Body Bone Mineral Research Articles

Total body bone mineral density and various spinal disorders: a Mendelian randomization study.

Observational studies have yielded inconsistent findings regarding the correlation between bone mineral density (BMD) and various spinal disorders. To explore the relationship between total-body BMD and various spinal disorders further, we conducted a Mendelian randomization analysis to assess this association. Two-sample bidirectional Mendelian randomization (MR) analysis was employed to investigate the association between total-body BMD and various spinal disorders. The inverse-variance weighted (IVW) method was used as the primary effect estimate, and additional methods, including weighted median, MR-Egger, simple mode, and weighted mode, were used to assess the reliability of the results. To examine the robustness of the data further, we conducted a sensitivity analysis using alternative bone-density databases, validating the outcome data. MR revealed a significant positive association between total-body BMD and the prevalence of spondylosis and spinal stenosis. When total-body BMD was considered as the exposure factor, the analysis demonstrated an increased risk of spinal stenosis (IVW odds ratio [OR] 1.23; 95% confidence interval [CI], 1.14-1.32; P < 0.001) and spondylosis (IVW: OR 1.24; 95%CI, 1.16-1.33; P < 0.001). Similarly, when focusing solely on heel BMD as the exposure factor, we found a positive correlation with the development of both spinal stenosis (IVW OR 1.13, 95%CI, 1.05-1.21; P < 0.001) and spondylosis (IVW OR 1.10, 95%CI, 1.03-1.18; P = 0.0048). However, no significant associations were found between total-body BMD and other spinal disorders, including spinal instability, spondylolisthesis/spondylolysis, and scoliosis (P > 0.05). This study verified an association of total-body BMD with spinal stenosis and with spondylosis. Our results imply that when an increasing trend in BMD is detected during patient examinations and if the patient complains of numbness and pain, the potential occurrence of conditions such as spondylosis or spinal stenosis should be investigated and treated appropriately.

The Use of Practical Measures to Determine Body Composition of Older People

Background: Older adults frequently experience body composition changes—decreased lean body mass (LBM) and bone mineral content (BMC), along with increased body fat mass (FM)— which affect their health and independence. However, the need for standard complex and costly imaging modalities could delay the detection of these changes and retard treatment effectiveness. Thus, this study explored the ability of practical measures, including simple muscle strength tests and demographic data, to determine the body composition of older adults. Methods: Participants (n = 111, with an average age of 77 years old) were cross-sectionally assessed for the outcomes of the study, including upper limb loading during a seated push-up test (ULL-SPUT), hand grip (HG) strength test and body composition. Results: The ULL-SPUT significantly correlated with body composition (r or rs, = 0.370–0.781; P &lt; 0.05), particularly for female participants and was higher than that found for the HG strength test (rs = 0.340–0.614; P &lt; 0.05). The ULL-SPUT and HG strength test, along with gender and body mass index (BMI), could accurately determine the LBM and BMC of the participants up to 82%. Conclusion: The ULL-SPUT along with gender and BMI can be used as a practical strategy to detect the LBM and BMC of older adults in various settings. Such a strategy would facilitate timely managements (i.e. standard confirmation or appropriate interventions) in various settings.

256 Evaluation Calcium and Phosphorus Ratios in the Presence of Phytase on Performance and Whole-Body Bone Mineralization in Growing Pigs

Abstract The objective of this study was to evaluate the effects of dietary calcium and phosphorus ratios in the presence of super dose phytase on grower pigs growth performance and bone mineral density. In two replicates, a total of 48 mixed sex pigs (26.7 kg BW) were allotted by BW and sex into individual pens across 3 dietary treatments (16 pigs/treatment) for 28 days. All diets contain phytase at 1,500 FTU/kg of complete feed and the three diet treatments were formulated with differing levels of Ca to achieve 0.7, 1.1 and 1.5 total Ca:total P. All diets were formulated to be isocaloric and isonitrogenous and ratios were achieved by vary limestone and sand. Pig BW and feed disappearance were recorded at the start (d 0) and end (d 28) of the study to calculate ADG, ADFI and G:F. On day 28, all pigs were euthanized to determine whole body bone, foot, rib, femur and tibia bone mineral density via dual x-ray absorptiometry. Data were analyzed with pen as the experimental unit, fixed effect of dietary treatment, sex and their interaction, and initial BW block and repartition as random effects. Differences were determined significant at P ≤ 0.05. Pig ADG was increased in the 1.1 verses 0.7 and 1.5 Ca:P diets (1.01, 0.95 and 0.95 kg/d, respectively, P = 0.046). End body weight was not different in the 0.7, 1.12 and 1.5 Ca:P treatments (53.5, 54.8 and 53.1 kg, respectively, P = 0.106). Diet Ca:P ratio did not alter ADFI or G:F. Whole body, tibia and femur bone mineral density was increased by 110% in 1.5 verses 0.7 Ca:P fed pigs, with bone mineral density being intermediated in the 1.1 Ca:P diets. Whole body (0.740, 0.752, 0.797, g/cm2, for 0.7, 1.1 and 1.5 Ca:P respectively, P = 0.033). For 0.7, 1.1 and 1.5 Ca:P femurs, bone mineral density was 0.463, 0.498 and 0.516, respectively, P = 0.034). Dietary treatment did not alter whole foot or 10th rib bone mineral densities (P &amp;gt; 0.05). Sex did not affect pig performance, but gilts had a 9% increase in bone mineral content. In conclusion, formulating dietary Ca:P in the presence of super dosing phytase at 1.1:1 total Ca:P resulted in the best ADG, but a ratio of 1.5:1 had the greatest bone mineral density.

