X-ray Densitometry Research Articles

Serum phosphorus levels and fracture following renal transplantation.

Increased fracture rates are observed in renal transplant recipients (RTRs) compared with the general population. Risk factors include age, diabetes, dialysis vintage, immunosuppression and mineral and bone disorders.1 Low serum phosphorus levels occur post-transplantation; however, its relationship with fracture risk has not been evaluated. The purpose of this study was to evaluate risk factors for fracture in RTRs at a single tertiary referral centre. A retrospective cross-sectional analysis of 146 patients (75M, 71F) who had been referred for dual energy X-ray densitometry (DXA) post-renal transplantation was performed. Aetiology of end stage kidney disease (ESKD), duration of dialysis, parathyroidectomy history, immunosuppression regimen, bone mineral density (BMD), biochemistry and fractures were documented. Statistical analyses included univariable and multivariable regression. The mean age of patients was 54years and mean time post-transplantation 6.7years. A total of 79 fractures occurred in 52 patients (35%), with 40 fractures occurring post-transplantation. Ankle/foot fractures were most common (48%). Lower serum phosphorus levels and declining femoral neck (FN) T-score and were associated with fractures in both univariable and multivariable regression analyses after adjusting for age, gender, weight, estimated glomerular filtration rate and pre-transplant history of fracture (P=.011 and P=.042 respectively). The relationship between serum phosphorus and fracture remained significant independent of FN T-score, parathyroid hormone levels, parathyroidectomy status and prednisolone use. Fracture was common post-renal transplantation. Lower serum phosphorus levels and declining FN T-scores were associated with fractures. The mechanism of this previously unreported observation requires further evaluation in prospective studies.

Osteoporosis and osteoporotic fractures risk factors in men aged 50 years and older

Cross-sectional screening of random samples of men aged 50 years and older living in five cities (Arkhangelsk, Murmansk, Tyumen, Krasnoyarsk, and Chelyabinsk) from three Federal Districts (FD) of the Russian Federation was conducted to evaluate the frequency of individual risk factors (RF) of osteoporotic fractures among them. Total 1330 men were included in the study. We found that the most common were the following RF: smoking, prior fragility fractures after age 40, secondary causes of OP, insufficient calcium intake. Significantly more smokers were among males in Siberian (S) FD and North –Western (NW)FD compared with those from Ural (U) FD (p=0,0011 and p=0,047, respectively), the frequency of other RF did not differ depending on region. The рprevalence of osteoporosis according to peripheral x-ray densitometry of the proximal forearm was higher among residents of the UFD (26%) than among men in the NWFD (17%) and SFO (19%). More than 50% of men in each region had 2 or more RF, while those with 3 or more RF were significantly more in the UFD at any age, and at the age of 50-59 years - in the NWFD. Calcium intake was inadequate in 85% of the respondents in these regions.

ОСОБЛИВОСТІ ЗМІН МІНЕРАЛЬНОЇ ЩІЛЬНОСТІ КІСТКОВОЇ ТКАНИНИ У ХВОРИХ НА РЕВМАТОЇДННИЙ АРТРИТ В ПОЄДНАННІ З НЕАЛКОГОЛЬНИМ СТЕАТОГЕПАТИТОМ

