Analysis of Dietary Intake and Body Composition of Collegiate Runners / Análisis de la Ingesta Dietética y Composición Corporal de Corredores Universitarios

SUMMARY: The aim of this cross-sectional study was to compare dietary intake to published recommendations and to analyze the potential relationship between body composition and dietary intake in collegiate athletes. Eighteen healthy male middle- and long- distance runners (age 20.11 ± 2.72 y; height, 174.7 ± 6.1 cm; body mass, 64.0 ± 7.7 kg), were recruited from a Mexican university track and field team at the beginning of the general preparation phase for national competitions. Participants completed three 24-hour dietary recalls, which were used to estimate dietary intake. Body composition was measured by Dual-energy X-ray absorptiometry (DXA). Athletes displayed high body fat values. Protein intake was significantly higher than published recommendations. Iron, zinc, sodium, and vitamin C intake were significantly higher than recommended values, while potassium and calcium intake were below established recommendations. No significant correlations between body composition variables (i.e body fat, lean body mass, bone mineral content) and dietary intake (i.e energy, macronutrients and selected vitamins and minerals) could be found. These findings suggest that coaches and practitioners should pay close attention to dietary intake and body composition of endurance athletes starting general preparation for competition. Future studies on changes of dietary intake and body composition during off-season and competitive phase, which also track physical activity, are warranted.

El objetivo de este estudio transversal fue comparar la ingesta dietética con las recomendaciones publicadas y analizar la relación potencial entre la composición corporal y la ingesta dietética en corredores universitarios. Dieciocho atletas masculinos sanos de media y larga distancia (edad 20,11 ± 2,72 años; altura, 174,7 ± 6,1 cm; masa corporal, 64,0 ± 7,7 kg), fueron reclutados de un equipo de atletismo de una universidad mexicana al comienzo de la fase de preparación general de competiciones nacionales. Los participantes completaron tres recordatorios dietéticos de 24 horas, que se utilizaron para estimar la ingesta dietética. La composición corporal se midió mediante absorciometría de rayos X de energía dual (DXA). Los atletas mostraron altos valores de grasa corporal. La ingesta de proteínas fue significativamente mayor que las recomendaciones publicadas. La ingesta de hierro, zinc, sodio y vitamina C fue significativamente superior a los valores recomendados, mientras que la ingesta de potasio y calcio estuvo por debajo de las recomendaciones establecidas. No se encontraron correlaciones significativas entre las variables de composición corporal (es decir, grasa corporal, masa corporal magra, contenido mineral óseo) y la ingesta dietética (es decir, energía, macronutrientes y vitaminas y minerales seleccionados). Estos hallazgos sugieren que los entrenadores y los practicantes deberían prestar mucha atención a la ingesta dietética y la composición corporal de los atletas de resistencia que comienzan la preparación general para la competencia. Se justifican estudios futuros sobre los cambios en la ingesta dietética y la composición corporal durante la fase fuera de temporada y competitiva, como también un seguimiento de la actividad física.

Association of blood heavy metal levels with osteocalcin abnormality and incidence of osteoporosis in Saudi subjects / Associação de anormalidades de osteocalcina nos níveis de metais pesados no sangue e incidência de osteoporose em indivíduos sauditas

Abstract Serum toxic metals have been implicated in development of many diseases. This study investigated the association between blood levels of lead and cadmium with abnormal bone mineral density (BMD) and incidence of osteoporosis. Sixty Saudi male adults age matching were assigned into two groups: A healthy control group (n = 30) and osteoporosis patients diagnosed according to T-score (n = 30). Serum calcium, vitamin D, osteocalcin, lead, cadmium were measured. Osteoporotic group showed a highly significant elevation of blood lead and cadmium levels compared to the control group (p <0.001). BMD was negatively correlated with serum osteocalcin level compared with control. There was a significant negative correlation between the cadmium and lead levels (r=-0.465 and p-value = 0.01) and calcium (p < 0.004). Our findings suggested that high cadmium and lead were negative correlated to BMD and increased the risk factor for osteoporosis.

Resumo Os metais tóxicos do soro têm sido implicados no desenvolvimento de muitas doenças. Este estudo investigou a associação entre os níveis sanguíneos de chumbo e cádmio com densidade mineral óssea anormal (DMO) e incidência de osteoporose. Sessenta adultos sauditas do sexo masculino com idades iguais foram divididos em dois grupos: um grupo de controle saudável (n = 30) e pacientes com osteoporose diagnosticados de acordo com o T-score (n = 30). Cálcio sérico, vitamina D, osteocalcina, chumbo, cádmio foram medidos. O grupo osteoporótico apresentou elevação altamente significativa dos níveis de chumbo e cádmio no sangue em comparação ao grupo controle (p < 0,001). A DMO foi negativamente correlacionada com o nível de osteocalcina sérica em comparação com o controle. Houve correlação negativa significativa entre os níveis de cádmio e chumbo (r = -0,465 ep = 0,01) e cálcio (p < 0,004). Nossos achados sugeriram que cádmio e chumbo elevados foram correlacionados negativamente à DMO e aumentaram o fator de risco para osteoporose.

Association of body fat distribution with depression and social anxiety in children and adolescents: A cross-sectional study based on dual-energy X-ray detection / 北京大学学报(医学版)

OBJECTIVE@#To investigate the status of depression and social anxiety in children and adolescents, and to analyze the association between body fat distribution and depression, social anxiety in children and adolescents.@*METHODS@#A total of 1 412 children aged 7 to 18 years in Beijing were included by stratified cluster random sampling method. Body fat distribution, including total body fat percentage (total BF%), Android BF%, Gynoid BF% and Android-to-Gynoid fat ratio (AOI), were obtained by dual-energy X-ray absorption method. Depression and social anxiety were evaluated by Children Depression Inventory and Social Anxiety Scale for Children. Multivariate linear regression and restricted cubic spline analysis were used to estimate the linear and non-linear correlation between body fat distribution and depression and social anxiety.@*RESULTS@#13.1% and 31.1% of the children and adolescents had depressive symptoms and social anxiety symptoms respectively, and the detection rate of depression and social anxiety in the boys and young groups was significantly lower than those in the girls and old groups. There was no significant linear correlation between total BF%, Android BF%, Gynoid BF%, AOI and depression and social anxiety in the children and adolescents. However, total BF% and Gynoid BF% had significant nonlinear correlation with depression, showing an inverted U-shaped curve relationship with the tangent points of 26.8% and 30.9%, respectively. In terms of the nonlinear association of total BF%, Android BF%, Gynoid BF% and AOI with depression and social anxiety, the change trends of the boys and girls, low age group and high age group were consistent. The overall anxiety risk HR of body fat distribution in the boys was significantly higher than that in the girls, and the risk HR of depression and social anxiety were significantly higher in the high age group than those in the low age group.@*CONCLUSION@#There was no significant linear correlation between body fat distribution and depression and social anxiety in children and adolescents. Total BF% and depression showed an inverted U-shaped curve, mainly manifested in Gynoid BF%, and this trend was consistent in different genders and different age groups. Maintaining children and adolescents' body fat distribution at an appropriate level is the future direction of the prevention and control of depression and social anxiety in children and adolescents.