PSIII-16 Body Calcium and Phosphorus Mobilization of Sows During Lactation

Abstract Considering the excess of phosphorus (P) as a fertilizer in some regions, optimizing its use by animals is crucial to reduce its excretion. During the production cycle of the sow, P and calcium (Ca) requirement are greatest in lactation. To satisfy P and Ca need for milk production, sows have Ca and P available from dietary intake, but may also mobilize Ca and P from bone reserves. If that is the case, considering bone mobilization during lactation would be an opportunity to reduce dietary P intake. However, to our knowledge, bone mobilization in lactating sows is not well documented because of the difficulty in measuring it. With the use of X-ray technology to determine body composition on live animals, this subject can now be studied. Thus, the objective of this experiment was to quantify the body mineral mobilization during lactation for sows up to 3rd parity using dual-energy X-ray absorptiometry (DXA, i-DXA, GE Medical Systems, Glattbrugg, Switzerland) to obtain whole body bone mineral content (BMC) and whole-body lean and fat tissue mass. Eighteen Swiss Large White sows were scanned on day 2 and 26 (weaning) after parturition. The lactation diet was formulated to meet nutritional requirements; parity 1 [digestible energy (DE): 12.1 MJ, digestible P (DigP): 3.0 g, Ca: 9.0 g /kg], parity 2 and 3 (DE: 14.1 MJ, DigP: 2.8 g, Ca: 8.0 g /kg). Whole body P and Ca contents were calculated from lean tissue mass and BMC obtained by DXA. Bone mineral mobilization (BMCMOB, g), body phosphorus mobilization (PMOB, g) and body calcium mobilization (CaMOB, g) were calculated as the difference in BMC, body P and body Ca between day 26 and day 2. Piglets were weighed at farrowing and weaning and the average daily gain per piglet (PigletADG, kg/d) and the birth weight of litter (LitterBW, kg) were calculated. The mean body composition was on day 2: BMC, 5,810 ± 1082 g; P, 1,344 ± 207 g; Ca, 2,362 ± 440 g and on day 26: BMC, 5,093 ± 1,001 g; P, 1,228 ± 198 g; Ca: 2,070 ± 407 g. The pigletADG was 0.24 ± 0.05 kg/d and LitterBW was 18.5 ± 2.47 kg. The prediction equations for BMCMOB and body Ca and P during lactation are presented in Table 1. The best predictor was PigletADG and for body P, LitterBW also tended to be an influencing factor. This study allowed to quantify the P and Ca mobilization of the sow during lactation. Next step will be to evaluate the impact of dietary supply on this mobilization to then integrate it in requirement models.

273 Dynamics of Bone Mineralization in Primiparous Sows as a Function of Dietary Phosphorus and Calcium During Lactation

Abstract In a context of maximizing the use of dietary phosphorus (P) in swine production, research should focus on understanding the mechanisms of bone P and calcium (Ca) utilization in sows. A better knowledge of P and Ca quantities that can be mobilized from bones during lactation, which would then be restored during gestation, would allow the development of new feeding strategies including this dynamic process. In turn, it can lead to a substantial decrease in dietary P supply. The role of dietary phytase supplementation also needs to be quantified in such potential strategies. In addition to the bone mineral status of sows, the consequences of these strategies on litter performance need to be documented. The objectives of the experiment were to measure the capacity of the sow to mobilize bone minerals reserves during lactation according to dietary digestible P (P dig) content and phytase addition, to restore them, during the following gestation, and to measure the effects on the growth performance of the offspring. Whole body bone mineral content (BMC) of primiparous Swiss Large White sows (n = 24) from the Agroscope sow herd was measured by dual-energy X-ray absorptiometry (DXA) on days 2, 14, 26, 66, and 106 after parturition. Four lactation diets were formulated to cover all nutritional requirements except for Ca and P dig: control without phytase (100%; 3.0 g P dig, 9.9 g Ca/kg), 75% of P dig without phytase (75%; 2.3 g P dig, 8.3 g Ca/kg), 50% of P dig without phytase (50; 1.5 g P dig, 6.0 g Ca/kg), and 50% of P dig with phytase (50+Phyt; 3.0 g P dig, 7.6 g Ca/kg). The gestation diet was formulated to cover nutritional requirements of Ca and P dig (2.6 g P dig, 8.2 g Ca/kg). Piglets were weighed at 1 and 14 days after parturition and at weaning (day 26), and the average daily gain (ADG) per piglet was calculated. During lactation, BMC of the sow (in g/kg of body weight, BW) tended to be less in treatment 50% than in treatment 100% (-12.8%, linear effect x time quadratic, P = 0.05). During gestation, BMC was similar between treatments. Therefore, sows in treatment 50% were able to recover their bone-mineralization deficit during the next gestation. The BMC (in g and in g/kg BW) was similar between treatments 100% and treatment 50+Phyt throughout the experimental period. Piglet weight at days 1, 14, and 26 and ADG (days 1 to 14, 14 to 26 and 1 to 26) were similar between dietary treatments. These results show the possibility of drastically reducing dietary P during lactation without decreasing litter performance and highlight the ability of primiparous sows to mobilize bone mineral during lactation and restore it during gestation.