РЕЗЮМЕ. РА займає особливе місце серед захворювань, які призводять до розвитку остеопорозу. Остеопороз при РА є наслідком як існуючого хронічного системного захворювання, так і терапії глюкокортикоїдами. Не проводилось вивчення взаємозв’язку між морфофункціональними порушеннями печінки і МЩКТ у хворих на РА.Мета дослідження – дослідити порушення структурно-функціонального стану кісткової тканини та виявити залежність змін мінеральної щільності кісткової тканини від наявності НАГС чи його відсутності, застосовуючи рентгенівську денситометрію в пацієнтів із РА.Матеріали та методи. Обстеження пацієнтів проводилося за традиційною методикою і включало: 1) загальноклінічні: огляд, опитування, наявність у минулому переломів, їх кількість та обставини їх виникнення, визначення ІМТ; 2) лабораторні (загальний та біохімічний аналіз крові, визначення РФ методом латекс- аглютинації, оцінку титру АТ ЦЦП методом ELISA (діагностична межа ≥15 ум. од./мл); 3) мінеральну щільність кісткової тканини визначали з використанням подвійного рентгенівського денситометра ДРХ-А (Dualenergy X-Ray Absorptiometry) фірми LUNAR (США) на рівні поперекового відділу хребта. У пацієнтів з МЩКТ на рівні поперекового відділу хребта ≤ -2,5 SD діагностували остеопороз; у пацієнтів, у яких рівень МЩКТ < -1 SD і ≥ -2,5 – SD- остеопенію; індекс Z (відхилення мінеральної щільності кістки від середнього значення у хворих відповідного віку), індекс Т (відхилення від референтного значення пікової кісткової маси у здорових осіб молодого віку); 4) статистичні.Результати. Денситометричні показники у когорті хворих з НАСГ вказують на значне зниження МЩКТ, порівняно з пацієнтами без ураження печінки. У більшості жінок з РА та супутнім ураженням печінки у постменопаузальному періоді відзначали явища остеопенії і остеопорозу (ОП). Серед пацієнтів із мінімальною активністю РА в поєднанні з НАСГ була незначна кількість обстежених із остеопорозом, у хворих на РА ІІ ступеня активності частка їх із остеопенією і остеопорозом розподілилася з невеликими відмінностями, хоча за відсотковим значенням переважали хворі з остеопенією. Найбільша кількість пацієнтів, яка становила групу максимальної активності РА, була представлена остеопорозом. Остеодефіцитні стани асоціювалися із ожирінням у пацієнтів з РА та НАСГ. За умов позитивності АТ ЦЦП кількість хворих із остеопорозом достовірно більша, ніж із нормальною мінеральною щільністю кісткової тканини і остеопенією. Пацієнти із серопозитивним РА мали статистично значущий вищий ризик виникнення остеодефіцитних станів і частіше хворіли на остеопороз, ніж особи із серонегативним РА. У більшої когорти хворих з РА в поєднанні з НАСГ діагностовано переломи в анамнезі: з остеопенією – у 6 (10,34%) осіб, з остеопорозом – у 12 (20,69%) хворих.Висновки. Серед хворих на РА із супутнім НАСГ діагностовано явища остеопенії та остеопорозу в 87,93 % випадків. Вивчення структурно-функціонального стану кісткової тканини поперекового відділу хребта в жінок до менопаузи і в постменопаузальному період із РА та супутнім НАСГ, порівняно з пацієнтами, які не мали супутнього ураження печінки, демонструвало достовірно вищий відсоток розвитку остеодефіцитних станів, який асоціювався із супутнім ожирінням, активністю РА, наявністю АТ ЦЦП і РФ як за кількісними значеннями МЩКТ, так й за частотою реєстрації даних станів.

New approaches to determine fatigue in elite athletes during intensified training: Resting metabolic rate and pacing profile.

BackgroundElite rowers complete a high volume of training across a number of modalities to prepare for competition, including periods of intensified load, which may lead to fatigue and short-term performance decrements. As yet, the influence of substantial fatigue on resting metabolic rate (RMR) and exercise regulation (pacing), and their subsequent utility as monitoring parameters, has not been explicitly investigated in elite endurance athletes.MethodTen National-level rowers completed a four-week period of intensified training. RMR, body composition and energy intake were assessed PRE and POST the four-week period using indirect calorimetry, Dual-Energy X-Ray Densitometry (DXA), and three-day food diary, respectively. On-water rowing performance and pacing strategy was evaluated from 5 km time trials. Wellness was assessed weekly using the Multicomponent Training Distress Scale (MTDS).ResultsSignificant decreases in absolute (mean ± SD of difference, p-value: -466 ± 488 kJ.day-1, p = 0.01) and relative RMR (-8.0 ± 8.1 kJ.kg.FFM-1, p = 0.01) were observed. Significant reductions in body mass (-1.6 ± 1.3 kg, p = 0.003) and fat mass (-2.2 ± 1.2 kg, p = 0.0001) were detected, while energy intake was unchanged. On-water 5 km rowing performance worsened (p < 0.05) and an altered pacing strategy was evident. Fatigue and total mood disturbance significantly increased across the cycle (p < 0.05), and trends were observed for reduced vigour and increased sleep disturbance (p < 0.1).ConclusionFour weeks of heavy training decreased RMR and body composition variables in elite rowers and induced substantial fatigue, likely related to an imbalance between energy intake and output. This study demonstrates that highly experienced athletes do not necessarily select the correct energy intake during periods of intensified training, and this can be assessed by reductions in RMR and body composition. The shortfall in energy availability likely affected recovery from training and altered 5 km time trial pacing strategy, resulting in reduced performance.

