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Environmental Science and Pollution... Oct 2023Previous epidemiological study has explored a positive association between methylparaben (Mep) and bone mineral density (BMD) in adults. Evidence linking Mep and BMD in...
Previous epidemiological study has explored a positive association between methylparaben (Mep) and bone mineral density (BMD) in adults. Evidence linking Mep and BMD in children and adolescents is very limited. This study examined the association between Mep and BMD in children and adolescents aged 8-19 years. In this cross-sectional study, 1830 children and adolescents aged 8-19 years from NHANES 2011-2016 were analyzed. Mep was ln-transformed for analysis of the skewed distribution. Multiple linear regression analyses were performed to evaluate Mep's association with BMD (containing total BMD, trunk bone BMD, pelvis BMD, lumbar spine BMD, and thoracic spine BMD). Moreover, a generalized additive model (GAM) and a fitted smoothing curve (penalized spline method) were conducted to explore the exact shape of curve between them. In the fully adjusted model, ln-transformed Mep and BMD showed an independent and positive association (total BMD (β = 0.003, 95% CI (0.001, 0.005), P = 0.01), trunk bone BMD (β = 0.002, 95% CI (0.000, 0.005), P = 0.04), pelvis BMD (β = 0.004, 95% CI (0.001, 0.008), P = 0.02), lumbar spine BMD (β = 0.005, 95% CI (0.001, 0.008), P = 0.01), thoracic spine BMD (β = 0.003, 95% CI (0.001, 0.005), P = 0.02)) and a linear association. Subgroup analysis showed positive association between ln-transformed Mep and BMD. Furthermore, the positive association was significant in females and children aged 12-19 years (P for trend < 0.05). This study is the first study to find evidence demonstrating that exposure to Mep may be positively associated with BMD in children and adolescents aged 8-19 years. Validation of our findings will need further research.
Topics: Adult; Female; Humans; Adolescent; Child; Bone Density; Absorptiometry, Photon; Nutrition Surveys; Cross-Sectional Studies
PubMed: 37749468
DOI: 10.1007/s11356-023-29951-2 -
International Ophthalmology Dec 2023To compare corneal densitometry in a consecutive series of 52 endothelial keratoplasties (DMEK/DSAEK) using a Scheimpflug-based device after six months of follow-up.
PURPOSE
To compare corneal densitometry in a consecutive series of 52 endothelial keratoplasties (DMEK/DSAEK) using a Scheimpflug-based device after six months of follow-up.
METHODS
Corneal densitometry (CD) values of 102 eyes were divided into three main groups: 33 DMEKs, 19 DSAEKs, and 50 healthy eyes without previous ocular surgery. The CD values were then analyzed and compared between the groups. We measured three main layers in depth and four different concentric zones at 1, 3, and 6 months postoperatively.
RESULTS
In the DMEK group, total CD significantly decreased from 38.02 ± 10.21 grayscale units (GSU) to 31.13 ± 9.25 GSU (P < 0.01) between the first and the sixth month postoperative. In the DSAEK group, we found significant changes only between the first and three months after surgery (from 42.62 ± 9.31 GSU to 38.71 ± 10.53 GSU (P < 0.01). Regarding the concentric zones, CD in the DMEK group significantly decreased in the central zone from 33.55 ± 12.07 GSU to 30.63 ± 10.15 GSU (P < 0.01) and significantly increased in the periphery from 30.63 ± 10.15 GSU to 36.72 ± 9.37 GSU, (P < 0.01). The DSAEK group showed no changes in the central zone (from 36.91 ± 13.80 GSU to 36.14 ± 11.47 GSU, P = 0.52) and CD significantly increased in the periphery (41.91 ± 9.28 GSU, P < 0.01).
CONCLUSION
When comparing CD values in DMEK versus DSAEK, we found no differences by layers or at central-paracentral concentric zones, although CD differences in the peripheral zones were statistically significant. This finding may be attributed to the thicker graft at periphery with a delayed clearance and less anatomical interphase in DSAEK.