Associations between body composition and cardiovascular disease risk in pre- and postmenopausal women

BackgroundMenopause transition is a critical phase of women’s life since body composition and cardiovascular risk factors begin to change during this period. This study investigated the associations between body composition and cardiovascular disease risk (CVDR) in pre (PrMW) and postmenopausal women (PMW).MethodsA community-based cross-sectional study involving 184 PrMW and 166 PMW, selected randomly from Bope-Poddala area in Galle, Sri Lanka was carried out. Total-body fat mass (TBFM, kg), total body skeletal muscle mass (TBSMM, kg), total body bone mineral density (TBBMD, g/cm2) and total body bone mineral content (TBBMC, g) were measured with total body DXA scanner and they were taken as indices of body composition. CVDR was evaluated using Framingham risk score (FRS%) and individual CVDR factors, such as systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), fasting blood sugar (FBS, mg/dl), total cholesterol, (TC, mg/dl), tryglycerides (TG, mg/dl), high-density lipoprotein (HDL, mg/dl) and low-density lipoprotein (LDL, mg/dl). Correlations between indices of body composition and CVDR factors were assessed with adjusted partial correlation (adjusted for socio-demographic and gynecologic status, age, daily calorie consumption and physical activity level).ResultsMean(SD) age of PrMW and PMW were 42.4(6.0) and 55.8(3.8) years respectively. TBFM correlated with SBP and DBP (r range; 0.15 to 0.21) and TBSMM correlated with SBP, DBP and HDL (r range; − 0.24 to 0.17) only in PrMW (p < 0.05). TBBMD correlated only with FBS in PMW (r; − 0.21, p = 0.01). TBBMC did not show correlations with CVDR factors (p > 0.05). Body composition indices did not show correlations with total CVDR estimated by FRS and in both groups of women (p > 0.05).ConclusionsBoth SBP and DBP are associated with FM and SMM in different ways among PrMW. This association, however, was not seen among PMW. FBS is associated with BMD only in PMW.

Association between body fat and bone mineral density in Korean adults: a cohort study

Although obesity was once considered protective against osteoporosis, various factors influence the relationship between fat and bone mineral density (BMD). To establish the importance of healthy body composition in decelerating declines in BMD, we conducted a study to compare the association between body fat composition and BMD in Korean adults. Using data collected from the Kangbuk Samsung Health Study from 2012 to 2019, this cohort study compared the incidence of decreased BMD among the following four groups: normal BMI and normal adiposity (NBMI-NA), normal BMI and high adiposity (NBMI-HA), overweight, and obesity. Decreased BMD was defined as a Z-score ≤ − 2.0 in premenopausal women and men < 50 years of age or a T-score < − 1.0 in postmenopausal women and men ≥ 50 years of age. Individuals who were diagnosed with osteoporosis or compression fracture after their second visit were categorized as having decreased BMD. The incidence rate of decreased BMD in the NBMI-NA group was 3.37, and that in the NBMI-HA group was 4.81, which was the highest among all groups. After adjusting for confounding factors, NBMI-HA led to a significantly greater risk of decreased BMD compared to NBMI-NA (HR 1.47; 95% CI 1.09–1.99). Even with a normal BMI, a high BFP was associated with an increased risk of decreased BMD. Therefore, healthy body composition management, not simply BMI, is important in preventing decreased BMD.

Effect of six weeks of resistance training on bone preservation in older adults: a randomized control trial.

