical Nutrition, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Fei Chen
- Department of Clinical Nutrition, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yuzhi Chen
- Department of Clinical Nutrition, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Ming Ma
- Department of Clinical Nutrition, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shanshan Mao
- Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Lalayiannis AD, Crabtree NJ, Ferro CJ, Wheeler DC, Duncan ND, Smith C, Popoola J, Varvara A, Mitsioni A, Kaur A, Sinha MD, Biassoni L, McGuirk SP, Mortensen KH, Milford DV, Long J, Leonard MD, Fewtrell M, Shroff R. Bone Mineral Density and Vascular Calcification in Children and Young Adults With CKD 4 to 5 or on Dialysis. Kidney Int Rep 2022; 8:265-273. [PMID: 36815116 PMCID: PMC9939315 DOI: 10.1016/j.ekir.2022.10.023] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Older adults with chronic kidney disease (CKD) can have low bone mineral density (BMD) with concurrent vascular calcification. Mineral accrual by the growing skeleton may protect young people with CKD from extraosseous calcification. Our hypothesis was that children and young adults with increasing BMD do not develop vascular calcification. Methods This was a multicenter longitudinal study in children and young people (5-30 years) with CKD stages 4 to 5 or on dialysis. BMD was assessed by tibial peripheral quantitative computed tomography (pQCT) and lumbar spine dual-energy X-ray absorptiometry (DXA). The following cardiovascular imaging tests were undertaken: cardiac computed tomography for coronary artery calcification (CAC), ultrasound for carotid intima media thickness z-score (cIMTz), pulse wave velocity z-score (PWVz), and carotid distensibility for arterial stiffness. All measures are presented as age-adjusted and sex-adjusted z-scores. Results One hundred participants (median age 13.82 years) were assessed at baseline and 57 followed up after a median of 1.45 years. Trabecular BMD z-score (TrabBMDz) decreased (P = 0.01), and there was a nonsignificant decrease in cortical BMD z-score (CortBMDz) (P = 0.09). Median cIMTz and PWVz showed nonsignificant increase (P = 0.23 and P = 0.19, respectively). The annualized increase in TrabBMDz (ΔTrabBMDz) was an independent predictor of cIMTz increase (R 2 = 0.48, β = 0.40, P = 0.03). Young people who demonstrated statural growth (n = 33) had lower ΔTrabBMDz and also attenuated vascular changes compared with those with static growth (n = 24). Conclusion This hypothesis-generating study suggests that children and young adults with CKD or on dialysis may develop vascular calcification even as their BMD increases. A presumed buffering capacity of the growing skeleton may offer some protection against extraosseous calcification.
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Affiliation(s)
- Alexander D. Lalayiannis
- Pediatric Nephrology, Birmingham Women’s and Children’s Hospitals, National Health Service Foundation Trust, Birmingham, UK; University College London Great Ormond Street Hospital Institute of Child Health, London, UK
- Nephrology, Birmingham Children’s Hospital, Birmingham, UK
- Correspondence: Alexander D. Lalayiannis, Nephrology Department, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Nicola J. Crabtree
- Densitometry Department, Birmingham Women’s and Children’s Hospitals National Health Service, Foundation Trust, Birmingham, UK
| | | | - David C. Wheeler
- Department of Renal Medicine, University College London, London, UK
| | - Neill D. Duncan
- Imperial College Healthcare National Health Service Trust, Renal and Transplant Center, London, UK
| | - Colette Smith
- Institute of Global Helath, University College London, London, UK
| | - Joyce Popoola
- St. George’s University Hospital National Health Service Foundation Trust, London, UK
| | - Askiti Varvara
- Department of Pediatric Nephrology, “P & A Kyriakou” Children’s Hospital, Athens, Greece
| | - Andromachi Mitsioni
- Department of Pediatric Nephrology, “P & A Kyriakou” Children’s Hospital, Athens, Greece
| | - Amrit Kaur
- Pediatric Nephrology, Manchester University National Health Service Foundation Trust, Manchester, UK
| | - Manish D. Sinha
- Pediatric Nephrology, Evelina Children’s Hospital, London, UK
| | - Lorenzo Biassoni
- University College London Great Ormond Street Hospital Institute of Child Health, London, UK
| | - Simon P. McGuirk
- Radiology Department, Birmingham Women’s and Children’s Hospitals National Health Service Foundation Trust, Birmingham, UK
| | - Kristian H. Mortensen
- Department of Cardiac Imaging, University College London Great Ormond Street Hospital Institute of Child Health, London, UK
| | | | - Jin Long
- Stanford University School of Medicine, Palo Alto, California, USA
| | - Mary D. Leonard
- Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Mary Fewtrell
- University College London Great Ormond Street Institute of Child Health, Population Policy and Practice, Childhood Nutrition Research Center, London, UK
| | - Rukshana Shroff
- University College London Great Ormond Street Hospital Institute of Child Health, London, UK
- Great Ormond Street Hospital, London, UK
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Igudesman D, Crandell J, Corbin KD, Muntis F, Zaharieva DP, Casu A, Thomas JM, Bulik CM, Carroll IM, Pence BW, Pratley RE, Kosorok MR, Maahs DM, Mayer-Davis EJ. The Intestinal Microbiota and Short-Chain Fatty Acids in Association with Advanced Metrics of Glycemia and Adiposity Among Young Adults with Type 1 Diabetes and Overweight or Obesity. Curr Dev Nutr 2022; 6:nzac107. [PMID: 36349343 PMCID: PMC9620390 DOI: 10.1093/cdn/nzac107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background Comanagement of glycemia and adiposity is the cornerstone of cardiometabolic risk reduction in type 1 diabetes (T1D), but targets are often not met. The intestinal microbiota and microbiota-derived short-chain fatty acids (SCFAs) influence glycemia and adiposity but have not been sufficiently investigated in longstanding T1D. Objectives We evaluated the hypothesis that an increased abundance of SCFA-producing gut microbes, fecal SCFAs, and intestinal microbial diversity were associated with improved glycemia but increased adiposity in young adults with longstanding T1D. Methods Participants provided stool samples at ≤4 time points (NCT03651622: https://clinicaltrials.gov/ct2/show/NCT03651622). Sequencing of the 16S ribosomal RNA gene measured abundances of SCFA-producing intestinal microbes. GC-MS measured total and specific SCFAs (acetate, butyrate, propionate). DXA (body fat percentage and percentage lean mass) and anthropometrics (BMI) measured adiposity. Continuous glucose monitoring [percentage of time in range (70-180 mg/dL), above range (>180 mg/dL), and below range (54-69 mg/dL)] and glycated hemoglobin (i.e., HbA1c) assessed glycemia. Adjusted and Bonferroni-corrected generalized estimating equations modeled the associations of SCFA-producing gut microbes, fecal SCFAs, and intestinal microbial diversity with glycemia and adiposity. COVID-19 interrupted data collection, so models were repeated restricted to pre-COVID-19 visits. Results Data were available for ≤45 participants at 101 visits (including 40 participants at 54 visits pre-COVID-19). Abundance of Eubacterium hallii was associated inversely with BMI (all data). Pre-COVID-19, increased fecal propionate was associated with increased percentage of time above range and reduced percentage of time in target and below range; and abundances of 3 SCFA-producing taxa (Ruminococcus gnavus, Eubacterium ventriosum, and Lachnospira) were associated inversely with body fat percentage, of which two microbes were positively associated with percentage lean mass. Abundance of Anaerostipes was associated with reduced percentage of time in range (all data) and with increased body fat percentage and reduced percentage lean mass (pre-COVID-19). Conclusions Unexpectedly, fecal propionate was associated with detriment to glycemia, whereas most SCFA-producing intestinal microbes were associated with benefit to adiposity. Future studies should confirm these associations and determine their potential causal linkages in T1D.This study is registered at clinical.trials.gov (NCT03651622; https://clinicaltrials.gov/ct2/show/NCT03651622).
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Affiliation(s)
- Daria Igudesman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jamie Crandell
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen D Corbin
- AdventHealth Translational Research Institute, Orlando, FL, USA
| | - Franklin Muntis
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dessi P Zaharieva
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, CA, USA
| | - Anna Casu
- AdventHealth Translational Research Institute, Orlando, FL, USA
| | - Joan M Thomas
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cynthia M Bulik
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, CA, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ian M Carroll
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, CA, USA
| | | | - Michael R Kosorok
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David M Maahs
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, CA, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, CA, USA
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Lee SK, Jun DS, Lee DK, Baik JM. Clinical Characteristics of Elderly People with Osteoporotic Vertebral Compression Fracture Based on a 12-Year Single-Center Experience in Korea. Geriatrics (Basel) 2022; 7. [PMID: 36412612 DOI: 10.3390/geriatrics7060123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
In an aging human population, osteoporotic vertebral compression fracture (OVCF) frequently occurs. We conducted this retrospective study to analyze the clinical characteristics of elderly people with OVCF who underwent percutaneous vertebroplasty or kyphoplasty over a 12-year period at a single medical center in Korea. Between 2007 and 2019, A total of 868 patients (n = 868) were treated at our institution. We assessed 600 of these patients as eligible for study purposes and divided them into three groups: Group A (spine and hip T-scores ≤-2.5; n = 332); Group B (spine T-scores ≤-2.5; n = 189); and Group C (hip T-scores ≤-2.5; n = 79). The baseline characteristics of the patients included age, sex, body mass index (BMI), past history of steroid use, alcohol consumption, use of osteoporosis therapy, smoking, and treatment for OVCF. We compared these characteristics between the three groups. We found that the mean patient age was significantly higher in Group A, compared with Group B, and significantly lower in Group B, compared with Group C. We also found significant differences in the male-to-female ratio and mean body mass index between the three groups. In conclusion, we suggest that special attention should be paid to factors closely associated with spine and hip T-scores when evaluating elderly people with OVCF and determining appropriate treatment.
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Lopes S, Fontes T, Tavares RG, Rodrigues LM, Ferreira-Pêgo C. Bioimpedance and Dual-Energy X-ray Absorptiometry Are Not Equivalent Technologies: Comparing Fat Mass and Fat-Free Mass. Int J Environ Res Public Health 2022; 19:13940. [PMID: 36360820 PMCID: PMC9657485 DOI: 10.3390/ijerph192113940] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Bioimpedance (BIA) is the most frequently used technology for body composition assessment at a daily clinical level, mostly due to its low price and user-friendly operation. However, many doubts persist regarding its physiological meaning and applicability. The present study aimed to compare one BIA system and the Dual-Energy X-ray Absorptiometry (DXA) for the characterization of body composition in a previously selected cohort of healthy adult participants. A descriptive observational cross-sectional study included a final sample of 121 participants, 93 women and 28 men, with a mean age of 28.26 ± 9.72 years old and a mean body mass index (BMI) of 22.68 ± 3.13 kg/m2. Statistics involved paired t-tests and agreement analysis by the Bland-Altman method. BIA underestimated the percent body fat (%BF) by 5.56% and overestimated Fat-Free Mass (FFM) by 2.90 kg. A strong positive correlation between both technologies was found for FFM (r = 0.980) and the %BF (r = 0.932), but the disagreement was statistically significant (p < 0.001). Although DXA and BIA seem to correlate, these technologies are not congruent. Therefore, the risk of (mis)interpretation and bias is clear with BIA, potentially impacting the nutritional planning of clinical dietitians and the further results of its patients.