Evaluation of intra-ring wood density profiles using NIRS: comparison with the X-ray method

Pith-to-bark wood density profiling is interesting in forestry science. By comparing it with the X-ray method, this study proved that a fiber optic NIR spectrometer with a high-precision displacement system could accurately measure intra-ring wood density with a spatial resolution of 0.5 mm. Most near-infrared spectroscopy (NIRS) studies for wood density determination use samples that have been pulverized beforehand. Attenuation of ionizing radiation is still the standard method to determine wood density with high spatial resolution. However, there is evidence that NIRS could be an accurate and affordable method for determining intra-ring density in solid wood strips. In this study, we research whether the results published for intra-ring density predictions in wood can be improved when calibrated with X-ray microdensitometry. The measurements were made using a fiber optic probe with a separation between measurement points of 0.508 mm in a range between 1200 and 2200 nm. A total of 4520 density points were used to create partial least squares regression (PLSR). X-ray densitometry data were used as reference values. Twenty PLSR calibrations were randomly executed on 31 samples collected from 28 Pinus radiata D. Don trees. Upon selecting 20 latent variables, the R 2 value was 0.873 for the training group and 0.895 for the validation group, while RMSEP values are 43.1 × 10−3 and 47.1 × 10−3 g cm−3 for the training and validation groups, respectively. The range error ratio (RER) was 13.7. The RER was high and almost in the range suggested for quantification purposes. Results are superior to wood density studies in the literature which do not employ spatial resolution and to those found in studies using hyperspectral imaging.

Evaluation of X-ray densitometry to identify tree-ring boundaries of two deciduous species from semi-arid forests in Brazil

The presence of visible annual rings in semi-arid tropical trees may allow the application of dendrochronological methods. However, variation in water availability may cause the formation of narrow, irregular ill- or non-defined annual rings hindering the correct dating of tree-ring series. We aimed to evaluate X-ray densitometry as a method to identify tree rings of two deciduous tree species from the Caatinga forest, a semi-arid region in the northeast of Brazil, and compare with two other methods commonly used in dendrochronology, the sliding-stage micrometer and image analysis. Xylem was observed macro- and microscopically and wood anatomical features were assessed in Aspidosperma pyrifolium and Poincianella pyramidalis trees. In both species, tree-ring boundaries were identified considering intra-annual density patterns and wood anatomical features. No significant differences in tree-ring widths were found among methods. X-ray densitometry measurements showed a positive correlation with the measurements obtained with image analysis and sliding-stage micrometer in A. pyrifolium and P. pyramidalis, revealing the high reliability of the methods used. However, inter-correlation of tree-ring width series showed differences in the accuracy of crossdating across measuring methods. The maximum, mean and minimum density values were species-dependent, with mean wood density of A. pyrifolium lower than P. pyramidalis. Our results highlight X-ray densitometry as an important and complementary tool to identify tree-rings boundaries in semi-arid tree species, especially in A. pyrifolium. Along with other measuring methods, it may provide higher accuracy in dendrochronological studies in semi-arid or subtropical environments.

Calibration of SilviScan data of Cryptomeria japonica wood concerning density and microfibril angles with NIR hyperspectral imaging with high spatial resolution

Abstract Wood density and microfibril angle (MFA) are strongly correlated with wood stiffness, swelling/shrinkage, and its anisotropy. Understanding the spatial distribution of these data is critical for solid timber applications. In this study, near-infrared (NIR) hyperspectral imaging has been calibrated for evaluation of wood density and MFA in an effective manner. Briefly, five wood samples collected from both normal wood (NW) and compression wood (CW) moieties of two different Cryptomeria japonica trees were analyzed. Partial least squares (PLS) regression analysis was performed to determine the relationship between X-ray densitometry data obtained by SilviScan and NIR spectra, and cross-validation (leave-one-out) approach served for prediction performances. The validation coefficient of determination (r2) between the predicted densities by the NIR technique and the X-ray data was 0.83 with a root mean squared error of cross-validation (RMSECV) of 105.2 kg m−3. Regarding MFA, the r2 was 0.77 and RMSECV 5.36°. Wood density was successfully maped as well as the MFA at a high spatial resolution. As a result, the detection of annual growth ring features and evaluation of aspects of heterogeneous wood quality has been facilitated. The mapping results were visually checked by looking at the difference between earlywood (EW) and latewood (LW) for density and by means of the Mäule color reaction indicating high lignin contents in CW in terms of MFA validation as CWs have high MFA values.