It has been established that chronic resistance exercise contributes to positive changes to bone in older adults. This study evaluated the effect of 6weeks of resistance exercise with either elastic bands or dumbbells vs. a control period on bone morphology of older adults. Fifty-seven adults (mean ± SD; age = 66.5 ± 7.09 yrs; height = 165.2 ± 10.6cm; body mass = 74.5 ± 14.6kg) were randomized into three groups (dumbbell, elastic, or control). Participants underwent a total body dual-energy X-ray absorptiometry (DXA) scan for total body and segmental bone mineral content (BMC) and bone mineral density (BMD) before and following 6-week intervention. Age-matched Z-scores for BMD and BMC were recorded. Data were analyzed using two-way repeated measures ANOVAs and 0.05 significance level. BMCarm improved for the dumbbell group (p = 0.016) after the training, with no change in BMD for any group (p > 0.05). Additionally, significant (time x treatment group) interaction (p = 0.024) of age-matched Z-scores indicated an improvement in only the dumbbell group after 6weeks (p = 0.015), with no change in the elastic group despite them having greater Z-scores than the control group. This study is the first to demonstrate acute normative adaptations as dumbbell-based programs may promote positive maintenance of bone metrics over 6weeks, despite the lack of significant change in absolute BMC or BMD. Adults did not lose relative bone mass with acute exercise using dumbbells as the external load applied and this may lead to positive changes following chronic training. There was no bone-related impact from elastic bands, suggesting a weighted load or force produced relative to gravity is beneficial.

Association between lean body mass to visceral fat mass ratio and bone mineral density in United States population: a cross-sectional study

BackgroundStudies have explored the correlation between body composition and bone mineral density (BMD), but there has yet to be a consensus. Thus, the present study aims to comprehensively investigate the association between lean body mass, adipose tissue, and BMD.MethodsWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) (2011–2018) with 11,227 subjects. Multiple linear regression, smoothed curve fitting, threshold, and saturation effect analysis were used to explore the association between lean body mass, visceral fat mass, and BMD. Also, we used the lean body mass to visceral fat mass ratio (Log LM/VFM) as a proxy variable to analyze its association with BMD alone.ResultsAfter adjusting for potential confounding factors, the results showed a positive correlation between lean mass and total BMD (for continuous: β = 0.078, P < 0.001; for quartile: β = 0.138, P < 0.001), while visceral fat mass was negatively correlated (for continuous: β = -0.027, P < 0.001; for quartile: β = -0.065, P < 0.001). A positive correlation was observed when the alternative variable Log LM/VFM was analyzed separately for its association with BMD (for continuous: β = 0.034, P < 0.001; for quartile: β = 0.084, P < 0.001). In addition, subgroup analyses for gender, age, body mass index, hypertension, and diabetes showed that all subgroups except the diabetes subgroup showed a substantial degree of robustness (P < 0.05). The smoothed curve fitting showed a nonlinear relationship between Log LM/VFM and BMD, and there was a threshold effect with a critical value of 2.60.ConclusionMaintaining a proper ratio of lean body mass and visceral fat mass is beneficial for increasing BMD.

A 20-week exercise program improved total body and legs bone mineral density in children with overweight or obesity: The ActiveBrains randomized controlled trial

ObjectivesThe aim of this study was to investigate the effect of a 20-week exercise program on bone mineral parameters in children with overweight or obesity. DesignRandomized controlled trial. MethodsThis study took part from November 21, 2014, to June 30, 2016, in Granada, Spain. A secondary analysis of this parallel-group randomized controlled trial was performed with 77 children with overweight or obesity (9.9 ± 1.2, 65 % boys) who were randomly allocated to exercise or control group. All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions/week of aerobic plus resistance training for 20 weeks. A whole-body scan by dual-energy X-ray absorptiometry was carried out to obtain body composition at total body less head, arms, lumbar spine, pelvis, and legs. ResultsParticipants in the exercise group acquired significantly higher total body aBMD (mean z-score [95 % confidence intervals, CI], 0.607 [0.522–0.692]) compared with the participants in the control group (mean z-score, 0.472 [0.388–0.556]); difference between groups, 0.135 standard deviations [95 % CI 0.015–0.255], and legs aBMD (mean z-score, 0.629 [0.550–0.708]); control group (mean z-score, 0.518 [0.440–0.596]); difference between groups, 0.111 [0.001–0.222]; all p < 0.05. There were no significant differences between exercise group and control group at the remaining evaluated regions (p > 0.05). ConclusionsA 20-week non-specifically bone-targeted exercise program induced a small, yet significant, improvement on total body and legs aBMD in children with overweight or obesity. Future studies should investigate the interaction of weight status in the bone response to exercise programs. Trial registrationProspectively registered in ClinicalTrials.gov Identifier: NCT02295072.

To Evaluate the Value of Vertebral Body Cortical Thickness in Predicting Osteoporosis by Opportunistic CT