Topics: Humans; Descemet Membrane; Corneal Diseases; Descemet Stripping Endothelial Keratoplasty; Visual Acuity; Densitometry; Endothelium, Corneal; Retrospective Studies
PubMed: 33763796
DOI: 10.1007/s10792-021-01817-x -
The Journal of Bone and Joint Surgery.... Nov 2023After combat-related lower extremity amputations, patients rapidly lose bone mineral density (BMD). As serial dual x-ray absorptiometry (DXA) scans are rarely performed... (Review)
Review
BACKGROUND
After combat-related lower extremity amputations, patients rapidly lose bone mineral density (BMD). As serial dual x-ray absorptiometry (DXA) scans are rarely performed in this setting, it is difficult to determine the timeline for bone loss and recovery or the role of interventions. However, a strong correlation has been demonstrated between DXA BMD and computed tomography (CT) signal attenuation. We sought to leverage multiple CT scans obtained after trauma to develop a predictive model for BMD after combat-related lower extremity amputations.
METHODS
We reviewed amputations performed within the United States military between 2003 and 2016 in patients with multiple CT scans. We collected pertinent clinical information, including amputation level(s), complications, and time to weight-bearing. The primary outcome measure was the development of low BMD, estimated in Hounsfield units (HU) from CT scans with use of a previously validated method. One hundred and twenty-eight patients with 613 femoral neck CT scans were available for analysis. A least absolute shrinkage and selection operator (LASSO) multiple logistic regression analysis was applied to determine the effects of modifiable and non-modifiable variables on BMD. A random-effects model was applied to determine which factors were most predictive of low BMD and to quantify their effects.
RESULTS
Both amputated and non-amputated extremities demonstrated substantial BMD loss, which stabilized approximately 3 years after the injury. Loss of BMD followed a logarithmic pattern, stabilizing after 1,000 days. On average, amputated limbs lost approximately 100 HU of BMD after 1,000 days. Other factors identified by the mixed-effects model included nonambulatory status (-33.5 HU), age at injury (-3.4 HU per year), surgical complications delaying weight-bearing (-21.3 HU), transtibial amputation (20.9 HU), and active vitamin-D treatment (-19.7 HU).
CONCLUSIONS
Patients with combat-related lower extremity amputations experience an initially rapid decline in BMD in both intact and amputated limbs as a result of both modifiable and non-modifiable influences, including time to walking, amputation level, surgical complications, and age. The paradoxical association of vitamin-D supplementation with lower HU likely reflects this treatment being assigned to patients with low BMD. This model may assist with clinical decision-making prior to performing lower extremity amputation and also may assist providers with postoperative decision-making to optimize management for prophylaxis against osteoporosis.
LEVEL OF EVIDENCE
Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
Topics: Humans; Bone Density; Dietary Supplements; Lumbar Vertebrae; Vitamin D; Bone Diseases, Metabolic; Absorptiometry, Photon; Lower Extremity; Amputation, Surgical; Vitamins; Retrospective Studies
PubMed: 37582168
DOI: 10.2106/JBJS.22.01258 -
Neuromuscular Disorders : NMD Sep 2023Facioscapulohumeral muscular dystrophy (FSHD) is a slowly progressive disease of skeletal muscle. Dual energy X-ray absorptiometry (DEXA) is a widely available,...
Lean tissue mass measurements by dual-energy X-ray absorptiometry and associations with strength and functional outcome measures in facioscapulohumeral muscular dystrophy.
Facioscapulohumeral muscular dystrophy (FSHD) is a slowly progressive disease of skeletal muscle. Dual energy X-ray absorptiometry (DEXA) is a widely available, cost-effective and sensitive technique for measuring whole body and regional lean tissue mass and has been used in prior clinical trials in neuromuscular diseases. The Clinical Trial Readiness to Solve Barriers to Drug Development in FSHD (ReSolve) study is a prospective, longitudinal, observational multisite study. We obtained concurrent DEXA scans and functional outcome measurements in 185 patients with FSHD at the baseline visit. We determined the associations between lean tissue mass in the upper and lower extremities and corresponding clinical outcome measures. There were moderate correlations between upper and lower extremity lean tissue mass and their corresponding strengths and function. Lean tissue mass obtained by DEXA scan may be useful as a biomarker in future clinical trials in FSHD.
Topics: Humans; Muscular Dystrophy, Facioscapulohumeral; Absorptiometry, Photon; Prospective Studies; Muscle, Skeletal; Outcome Assessment, Health Care
PubMed: 37400350
DOI: 10.1016/j.nmd.2023.06.008 -
International Ophthalmology Jun 2024To investigate the clinical significance of the correlation between optical densitometry and both biomechanical and morphological parameters in keratoconus (KC) and to...
PURPOSE
To investigate the clinical significance of the correlation between optical densitometry and both biomechanical and morphological parameters in keratoconus (KC) and to verify the diagnostic value of optical densitometry in KC.