A RELATIONSHIP BETWEEN ARTERIAL STIFFNESS, CYTOKINE LEVELS, AND BONE MINERAL DENSITY IN WOMEN WITH POSTMENOPAUSAL OSTEOPOROSIS

Arterial stiffness is an independent predictor of cardiovascular diseases. A possible link between the development of osteoporosis (OP) and cardiovascular diseases is presently being considered. Cytokines that can affect the skeletal and cardiovascular systems act as pathogenetic factors of this interaction. Objective: to identify a relationship between the measures of arterial stiffness, the serum level of cytokines and the state of bone mineral density (BMD) in women with OP; to establish the role of elevated cytokine concentrations in lowering BMD and raising pulse wave velocity (PWV) in this category of patients. Subjects and methods. A total of 115 postmenopausal women were examined. X-ray densitometry was used to investigate BMD in two areas: the lumbar vertebrae and the proximal femur. Carotid-femoral PWV was measured by applanation tonometry. The serum level of cytokines was investigated by enzyme immunoassay. Results and discussion. Women with osteoporosis were found to have a higher PWV and elevated concentrations of interleukin (IL) 6, IL-8, tumor necrosis factor-α, IL-4, and IL-10. The higher level of IL-6 is an independent factor in decreasing proximal femur bone BMD and in increasing PWV.

Predictive Modeling of Black Spruce (Picea mariana (Mill.) B.S.P.) Wood Density Using Stand Structure Variables Derived from Airborne LiDAR Data in Boreal Forests of Ontario

Our objective was to model the average wood density in black spruce trees in representative stands across a boreal forest landscape based on relationships with predictor variables extracted from airborne light detection and ranging (LiDAR) point cloud data. Increment core samples were collected from dominant or co-dominant black spruce trees in a network of 400 m2 plots distributed among forest stands representing the full range of species composition and stand development across a 1,231,707 ha forest management unit in northeastern Ontario, Canada. Wood quality data were generated from optical microscopy, image analysis, X-ray densitometry and diffractometry as employed in SilviScan™. Each increment core was associated with a set of field measurements at the plot level as well as a suite of LiDAR-derived variables calculated on a 20 × 20 m raster from a wall-to-wall coverage at a resolution of ~1 point m−2. We used a multiple linear regression approach to identify important predictor variables and describe relationships between stand structure and wood density for average black spruce trees in the stands we observed. A hierarchical classification model was then fitted using random forests to make spatial predictions of mean wood density for average trees in black spruce stands. The model explained 39 percent of the variance in the response variable, with an estimated root mean square error of 38.8 (kg·m−3). Among the predictor variables, P20 (second decile LiDAR height in m) and quadratic mean diameter were most important. Other predictors describing canopy depth and cover were of secondary importance and differed according to the modeling approach. LiDAR-derived variables appear to capture differences in stand structure that reflect different constraints on growth rates, determining the proportion of thin-walled earlywood cells in black spruce stems, and ultimately influencing the pattern of variation in important wood quality attributes such as wood density. A spatial characterization of variation in a desirable wood quality attribute, such as density, enhances the possibility for value chain optimization, which could allow the forest industry to be more competitive through efficient planning for black spruce management by including an indication of suitability for specific products as a modeled variable derived from standard inventory data.

INFORMATIONAL CONTENT OF RADIOLOGICAL DIAGNOSTIC METHODS IN DETERMINATION OF BONE TISSUE CONDITION IN PATIENTS WITH CHRONIC ARTERIAL INSUFFICIENCY OF THE LOWER EXTREMITIES

The methods of radiological diagnostics of the osseous tissue of the lower extremities in patients with chronic arterial insufficiency caused by type II diabetes mellitus are analyzed in the article. Etalon densitometry and a multidetector computed tomography were found to have the highest sensitivity, specificity and correlation. Dual-energy X-ray densitometry has a weak correlation with the above mentioned methods and low rates of sensitivity and specificity respectively.