In vertebrae, the amount of cortical bone has been estimated at 30-60%, but 45-75% of axial load on a vertebral body is borne by cortical bone(1). The purpose of this study is to investigate the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of vertebral body cortical thickness in predicting osteoporosis(OP) by analyzing the relationship between vertebral body cortical thickness and bone mineral density(BMD) in different age and gender groups. The optimal diagnostic cut-off value of vertebral body cortical thickness in predicting OP was analyzed. The data of 150 patients (50-89 years old) who underwent chest or abdominal Quantitative computed tomography (QCT) scan(obtained in one scan) in our hospital from July 2021 to July 2022 were retrospectively analyzed. The average volume bone mineral density (vBMD) of L1-L2 vertebral bodies was obtained and grouped according to BMD, age, and gender. According to BMD, the patients were divided into three groups: osteoporosis, osteopenia and normal. According to age, the patients were divided into three groups: 50-59 years, 60-69 years and ≥70 years. The axial images of T11, T12 and L1 were reconstructed with 1.25mm slice thickness by AW4.7 workstation provided by General Electric Co (GE) Company. The images were imported into the computed tomography (CT) Spine Bone Quantification System software for spine analysis, and the vertebral body cortical thickness values were obtained. CT Spine Bone Quantification System is a software for quantitative analysis and separation of cortical bone and cancellous bone. A total of 150 patients were enrolled in this study, including 49 patients in the osteoporosis group, 51 patients in the osteopenia group, and 50 patients in the normal group. The cortical thickness values of T11, T12 and L1 were positively correlated with BMD, and the correlation coefficient was 0.750 at T11. According to the receiver operating characteristic (ROC) curve analysis of T11, T12, L1 cortical thickness value and BMD, OP was diagnosed when T11<2.75mm, T12<3.06mm, and L1<2.67mm. The sensitivity was 83.67%, 87.76%, 75.51%, respectively. The specificity was 79.21%, 71.29% and 90.10%, respectively, and the difference was statistically significant. Vertebral body cortical thickness is correlated with BMD and age. According to the cut-off value of different vertebral bodies, OP can be predicted when T11<2.75mm or T12<3.06mm or L1<2.67mm.

Small animal DXA instrument comparison and validation

Several new peripheral dual-energy X-ray absorptiometry (DXA) devices designed for assessment of bone and body composition in rodents have been developed. We compared the performance (accuracy and precision) of two of these devices, the InAlyzer and the iNSiGHT, to those of an established device, the PIXImus. We measured total body bone mineral content (BMC), bone mineral density (BMD), and body composition (lean and fat mass) on the three DXA devices in 18 male C57Bl/6 J mice (6 each of ages 8, 14, and 24 weeks, weighing 22 to 33 g). DXA body composition measures were compared to whole-body nuclear magnetic resonance (NMR) outcomes. BMC of the femur was also compared to ex vivo micro-computed tomography (microCT). Total body BMD from the InAlyzer and iNSiGHT devices was strongly correlated to that from PIXImus (R2 = 0.83 and 0.82, respectively), but was ~25 % higher than PIXImus. Total body BMC measures by InAlyzer were strongly associated with those from PIXImus (R2 = 0.86), whereas those from iNSiGHT were only weakly correlated (R2 = 0.29). Femur BMC from InAlyzer was strongly correlated with microCT outcomes, whereas iNSiGHT was only weakly correlated. InAlyzer and iNSiGHT fat mass measures were very strongly correlated with PIXImus and NMR outcomes (R2 = 0.91 to 0.97), with slightly weaker associations for lean mass (R2 = 0.81 to 0.76). Short-term precision of InAlyzer and iNSiGHT measurements were excellent, and akin to those from the PIXImus for both body composition and bone measures, ranging between 0.39 and 3.2 %. With faster scan times, closed X-ray source and excellent precision, the new devices are both satisfactory replacements for the now discontinued PIXImus system. However, given the accuracy of the bone and body composition measures, the InAlyzer may be preferable for studies where musculoskeletal changes are the main interest.

Alloferon-1 ameliorates estrogen deficiency-induced osteoporosis through dampening the NLRP3/caspase-1/IL-1β/IL-18 signaling pathway

Alloferon-1 is an insect polypeptide that has anti-inflammatory, antitumor and antiviral activity. This study aimed to determine the effects of alloferon-1 on estrogen deficiency-induced osteoporosis and explore the associated mechanism using a murine model of ovariectomy (OVX)-induced osteoporosis. Results showed that alloferon-1 prevented ovariectomy‑induced body weight gain, bone loss and bone mineral content reduction, affected biochemical markers of bone turnover, and restored the microstructure of bone trabeculae. Moreover, alloferon-1 suppressed the expression of the ovariectomy‑mediated inflammatory cytokines in the vertebrae bone tissues, including nucleotide-binding oligomerization domain-like-receptor family pyrin domain-containing 3 (NLRP3), cysteinyl aspartate specific proteinase-1 (Caspase-1), interleukin 1β (IL-1β) and interleukin 18 (IL-18) which were determined by immunofluorescence staining and western blot. Overall, the present study provides evidence for the effectiveness of alloferon-1 against estrogen deficiency-induced osteoporosis, suggesting an alternative drug or an auxiliary modulator for the treatment of postmenopausal osteoporosis (PMOP).

