Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

Vitamin D receptor gene polymorphisms, bone mineral density and bone turnover: FokI genotype is related to postmenopausal bone mass

The relationship between vitamin D receptor (VDR) intragenic polymorphisms FokI, BsmI, ApaI and TaqI and bone mineral density (BMD) or biochemical markers of bone remodeling were investigated in 114 Czech postmenopausal women, on the average 62.5+/-8.9 years of age. Restriction fragment length polymorphisms in the VDR gene were assessed by PCR amplification and digestion with restriction enzymes FokI, BsmI, ApaI, and TaqI recognizing polymorphic sites in the VDR locus. Bone mineral density was measured at the lumbar spine and at the hip by dual-energy X-ray absorptiometry (DEXA, g/cm2). After adjusting for age and the body mass index (BMI), subjects with the ff genotype had 9.4% lower BMD at the hip than those with the Ff genotype (p=0.0459, Tukey's test). FF individuals had an intermediate BMD at the hip. A similar pattern of lower lumbar spine BMD was also found in ff individuals, but it did not reach statistical significance. There was no relationship between BsmI, ApaI and TaqI VDR polymorphisms and BMD at any skeletal site. Subjects with Aa (ApaI) genotypes had higher levels of propeptide of type I collagen (PICP) than homozygous AA (p=0.0459, Tukey's test). In FokI, BsmI and TaqI restriction sites the biochemical markers of bone remodeling did not differ by genotype. In addition, no significant difference was observed in VDR genotypic distribution between osteoporotic women and non-osteoporotic controls in the study group. To conclude, the FokI genotype of the vitamin D receptor gene is related to bone mass at the hip in Czech postmenopausal women, whereas the importance of remaining VDR genotypes was not evident.

Costs and outcomes of risperidone treatment in schizophrenia in the Czech Republic

The increasing cost of pharmaceuticals in the Czech Republic has led to restrictions on the prescription of more expensive atypical antipsychotics. The aim of the study was to compare the costs and outcomes of using risperidone versus classical neuroleptics in treatment of schizophrenia in order to see if there was any cost advantage in restricting use of more recent antipsychotics. Sixty-seven patients (39 women) with a mean age of 34.6 years (S.D. = 9.74) suffering from schizophrenia or schizoaffective disorder were treated with risperidone while 67 patients (39 women) with the same diagnoses with a mean age of 35.7 years (S.D. = 9.91) received standard neuroleptics. Yearly direct medical costs and outcomes (indicated by the average Global Assessment of Functioning score) were assessed retrospectively in an open, intent-to-treat study by abstracting psychiatric outpatient charts. The outcomes were not significantly different between the treatment groups while the risperidone treatment was significantly more expensive than the therapy with standard neuroleptics. This result which appears to be inconsistent with the literature was caused by the cheap labor force in the Czech Republic. The difference between the followed treatments in the direct costs will probably become insignificant in the future when the country's economy will be more developed.

Higher prevalence of antibodies to Borrelia burgdorferi in psychiatric patients than in healthy subjects

OBJECTIVE

Borrelia burgdorferi infection can affect the CNS and mimic psychiatric disorders. It is not known whether Borrelia burgdorferi contributes to overall psychiatric morbidity. The authors compared the prevalence of antibodies to Borrelia burgdorferi in groups of psychiatric patients and healthy subjects to find out whether there is an association between this infection and psychiatric morbidity.

METHOD

Between 1995 and 1999 the authors screened for antibodies to Borrelia burgdorferi in 926 psychiatric patients consecutively admitted to Prague Psychiatric Center. They compared the results of this screening with findings from 884 consecutive healthy subjects who took part in an epidemiological survey of antibodies to Borrelia burgdorferi in the general population of the Czech Republic. Sera were tested by means of enzyme-linked immunosorbent assay. Circulating immune complexes were isolated by polyethylene glycol precipitation. To control for potential confounders, the two groups of patients and healthy subjects were matched according to gender and age. Results were obtained in a sample of 499 matched pairs.

RESULTS

Among the matched pairs, 166 (33%) of the psychiatric patients and 94 (19%) of the healthy comparison subjects were seropositive in at least one of the four assays.

CONCLUSIONS

These findings support the hypothesis that there is an association between Borrelia burgdorferi infection and psychiatric morbidity. In countries where this infection is endemic, a proportion of psychiatric inpatients may be suffering from neuropathogenic effects of Borrelia burgdorferi.

Systemic insulin-like growth factor-I, insulin and vitamin D status in relation to age-associated bone loss in women

This cross-sectional study, performed on 146 healthy (n = 64) or osteoporotic but otherwise normal (n = 82) pre- (n = 38) or post-menopausal (n = 108) female subjects, analyzed the relationships between bone mineral density (BMD) (measured by dual-energy X-ray absorptiometry), parameters of bone remodelling, indices of calcium homeostasis and systemic IGF-I or insulin levels against a background of natural aging. BMD (g/cm(2)) at the hip correlated to serum IGF-I concentration (r = 0.207, p < 0.05), as well as to insulin levels (r = 0.241, p < 0.01), while BMD at the spine correlated only to IGF-I levels (r = 0.173, p < 0.05). After adjustment for age, body mass index, serum PTH, vitamin D status and calcitonin levels, neither IGF-I nor insulin levels could be significantly related to BMD at the spine or hip. On the other hand, 25-OH vitamin D(3) was found to be an important predictor of BMD at the hip (beta = 0.1686, p = 0.0437). In conclusion, this study failed to demonstrate a predictive importance of insulin-IGF-I axis to the development of bone mass. Instead, a significant predictive value to BMD at the hip was documented for serum 25-OH vitamin D(3).