METHOD
This cross-sectional study included 436 eyes of 295 patients with KC. Corneal optical densitometry, morphological parameters and biomechanical parameters were measured. Spearman's correlation analysis was employed to investigate the association between optical densitometry and both biomechanical and morphological parameters.
RESULT
Optical densitometry of the anterior (0-2 mm and 2-6 mm), central (0-2 mm), posterior (2-6 mm) and total (2-6 mm) layers correlated positively with SPA1, while the posterior layer (0-2 mm) correlated negatively. Optical densitometry of the anterior layers 2-6 mm, 6-10 mm, and the central layer 6-10 mm negatively affected AL1, while the posterior layer 0-2 mm positively affected it. Optical densitometry of the anterior, central, and posterior layers 0-2 mm and 2-6 mm positively influenced the morphological parameters K, K, K and the absolute values of K, K, K. Optical densitometry of the center (0-2 mm) and posterior (2-6 mm) layers negatively influenced TCT. Optical densitometry of the anterior (0-2 mm and 2-6 mm), center (0-2 mm), posterior (2-6 mm) and total (2-6 mm) layers correlated positively with ACE and PCE, whereas the posterior layer (0-2 mm) correlated negatively.
CONCLUSION
Optical densitometry was correlated with biomechanical and morphological parameters in keratoconus, suggesting its potential as a diagnostic indicator for assessing keratoconus progression and treatment efficacy.
Topics: Humans; Keratoconus; Cross-Sectional Studies; Female; Densitometry; Male; Cornea; Adult; Corneal Topography; Young Adult; Adolescent; Middle Aged; Biomechanical Phenomena
PubMed: 38943020
DOI: 10.1007/s10792-024-03212-8 -
Journal of Bone and Mineral Research :... Dec 2023Dietary interventions designed to examine the role of nutrition on childhood bone accrual have often focused on the role of individual micronutrients (eg, calcium,...
Dietary interventions designed to examine the role of nutrition on childhood bone accrual have often focused on the role of individual micronutrients (eg, calcium, vitamin D, and zinc) and macronutrients (eg, protein). The osteogenic benefits of whole foods, such as eggs, are not well understood despite eggs being a source of high-quality nutrients and bioactive compounds known to positively influence bone. A significant positive cross-sectional association between whole egg consumption and tibia cortical bone mass has recently been shown in young children; however, randomized controlled trials (RCTs) have not been conducted. This study is a double-blind RCT in male and female children ages 9-13 years of different ancestries, designed to determine if consuming food products with whole eggs (equivalent to 8-10 eggs/wk) versus foods with milk or gelatin (placebo) over a 9-month period will improve measures of bone strength. Total body less head (TBLH) and lumbar spine bone mineral content (BMC) and areal bone mineral density (aBMD) were assessed using dual-energy X-ray absorptiometry (DXA). DXA Z-scores were computed using published pediatric growth charts and were adjusted for height-for-age Z-score (HAZ). Mid-tibia cortical volumetric BMD, BMC, cortical area, total bone area, cortical thickness, and strength strain index were measured using peripheral quantitative computed tomography. Overall, there were no significant intervention effects for any bone outcomes. The increase in spine BMC Z-score in the egg group versus the gelatin group approached significance (p = 0.07). Significant time effects in TBLH aBMD Z-score occurred as all groups decreased over 9 months (p < 0.03). Most tibia cortical bone outcomes increased over time (all p < 0.02), but changes did not differ across intervention groups. Whole eggs provide important nutritional benefits for children, but the bone responses to consumption of 8-10 eggs/wk over a period of 9 months in children entering the early stages of puberty were small. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Topics: Male; Female; Humans; Child; Child, Preschool; Gelatin; Bone and Bones; Bone Density; Absorptiometry, Photon; Lumbar Vertebrae; Minerals; Randomized Controlled Trials as Topic
PubMed: 37950643
DOI: 10.1002/jbmr.4929 -
BMJ Open Nov 2023To investigate the association of fat and lean mass in specific regions with all-cause and cardiovascular-related mortality.
OBJECTIVE
To investigate the association of fat and lean mass in specific regions with all-cause and cardiovascular-related mortality.
DESIGN
Population based cohort study.
SETTING
US National Health and Nutrition Examination Survey (2003-2006 and 2011-2018).
PARTICIPANTS
22 652 US adults aged 20 years or older.
EXPOSURES
Fat and lean mass in specific regions obtained from the whole-body dual-energy X-ray absorptiometry.
MAIN OUTCOME MEASURES
All-cause and cardiovascular-related mortality.