The correlation between nutritional status, body composition, and symptoms in Parkinson's disease patients

Objective: To investigate the relationship between nutritional status, body composition and symptoms of Parkinson's disease (PD). Methods: The study was conducted among 102 PD patients between November 2020 to April 2021 in the outpatient and inpatient of Neurology department of the Second Affiliated Hospital of Suzhou University. Basic data, such as age, gender, course of disease and Hoehn-Yahr (H-Y) stage of the patients, were collected. In the "open" state, the Unified Parkinson's Disease Rating Scale (UPDRS) and other scales were used to evaluate the clinical symptoms of PD patients. The nutritional status of PD patients was evaluated by the micro-nutrition rating Scale (MNA), and the body composition data of PD patients was measured by the body composition analyzer.The patients were divided into three groups according to the MNA: well-nourished group(45 cases), malnutrition-risk group (43 cases)and malnutrition group(14 cases). Body composition, laboratory tests, bone density, and symptoms of PD were compared among the three groups. Results: Among 102 PD patients, 48 were males (47.1%) and 54 were females (52.9%), aged 42-86 (66±9) years old. Compared with the malnutrition-risk group, lymphocytes in the malnutrition group [(1.45±0.48) × 109/L vs (1.76±0.43)×109/L], uric acid [(227±54) μmol/L vs (282±63) μmol/L] were all low, and the difference was statistically significant (all P<0.05). Compared with the well-nourished group, hemoglobin [(125±17) g/L vs (136±14) g/L], prealbumin [(0.23±0.05) g/L vs (0.27±0.06) g/L], and uric acid [(227±54) μmol/L vs (312±76) μmol/L] and Retinol binding protein [(33±7) mg/L were lower than (39±10) mg/L] in the malnutrition group, the difference was statistically significant (P<0.05). Except for the visceral fat area and body fat percentages, there was no significant difference in body composition indexes and bone mineral density T-value between the malnutrition-risk and malnutrition groups (P<0.05). Compared with the well-nourished group, the body fat [(16±6) kg vs (20±6) kg], the percentage of body fat [(26±9)% vs (29±7)%], the waist-hip ratio [(0.86±0.05) vs (0.89±0.05)], and the upper arm circumference [(29.00±2.59) cm vs (30.74±2.75) cm] in the malnutrition risk group were lower, and the difference was statistically significant (P<0.05). There were statistically significant differences in all body composition indicators and T-values of bone density between the malnourished and well nourished groups (all P<0.05). The MNA score of PD patients was negatively correlated with UPDRS Ⅰ, UPDRS Ⅱ, and UPDRS Ⅳ scores (r=-0.347, -0.364, -0.303, all P<0.05); Body composition indicators: total body water and inorganic salts were negatively correlated with UPDRS-I (r=-0.206, -0.223, all P<0.05), and body fat was negatively correlated with levodopa Equivalent dose (LED) (r=-0.209, P<0.05) Conclusions: The malnutrition risk and incidence of malnutrition in PD patients are high; lymphocyte, uric acid, hemoglobin, Retinol binding protein, body composition and bone mineral density were low in malnutrition group. MNA score of PD patients was negatively correlated with Parkinson's disease symptoms.

Mood instability and low back pain: a mendelian randomization study.

Low back pain is a prevalent and debilitating condition worldwide, with significant implications for individuals' quality of life and productivity. The aim of this study was to assess the relationship between mood instability and the risk of developing chronic low back pain, using a rigorously designed mendelian randomization methodology. The study incorporated both univariate and multivariate mendelian randomization to analysis the causal relationship between mood instability and the risk of developing chronic low back pain. The data on mood instability from the Integrative Epidemiology Unit (IEU) opened Genome-Wide Association Studies (GWAS) project (IEU-opened GWAS project). Data on low back pain were collected from two sources: One source is the IEU open GWAS project (discovery data). Another source is a GWAS meta-analysis (replication data). Inverse variance weighted method, weighted median method, MR-Egger regression, and mendelian randomization pleiotropy residual sum and outlier method were used for mendelian randomization analysis. The univariable mendelian randomization analysis shows a statistically significant correlation between mood instability and the risk of low back pain. Several methods were performed, including inverse variance weighting (discovery data: odds ratio = 3.544, 95% confidence interval = 1.785-7.039, p = 0.000; replication data: odds ratio = 3.167, 95% confidence interval = 2.476-4.052, p = 0.000), MR-Egger (discovery data: odds ratio = 7.178, 95% confidence interval = 0.057-909.525, p = 0.429; replication data: odds ratio = 2.262, 95% confidence interval = 0.580-8.825, p = 0.246), weighted median (discovery data: odds ratio = 2.730, 95% confidence interval = 1.112-6.702, p = 0.028; replication data: odds ratio = 3.243, 95% confidence interval = 2.378-4.422, p = 0.000), MR-PRESSO (discovery data: odds ratio = 3.544, 95% confidence interval = 1.785-7.039, p = 0.001; replication data: odds ratio = 3.167, 95% confidence interval = 2.476-4.052, p = 0.000) methods. The results were consistent across these methods. The results obtained from discovery data are consistent with those obtained from discovery data. In the multivariable mendelian randomization, after adjusting for various covariates such as body mass index, current tobacco smoking, alcohol intake frequency, Total body bone mineral density, and vigorous physical activity, there is a consistent correlation between mood instability and chronic low back pain. This study provides robust evidence supporting a causal relationship between mood instability and the development of low back pain. Our findings suggest that addressing mood instability may play a crucial role in prevention and management strategies for individuals experiencing low back pain.