Absorción mineral y retención ósea en ratas normales en crecimiento por el consumo de un yogur experimental reducido en lactosa que contiene galactooligosacáridos (GOS) / Mineral absorption and bone retention in normal growing rats by consumption of an experimental lactose-reduced yogurt containing galactooligosaccharides (GOS)

Introducción: Los GOS son prebióticos naturales presentes en la leche materna que pue-den obtenerse enzimáticamente a partir de la lactosa de leche de vaca durante la fabricación de yogur. El producto lácteo resultante será reducido en lactosa y contendrá prebióticos y bacterias potencialmente probióticas. Sin embargo, mantendrá la baja relación Ca/Pi que aporta la leche de vaca, lo que podría alterar el remodelamiento óseo y la mineralización. Objetivo: comparar si un yogur reducido en lactosa que contiene GOS (YE) ofrece ventajas adicionales respecto de un yogur regular sin GOS (YR) sobre las absorciones (Abs) de Ca y Pi, retención y calidad ósea durante el crecimiento normal. Al destete, ratas machos fueron divididas en 3 grupos alimentados con AIN ́93-G (C), YE o YR durante 28 días. Resultados: YE mostró el mayor aumento de lactobacilos fecales; producción de ácidos grasos de cadena corta especialmente p, profundidad de las criptas colónicas y menor pH cecal. El %AbsCa y %AbsPi aumentó en el siguiente órden: YE> YR> C (p < 0,05). El contenido de Ca y Pi en fémur, la densidad y contenido mineral óseos y los parámetros biomecánicos fueron similares en YE y C, mientras que YR mostró valores significativa-mente menores (p < 0,05). Conclusiones: YE aumentó las Abs y biodisponibilidad de minerales, alcanzando la retención y calidad ósea de C. El aumento en las Abs observado en YR no logró obtener la retención y calidad ósea de C. Conclusión: YE habría contrarrestado el efecto negativo del mayor aporte de Pi de la leche de vaca y sería una buena estrategia para lograr el pico de masa ósea y calidad del hueso adecuados, especialmente en individuos intolerantes a la lactosa. (AU)

Breast milk contains an optimal calcium/phosphate (Ca/Pi) ratio and GOS. These natural prebiotics can be enzymatically produced via cow's milk lactose inyogurt manufacture. This milk product is low in lactose and contains prebiotics and potentially probiotic bacteria but maintains a low Ca/Pi ratio that could alter bone remodeling and mineralization. We evaluated if a lactose-reduced yogurt containing GOS (YE) offers additional advantages over regular yogurt without GOS (YR) on Ca and Pi absorption (Abs), bone retention and quality during normal growth. Weaning male rats were divided into 3 groups fed AIN'93-G (C), YE or YR for 28 days. Results: YE showed the highest increase in fecal lactobacilli; short-chain fatty acids production, especially propionate and butyrate; intestine crypt depth, and the lowest cecal pH. AbsCa% and AbsPi% increased in this order: YE> YR> C (p <0.05). Ca and Pi content in femur, bone density and mineral content, and biomechanical parameters were similar in YE and C, while YR showed the significantly lowest value (p < 0.05). Conclusions: YE increased mineral Abs reaching the retention and bone quality of C. Although YR increased Abs, bone retention and quality did not achieve C values. Seemingly, YE compensated for the negative effect of the higher Pi supply and would be a good strategy to achieve adequate peak bone mass and bone quality, especially in lactose intolerant individuals. (AU)

Ausencia de diferencias relacionadas con el sexo en los valores de los cambios mínimos significativos para composición corporal por DXA en sujetos adultos / Absence of sex-related differences in the values of minimum significant changes for body composition by DXA in adult subjects

Para la evaluación longitudinal de la composición corporal por DXA se deben calcular los cambios mínimos significativos (CMS). No está claro si hay diferencias de género para los CMS de adultos. Con consentimiento informado se realizaron 2 escaneos DXA de cuerpo completo consecutivos, con reposicionamiento entre ellos, en 40 varones y 40 mujeres (rango de edad de 22 a 85 años), con un equipo GE Lunar Prodigy Advance®, siguiendo las pautas de la International Society for Clinical Densitometry (ISCD). Todos los escaneos fueron obtenidos por la misma técnica experta. Los CMS se calcularon de acuerdo con el método propuesto por la ISCD. Los resultados se analizaron con GraphPad® para Windows 6.0, con una significancia fijada en p < 0,05. No hubo diferencias de género para la edad (p = 0,846) o el índice de masa corporal (p = 0,802). La altura, la masa corporal, la masa magra y el contenido mineral óseo (CMO) fueron mayores en los varones (todos p < 0,0001), mientras que la masa grasa fue mayor en las mujeres (p = 0,0036). No hubo diferencias significativas entre géneros para los coeficientes de variación de masa grasa (p = 0,0698), masa magra (p = 0,1483) o CMO (p = 0,5254). Los CMS (para IC de 95%) para la masa grasa fueron 1,780 kg (varones), 1,671 kg (mujeres) y 1,727 kg (ambos sexos); para masa magra, 1,658 kg (varones), 1,644 kg (mujeres) y 1,651 (ambos sexos); y para CMO, 112,2 g (varones), 109,4 (mujeres) y 110,8 g (ambos sexos). Los resultados sugieren que los CMS para la composición corporal de su-jetos adultos pueden calcularse a partir de una muestra de cualquier género o una que incluya sujetos de ambos sexos. (AU)