RESULTS
During a median of 83 months of follow-up, 1432 deaths were identified. Associations between body composition metrics and mortality risks were evident above specific thresholds. For all-cause mortality, Android fat mass showed elevated HRs above 2.46 kg (HR: 1.17, 95% CI 1.02 to 1.34), while Android lean mass (ALM) had similar trends above 2.75 kg (HR: 1.17, 95% CI 1.03 to 1.33), and Android total mass above 5.75 kg (HR: 1.08, 95% CI 1.01 to 1.16). Conversely, lower HRs were observed below certain thresholds: Gynoid fat mass (GFM) below 3.71 kg (HR: 0.72, 95% CI 0.56 to 0.93), Gynoid lean mass below 6.44 kg (HR: 0.77, 95% CI 0.64 to 0.92), and Gynoid total mass below 11.78 kg (HR: 0.76, 95% CI 0.70 to 0.84). Notably, below 0.722 kg, the HR of visceral adipose tissue mass (VATM) was 1.25 (95% CI 1.04 to 1.48) for all-cause mortality, and above 3.18 kg, the HR of total abdominal fat mass was 2.41 (95% CI 1.15 to 5.05). Cardiovascular-related mortality exhibited associations as well, particularly for Android fat mass (AFM) above 1.78 kg (HR: 1.22, 95% CI 1.01 to 1.47) and below 7.16 kg (HR: 0.50, 95% CI 0.36 to 0.69). HRs varied for Gynoid total mass below and above 10.98 kg (HRs: 0.70, 95% CI 0.54 to 0.93, and 1.12, 95% CI 1.02 to 1.23). Android per cent fat, subcutaneous fat mass (SFM), AFM/GFM, and VATM/SFM were not statistically associated with all-cause mortality. Android per cent fat, Gynoid per cent fat, AFM/GFM, and VATM/SFM were not statistically associated with cardiovascular-related mortality. Conicity index showed that the ALM/GLM had the highest performance for all-cause and cardiovascular-related mortality with AUCs of 0.785, and 0.746, respectively.
CONCLUSIONS
The relationship between fat or lean mass and all-cause mortality varies by region. Fat mass was positively correlated with cardiovascular mortality, regardless of the region in which they located. ALM/GLM might be a better predictor of all-cause and cardiovascular-related mortality than other body components or body mass index.
Topics: Humans; Adult; Nutrition Surveys; Cohort Studies; Body Fat Distribution; Body Composition; Body Mass Index; Absorptiometry, Photon; Cardiovascular Diseases
PubMed: 37989359
DOI: 10.1136/bmjopen-2023-072752 -
Osteoporosis International : a Journal... Oct 2023Among those who use of liver-enzyme inducing anticonvulsant medication for more than 2 years, 27% have a prevalent vertebral fracture on vertebral fracture assessment...
UNLABELLED
Among those who use of liver-enzyme inducing anticonvulsant medication for more than 2 years, 27% have a prevalent vertebral fracture on vertebral fracture assessment (VFA) lateral spine imaging. VFA imaging at the time of bone densitometry may be appropriate for older individuals who are chronic users of these medications.
PURPOSE
It is unclear whether prevalent vertebral fractures are associated with use of anticonvulsant drugs, especially those that induce liver enzymes (LEI) that metabolize drugs and vitamin D. Our purpose was to estimate the prevalence of vertebral fracture on densitometric lateral spine images according to duration of prior anticonvulsant medication use.
METHODS
Our study population was 11,822 individuals (mean [sd] age 76.1 [6.8] years, 94% female) who had bone densitometry with VFA between 2010 and 2018. Cumulative prior exposure to LEI anticonvulsants (carbamazepine, phenobarbital, phenytoin, valproic acid, n = 538), non-LEI anticonvulsants (clonazepam, gabapentin, levetiracetam, others, n = 2786), and other non-clonazepam benzodiazepines (n = 5082) was determined using linked pharmacy records. Prevalent vertebral fractures were identified on VFA images using the modified ABQ method. Logistic regression models were used to estimate the association of anticonvulsant drug exposure with prevalent vertebral fractures.
RESULTS
Prevalence of one or more vertebral fractures was 16.1% for the entire analytic cohort, and 27.0%, 19.0%, and 18.5% for those with ≥ 2 years of prior LEI anticonvulsant use, non-LEI anticonvulsant use, and other benzodiazepine use, respectively. Adjusted for multiple covariates, use of prior LEI anticonvulsant medication for ≥ 2 years was associated with prevalent fracture on VFA (OR 1.48 [95% CI 1.04, 2.10]).