A novel non-invasive method for predicting bone mineral density and fracture risk using demographic and anthropometric measures

Fractures are costly to treat and can significantly increase morbidity. Although dual-energy x-ray absorptiometry (DEXA) is used to screen at risk people with low bone mineral density (BMD), not all areas have access to one. We sought to create a readily accessible, inexpensive, high-throughput prediction tool for BMD that may identify people at risk of fracture for further evaluation. Anthropometric and demographic data were collected from 492 volunteers (♂275, ♀217; [44 ​± ​20] years; Body Mass Index (BMI) = [27.6 ​± ​6.0] kg/m2) in addition to total body bone mineral content (BMC, kg) and BMD measurements of the spine, pelvis, arms, legs and total body. Multiple-linear-regression with step-wise removal was used to develop a two-step prediction model for BMC followed by BMC. Model selection was determined by the highest adjusted R2, lowest error of estimate, and lowest level of variance inflation (α ​= ​0.05). Height (HTcm), age (years), sexm=1, f=0, %body fat (%fat), fat free mass (FFMkg), fat mass (FMkg), leg length (LLcm), shoulder width (SHWDTHcm), trunk length (TRNKLcm), and pelvis width (PWDTHcm) were observed to be significant predictors in the following two-step model (p ​< ​0.05). Step1: BMC (kg) = (0.006 3 × HT) ​+ ​(−0.002 4 × AGE) ​+ ​(0.171 2 × SEXm=1, f=0) ​+ ​(0.031 4 × FFM) ​+ ​(0.001 × FM) ​+ ​(0.008 9 × SHWDTH) ​+ ​(−0.014 5 × TRNKL) ​+ ​(−0.027 8 × PWDTH) - 0.507 3; R2 ​= ​0.819, SE ​± ​0.301. Step2: Total body BMD (g/cm2) = (−0.002 8 × HT) ​+ ​(−0.043 7 × SEXm=1, f=0) ​+ ​(0.000 8 × %FAT) ​+ ​(0.297 0 × BMC) ​+ ​(−0.002 3 × LL) ​+ ​(0.002 3 × SHWDTH) ​+ ​(−0.002 5 × TRNKL) ​+ ​(−0.011 3 × PWDTH) ​+ ​1.379; R2 ​= ​0.89, SE ​± ​0.054. Similar models were also developed to predict leg, arm, spine, and pelvis BMD (R2 ​= ​0.796–0.864, p ​< ​0.05). The equations developed here represent promising tools for identifying individuals with low BMD at risk of fracture who would benefit from further evaluation, especially in the resource or time restricted setting.

Vitamin D supplementation for improving bone density in vitamin D–deficient children and adolescents: systematic review and individual participant data meta-analysis of randomized controlled trials

BackgroundVitamin D supplements are widely used for improving bone health in children and adolescents, but their effects in vitamin D–deficient children are unclear. ObjectivesThis study aimed to examine whether the effect of vitamin D supplementation on bone mineral density (BMD) in children and adolescents differs by baseline vitamin D status and estimate the effect in vitamin D–deficient individuals. MethodsThis is a systematic review and individual participant data (IPD) meta-analysis. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, MBASE, CINAHL, AMED, and ISI Web of Science (until May 27, 2020) for randomized controlled trials (RCTs) of vitamin D supplementation reporting bone density outcomes after ≥6 mo in healthy individuals aged 1–19 y. We used two-stage IPD meta-analysis to determine treatment effects on total body bone mineral content and BMD at the hip, femoral neck, lumbar spine, and proximal and distal forearm after 1 y; examine whether effects varied by baseline serum 25-hydroxyvitamin D [25(OH)D] concentration, and estimate treatment effects for each 25(OH)D subgroup. ResultsEleven RCTs were included. Nine comprising 1439 participants provided IPD (86% females, mean baseline 25(OH)D = 36.3 nmol/L). Vitamin D supplementation had a small overall effect on total hip areal BMD (weighted mean difference = 6.8; 95% confidence interval: 0.7, 12.9 mg/cm2; I2 = 7.2%), but no effects on other outcomes. There was no clear evidence of linear or nonlinear interactions between baseline 25(OH)D and treatment; effects were similar in baseline 25(OH)D subgroups (cutoff of 35 or 50 nmol/L). The evidence was of high certainty. ConclusionsClinically important benefits for bone density from 1-y vitamin D supplementation in healthy children and adolescents, regardless of baseline vitamin D status, are unlikely. However, our findings are mostly generalizable to White postpubertal girls and do not apply to those with baseline 25(OH)D outside the studied range or with symptomatic vitamin D deficiency (e.g., rickets).This study was preregistered at PROSPERO as CRD42017068772. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017068772