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Sebastiani G, Paisible N, Costiniuk C, Cox J, Kablawi D, Klein MB, Kronfli N, Routy JP, Falutz J, Lebouché B, Guaraldi G. The Relationship between Visceral Adiposity and Nonalcoholic Fatty Liver Disease Diagnosed by Controlled Attenuation Parameter in People with HIV: A Pilot Study. Diagnostics (Basel) 2022; 12:diagnostics12112590. [PMID: 36359434 PMCID: PMC9689790 DOI: 10.3390/diagnostics12112590] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Fat alterations are frequent in people with HIV (PWH) and predict worse cardiometabolic outcomes. Visceral adipose tissue (VAT) is associated with ectopic fat accumulation in the liver. We aimed to investigate nonalcoholic fatty liver disease (NAFLD) diagnosed by controlled attenuation parameter (CAP) as a potential marker of visceral adiposity in PWH. Methods: We conducted a prospective pilot study of HIV mono-infected patients undergoing metabolic characterization and paired CAP measured by transient elastography with dual-energy X-ray absorptiometry (DEXA) scan. NAFLD was defined as CAP ≥ 285 dB/m, in absence of alcohol abuse. Excess visceral adiposity was defined as VAT > 1.32 Kg. Pairwise correlation, area under the curve (AUC) and logistic regression analysis were employed to study the association between VAT and CAP. Results: Thirty patients were included, of whom 50% had NAFLD. CAP was correlated with VAT (r = 0.650, p < 0.001) measured by DEXA scan. After adjusting for duration of HIV infection, body mass index and waist circumference, CAP remained the only independent predictor of excess VAT (adjusted odds ratio 1.05, 95% confidence interval [CI] 1.01−1.10). The AUC analysis determined CAP had excellent performance to diagnose excess VAT (AUC 0.92, 95% CI 0.81−1.00), higher than BMI and waist circumference. The optimized CAP cut-off to diagnose excess VAT was 266 dB/m, with a sensitivity of 88.3% and a specificity of 84.6%. Conclusions: NAFLD diagnosed by CAP is associated with VAT in PWH independently of anthropometric measures of obesity. CAP may be a potential diagnostic marker of visceral adiposity in the practice of HIV medicine.
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Affiliation(s)
- Giada Sebastiani
- Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC H4A3J1, Canada
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
- Correspondence: ; Tel.: +1-514-843-1616
| | - Nathalie Paisible
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Cecilia Costiniuk
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Joseph Cox
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Dana Kablawi
- Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Marina B. Klein
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Nadine Kronfli
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Jean-Pierre Routy
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Julian Falutz
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
| | - Bertrand Lebouché
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A3J1, Canada
- Department of Family Medicine, McGill University, Montreal, QC H4A3J1, Canada
| | - Giovanni Guaraldi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41100 Modena, Italy
- Modena HIV Metabolic Clinic, Azienda Ospedaliero-Universitaria di Modena, 41100 Modena, Italy
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Tan C, Chan KE, Ng CH, Tseng M, Syn N, Tang ASP, Chin YH, Lim WH, Tan DJH, Chew N, Ong EYH, Koh TK, Xiao J, Chee D, Valsan A, Siddiqui MS, Huang D, Noureddin M, Wijarnpreecha K, Muthiah MD. DEXA Scan Body Fat Mass Distribution in Obese and Non-Obese Individuals and Risk of NAFLD-Analysis of 10,865 Individuals. J Clin Med 2022; 11:jcm11206205. [PMID: 36294526 PMCID: PMC9605163 DOI: 10.3390/jcm11206205] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide yet predicting non-obese NAFLD is challenging. Thus, this study investigates the potential of regional fat percentages obtained by dual-energy X-ray absorptiometry (DXA) in accurately assessing NAFLD risk. Using the United States National Health and Nutrition Examination Survey (NHANES) 2011−2018, multivariate logistic regression and marginal analysis were conducted according to quartiles of regional fat percentages, stratified by gender. A total of 23,752 individuals were analysed. Males generally showed a larger increase in marginal probabilities of NAFLD development than females, except in head fat, which had the highest predictive probabilities of non-obese NAFLD in females (13.81%, 95%CI: 10.82−16.79) but the lowest in males (21.89%, 95%CI: 20.12−23.60). Increased percent of trunk fat was the strongest predictor of both non-obese (OR: 46.61, 95%CI: 33.55−64.76, p < 0.001) and obese NAFLD (OR: 2.93, 95%CI: 2.07−4.15, p < 0.001), whereas raised percent gynoid and leg fat were the weakest predictors. Ectopic fat deposits are increased in patients with non-obese NAFLD, with greater increases in truncal fat over gynoid fat. As increased fat deposits in all body regions can increase odds of NAFLD, therapeutic intervention to decrease ectopic fat, particularly truncal fat, may decrease NAFLD risk.
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Affiliation(s)
- Caitlyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Correspondence: (C.H.N.); (M.D.M.); Tel.: +65-6772-3737 (C.H.N.); +65-6772-4354 (M.D.M.)
| | - Michael Tseng
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Nicholas Syn
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Department of Hematology-Oncology, National University Cancer Institute, Singapore 119074, Singapore
| | - Ansel Shao Pin Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Nicholas Chew
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore 119074, Singapore
| | - Elden Yen Hng Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Teng Kiat Koh
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
| | - Jieling Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Douglas Chee
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
| | - Arun Valsan
- Department of Gastroenterology and Hepatology, Amrita Hospital, Kochi 682041, India
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Daniel Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore
| | | | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, University of Arizona College of Medicine Phoenix, Phoenix, AZ 85004, USA
| | - Mark D. Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore
- Correspondence: (C.H.N.); (M.D.M.); Tel.: +65-6772-3737 (C.H.N.); +65-6772-4354 (M.D.M.)