Acoustic emission due to partial cavity shedding on a hydrofoil

The partial cavity shedding dynamics on a NACA 0015 hydrofoil were examined at angles of attack of 7 and 10 degrees over a range of cavitation numbers. Hydrophone measurements in conjunction with high-speed videos and time resolved X-ray densitometry were used to acquire time synchronous measurements of the void fraction field of the cavity and the emitted noise. Cavitation dynamics changed significantly with the reduction of the inlet cavitation number. At higher cavitation numbers, small stable partial cavities were observed. Upon reduction of cavitation number, the cavities grew in length and pinched off from the rear of the cavity, due to a liquid re-entrant jet. Upon further reduction of inlet cavitation number, the dynamics changed significantly with the cloud collapse of the shed vapor inhibiting the cavity growth. X-ray densitometry measurements revealed the presence of a propagation bubbly shockwave as a mechanism of shedding at the lowest cavitation numbers. This process caused complex, multi-st...

The added value of trabecular bone score to FRAX® to predict major osteoporotic fractures for clinical use in Chinese older people: the Mr. OS and Ms. OS cohort study in Hong Kong.

Trabecular bone score (TBS) of lumbar spine on Dual X-ray densitometry provides information on bone architecture. We therefore examined the additive value of TBS to FRAX® in predicting major osteoporotic fractures (MOFs) in older Chinese people. Four thousand community-dwelling Chinese men and women aged ≥65years were followed up for fracture incidence for an average period of 9.94 and 8.82years, respectively. At baseline, areal BMD of hip and lumbar spine were measured by DXA, TBS was estimated for the lumbar spine, and FRAX® for 10-year risk of MOFs (hip, clinical spine, shoulder, and wrist) was estimated. Cox regression model was used to evaluate the associations between TBS and FRAX® with the MOFs risk. The area under receiver-operating characteristic curve (AUC), integrated discrimination improvement (IDI), and category-based net reclassification improvement (NRI) were applied to evaluate the improved prediction ability. During the follow-up, 126 men and 215 women had at least one incident MOF. Each SD decrease in TBS was significantly associated with incident MOFs, with HR (95%CI) of 1.53 (1.30-1.80) and 1.40 (1.22-1.61) in men and women, respectively. TBS-adjusted FRAX® predicts better than FRAX® with a significantly increased AUC and IDI in men. Using specific intervention thresholds, TBS-adjusted FRAX® brings about 5% overall correct reclassification for MOFs prediction than FRAX® in men. The increased correct MOFs risk classifications were not significant in older women. TBS-adjusted FRAX® may improve the predictive power of FRAX® on MOFs for clinical use in older Chinese men.

PROGNOSTIC VALUE OF X-RAY DENSITOMETRY IN OSTEOPOROSIS

Introduction of X-ray densitometry had revolutionized the diagnostics of osteoporosis. Majority of scientists believed that it was a diagnostic instrument close to almost ideal one capable evaluation of both: bone mineral density and likelihood of future fractures. Experiences accumulated during the previous years have slightly shaken this belief. It is more frequently heard that DEXA is not an ideal diagnostic instrument, but no better instrument has been created yet, which is also proved by our 12 years of experience. Materials and Methods. X-ray densitometry research evaluated 5200 patients aged 40-70. 4100 women and 1100 men. Medical History of 825 patients showed that they had bone fractures, 136 out of them were high energy ( pressure), the rest of them low trauma or no-trauma fractures. BMD index was low in 2736 patients (T score&gt; -2.5). 48 patients had fractures in earlier lives registered in their medical records. Results. Low BMD index was identified in 2736 patients with osteoporosis only during the DXA lateral scans. It is arguable thatx-ray densitometry and BMD evaluation is the only criteria for the standards of diagnostics and the predictor of progressive bone loss and fractures. Discussion. While analyzing the results, diagnostic problems emerged at diagnostic process were taken into account, namely spine deformation, osteoporosis, osteochondrosis that camouflage real mineral density of the bones. At the same time, each patients with existing fractures in their record filled in special questionnaires describing clinical symptoms of the disease and risk-factors influencing the likelihood of the disease. Results of the work were processed through the analysis of variance (Fisher). Reliable correlation was not identified between DXA results and fracture risk index. This last one encourages routine use of FRAX in diagnostics of osteoporosis and prognosis of fractures before morphological evaluation of bones will be readily available to use as an additional diagnostic tool.