Evaluation of Biological Mechanisms of Quanduzhong Capsule for Treating Osteoporosis by Integrating Untargeted Metabolomics and Network Pharmacology

AbstractOsteoporosis (OP) is a metabolic disease characterized by bone formation and resorption disturbances. Quanduzhong Capsule (QDZC) is a common treatment for OP in China; however, the effective components and metabolites of the drug after oral administration remain largely unknown. This study aims to identify the active components, analyze the metabolite changes, and investigate the underlying mechanism against OP. In the study, ovariectomy-induced rat OP model was established, then treated with QDZC. Alendronate sodium tablets (ASTs) were used as a reference drug. The chemical constituents of QDZC were analyzed by UPLC-QTOF-MS (ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry) and network pharmacology. The metabolomics was used to analyze differences in serum metabolites of rats in different groups [Sham, Model, Model + QDZC, and Model + AST] at 4, 8, and 12 weeks. Body weight and bone mineral density (BMD) were assessed. Enzyme-linked immunosorbent assay was used to determine serum levels of Akt, p-Akt, ERK, and p-ERK. Our data suggested 86 different chemicals from QDZC, including nine core compounds. QDZC significantly regulated 25 biomarkers linked to arachidonic acid metabolism and unsaturated fatty acid biosynthesis, and promoted serum expression of Akt, p-Akt, ERK, and p-ERK. QDZC might act by activating PI3K-Akt and MAPK signaling pathways. In addition, QDZC may use arachidonic acid derivatives to inhibit osteoclast generation and bone resorption and enhance calcitriol formation to improve calcium absorption and increase bone mass.

Heterogeneity in regional changes in body composition induced by androgen deprivation therapy in prostate cancer patients: potential impact on bone health-the BLADE study.

It is not clear whether changes in body composition induced by androgen deprivation therapy (ADT) in prostate cancer (PC) patients are uniform or vary in the different body districts and whether regional lean body mass (LBM) and fat body mass (FBM) could have an impact on bone health. To prospectively evaluate the regional changes in LBM and FBM in PC patients submitted to degarelix; to explore the relationship of regional body composition and bone mineral density (BMD) and bone turnover markers. 29 consecutive non metastatic PC patients enrolled from 2017 to 2019. FBM, LBM and bone mineral density (BMD) evaluated by dual-energy x-ray absorptiometry (DXA) at baseline and after 12-month of ADT. Alkaline phosphate (ALP) and C-terminal telopeptide of type I collagen (CTX) assessed at baseline, 6 and 12months. All patients underwent degarelix administration. T-test or sign test and Pearson or Spearman test for continuous variables were used when indicated. Median percent increase in FBM ranged from + 14.5% in trunk to + 25.4% in the left leg after degarelix. LBM changes varied from + 2% in the trunk to -4.9% in the right arm. LBM in both arms and legs and their variations after degarelix directly correlated with ALP and inversely correlated with CTX. Lean mass of limbs, trunk and legs significantly correlated with BMD of the hip, lean mass of the trunk significantly correlated with spine BMD. These are post-hoc analysis of a prospective study and this is the main limitation. an heterogeneous change in body composition among body district is observed after ADT and bone turnover is influenced by lean mass and its variation. A supervised physical activity is crucial to maintain general physical performance and preserving bone health.

Impact of nutritional-behavioral and supervised exercise intervention following bariatric surgery: The BARI-LIFESTYLE randomized controlled trial.

The study's aim was to investigate the impact of a 12-month adjunctive lifestyle intervention on weight loss and health outcomes after bariatric surgery. A total of 153 participants (78.4% females; mean [SD], age 44.2 [10.6] years; BMI 42.4 [5.7] kg/m2 ) were randomized to intervention (n = 79) and control (n = 74). The BARI-LIFESTYLE program combined 17 nutritional-behavioral tele-counseling sessions plus once-weekly supervised exercise for 12 weeks. The primary outcome was percentage weight loss at 6 months post surgery. Secondary outcomes included body composition, physical activity levels, physical function and strength, health-related quality of life, depressive symptomatology, and comorbidities. Longitudinal analysis of the entire cohort showed significant reductions in body weight, fat mass, fat-free mass, and bone mineral density at the total hip, femoral neck, and lumbar spine (all p < 0.001). The 6-minutewalk test, sit-to-stand test, health-related quality of life, and depressive symptomatology improved significantly (all p < 0.001). The time spent in moderate-to-vigorous physical activity and sedentary behavior remained the same as before surgery (both p > 0.05). There was no significant difference in the primary outcome between the intervention versus control (20.4% vs. 21.2%; mean difference = -0.8%; 95% CI: -2.8 to 1.1; p > 0.05) and no between-group differences in secondary outcomes. An adjunctive lifestyle program implemented immediately after surgery had no favorable impact upon weight loss and health outcomes.