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Holm-Glad T, Røkkum M, Röhrl SM, Roness S, Godang K, Reigstad O. A randomized controlled trial comparing two modern total wrist arthroplasties : improved function with stable implants, but high complication rates in non-rheumatoid wrists at two years. Bone Joint J 2022; 104-B:1132-1141. [PMID: 36177637 DOI: 10.1302/0301-620x.104b10.bjj-2022-0201.r2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To analyze the short-term outcome of two types of total wrist arthroplasty (TWA) in terms of wrist function, migration, and periprosthetic bone behaviour. METHODS A total of 40 patients suffering from non-rheumatoid wrist arthritis were enrolled in a randomized controlled trial comparing the ReMotion and Motec TWAs. Patient-rated and functional outcomes, radiological changes, blood metal ion levels, migration measured by model-based radiostereometric analysis (RSA), bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), complications, loosening, and revision rates at two years were compared. RESULTS Patient-Rated Wrist and Hand Evaluation (PRWHE) scores, abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire scores, and pain improved similarly and significantly in both groups. Wrist motion improved significantly in the Motec group only, and forearm rotation in the ReMotion group only. Cobalt (Co) and chromium (Cr) blood ion levels were significantly higher in the metal-on-metal (MoM) Motec group than in the metal-on-polyethylene (MoP) ReMotion group. Mean total translation was 0.65 mm (95% confidence interval (CI) 0.26 to 1.12) and 0.27 mm (95% CI 0.14 to 0.47) for the ReMotion carpal and radial components, and 0.32 mm (95% CI 0.22 to 0.45) and 0.26 mm (95% CI 0.20 to 0.34) for the Motec metacarpal and radial components, respectively. Apart from dorsal and volar tilts, which were significantly higher for the radial ReMotion than for the Motec component, no significant differences in absolute migration occurred. BMD around the radial components never returned to baseline. Almost one-third of patients required reoperation due to complications. Two ReMotion implants were revised to Motec TWAs due to carpal component loosening, and three Motec MoM articulations were revised to metal-on-polyether ether ketone due to painful synovitis. CONCLUSION Both implants provided matched function and were stable at short-term follow-up, but with a high complication rate. This procedure should be restricted to specialist centres undertaking prospective analysis until its role is clarified.Cite this article: Bone Joint J 2022;104-B(10):1132-1141.
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Affiliation(s)
- Trygve Holm-Glad
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Magne Røkkum
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stephan M Röhrl
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siri Roness
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Kristin Godang
- Section of Specialized Endocrinology, Oslo University Hospital, Oslo, Norway
| | - Ole Reigstad
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Shevroja E, White R, Lamy O, Krueger D, Hans D, Binkley N. Bone Texture Assessment on Lateral VFAs Using the Texture Research Investigational Platform (TRIP) and its Fracture Discrimination Ability. J Clin Densitom 2022; 25:599-605. [PMID: 35430132 DOI: 10.1016/j.jocd.2022.02.028] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/04/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
Texture Research Imaging Platform applies trabecular bone score (TBS) measurement principles to images acquired with multiple modalities to assess bone texture at various skeletal sites. This study aimed to assess the bone texture score in dual-energy X-ray absorptiometry-acquired lateral vertebral fracture assessment (VFA) images (BTSVFA), evaluate its reproducibility, and vertebral fracture discrimination ability. Subjects included 178 VF cases and 178 non-VF controls, 136 women and 42 men in each group, age 55-92 years, from two research centers. Cases and controls were matched for age (±5 years), body mass index (±5 kg/m2) and TBS. All participants underwent dual-energy X-ray absorptiometry TBS assessment from standard posterior-anterior lumbar spine scans and BTSVFA assessment. VF presence was determined using VFA images applying the Genant's method. BTSVFA was lower among fractured women compared to non-fractured (0.626 ± 0.109 vs 0.675 ± 0.099, p < 0.01), but not among men. In a binary logistic regression adjusted for study center and sex, for each SD lower BTSVFA, there was a 40% increase (OR 1.40, 95% CI (1.13-1.74)) in the risk of having a prevalent VF; area under the curve (95% CI) 0.616 (0.557-0.675). Inter-assessor and inter-centers ICCs for BTSVFA measurements were very good; 0.96 (0.64-0.99) and 0.98 (0.95-0.99), respectively. The BTSVFA precision (coefficient of variation) was 2.42%. This feasibility study demonstrates the potential to assess trabecular bone texture in lateral VFA images with good reproducibility. BTSVFA can discriminate between fractured and non-fractured women independent of their age, body mass index and TBS. In conclusion, BTSVFA, a potential trabecular texture assessment that excludes the posterior elements, may have value in fracture prediction or as a novel approach to be further investigated in spine surgery planning.
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Affiliation(s)
- Enisa Shevroja
- Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Ryleigh White
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - Olivier Lamy
- Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Diane Krueger
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - Didier Hans
- Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland; Research and Development Department, Medimaps, Bordeaux, France
| | - Neil Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
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Faber BG, Ebsim R, Saunders FR, Frysz M, Lindner C, Gregory JS, Aspden RM, Harvey NC, Davey Smith G, Cootes T, Tobias JH. A novel semi-automated classifier of hip osteoarthritis on DXA images shows expected relationships with clinical outcomes in UK Biobank. Rheumatology (Oxford) 2022; 61:3586-3595. [PMID: 34919677 PMCID: PMC9434243 DOI: 10.1093/rheumatology/keab927] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Conventional scoring methods for radiographic hip OA (rHOA) are subjective and show inconsistent relationships with clinical outcomes. To provide a more objective rHOA scoring method, we aimed to develop a semi-automated classifier based on DXA images and confirm its relationships with clinical outcomes. METHODS Hip DXAs in UK Biobank (UKB) were marked up for osteophyte area from which acetabular, superior and inferior femoral head osteophyte grades were derived. Joint space narrowing (JSN) grade was obtained automatically from minimum joint space width (mJSW) measures. Clinical outcomes related to rHOA comprised hip pain, hospital diagnosed OA (HES OA) and total hip replacement. Logistic regression and Cox proportional hazard modelling were used to examine associations between overall rHOA grade (0-4; derived from combining osteophyte and JSN grades) and the clinical outcomes. RESULTS A toal of 40 340 individuals were included in the study (mean age 63.7), of whom 81.2% had no evidence of rHOA, while 18.8% had grade ≥1 rHOA. Grade ≥1 osteophytes at each location and JSN were associated with hip pain, HES OA and total hip replacement. Associations with all three clinical outcomes increased progressively according to rHOA grade, with grade 4 rHOA and total hip replacement showing the strongest association [57.70 (38.08-87.44)]. CONCLUSIONS Our novel semi-automated tool provides a useful means for classifying rHOA on hip DXAs, given its strong and progressive relationships with clinical outcomes. These findings suggest DXA scanning can be used to classify rHOA in large DXA-based cohort studies supporting further research, with the future potential for population-based screening.