Bubbly shock propagation as a mechanism for sheet-to-cloud transition of partial cavities

Partial cavitation in the separated region forming from the apex of a wedge is examined to reveal the flow mechanism responsible for the transition from stable sheet cavity to periodically shedding cloud cavitation. High-speed visualization and time-resolved X-ray densitometry measurements are used to examine the cavity dynamics, including the time-resolved void-fraction fields within the cavity. The experimentally observed time-averaged void-fraction profiles are compared to an analytical model employing free-streamline theory. From the instantaneous void-fraction flow fields, two distinct shedding mechanisms are identified. The classically described re-entrant flow in the cavity closure is confirmed as a mechanism for vapour entrainment and detachment that leads to intermittent shedding of smaller-scale cavities. But, with a sufficient reduction in cavitation number, large-scale periodic cloud shedding is associated with the formation and propagation of a bubbly shock within the high void-fraction bubbly mixture in the separated cavity flow. When the shock front impinges on flow at the wedge apex, a large cloud is pinched off. For periodic shedding, the speed of the front in the laboratory frame is of the order of half the free-stream speed. The features of the observed condensation shocks are related to the average and dynamic pressure and void fraction using classical one-dimensional jump conditions. The sound speed of the bubbly mixture is estimated to determine the Mach number of the cavity flow. The transition from intermittent to transitional to strongly periodic shedding occurs when the average Mach number of the cavity flow exceeds that required for the generation of strong shocks.

AN ATTITUDE OF TRAUMATOLOGISTS-ORTHOPAEDICS TO THE OSTEOPOROSIS PROBLEM IN RUSSIAN FEDERATION AND THEIR PARTICIPATION IN ITS SOLVING

The results of an osteoporosis survey held around 153 traumatologists-orthopaedics are analyzed in this article. The survey aim: the assessment of an awareness level and opinion record among traumatologists-orthopaedics about diagnostics and treatment of osteoporosis and their participation in solving these problems. An executed survey revealed low level of the osteoporosis registration as an independent nosologic unit with individual ICS code. The registration was held barely by 23% of interviewed doctors. Despite the fact that there is a sufficient provision of X-ray densitometers (91% respondents showed) and osteoporosis prophylaxis centers in the regions (75% respondents showed) only 34% patients with diagnosis «osteoporosis» are guided to the X-ray densitometry. According to doctors’ opinions the X-ray radiography appears to be the leading research for osteoporosis diagnostics. The FRAX method is used in a real clinical practice rarely. Due to the doctors’ opinions the following results confirm the necessity of creation of fracture liaison service in our country that would deal with secondary prevention of osteoporotic fractures. This service should mobilize traumatologists-orthopaedics in order to increase the knowledge level of osteoporosis diagnostics and treatment.