Lack of gender-related differences in least significant changes for DXA body composition analysis in adult subjectsFor longitudinal assessment of body composition by DXA, least significant changes (LSCs) should be calculated. It is unclear if there are gender differences for adult LSCs. With informed consent, 2 consecutive total-body DXA scans, with repositioning between them, were performed on 40 males and 40 females (age range 22 to 85 years) with a GE Lunar Prodigy Advance scanner, following the guidelines of the International Society for Clinical Densitometry (ISCD). All scans were obtained by the same skilled technologist. The LSCs were calculated according to the method proposed by the ISCD. Results were analyzed with GraphPad for Windows 6.0, with significance set at p < 0.05. There were no gender differences for age (p = 0.846) or body mass index (p = 0.802). Height, body mass, lean mass, and bone mineral content (BMC) were higher in males (all p < 0.0001), whereas fat mass was higher in females (p = 0.0036). There was no significant difference between genders for the coefficients of variation of fat mass (p = 0.0698), lean mass (p = 0.1483), or BMC (p = 0.5254). The LSCs (for a 95% CI) for fat mass were 1.780 kg (men), 1.671 kg (women), and 1.727 kg (both genders); for lean mass, 1.658 kg (men), 1.644 kg (women) and 1,651 (both genders); and for BMC, 112.2 g (men), 109.4 (women), and 110.8 g (both genders). These results suggest that LSCs for body composition of adult subjects can be calculated from either a sample of each gender or one that includes subjects of both genders. (AU)

Cambios en la composición corporal y ángulo de fase durante la pretemporada en jugadores de fútbol profesional / Changes in body composition and phase angle during pre-season in professional soccer players

RESUMEN: El análisis y el control de la composición corporal son claves en el fútbol por su implicación en el rendimiento. El objetivo de este estudio fue identificar, en jugadores de futbol profesional, el ángulo de fase (PhA) de miembros inferiores con los posibles patrones de mejora del componente magro en los mismos medido por DEXA. Al mismo tiempo, se estudió mediante BIA la evolución de parámetros hídricos de los jugadores, sometidos a un entrenamiento intenso y a un control nutricional de su alimentación y suplementación. Se evaluaron a 18 jugadores (26,28 ± 5,1 años; 85,09 ± 9,16 kg; 185,5 ± 4,32 cm) de un equipo de la primera división de fútbol italiana. Se llevó a cabo el estudio durante cuatro semanas, entre el 11 de julio (pre-test) y el 11 de agosto de 2021 (post-test). La intervención se llevó a cabo en su totalidad en pretemporada, con un confinamiento en modalidad de aislamiento o burbuja total por prevención al contagio del COVID-19, dónde se monitorizaba en un alto porcentaje la vida del jugador, incluyendo factores como la alimentación, el entrenamiento y el descanso. La suplementación estuvo basada en antioxidantes, multivitamínicos, minerales y ácidos grasos poliinsaturados y dos productos en polvo (uno a base de creatina, glutamina y leucina, y otro, a base de aminoácidos esenciales). Los jugadores presentaron una mejora del PhA y del componente magro en los miembros inferiores, con una moderada correlación (r = 0,6). Con respecto al agua intracelular y extracelular, señalar que, a pesar de la alta intensidad del ejercicio durante cuatro semanas, éstas se han mantenido constantes sin presentar variaciones significativas durante el periodo de estudio, lo que indica que no se ha producido un proceso de deshidratación del jugador.

SUMMARY: The analysis and control of body composition is essential in soccer due to its implication in performance. The aim of this study was to identify, in professional soccer players, the phase angle (PhA) of the lower limbs with possible patterns of improvement of the lean component measured by DEXA. At the same time, the evolution of hydric parameters of the players, subjected to intense training and nutritional control of their diet and supplementation, was studied by means of BIA. Eighteen players (26.28 ± 5.1 years; 85.09 ± 9.16 kg; 185.5 ± 4.32 cm) from an Italian first division football team were evaluated. The study was conducted for four weeks, between 11th July (pre- test) and 11th August of 2021 (post-test). The intervention was carried out entirely in pre-season, with confinement in isolation or total bubble mode for prevention of COVID-19 infection, where a high percentage of the player's life was monitored, including factors such as diet, training and rest. Supplementation was based on antioxidants, multivitamins, minerals and polyunsaturated fatty acids and two powdered products (one based on creatine, glutamine and leucine, and the other one, on essential amino acids). The players showed an improvement in PhA and in the lean component in the lower limbs, with a moderate correlation (r = 0.6). With regard to intracellular and extracellular water, it should be noted that, despite the high intensity of exercise during four weeks, these have remained constant without significant variations during the study period, indicating that there has not been a process of dehydration of the player.

Utilidad del Trabecular Bone Score combinado con la densitometría ósea en la valoración de una serie 194 pacientes / Usefulness of Trabecular Bone Score in combination with bone densitometry to assess a series of 194 patients / Utilidade do Trabecular Bone Score combinado com densitometria óssea na avaliação de uma série de 194 pacientes

Resumen: Introducción: la mayoría de las fracturas por fragilidad ocurren en rango densitométrico de osteopenia, la escala ósea trabecular (TBS) permite valorar aspectos de la microarquitectura que influyen en la resistencia ósea. Objetivo: describir las características clínicas y los hallazgos de la microarquitectura ósea aplicando TBS combinado con densitometría ósea (DXA) en un grupo de pacientes. Material y métodos: estudio descriptivo, de recolección retrospectiva. Se incluyen los pacientes a los que se les realizó DXA con TBS en el INRU en julio y agosto de 2020. Resultados: se analizaron 194 pacientes, 173 (89%) de sexo femenino y 21 (11%) de sexo masculino. El 36,1% (70 pacientes) en rango de osteopenia, 36,1 (70 pacientes) en rango de osteoporosis. El 32,9% (23 pacientes) con osteopenia y el 47,1% (33 pacientes) con osteoporosis tenían microarquitectura degradada. 76,9% de los pacientes con artritis reumatoidea y 45,8% de los que tenían espondiloartritis presentaban microarquitectura alterada. Conclusiones: el TBS permitió reestratificar el riesgo de fractura en un número importante de pacientes, mostrándose como una herramienta muy útil en la valoración complementaria de la salud ósea.