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Affiliation(s)
- Benjamin G Faber
- Musculoskeletal Research Unit
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol
| | - Raja Ebsim
- Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester
| | - Fiona R Saunders
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen
| | - Monika Frysz
- Musculoskeletal Research Unit
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol
| | - Claudia Lindner
- Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester
| | - Jennifer S Gregory
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen
| | - Richard M Aspden
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol
| | - Timothy Cootes
- Division of Informatics, Imaging and Data Science, The University of Manchester, Manchester
| | - Jonathan H Tobias
- Musculoskeletal Research Unit
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol
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Smoot BJ, Mastick J, Shepherd J, Paul SM, Kober KM, Cooper BA, Conley YP, Dixit N, Hammer MJ, Fu MR, Abrams G, Miaskowski C. Use of Dual-Energy X-Ray Absorptiometry to Assess Soft Tissue Composition in Breast Cancer Survivors With and Without Lymphedema. Lymphat Res Biol 2022; 20:391-397. [PMID: 34793255 PMCID: PMC9422781 DOI: 10.1089/lrb.2021.0030] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: In patients with lymphedema (LE), in addition to hand dominance, between-group comparisons of interlimb soft tissue differences need to account for differences in whole-body adiposity, measured directly by dual energy X-ray absorptiometry (DXA) or indirectly by body mass index. No study has evaluated the effects of hand dominance and whole-body adiposity on limb composition in patients with LE. This study's purpose was to compare soft tissue composition of affected and unaffected limbs of women with breast cancer, who did and did not have LE, controlling for dominance and percent body fat. Methods and Results: Whole-body DXA scans were acquired and included measures of percent body fat, upper limb total mass, upper limb fat mass, and upper limb fat-free mass. Participants were classified into one of three groups: women without LE; women with only subjective LE; and women with objective signs of LE at the time of assessment. Differences among the LE groups were evaluated using analysis of variance (ANOVA) and Chi-square analyses. Analysis of covariance (ANCOVA) was used to control for percent body fat and for the affected limb dominance. Compared to women without LE, women with objective signs of LE have greater total limb mass, fat mass, and fat-free mass in their affected limbs, independent of affected side dominance and percent body fat. In addition, the interlimb differences in total mass, fat mass, and fat-free mass were greater for the women with objective signs of LE, compared to the other two groups. Conclusions: DXA is useful in identifying soft tissue changes in patients with LE. Given that limb circumferences measure only changes in limb volume and that bioimpedance provides estimates of extracellular fluid, DXA has the advantage of being able to estimate the volumes of specific tissues in the limb.
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Affiliation(s)
- Betty J. Smoot
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Judy Mastick
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Steven M. Paul
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Kord M. Kober
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Bruce A. Cooper
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Niharika Dixit
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Mei R. Fu
- School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Gary Abrams
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Christine Miaskowski
- School of Medicine, University of California San Francisco, San Francisco, California, USA
- School of Nursing, University of California San Francisco, San Francisco, California, USA
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Berglund NR, Lewis JI, Michaelsen KF, Mølgaard C, Renault KM, Carlsen EM. Birthweight z-score and fat-free mass at birth predict body composition at 3 years in Danish children born from obese mothers. Acta Paediatr 2022; 111:1427-1434. [PMID: 35357724 PMCID: PMC9322285 DOI: 10.1111/apa.16346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 01/02/2023]
Abstract
Aim We investigated associations between newborn body composition and anthropometry and body composition at 3 years in Danish children born from obese mothers. Methods Analyses are based on data from the observational cohort study SKOT II (SKOT; small children's diet and well‐being (Danish)). Body composition at birth and at 3 years was assessed by dual‐energy X‐ray absorptiometry (DXA) scans and bioelectrical impedance analysis (BIA), respectively. Multiple linear regression models were applied to determine associations between newborn body composition and anthropometry and body composition at 3 years. Results Birthweight z‐score (BWZ) was positively associated with fat‐free mass (FFM), height, fat‐free mass index (FFMI), fat mass (FM) and fat mass index (FMI) at 3 years. Newborn FFM was positively associated with FFM, height, FFMI and FM at 3 years, and positive trends were seen between newborn FM and FM and FMI at 3 years. Conclusion We showed that infants born with a higher BWZ go on to be taller at 3 years. They also grow to be heavier, to which FM and FFM both contribute, independently of linear growth. Additionally, it seems that FFM tracks into early childhood, thus supporting intrauterine programming of later health.
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Affiliation(s)
- Nanna R. Berglund
- Department of Nutrition, Exercise and Sports Faculty of Science University of Copenhagen Frederiksberg Denmark
| | - Jack I. Lewis
- Department of Nutrition, Exercise and Sports Faculty of Science University of Copenhagen Frederiksberg Denmark
| | - Kim F. Michaelsen
- Department of Nutrition, Exercise and Sports Faculty of Science University of Copenhagen Frederiksberg Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports Faculty of Science University of Copenhagen Frederiksberg Denmark
| | - Kristina M. Renault
- Department of Obstetrics and Gynecology Rigshospitalet, Copenhagen University Hospital Copenhagen Denmark
| | - Emma M. Carlsen
- Department of Pediatrics Hvidovre Hospital Copenhagen University Hospital Hvidovre Denmark
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Martin CB, Stierman B, Yanovski JA, Hales CM, Sarafrazi N, Ogden CL. Body fat differences among US youth aged 8-19 by race and Hispanic origin, 2011-2018. Pediatr Obes 2022; 17:e12898. [PMID: 35135038 PMCID: PMC9177747 DOI: 10.1111/ijpo.12898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The association between body mass index (BMI) and adiposity differs by race/ethnicity. OBJECTIVE To examine differences in adiposity by race/Hispanic origin among US youth and explore how those differences relate to differences in BMI using the most recent national data, including non-Hispanic Asian youth. METHODS Weight, height and DXA-derived fat mass index (FMI) and percentage body fat (%BF) from 6923 youth 8-19 years in the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were examined. Age-adjusted mean BMI, FMI and %BF were reported. Sex-specific linear regression models predicting %BF and FMI were adjusted for age, BMI category and BMI category*race/Hispanic origin interaction. RESULTS %BF was highest among Hispanic males (28.2%) and females (35.7%). %BF was lower among non-Hispanic Black (23.9%) compared with non-Hispanic White (26.0%) and non-Hispanic Asian (26.6%) males. There was no difference between non-Hispanic Black females (32.7%) and non-Hispanic White (33.2%) or non-Hispanic Asian (32.7%) females. FMI was higher among Hispanic youth compared with non-Hispanic White youth. Among youth with underweight/healthy weight, predicted %BF and FMI were lower among non-Hispanic Black males (-2.8%; -0.5) and females (-2.0%; -0.3), compared with non-Hispanic White youth, and higher among Hispanic males (0.9%; 0.2) and females (2.0%; 0.5), while %BF but not FMI was higher among non-Hispanic Asian males (1.3%) and females (1.4%). Among females with obesity, non-Hispanic Asian females had lower %BF (-2.3%) and FMI (-1.7) than non-Hispanic White females. CONCLUSIONS Differences in %BF and FMI by race/Hispanic origin were not consistent by BMI category among US youth in 2011-2018.