THE RISK FACTORS AND SPECIFIC FEATURES OF OSTEOPENIC SYNDROME IN PATIENTS WITH CHRONIC NON-INFECTIOUS DISEASES

Objective: to analyze the risk factors (RFs) of osteoporosis (OP), the risk of OP-related fractures, the specific features of osteopenic syndrome in patients with chronic non-infectious diseases (CNID) (coronary heart disease (CHD), hypertension, chronic obstructive pulmonary disease (COPD), and asthma). Materials and methods. The investigation enrolled 377 patients (mean age 55.3 ± 1.6 years) with CNID and 221 persons (mean age, 53.2 ± 1.3 years) who formed a control group. According to the nosological entity, the patients were divided as follows: Group 1 included 84 patients with CHD and hypertension; Group 2 comprised 99 hypertensive patients; Group 3 consisted of 70 patients with COPD; and Group 4 included 124 asthmatic patients. The examinees of all the groups were matched for age, gender, and body mass index. The investigation excluded patients with functional class IV chronic heart failure, continuous atrial fibrillation, heart valve disease, or myocardial noncoronarogenic diseases and those with other diseases and conditions that could have an independent impact on bone metabolism. Prior to the examination, the patients had received no specific therapy for the prevention and treatment of OP. RFs for OP were assessed using the one-minute test recommended by the International OP Foundation (2008); 10-year risk for OP-related fractures were calculated applying the FRAX computer program in accordance with the guidelines of the International OP Association and the World Health Organization (WHO, 2008). To investigate bone mineral density (BMD), bioenergy X-ray densitometry of the lumbar spine and proximal femur was carried out by means of a Lunar DPX apparatus (USA). The results were assessed using the t-test in standard deviations (SD) from the peak bone mass according to the WHO guidelines. Results. The RFs of OP were more frequently recorded in the patients with CNID than in the healthy individuals. RFs, such as smoking, low physical activity, and low-energy fractures, were most common in the patients with cardiovascular disease or COPD. The frequent use of glucocorticoid therapy was also an important RF in the patients with COPD. CHID considerably increased the risk of fractures in the succeeding 10 years after disease onset. The high risk of fractures, those of the proximal femur in particular, provides a rationale for the need for timely antiosteoporotic therapy in the majority of patients with CNID. The performed investigation demonstrated that the BMD values in the patients with CNID corresponded, on the average, to the osteopenia criteria; the lowest BMD values were recorded in the patients with COPD and associated cardiovascular disease. The severe course of osteopenic syndrome (a BMD decrease that was diagnostically significant for OP concurrent with fractures was observed in one-third of patients with CNID. The patients with cardiovascular disease or COPD showed a high incidence and degree of OP, which allows these diseases to be considered as a RF for decreased BMD. The long-term uncontrolled course of disease, the degree of organ and functional disorders in the patients with CNID, and concomitant use of glucocorticoid therapy contribute to a reduction in BMD. Conclusion. RFs for OP were identified in the majority of patients with CNID. The high risk of fractures due to an obvious BMD decrease in patients with CNID requires timely diagnosis, treatment, and prevention of osteopenia.

Twenty-four-week effects of liraglutide on body composition, adherence to appetite, and lipid profile in overweight and obese patients with type 2 diabetes mellitus.

BackgroundLiraglutide has well-known effects on glucose patterns. However, its several other metabolic properties are still controversial. Given this background, the aims of the present study are to evaluate the effects of 24-week liraglutide treatment on body composition, appetite, and lipid profile in overweight and obese type 2 diabetes mellitus (T2DM) patients.MethodsA cohort study was carried out on overweight and obese T2DM patients with glycosylated hemoglobin A1c equal to 6% (42 mmol/mol)−10% (86 mmol/mol), under a 3-month treatment (at least) with maximal dose of metformin as stable regime, by adding liraglutide at doses up to 3 mg/d. Body composition markers were measured by dual-energy X-ray densitometry at baseline and after 24 weeks of liraglutide treatment. Glucose control was monitored by glucose, glycosylated hemoglobin A1c, insulin, and homeostasis model assessment. Finally, the appetite sensation and plasma lipids were also evaluated.ResultsTwenty-eight subjects (male/female: 16/12, mean age: 58.75±9.33 years, body mass index: 34.13±5.46 kg/m2) were evaluated. Accounting for the adjustment for age, sex, and duration of diabetes, we noted significant decreases in body mass index (−0.86 kg/m2, P=0.024), fat mass (−2.01 kg, P=0.015), fat mass index (−0.71 kg/m2, P=0.014), android fat (−1.72%, P=0.022), trunk fat (−1.52%, P=0.016), and waist circumference (−6.86 cm, P<0.001) from the baseline values. Haber score was increased by 3.82 units (P=0.009), and the number of metabolic syndrome risk factors was decreased (−0.69 units, P=0.012). The glucose control variables and total cholesterol/high-density lipoprotein cholesterol ratio also showed significant decreases from baseline values.ConclusionThe 24-week liraglutide treatment leads to the reduction of fat mass, android fat, trunk fat, and appetite by improving the lipid profile, glucose control, and insulin sensitivity.

Skeletal extension, density and calcification rates of massive free-living coral Porites lobata Dana, 1846

Hermatypic corals are an important sessile group in the benthic structure of tropical coral reef communities. Many organisms, in response to the environmental conditions, have developed different strategies of growth by modifying their morphologies and reproduction mode, as is the case of free-living colonies called coralliths. So far, important parameters such as calcification, growth rates and their relation with biotic and abiotic factors on coralliths have not been described. This study represents the first record of a corallith form of Porites lobata and provides information on its sclerochronology. Coral growth parameters of different coralliths were compared by measuring extension rate (cmy−1), skeletal density (gcm−3), calcification rate (gcm−2y−1), average age (yr) and sphericity (S). The influence of the environment on corallith growth was assessed using water temperature as an abiotic factor and bioturbation by fish as a biotic factor. Analysis of annual density bands using X-ray densitometry provided a mean extension rate of 0.47±0.23cmy−1, skeletal density of 1.08±0.14gcm−3, and calcification rate of 0.51±0.26gcm−2y−1. The results reveal differences in growth parameters between coralliths including a strong relationship of calcification rate with seawater temperature. In addition, direct and indirect bioturbations promoted the colony rotation resulting in a hemispherical form. Hence, the evidence suggests that scleractinian corals have developed an important growth strategy that allows the species to form new colonies and maintain successful coral reef communities through free-living corallith growth.