Summary: Introduction: most fractures that result from bone fragility occur in the osteopenia range The trabecular bone score (TBS) enables the assessment of microarchitecture aspects that impact bone resistance. Objective: to describe the clinical characteristics and findings of bone microarchitecture, by applying TBS and bone densitometry in a group of patients. Method: descriptive study of retrospective collection. Patients who were included in the study underwent a Dual-energy X-ray Absorptiometry (DXA) with TBS at the National Rheumatology Service between July and August, 2020. Results: 94 patients were analysed, 173 (89%) were female and 21 (11%) were male. 36.1% (70 patients) lay in the osteopenia range, 36.1 (70 patients) in the osteoporotic range. 32.9% (23 patients) with osteopenia and 47.1% (33 patients) with osteoporosis evidenced a degraded bone microarchitecture. 76.9 % of patients with rheumatoid arthritis and 45.8 % of patients with spondyloarthritis respectively evidenced altered bone microarchitecture. Conclusions: TBS allowed stratification of fracture risk in a significant number of patients, which may suggest it is a useful tool for complementary assessment of bone health.

Resumo: Introdução: a maioria das fraturas por fragilidade ocorre na faixa densitométrica da osteopenia; o escore de osso trabecular (TBS) permite avaliar aspectos da microarquitetura que influenciam a resistência óssea. Objetivo: descrever as características clínicas e os achados da microarquitetura óssea aplicando TBS combinado com densitometria óssea (DMO) em um grupo de pacientes. Material e métodos: estudo descritivo, retrospectivo, incluindo pacientes que realizaram DXA (absorciometria de raios-X de dupla energia) com TBS no INRU em julho e agosto de 2020. Resultados: foram analisados 194 pacientes, 173 (89%) mulheres e 21 (11%) homens. 36,1% (70 pacientes) na faixa de osteopenia, 36,1 (70 pacientes) na faixa de osteoporose. 32,9% (23 pacientes) com osteopenia e 47,1% (33 pacientes) com osteoporose tinham microarquitetura degradada. Nos pacientes com artrite reumatoide 76,9% e nas espondiloartrite 45,8% apresentaram microarquitetura alterada, respectivamente. Conclusões: a TBS permitiu fazer uma nova estratificação do risco de fratura em um número significativo de pacientes, mostrando-se uma ferramenta muito útil na avaliação complementar da saúde óssea.

Cross-validation of 20 anthropometric prediction equations for appendicular muscle mass in older Brazilian women: a cross-sectional study / Validação cruzada de 20 equações antropométricas de massa muscular apendicular para idosas brasileiras: um estudo transversal

Objective: To test the cross-validation of anthropometric prediction equations for appendicular muscle mass (AMM) in older Brazilian women. Methods: Sixty-seven older women (69.84 ± 5.95 years old) underwent anthropometric measurements. AMM (kg) reference values obtained by dual-energy X-ray absorptiometry (AMMDXA) were compared to 20 anthropometric equations for estimating AMM in older adults. A paired t-test (p > 0.05), standard error of estimate (SEE < 3.50 kg), and r2 > 0.70 confirmed the validity of the equations. The agreement between predictions and the reference was also verified (Bland-Altman analysis of agreement between methods). Results: Four American equations and one Mexican equation were not statistically different from AMMDXA (p > 0.05) but did not present suitable r2 values for validation. The American equation from the National Health and Nutrition Examination Survey (NHANES), AMM (kg) = (-0.04 × age [years]) + (0.46 × calf circumference [cm]) + (0.32 × arm circumference [cm]) + (0.11 × thigh circumference [cm]) ­ (0.27 × body mass index [BMI, kg/m2 ]) + (0.07 × waist circumference [cm]) ­ 13 119 showed the best performance (r2 = 0.64; SEE = 3.24 kg), with minimal mean difference (0.26 kg), no heteroscedasticity for extreme values, and with high agreement with the Brazilian sample (-3.90 to 3.40 kg). Conclusion: When specific equations for a given population are not available, the use of generic equations of greater sample representativeness with scientifically and reliably analyzed data is allowed.

Objetivo: Testar a validação cruzada das equações antropométricas preditivas da massa muscular apendicular (MMA) em idosas brasileiras. Metodologia: Sessenta e sete idosas (69,84 ± 5,95 anos) foram submetidas a medidas antropométricas. Os valores de referência da MMA (kg) fornecida pela absorciometria de raios X de dupla energia (MMADXA) foi comparada com 20 equações antropométricas preditivas para estimar a MMA para idosos. Teste t pareado (p > 0,05), erro padrão de estimativa (EPE) < 3,50 kg e r2 > 0,70 confirmaram a validade das equações. A concordância entre as previsões e a referência também foi verificada (análise de concordância entre métodos de Bland-Altman). Resultados: Quatro equações americanas e uma equação mexicana não foram estatisticamente diferentes da MMADXA (p > 0,05), mas nenhuma delas apresentou r2 adequado para validação. A equação americana dos dados do National Health and Nutrition Examination Survey (NHANES), MMA (kg) = (-0,04 × idade [anos]) + (0,46 × circunferência da panturrilha [cm]) + (0,32 × circunferência do braço [cm]) + (0,11 × circunferência da coxa [cm]) ­ (0,27 × índice de massa corporal-IMC [kg/m2 ]) + (0,07 × circunferência da cintura [cm]) ­ 13,12 apresentou o melhor desempenho (r2 = 0,64; EPE = 3,24 kg): com diferença média mínima (0,26 kg), sem heterocedasticidade para valores extremos e alta concordância com a amostra brasileira (-3,90 a 3,40 kg). Conclusão: Quando não existem equações específicas para uma determinada população, é permitida a utilização de equações genéricas de maior representatividade amostral, cujos dados tenham sido analisados de forma científica e confiável

Ostéoporose et évaluation du risque fracturaire par l'outil frax chez des patients Congolais présentant un rhumatisme axial Une série des cas multicentriques

Contexte et objectif. L'enjeu majeur dans le management de l'ostéoporose est l'identification des sujets à risque par la quantification du risque fracturaire. L'objectif de l'étude était d'évaluer le risque fracturaire chez les patients ayant consulté pour douleur du squelette axial. Méthodes. Il s'agissait d'une série des cas multicentriques menée sur des patients recrutés dans 8 hôpitaux de Kinshasa. Les paramètres d'intérêt comme l'âge, le sexe, l'alcoolisme, le tabagisme, la fracture de hanche chez un parent de 1er degré ou une fracture personnelle de fragilité ont été collectés auprès de chaque patient. La mesure de la densité osseuse avait été réalisée par absorptiométrie biphotonique à rayons X. Le risque fracturaire a été évalué par le calcul de l'indice fracturaire FRAX. Ce risque était élevé lorsque la probabilité de survenue de fracture de hanche était ≥ 3% et/ou des fractures ostéoporotiques majeures ≥ 20%. Des tests statistiques usuels ont été utilisés pour l'analyse des résultats. Résultats. 90 patients dont 75 femmes étaient inclus. Leur âge moyen était de 63, 5±12ans.L'ostéoporoseétaitdiagnostiquée chez 34,4% des patients, l'ostéopénie chez 43,9% et 16,7% avaient une densité minérale osseuse normale. Aucune fracture ostéoporotique n'a été observée dans la présente étude, mais près de 30% de l'ensemble de l'échantillon avaient un risque fracturaire élevé. L'ostéoporose était associée, dans environ 80% des cas (p<0,005), à un risque fracturaire élevé. Conclusion. La présente étude a montré que le risque fracturaire était élevé chez les patients atteints d'ostéoporose. Elle met en lumière la nécessité d'un dépistage précoce de cette pathologie.