[Clinical and economic significance of iron replacement in anemia treated with recombinant human erythropoietin in patients on hemodialysis]

BACKGROUND

Anaemia is a common phenomenon encountered in patients on hemodialysis. Although treatment with rHuEPO therapy is effective, it may fail even at high doses. As rHuEPO efficacy depends on the bioavailability of iron, we monitored the effect of consistent iron supplementation on hematocrit levels and rHuEPO dosage.

METHODS AND RESULTS

24 patients of our outpatient dialysis centre were included in this study. The mean age was 59 years. The age group over 60 included 14 patients. The mean duration of dialysis treatment was 23.8 months. The patients were followed for 6 months according to the NKF-DOQI (National Kidney Foundation Dialysis Outcomes Quality Initiative) recommendations for the treatment of anaemia. Following values were examined monthly: hematocrit, transferin saturation (TSAT) and ferritin. Iron and rHuEPO dosage was adjusted accordingly. Genetic tests for haemochromatosis were conducted in 4 patients with the highest value of TSAT and ferritin. TSAT increased from a mean of 15.9% to 35.9% (p < 0.001). In 23 patients (96%) TSAT levels were within the recommended range after the treatment. Hematocrit increased from 27.7% to 35.7% (p < 0.001). The recommended value of 33% was achieved in 18 patients (75%). The weekly dose of eHuEPO fell from 3958 IU (International Unit) to 2042 IU (p < 0.001), i.e. 1857 IU of rHuEPO were saved per week, per patient. The average dose of iron administered was 157 mg per week. The average level of ferritin rose from 457 micrograms/k to 1387 micrograms/l (p < 0.001). All results were comparable, even in the group of the senior's selected cases. Genetic testing for haemochromatosis showed mutation H63D in heterozygous state of HFE gene in 2 of 4 patients with the highest value of TSAT and ferritin. Sufficient iron supplementation leads to a significant rise in hematocrit and a concomitant decrease of required rHuEPO doses. TSAT, and not ferritin, is a good marker of iron bioavailability.

CONDITIONS

The financial savings due to decreased rHuEPO requirements are 20 times higher than the costs related to iron supplementation, calculated in relation to prices valid for the Czech Republic in 1999. Cause and effect of increased level of ferritin should be carefully studied.

The pathophysiological implications of circulating androgens on bone mineral density in a normal female population

In this cross-sectional study performed on 147 healthy or osteoporotic, but otherwise normal premenopausal (n = 26 and n = 13, respectively) or postmenopausal (n = 40 and n = 68, respectively) women aged 40.1+/-9.9 and 61.9+/-8.9 years, respectively (range 20-82 years), serum ovarian and adrenal sex steroids and their relationship to bone mineral density (BMD) were evaluated. The levels of dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione (AD), and estradiol correlated positively with BMD at the hip and spine as did serum testosterone with BMD at the spine. An inverse relationship was found between sex hormone binding globulin (SHBG) levels and BMD at the spine and hip. After adjustment for age, body mass, and sex steroid confounders, the bioavailable testosterone value (but not the DHEAS, DHEA, AD, or SHBG) values was demonstrated to be an independent determinant of BMD at the spine (beta 0.18, P<0.02) and hip (beta 0.24, P<0.02). Similarly, estradiol was found to be an independent determinant of BMD at the spine (beta 0.25, P<0.007). However, only SHBG levels (but not other steroid parameters) correlated positively with indices of bone remodeling, namely, serum osteocalcin and cross-linked telopeptide of type I collagen (ICTP). The present study suggests that a major decline in index of free testosterone (testosterone/SHBG) may influence the development of female osteoporosis. The clinical significance of circulating SHBG levels in the assessement of bone metabolic turnover remains to be established.

Circulating beta(2) microglobulin in relation to bone metabolism: implications for bone loss with aging

The aim of this cross-sectional study was to evaluate the relationships between circulating beta(2) microglobulin (beta(2) m) and bone mineral density (BMD), parameters of bone remodeling, vitamin D metabolites, parathyroid hormone (PTH), estradiol levels, and age in a group of 165 clinically healthy or osteoporotic, but otherwise normal untreated women. In this group of women, systemic beta(2) m correlated with BMD (g/cm(2)) levels for total hip and Ward's triangle (r = -0.298, P < 0.0001; and r = -0.299, P < 0.0001, respectively), but only at the borderline level with BMD at the spine (r = -0.145, P = 0.0604). Serum beta(2) microglobulin markedly correlated with age (r = 0.512, P = 0.0001). beta(2) m levels correlated with indices of bone remodeling, as well as with serum creatinine and estradiol levels. However, after stratification of all analyses by age, body mass index, and serum 25OHD(3), 1, 25(OH)(2)D(3), PTH, or estradiol levels (using standard multiple regression and stepwise forward regression models), only 25OHD(3) was found to be an independent predictor of BMD at the hip, including Ward's triangle, as estradiol of BMD at the spine. On the other hand, beta(2) m was not associated with BMD at any of the measured regions. Also, no association was found between serum PTH and BMD values. Therefore, systemic beta(2) m seems to be an indicator of bone remodeling in the course of natural skeletal aging rather than a variable independently predicting bone loss.