CONCLUSION
LEI anticonvulsant use for ≥ 2 years is associated with higher vertebral fracture prevalence. Lateral spine VFA imaging at the time of bone densitometry may be appropriate for older individuals who have used LEI anticonvulsant medications for ≥ 2 years.
Topics: Humans; Female; Child; Male; Spinal Fractures; Anticonvulsants; Bone Density; Spine; Benzodiazepines; Liver; Absorptiometry, Photon
PubMed: 37380883
DOI: 10.1007/s00198-023-06820-9 -
European Journal of Pediatrics Oct 2023Fontan circulation is a highly abnormal circulatory state that may affect various organ systems. The effect on body composition is an important factor to assess the... (Review)
Review
Fontan circulation is a highly abnormal circulatory state that may affect various organ systems. The effect on body composition is an important factor to assess the condition of the patient. This systematic review assesses body composition and possibly related adverse outcomes in patients with a Fontan circulation, to provide an overview of current insights. Studies evaluating body composition by compartment (either fat mass or lean/muscle mass) in Fontan patients published up to April 2023 were included in this systematic review. Of 1392 potential studies, 18 studies met the inclusion criteria. In total, body composition measurements of 774 Fontan patients were included. Body composition was measured using dual-energy X-ray absorptiometry (DXA) (n = 12), bioelectrical impedance analysis (BIA) (n = 5), computer tomography (CT) (n = 1), or magnetic resonance imaging (MRI) (n = 1). All studies reported a normal body mass index (BMI) in Fontan patients, compared to controls. Five out of nine studies reported significantly higher body fat values, and twelve out of fifteen studies reported significantly lower muscle or lean mass values in the Fontan population compared to the healthy population. Unfavorable body composition in Fontan patients was associated with decreased exercise capacity, worse cardiac function, and adverse outcomes including hospital admissions and death. Conclusions: Despite having a normal BMI, Fontan patients have an increased fat mass and decreased muscle mass or lean mass compared to the healthy population. This unfavorable body composition was associated with various adverse outcomes, including a decreased exercise capacity and worse cardiac function. What is Known: • Patients with a Fontan circulation have a decreased exercise capacity compared to healthy peers, an unfavorable body composition might be a contributor to their impaired exercise capacity. What is New: • Fontan patients are predisposed to an unfavorable body composition, characterized by increased fat mass and decreased muscle mass accompanied by a normal BMI compared to the healthy population. • Among others, unfavorable body composition was associated with decreased exercise capacity, cardiac function, and increased morbidity in patients with a Fontan circulation.
Topics: Humans; Body Composition; Adipose Tissue; Magnetic Resonance Imaging; Absorptiometry, Photon; Electric Impedance; Body Mass Index
PubMed: 37542012
DOI: 10.1007/s00431-023-05100-2 -
Journal of Clinical Densitometry : the... 2024After 15 months of preparation by task force chairs and teams, ISCD's 9th Position Development Conference (PDC) convened in Northbrook, IL, USA on March 28th and 29th,... (Review)
Review
Executive Summary of the 2023 Adult Position Development Conference of the International Society for Clinical Densitometry: DXA Reporting, Follow-up BMD Testing and Trabecular Bone Score Application and Reporting.
After 15 months of preparation by task force chairs and teams, ISCD's 9th Position Development Conference (PDC) convened in Northbrook, IL, USA on March 28th and 29th, 2023 to approve new ISCD Official Positions in the topic areas of DXA Reporting, Follow-up BMD Testing and TBS Application and Reporting. Three teams of participants work to bring the PDC to fruition: the Steering Committee, Task Forces and Chairs, and the Expert Panel. To reach agreement on draft Official Positions, the PDC follows a scripted process with the UCLA/RAND Appropriateness Method (UCLA/RAM) as its foundation. Multiple rounds of data review, public debate and voting resulted in 32 new or modified Official Positions. Six companion position papers are also published along with this Executive Summary, serving as the detailed substantiation for the Official Positions. This Executive Summary reviews the personnel groups, activities and products of the 2023 PDC, with the entirety of the updated 2023 Official Positions presented in Appendix A. New Official Positions are highlighted in bold.
Topics: Adult; Humans; Absorptiometry, Photon; Cancellous Bone; Follow-Up Studies; Societies, Medical; Voting; Bone Density
PubMed: 38007332
DOI: 10.1016/j.jocd.2023.101435