Prevalence of osteoporosis and related factors in postmenopausal women aged 40 and above in China / 中华流行病学杂志

Objective: To understand the prevalence of osteoporosis and related factors in postmenopausal women aged ≥40 years in China and provide scientific evidence for osteoporosis prevention and control. Methods: Data of this study were from the 2018 China Osteoporosis Epidemiological Survey, covering 44 counties (districts) in 11 provinces in China. Related variables were collected by questionnaire survey and physical measurement, and the BMD of lumbar spine and proximal femur was measured by dual-energy X-ray absorption method. The prevalence of osteoporosis and its 95%CI in postmenopausal women aged ≥40 years were estimated with complex sampling weights. Results: A total of 5 728 postmenopausal women aged ≥40 years were included in the analysis and the prevalence of osteoporosis was 32.5% (95%CI: 30.3%-34.7%). The prevalence of osteoporosis in postmenopausal women aged 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years were 16.0% (95%CI:4.5%-27.5%), 18.4% (95%CI:15.9%-20.8%), 37.5% (95%CI:34.5%-40.4%), 52.9% (95%CI: 47.5%-58.3%), and 68.0% (95%CI:55.9%-80.1%) respectively. The prevalence of osteoporosis was higher (P<0.001) in those with education level of primary school or below (47.2%, 95%CI: 43.0%-51.3%) and in those with individual annual income less than 10 000 Yuan, (40.3%, 95%CI: 36.9%-43.7%). The prevalence of osteoporosis was 35.1% in rural areas (95%CI: 32.0%-38.1%), which was higher than that in urban areas (P<0.001). The prevalence of osteoporosis in low weight, normal weight, overweight and obese groups were 69.9% (95%CI: 59.0%-80.8%), 42.2% (95%CI: 38.7%-45.7%), 24.2% (95%CI: 21.3%-27.1%) and 14.6% (95%CI: 11.1%-18.0%), respectively. The prevalence of osteoporosis in those with menstrual maintenance years ≤30 years and in those with menopause years ≥11 years were 46.1% (95%CI:40.8%-51.3%) and 48.2% (95%CI:45.0%-51.3%), respectively. Multivariate logistic analysis showed that age ≥60 years, education level of primary school or below, annual household income per capita less than 10 000 Yuan, low body weight, menstrual maintenance years ≤30 years, menopause years ≥11 years were risk factors of osteoporosis in postmenopausal women in China. Conclusions: The prevalence of osteoporosis was high in postmenopausal women aged ≥40 years in China, and there were differences in osteoporosis prevalence among different socioeconomic groups. Effective interventions should be taken for the prevention and control of osteoporosis in key groups in the future.

Comparison of femoral neck geometric parameters between Chinese and Japanese females / 中南大学学报(医学版)

OBJECTIVES@#Femoral neck fracture is the most serious osteoporotic fractures that is responsible for high medical costs and high mortality. Femoral neck geometric parameters (FNGPs) are important parameters that reflect the geometrical characteristics of femoral neck, and are closely related to the strength of femoral neck and the risk of fragility fracture.There are differences in the incidence of femoral neck fractures among races. However, whether there is difference in FNGPs among races is unknown.Therefore, this study aims to compare the differences in FNGPs between Chinese and Japanese females.@*METHODS@#This study was a cross-sectional study, in which 3 859 healthy females aged 10-86 (45.7±17.1) years old were recruited from Changsha City of Hunan Province and surrounding areas. The weight and height were measured and recorded, and the body mass index (BMI) was calculated. A dual energy X-ray absorptiometry (DXA) bone densitometer was used to measure femoral neck projective bone area (BA) and bone mineral density (BMD). FNGPs were calculated using the BMD and BA, which included the outer diameter (OD), cross-sectional area (CSA), cortical thickness (CT), endocortical diameter (ED), buckling ratio (BR), section modulus (SM), cross-sectional moment of inertia (CSMI), and compression strength index (CSI). The data of FNGPs in Japanese females was collected from literature. These subjects were grouped by 10-year age. The mean and standard deviation of height, weight, BMI, femoral neck BMD, and FNGPs of each group were calculated. The model with the best goodness-of-fit was selected from various mathematical regression models to analyze the distribution trend and the best fitting curve of FNGPs with age. The differences in FNGPs between Chinese and Japanese females were analyzed by using age-corresponding mean fitting curve for paired t-test, and the relative change rates of FNGPs were compared.@*RESULTS@#The mean values of FNGPs were significantly different among different years old healthy females (all P<0.01). The mean values of OD, CSA, CT, SM, and CSMI in femoral neck were high at 30 to 39 years old, and then they were gradually decreased with age. The CSI reached its peak at 20-29 years old, and it was decreased gradually after 30 years old. ED and BR were at a low level before 40 years old, they were gradually increased after 40 years old, and reached the maximum average value at 80-86 years old. The variations in FNGPs with age were fitted with the best goodness-of-fit by applying the cubic regression model and the determination coefficients of regression equations (R2: 0.062-0.404) were significant (all P<0.01). The distribution trend of FNGPs with age varied with the indices, among which CSA, CT, SM, CSMI and CSI were increased with age before 35 years old, and then they were decreased with age; BR was at a low level in the early stage, and then it was increased with age after about 40 years. There were significant differences in the fitting curves of FNGPs related to age between Chinese and Japanese females (all P<0.01). The fitting curves of OD, ED, BR and SM in Chinese females were significantly higher than those in Japanese females (all P<0.01), while those of CSA and CT in Chinese females were significantly lower than those in Japanese females (all P<0.01). Before the age of 50, the curves of CSMI and CSI of Chinese females were significantly higher than those of Japanese females (all P<0.01), while after the age of 60 the situation was reversed (all P<0.01). Except for SM and CSI, there were significant differences in the rate of OD, CSA, CT, ED, BR and CSMI with age (all P<0.01). By the age of 80 years old, the rates of change in OD, ED, and BR with the age in Chinese females were increased by 0.91%,3.94%, and 47.5%, respectively, while those in Japanese females were increased by 8.57%, 15.8% and 85.3%, respectively；the rates of change of CSA, CT, and CSMI with the age in Chinese females were declined 28.0%, 29.6%, and 25.2%, respectively, while those in Japanese females were declined 29.9%, 36.2%, and 10.9%, respectively. There were significant difference in the rates of change in FNGPs with the age between Chinese and Japanese females (all P<0.01).@*CONCLUSIONS@#The study reveals the variation of FNGPs with age in Chinese, and confirms that there are racial differences in FNGPs between Chinese and Japanese females, which may be one of the important reasons for the difference in the incidence of femoral neck fracture between Chinese and Japanese females.