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Affiliation(s)
- Crescent B. Martin
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
| | - Bryan Stierman
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC; Epidemic Intelligence Service, CDC
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH
| | - Craig M. Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC; United States Public Health Service
| | - Neda Sarafrazi
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
| | - Cynthia L. Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
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Zhu K, Walsh JP, Murray K, Hunter M, Hui J, Hung J. DXA-Derived vs Standard Anthropometric Measures for Predicting Cardiometabolic Risk in Middle-Aged Australian Men and Women. J Clin Densitom 2022; 25:299-307. [PMID: 35177350 DOI: 10.1016/j.jocd.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/08/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
It is not clear if dual-energy X-ray absorptiometry (DXA) adiposity measures are superior to standard anthropometric measures for predicting cardiometabolic (CM) risk factors in a middle-aged general population. In the Busselton Healthy Ageing Study, we assessed a range of standard anthropometric and DXA-derived adiposity measures to predict metabolic syndrome (MetS) and CM risk factors in 4831 "baby boomers" aged 45-69 yr. Anthropometric and whole body DXA (GE Lunar Prodigy) measures were collected. Cross-sectional relationships of overall adiposity (BMI; DXA fat mass index, body fat %), central adiposity (waist circumference (WC); DXA trunk fat, android fat, abdominal visceral adipose tissue (VAT)) and ratio index (waist-to-hip ratio; DXA trunk/legs fat, android/gynoid ratio, VAT/total fat) with MetS and its components (as both continuous and binary outcomes) were evaluated using linear and logistic regression adjusting for age and lifestyle factors. Youden's Index was used to determine the optimal cut-points for predicting MetS. In linear regression analyses, central adiposity measures showed stronger associations with MetS score and CM risk factors than overall adiposity measures and fat ratio index, and DXA-VAT provided stronger associations than WC. Logistic regression models showed similar findings. For MetS diagnosis present in 35.9% of males and 24.4% of females, the highest odds ratio (95% CI) per SD change was observed for DXA-VAT (males: 5.02 [4.28, 5.88]; females: 3.91 [3.40, 4.49]), which remained significant (all p < 0.001) after further adjustment for BMI (males: 3.27 [2.65, 4.02]; females: 3.37 [2.79, 4.06]) or WC (males: 2.46 [1.95, 3.10]; females: 2.75 [2.21, 3.43]). The optimal DXA-VAT mass cut-point for predicting MetS was 1608 grams in males and 893 grams in females. DXA-VAT was superior to standard anthropometric and other DXA-derived adiposity measures for prediction of cardiometabolic risk factors, and has clinical utility for identifying middle-aged individuals at increased risk of MetS.
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Affiliation(s)
- Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia.
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia; Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Jennie Hui
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Joseph Hung
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
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Cirnigliaro CM, Myslinski MJ, Parrott JS, Cross GT, Gilhooley S, La Fountaine MF, Kirshblum SC, McClure IA, Forrest GF, Spungen AM, Bauman WA. Generation of a Reference Dataset to Permit the Calculation of T-scores at the Distal Femur and Proximal Tibia in Persons with Spinal Cord Injury. J Clin Densitom 2022; 25:308-318. [PMID: 35216904 DOI: 10.1016/j.jocd.2022.01.005] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/17/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022]
Abstract
Persons with traumatic spinal cord injury (SCI) have severe bone loss below the level of lesion with the distal femur (DF) and proximal tibia (PT) being the skeletal regions having the highest risk of fracture. While a reference areal bone mineral density (aBMD) database is available at the total hip (TH) using the combined National Health and Nutrition Examination Survey (NHANES) III study and General Electric (GE) combined (GE/NHANES) to calculate T-score (T-scoreGE/NHANES), no such reference database exists for aBMD of the DF, and PT. The primary objectives of this study were (1) to create a reference dataset of young-healthy able-bodied (YHAB) persons to calculate T-score (T-scoreYHAB) values at the DF and PT, (2) to explore the impact of time since injury (TSI) on relative bone loss in the DF and PT regions using the two computation models to determine T-score values, and (3) to determine agreement between T-score values for a cohort of persons with SCI using the (T-scoreYHAB) and (T-scoreGE/NHANES) reference datasets. A cross-sectional prospective data collection study. A Department of Veterans Affairs Medical Center and a Private Rehabilitation Hospital. A normative reference aBMD database at the DF and PT was collected in 32 male and 32 female Caucasian YHAB participants (n=64) and then applied to calculate T-score values at the DF and PT in 105 SCI participants from a historical cohort. The SCI participants were then grouped based on TSI epochs (E-I: TSI < 1y, E-II: TSI 1-5y, E-III: TSI 6-10y, E-IV: TSI 11-20y, E-V: TSI > 20y). N/A. The knee and hip aBMD values were obtained by dual energy X-ray absorptiometry (GE Lunar iDXA) using standard clinical software for proximal femur orthopedic knee software applications. There were no significant differences in mean aBMD values across the four YHAB age subgroups (21-25, 26-30, 31-35, and 36-40 yr of age) at the TH, DF, and PT; mean aBMD values were higher in men compared to the women at all skeletal regions of interest. Using the mean YHAB aBMD values to calculate T-score values at each TSI epoch for persons with SCI, T-score values decreased as a function of TSI, and they continued to decline for 11-20 yr. Moderate kappa agreement was noted between the YHAB and the GE/NHANES reference datasets for the T-score cutoff criteria accepted to diagnose osteoporosis (i.e., SD <-2.5). A homogeneous reference dataset of YHAB aBMD values at the DF and PT was applied to calculate T-score values in persons with chronic SCI. There was a moderate level of agreement at the TH between the YHAB and GE/NHANES reference datasets when applying the conventional T-score cutoff value for the diagnosis of osteoporosis.