Liraglutide and obesity in elderly: efficacy in fat loss and safety in order to prevent sarcopenia. A perspective case series study

For the growing numbers of obese elderly with diabetes, the glucagon-like peptide-1 (GLP-1) receptor analogue (liraglutide) appears a safe way to promote and maintain substantial weight loss. Given this background, the aim of this study was to assess the effect of the liraglutide treatment, at doses up to 3.0mg per day, on the body composition, focusing on sarcopenia, in overweight and obese elderly with type 2 diabetes mellitus (T2DM). A perspective study was carried out in overweight and obese T2DM patients with HbA1c equal to 7.0% (53mmol/mol) ~10.0% (86), under 3-month treatment (at least) of maximal dose of metformin at stable regime, and additional liraglutide at doses up to 3.0mg per day. Body composition markers such as skeletal muscle index (SMI), android and gynoid fat mass, and arms and legs fat free mass, was measured by dual-energy X-ray densitometry (DXA) at baseline and after 24 weeks of liraglutide treatment. Glucose control was also carried out by glucose and HbA1c. Nine subjects (male/female 6/3, mean age 68.22±3.86years, BMI 32.34±4.89kg/m2) were evaluated. We noted a median decrease in BMI (-0.78kg/m2), weight (-2000g), fat mass (-1498g) and android fat (-0.9%), and a increase in SMI (+0.03kg/m2) from baseline. Glycemic control also improved, with a median change HbA1c of -0.80%. Twenty-four weeks of liraglutide treatment was associated with reductions in fat mass and android fat. In addition, in order to prevent sarcopenia, it preserved the muscular tropism.

FARNESYL DIPHOSPHATE SYNTHASE (FDRS) AND GERANYLGERANYL DIPHOSPHATE SYNTHASE (GGSP1) GENE POLYMORPHISMS AND EFFICIENCY OF THERAPY WITH BISPHOSPHONATES IN RUSSIAN WOMEN WITH POSTMENOPAUSAL OSTEOPOROSIS: A PILOT STUDY

Genetic factors that are an important hereditary component determining a predisposition to osteoporosis (OP) are 60–80% responsible for bone mineral density (BMD). Some polymorphic genes have been previously shown to affect the efficiency of performed anti-osteoporotic therapy. Objective: to study the impact of farnesyl diphosphate synthase (FDRS) and geranylgeranyl diphosphate synthase (GGSPI) gene polymorphisms on BMD changes during 12-month therapy with bisphosphonates (BP) in women with postmenopausal OP. Subjects and methods. The investigation enrolled 53 women with OP. Spine and proximal femur BMD was determined using X-ray densitometry before and after BP treatment. The -99A/C and -8188T ins/del polymorphisms in the FDPS and GGPS1 genes were investigated using real-time polymerase chain reaction. Results and discussion. The BMD changes were less marked in women with the C allele of C/T -99/C polymorphism in the FDPS gene than those in carriers of the genotype AA: 2.3±3.6 and 4.4±3.8% (р = 0.062) in the spine; 0.6±3.1 and 2.8±4.5% (р = 0.075) in the femoral neck; 0.5±2.9 and 2.5±2.8% (р = 0.020) in the entire femur, respectively. Femoral neck densitometry showed a significantly weaker response to BP treatment in the patients carrying the mutant genotype del/del of GGSP1 -8188T ins/del polymorphism than in those with the wild-type genotype ins/ins (0.8±4.2 and 4.1±2.5%, respectively; р = 0.030). No significant differences for this polymorphism were found in other areas of BMD measurement. Conclusion. The described pilot study has indicated that the examined FDPS and GGSP1 gene polymorphisms may be predictors for a response to BP therapy in patients with OP. Further investigations that will contribute to the choice of the most effective therapy for this disease are needed to confirm our results.