Association of osteoporosis with radiologic grading of the hip among older Filipino patients with suspected hip osteoarthritis

Introduction@#Among older populations, osteoarthritis (OA) is one of the most common chronic joint disorders and is a leading cause of disability, while osteoporosis is the most common metabolic bone disease, conferring fragility and significant risk of fracture. The relationship between OA and osteoporosis remains controversial. Although earlier studies reported an inverse association between the two diseases, more recent literature found a complex relationship mediated by various factors. @*Objective@#The investigators sought to determine the association of osteoporosis with radiologic grading of the hip among older Filipino patients with suspected hip osteoarthritis.@*Methodology@#A cross-sectional analytical study was conducted involving 256 patients with suspected hip OA who underwent radiography of the hips and central dual energy x-ray absorptiometry (DXA). Radiographs of the hips were evaluated by a radiologist using the Kellgren-Lawrence (KL) grading scale, while central DXA images were processed and evaluated by a nuclear medicine physician using the World Health Organization criteria for the diagnosis of osteoporosis and the 2019 International Society for Clinical Densitometry guidelines. The primary outcome measures were the prevalence of osteoporosis in patients with suspected hip OA, and the association of osteoporosis with radiologic KL grading of the hips. The secondary outcome measure was the association of osteoporosis with sex and BMI. @*Results@#The study found that osteoporosis was present in 136 (53.1%) of the 256 patients who all presented with radiologic evidence of hip OA. There was a positive association between the presence of osteoporosis and the radiologic grade of hip OA (p-value: 0.006 on the right hip and 0.036 on the left). Osteoporosis was more prevalent in women compared to men (p-value: 0.031). Likewise, osteoporosis had a direct relationship with BMI (p-value: <0.001). @*Conclusion@#Osteoporosis was prevalent in a significant proportion of older Filipino patients with clinical and radiologic evidence of hip OA, particularly among women, and was positively associated with increasing severity of OA. The study suggests that obesity may not necessarily protect against osteoporosis in this population, possibly relating to increased adiposity and decreased lean muscle mass.

Osteosarcopenia and trabecular bone score in patients with type 2 diabetes mellitus

ABSTRACT Objective: To evaluate the prevalence of osteosarcopenia and the association of osteosarcopenia with trabecular bone score (TBS) in a group of patients with type 2 diabetes mellitus(T2DMG) compared with a paired control group (CG). Materials and methods: Cross-sectional study with men and women ≥ 50 years recruited by convenience. Patients in both groups answered questionnaires and underwent evaluation of bone mineral density (BMD), handgrip strength (HGS), and TBS. The T2DMG also underwent a gait speed (GS) test. Sarcopenia was defined as low lean mass plus low HGS or GS according to the Foundation for the National Institute of Health Sarcopenia Project, and osteosarcopenia was deemed present when sarcopenia was associated with osteopenia, osteoporosis, or low-energy trauma fractures. Results: The T2DMG (n = 177) and CG (n = 146) had, respectively, mean ages of 65.1 ± 8.2 years and 68.8 ± 11.0 years and 114 (64.4%) and 80 (54.7%) women. T2DMG versus the CG had higher rates of osteosarcopenia (11.9% versus 2.14%, respectively, p = 0.010), sarcopenia (12.9% versus 5.4%, respectively, p < 0.030), and fractures (29.9% versus 18.5%, respectively, p = 0.019), and lower HGS values (24.4 ± 10.3 kg versus 30.9 ± 9.15 kg, respectively, p < 0.001), but comparable BMD values. Mean TBS values were 1.272 ± 0.11 and 1.320 ± 0.12, respectively (p = 0.001). On multivariate analysis, age, greater waist circumference, fractures, and osteoporosis increased the risk of degraded TBS. Osteosarcopenia was associated with diabetes complications (p = 0.03), calcium and vitamin D supplementation (p = 0.01), and all components of osteosarcopenia diagnosis (p < 0.05). Conclusion: Compared with the CG, the T2DMG had a higher prevalence of osteosarcopenia, sarcopenia, and fractures and lower bone quality assessed by TBS.

Height adjustment reduces occurrence of low bone mineral density in children and adolescents with HIV

SUMMARY OBJECTIVE: The aim of this study was to quantify the reduction of bone mineral density with and without height adjustment. METHODS: A cross-sectional study was performed with 69 Brazilian children and adolescents vertically infected by HIV. Bone mineral density was measured by dual-energy absorptiometry in the lumbar spine. Anthropometric, demographic, and clinical variables were analyzed. A specific calculator was used for height adjustment. RESULTS: The majority of participants (52.2%) were adolescents and did not present with immunological alterations (61%). Reduced bone mineral density (Z-score <-1) was present in 23.2% and low bone mass (Z-score <-2) in 5.8%. After height adjustment, these occurrences decreased to 11.6% and 0%, respectively. Patients with reduced bone mineral density had a higher mean age and lower body mass index than patients with normal bone mineral density. CONCLUSION: The occurrence of reduced bone mineral density decreased after adjustment for height.