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Affiliation(s)
- Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.
| | - Mary Jane Myslinski
- Department of Physical Therapy, School of Biomedical and Health Sciences, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Scott Parrott
- Department of Physical Therapy, School of Biomedical and Health Sciences, Rutgers New Jersey Medical School, Newark, NJ, USA; Department of Interdisciplinary Studies, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Gregory T Cross
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Shawn Gilhooley
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Michael F La Fountaine
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA
| | - Steven C Kirshblum
- Kessler Institute for Rehabilitation, West Orange, NJ, USA; Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Isa A McClure
- Kessler Institute for Rehabilitation, West Orange, NJ, USA
| | - Gail F Forrest
- Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Ann M Spungen
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William A Bauman
- Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Departments of Medicine and Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kılınc RM, Açan AE, Türk G, Kılınç CY, Yeniçeri İÖ. Evaluation of femoral head bone quality by Hounsfield units: a comparison with dual-energy X-ray absorptiometry. Acta Radiol 2022; 63:933-941. [PMID: 34078124 DOI: 10.1177/02841851211021035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Osteoporosis is associated with decreases in bone mineral density (BMD) and is diagnosed using dual-energy X-ray absorptiometry (DXA). Computed tomography (CT), performed in routine practice, can also be used to evaluate bone quality without additional cost. PURPOSE To determine whether Hounsfield units (HU), a standardized CT attenuation coefficient, measured from the femoral head correlated with DXA-measured BMD. MATERIAL AND METHODS We evaluated 82 patients (14 men, 68 women; mean age, 67 years) undergoing femoral DXA and CT (non-enhanced abdominopelvic and hip scans) with 130 kV to determine whether HU correlated with T-scores. HU were measured by two radiologists using the largest spherical region of interest including the medullary bone of the femoral head from the junction point of the most caudal section of the femoral head with the femoral neck in 5-mm axial sections. The correlations of both sides' HU values with their ages and DXA femur T-score were evaluated. RESULTS HU values obtained from both femoral heads showed significant variation between the osteoporotic and non-osteoporotic groups (both P = 0.000) and strongly correlated with each other and DXA femur T-scores (left r = 0.75, right r = 0.73, respectively). In ROC curve analysis, predictive power of left HU values in identifying patients with osteoporotic femur DXA T-score was 0.905, and for right HU values it was 0.924. Osteoporosis cutoff values were 198 HU and 204 HU for the left and right hips, respectively. CONCLUSIONS HU obtained from CT performed in routine practice correlated with the DXA scores, thus providing an alternative method to determine regional bone quality without additional cost. This may be useful when choosing a fixation method, especially in trauma cases with already-performed abdominopelvic or pelvic CT in emergency services.
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Affiliation(s)
- Rabia Mihriban Kılınc
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Radiology, Mugla, Turkey
| | - Ahmet Emrah Açan
- Balıkesir University, Faculty of Medicine, Department of Orthopedics and Traumatology, Balıkesir, Turkey
| | - Gamze Türk
- Kayseri Training and Research Hospital, Department of Radiology, Kayseri, Turkey
| | - Cem Yalın Kılınç
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Orthopedics and Traumatology, Muğla, Turkey
| | - İbrahim Önder Yeniçeri
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Radiology, Mugla, Turkey
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Saito H, Matsue Y, Maeda D, Kasai T, Kagiyama N, Endo Y, Zoda M, Mizukami A, Yoshioka K, Hashimoto T, Ishikawa K, Minamino T. Prognostic values of muscle mass assessed by dual-energy X-ray absorptiometry and bioelectrical impedance analysis in older patients with heart failure. Geriatr Gerontol Int 2022; 22:610-615. [PMID: 35751442 DOI: 10.1111/ggi.14424] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/06/2021] [Revised: 03/23/2022] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
AIM This study aimed to compare bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA) in measuring skeletal muscle mass (MM), and its prognostic implications in old patients with heart failure. METHODS We prospectively evaluated MM measured by both BIA and DEXA in 226 hospitalized elderly (≥65 years) patients with heart failure. The cut-off values proposed by the Asian Working Group in Sarcopenia were used to define low MM. The prognostic endpoint was all-cause death. RESULTS The median age of the cohort was 82 years (interquartile range: 75-87), and 51.8% of patients were men. According to the BIA and DEXA, 177 (78.3%) and 120 (53.1%) patients were diagnosed with low MM, respectively, and the two assessment tools showed poor agreement (Cohen's kappa coefficient: 0.294). During the follow-up, 32 patients (14.2%) died; only low MM defined by DEXA (hazard ratio 2.45, 95% confidence interval 1.05-5.72, P = 0.039), but not BIA (hazard ratio 1.03, 95% confidence interval 0.35-3.06, P = 0.955), was associated with poor prognosis after adjusting for pre-existing risk factors. Moreover, low MM defined by DEXA (net reclassification improvement: 0.58, P < 0.001), but not BIA (net reclassification improvement: -0.005, P = 0.975), provides incremental prognostic predictability when considered with pre-existing risk factors and brain natriuretic peptide level at discharge. CONCLUSIONS In elderly hospitalized patients with heart failure, low MM defined by DEXA and BIA show significant discordance. The MM defined by DEXA, but not BIA, provides additional prognostic value to pre-existing prognostic models. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshiko Endo
- Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Masato Zoda
- Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Akira Mizukami
- Department of Cardiology, Kameda Medical Center, Chiba, Japan
| | - Kenji Yoshioka
- Department of Cardiology, Kameda Medical Center, Chiba, Japan
| | | | - Kazuya Ishikawa
- Department of Diagnostic Radiology, Kameda Medical Center, Chiba, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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Xu Q, Kong N, Zhang Z, Cui A, Tan S, Bai N. Changes in Bone Mineral Density After Parathyroidectomy and Their Relations With Biochemical Markers of Bone Metabolism. Am Surg 2022:31348221096574. [PMID: 35570721 DOI: 10.1177/00031348221096574] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND To measure total type 1 serum amino-terminal propeptide procollagen (t-P1NP), β- type 1 cross-linked C-terminal telopeptide collagen (β-CTX), N-terminal osteocalcin (OC), and 25-(OH)-VD3 levels before parathyroidectomy (PTX) in patients with PHPT, and correlate these measurements with bone mineral density (BMD) changes at 1-year post-PTX. METHODS Patients with primary hyperparathyroidism (PHPT) were followed from diagnosis to 12 months after surgery. Serum levels of calcium, parathyroid hormone (PTH), vitamin 25-(OH)-VD3, OC, β-CTX, t-P1NP, and BMD were measured before and 1 year after surgery. RESULTS One year after PTX, mean BMD increased by 25.7, 27.7, and 33.5% in the lumbar spine (L1-L4), femoral neck (FN), and greater trochanter (GT), respectively. Percent BMD change 1-year post-PTX was significant correlated with preoperative levels of β-CTX (L1-L4: r = 0.41, P < 0.0001; FN: r = 0.54, P = 0.0003; GT: r = 0.46, P = 0.0029), t-P1NP (L1-L4: r = 0.58, P < 0.0001; FN: r = 0.73, P < 0.0001; GT: r = 0.65, P < 0.0001), 25-(OH)-VD3 (L1-L4: r = -0.33, P = 0.034; FN: r = -0.48, P = 0.002; GT: r = -0.52, P = 0.0007), and OC (L1-L4: r = 0.49, P = 0.0013; FN: r = 0.55, P = 0.0002; GT: r = 0.47, P = 0.002). CONCLUSIONS Preoperative levels of turnover markers and BMD improvements were significantly correlated in patients with PHPT 1 year after PTX.
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Affiliation(s)
- Qiqi Xu
- General Surgery of Beijing Jishuitan Hospital, 66526The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Na Kong
- General Surgery of Beijing Jishuitan Hospital, 66526The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Ziqin Zhang
- General Surgery of Beijing Jishuitan Hospital, 66526The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Aimin Cui
- General Surgery of Beijing Jishuitan Hospital, 66526The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Shen Tan
- General Surgery of Beijing Jishuitan Hospital, 66526The Fourth Clinical Medical College of Peking University, Beijing, China
| | - Nan Bai
- General Surgery of Beijing Jishuitan Hospital, 66526The Fourth Clinical Medical College of Peking University, Beijing, China
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Association of strength, power, and function with muscle thickness, echo intensity, and lean tissue in older males. Appl Physiol Nutr Metab 2022; 47:521-528. [PMID: 35104155 DOI: 10.1139/apnm-2021-0690] [Citation(s) in RCA: 2] [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] [Indexed: 11/22/2022]
Abstract
Dual-energy X-ray absorptiometry (DXA) appendicular lean tissue is used to screen older adults for sarcopenia. However, emerging data indicates that ageing-related muscle atrophy largely occurs within specific muscles, which may be masked using appendicular lean tissue. Comparisons between appendicular lean tissue and site-specific measures of muscle in relation to strength and physical function are needed to advance our understanding of these features in the context of poor muscle function in aged adults. Our primary objective was to compare correlations between lean tissue and site-specific muscle characteristics in relation to strength and physical function in older males. Older males (≥65 years) were evaluated for muscle strength, physical function (6-minute walk and 30-second sit-to-stand), and muscle size (appendicular and site-specific) and composition (echo intensity) using DXA and ultrasound. Of the 32 older males (75.4 ± 7.9 years), 12 had low appendicular lean tissue. All DXA and ultrasound muscle characteristics were associated (r = 0.39 to 0.83, p < 0.05) with torque or power producing capabilities. Except for the knee flexors, no differences in correlation coefficients were observed between muscle thickness or regional lean tissue in relation to muscle strength. Neither DXA nor ultrasound muscle characteristics were associated with physical function. In older males, ultrasound-based muscle thickness and DXA lean tissue provided similar associations with strength. Novelty: Lean tissue and muscle thickness provide similar associations with strength. Muscle thickness can distinguish low and normal appendicular lean tissue in older adults.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Egor Avrutin
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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Milanese C, Cavedon V, Peluso I, Toti E, Zancanaro C. The Limited Impact of Low-Volume Recreational Dance on Three-Compartment Body Composition and Apparent Bone Mineral Density in Young Girls. Children (Basel) 2022; 9. [PMID: 35327763 DOI: 10.3390/children9030391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/24/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Recreational dance is practiced worldwide as a multidimensional physical activity with a potential for prevention of a sedentary lifestyle and overweight/obesity. This study explored in young (7−15 year; n = 21) girls the effect of long-term (>1 year) exposure to recreational (2 h/w) dancing on three-compartment body composition. Recreational dancers (RD) were compared with recreational (≤4 h/w) artistic gymnasts (RG, n = 22) and physically active young girls not involved in structured extracurricular physical activity (control; C, n = 22), adjusting for confounding variables (age, body mass, menarche). We hypothesized for RD an intermediate body composition between RG and C. The three groups had similar age and body mass index. Body composition indices in RD were intermediate between that of C and RG, but RD values were not statistically significantly different vs. C. This agreed with the not statistically significant higher energy expenditure (MET-min/w) in RD vs. C (1357.7 ± 805.32 and 1090.9 ± 596.63, p = 0.172). In conclusion, long-term recreational dance exposure at low volume had limited positive effect on body composition of young girls vs. unstructured extracurricular physical activity. Future work will explore the potential of recreational dance at higher volume (3−4 h/w) to improve body composition in young girls.
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