Morphological study of the pelvis and vertebral column in university dance major students / Estudio morfológico de la pelvis y la columna vertebral en estudiantes universitarios de danza

SUMMARY: The purpose of this study was to investigate the pelvis and spine of university dance major students. The spine and pelvic morphology were measured in 32 students (eight ballet, eight Korean dance, and eight modern dance) and eight general studies students. using dual energy X-ray absorptiometry and Formetric III 4D. First, as a result of measuring the front and rear tilt, a back tilt of the torso was found in all groups. Second, measurement of the left and right tilt of the spine showed a tilt to the right, and the angle and distance of the tilt were 1.25 ? 1.16 ? and 10.5 ? 9.3 mm, respectively in the ballet major group. Third, the kyphosis angle was the highest in the Korean dance students, exceeding the normal range (ballet: 46 ?, Korean dance: 54 ?, modern dance: 47 ?, general department: 49?). Although, there was no significant difference among the groups, but the spine and pelvic morphology were measured in different forms (shapes) according to the majors. Therefore, according to the major, the movements used to affect the shape of the spine and the pelvis are considered to change. This suggests that follow-up studies are needed. If the displacement is severe due to the movement, pain may occur and it is necessary to study how to identify the pain area when the pain occurs.

RESUMEN: El propósito de este estudio fue investigar la pelvis y la columna vertebral de estudiantes universitarios de danza. Se realizaron mediciones morfológicas de la columna y la pelvis en 32 estudiantes (ocho de ballet, ocho de danza coreana y ocho de danza moderna) y ocho estudiantes de estudios generales. utilizando absorciometría de rayos X de energía dual y formétrico ? 4D. Primero, como resultado de medir la inclinación delantera y trasera, se encontró una inclinación del torso hacia atrás en todos los grupos. En segundo lugar, la medición de la inclinación izquierda y derecha de la columna mostró una inclinación hacia la derecha, y el ángulo y la distancia de la inclinación fueron 1,25 ? 1,16 ? y 10,5 ? 9,3 mm, respectivamente, en el grupo principal de ballet. En tercer lugar, el ángulo de cifosis fue el más alto en los estudiantes de danza coreana, excediendo el rango normal (ballet: 46 ?, danza coreana: 54 ?, danza moderna: 47 ?, departamento general: 49 ?). Aunque no hubo diferencia significativa entre los grupos, la morfología de la columna y la pelvis se midió en diferentes formas (formas) según las carreras. Por lo tanto, según la especialidad, se considera que cambian los movimientos utilizados afectando la forma de la columna y la pelvis. Esto sugiere que se requieren estudios de seguimiento. Si el desplazamiento es severo debido al movimiento, este puede generar dolor y es necesario estudiar cómo identificar el área de dolor cuando ocurre.

Vitamin D and bone health in adults: a systematic review and meta-analysis / Vitamina D e saúde óssea em adultos: uma revisão sistemática e metanálise

Abstract Low bone health is associated with vitamin D deficiency in older individuals; however, this association is not well established in adults. The aim of the study was to analyze the association between serum concentrations of 25-hydroxyvitamin D and bone health in adults by systematic review and meta-analysis. The search was carried out in the LILACS, PubMed, Scopus, Web of Science, ScienceDirect databases from March 2017 to October 2018 with adult individuals (20-59 years). Bone health was evaluation performed through dual X-ray absorptiometry and serum concentrations of 25(OH)D. The random effect model was used to analyze data from bone mineral content and bone mineral. Random effects models were used and the sources of heterogeneity were explored by means of meta-regression. Thirty-five articles were selected. There was positive correlation between vitamin D and bone health in most of the evaluated sites. Correlation was observed in the analysis of subgroups for lumbar spine among men. When stratified, the studies presented high heterogeneity, which was explained by the sample size, mean serum vitamin D levels and risk of bias. Vitamin D is positively correlated to bone health in adult individuals.

Resumo A baixa saúde óssea está associada à deficiência de vitamina D em indivíduos mais velhos; no entanto, isso não está bem estabelecido em adultos. O estudo objetivou-se analisar a associação entre concentrações séricas de 25-hidroxivitamina D e baixa saúde óssea em adultos por revisão sistemática e metanálise. A pesquisa foi realizada nas bases LILACS, PubMed, Scopus, Web of Science, ScienceDirect de março de 2017 a outubro de 2018 com indivíduos adultos (20-59 anos). A avaliação da saúde óssea foi realizada através da absorciometria dupla de raios X e concentrações séricas de 25(OH)D. O modelo de efeito aleatório foi utilizado para analisar dados do conteúdo mineral ósseo e densidade mineral óssea. Modelos de efeitos aleatórios foram utilizados e a heterogeneidade foi explorada por meio de meta-regressão. Trinta e cinco artigos foram selecionados. Houve correlação positiva entre a vitamina D e a saúde óssea na maioria dos locais avaliados. Observou-se correlação na análise de subgrupos da coluna lombar entre homens. Quando estratificados, os estudos apresentaram alta heterogeneidade, explicada pelo tamanho da amostra, pelos níveis séricos médios da vitamina e pelo risco de viés. A vitamina D está positivamente correlacionada com a saúde óssea em indivíduos adultos.

Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density

ABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

The disparity of measuring bone mineral content using bioimpedance and dual-energy absorptiometry in the context of hyperparathyroidism / A disparidade nos valores do conteúdo mineral ósseo medido usando bioimpedância e absorciometria de dupla energia no contexto do hiperparatireoidismo

Abstract Introduction: Body composition is critical for the evaluation of patients with Chronic Kidney Disease (CKD) and can be obtained from either multifrequency bioelectrical impedance analysis (BIA) or dual-energy absorptiometry (DXA). Although the discrepancy between the results obtained from both methods has already been described, reasons are unknown, and might be related to secondary hyperparathyroidism, which is associated with bone loss. Methods: We have evaluated 49 patients (25 males and 24 females): 20 with CKD not on dialysis and 29 on maintenance hemodialysis [18 with severe hyperparathyroidism (HD-SHPT) and 11 submitted to parathyroidectomy (HD-PTX)]. All patients underwent DXA and BIA. Results: The median age and body mass index (BMI) were 49 years and 25.6 kg/m2, respectively. Patients exhibited low bone mineral content (BMC) measured by DXA, particularly those from the HD-SHPT group. The largest BMC measurement disagreement between DXA and BIA was found in the HD-SHPT group (p=0.004). Factors independently associated with this discrepancy in BMC measurement were serum phosphate (p=0.003) and patient group (p=0.027), even after adjustments for age, BMI, and gender (adjusted r2=0.186). PTX attenuated this difference. Discussion: BIA should be interpreted with caution in patients with SHPT due to a loss of accuracy, which can compromise the interpretation of body composition.

Resumo Introdução: A composição corporal é fundamental para a avaliação de pacientes com Doença Renal Crônica (DRC), e pode ser obtida por análise de impedância bioelétrica por multifrequência (BIA) ou absorciometria de dupla energia (DXA). Embora a discrepância entre os resultados obtidos pelos dois métodos já tenha sido descrita, os motivos são desconhecidos e podem estar relacionados ao hiperparatireoidismo secundário, devido à perda óssea. Métodos: Avaliamos 49 pacientes (25 homens e 24 mulheres): 20 com DRC não em diálise e 29 em hemodiálise de manutenção [18 com hiperparatireoidismo grave (HD-SHPT) e 11 submetidos à paratireoidectomia (HD-PTX)]. Todos os pacientes foram submetidos à DXA e BIA. Resultados: A mediana da idade e do índice de massa corporal (IMC) foram de 49 anos e 25,6 kg/m2, respectivamente. Os pacientes exibiram baixo conteúdo mineral ósseo (CMO) medido pelo DXA, particularmente aqueles do grupo HD-SHPT. A maior discordância da medida do CMO entre DXA e BIA foi encontrada no grupo HD-SHPT (p = 0,004). Os fatores independentemente associados a essa discrepância na medida do CMO foram fosfato sérico (p = 0,003) e grupo de pacientes (p = 0,027), mesmo após ajustes para idade, IMC e sexo (r2 ajustado = 0,186). PTX atenuou essa diferença. Discussão: A BIA deve ser interpretada com cautela em pacientes com HPTS devido a uma perda de precisão, o que pode comprometer a interpretação da composição corporal.

Efeitos do treinamento de força com intensidade autosselecionada em paciente pós cirurgia bariátrica: um estudo de caso / Strenght training with self-selected intensity on a pacient post bariatric surgery

A prescrição de exercícios físicos em intensidades moderada e alta, para indivíduos obesos, pode induzir maiores percepções de desconforto/desprazer e, consequentemente, desencorajá-los a aderir a uma rotina de exercícios físicos. O objetivo deste trabalho foi investigar os efeitos de um programa de treinamento de força com intensidade autosselecionada, na composição corporal, hipertrofia e qualidade do sono de uma voluntária recémsubmetida a cirurgia bariátrica (idade: 28 anos; altura: 158cm; peso: 69 kg; índice de massa corporal: 27,64). A voluntária realizou um programa de treinamento de força com intensidade autosselecionada, pelo período de oito semanas (2 sessões semanais). Foi avaliada a qualidade de sono, por meio do questionário Pittsburgh sleep quality index; a composição corporal, por absorciometria de feixe duplo; e, a espessura muscular e do tecido adiposo, por ultrassonografia; antes e após a intervenção. Antes e após as sessões de treinamento, a percepção de prazer/desprazer foi mensurada com o auxílio de uma escala de valência afetiva. O programa de exercícios com intensidade autosselecionada resultou em uma diminuição de 2% no percentual de gordura, e de 7% na massa corporal total; sem modificação para a massa livre de gordura. Houve redução de 22% na espessura do tecido adiposo, e de 11% na espessura muscular do bíceps braquial; de 28% na espessura do tecido adiposo, e de 4% na espessura muscular do vasto lateral. A voluntária reportou percepção de prazer/desprazer positiva na maioria das sessões. No entanto, não houve diferença significativa entre os resultados para qualidade de sono. O treinamento com intensidade autosselecionada promoveu respostas positivas, relacionadas à percepção de prazer/desprazer, além de favorecer uma tendência à perda significativa de massa corporal total, sem prejuízos para a massa magra.(AU)

The prescription of physical exercise in moderate and high intensities for obese individuals may induce greater perceptions of discomfort/displeasure, consequently, decline adherence to a physical exercise routine. The objective of this study was investigate the effects of a strength training program with self-selected intensity, body composition, hypertrophy and sleep quality of a participant recently bariatric surgery (age: 28 years; height: 158cm; weight: 69 kg; body mass index: 27.64). The participant performed a strength training program with self-selection intensity, for a period of eight weeks (2 weekly sessions). Sleep quality was evaluated using the Pittsburgh sleep quality index questionnaire; body composition, by dual-energy x-ray absorptiometry, muscle and adipose tissue thickness by ultrasound. Each measure was before and after the intervention. Before and after the training sessions, the perception of pleasure/displeasure was measured with the affective valence scale. The exercise program with self-selected intensity resulted in a 2% decrease in fat percentage, and 7% in total body mass; without modification to the fat-free mass. Yet, there was a reduction of 22% in the thickness of adipose tissue, and 11% in the muscle thickness of the brachial biceps; 28% in the thickness of adipose tissue, and 4% in the muscle thickness of the vastus lateralis. The participant reported a perception of positive pleasure in most sessions. However, there was no significant difference between the results for sleep quality. The training with self-selected intensity promoted positive responses, related to the perception of pleasure/displeasure, besides promote a tendency to significant loss of total body mass, without damage to lean mass. (AU)

Metabolic bone disease in children and adolescent patients with ulcerative colitis

Abstract Objective: Metabolic bone disease concerns a broad spectrum of conditions related to reduced bone density. Metabolic bone disease has been linked to chronic inflammatory diseases, such as ulcerative colitis. This study examines the prevalence of metabolic bone disease in ulcerative colitis patients and explores possible clinical predictors. Method: The authors performed a retrospective study involving children and adolescents with confirmed ulcerative colitis between January 2013 and December 2018. Bone density was evaluated through a dual-energy X-ray absorptiometry scan of the spine and total body. Osteoporosis was defined as a bone mineral density Z-score of <−2 and osteopenia as a Z-score of between −1.0 and −2. Results: A total of 37 patients were included in this analysis, with a mean age of 13.4 ± 3.9 years and a mean duration of illness of 2.1 ± 2.4 years. Using lumbar spine Z-scores and total body Z-scores, osteoporosis and osteopenia were identified by dual-energy X-ray absorptiometry scan measurements in 11 patients (29.7%) and 15 patients (40.5%), and in ten patients (27%) and 13 patients (35%), respectively. Lumbar spine Z-scores were significantly positively associated with male gender (B = 2.02; p = 0.0001), and negatively associated with the presence of extraintestinal manifestations (B = −1.51, p = 0.009) and the use of biologics (B = −1.33, p = 0.004). However, total body Z-scores were positively associated with body mass index Z-scores (B = 0.26, p = 0.004) and duration of illness in years (B = 0.35, p = 0.003). Conclusions: Metabolic bone disease is very common in this cohort of Saudi Arabian children and adolescents with ulcerative colitis and its occurrence appears to increase in female patients who suffer from extraintestinal manifestations.