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Revista Brasileira de Ginecologia E... 2024To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal... (Observational Study)
Observational Study
OBJECTIVE
To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal muscle mass (SMM).
METHODS
This cross-sectional observational study was conducted with postmenopausal women aged ≥ 50 years. SMM was obtained from a predictive equation, Bioelectrical Impedance (BIA), and Dual Energy X-Ray Absorptiometry (DXA). The skeletal muscle mass index (SMI) and the appendicular skeletal muscle mass index (ASMI) were calculated. The cut-off point of SMI was determined for the population itself. The agreement between the SMI obtained using the different methods was verified. Sarcopenia was diagnosed according to the criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The significance level adopted for all tests was 5.0%.
RESULTS
A total of 112 women were evaluated, with an average age of 66.1 ± 5.65 years. Among them, 51.8% were sufficiently active and 43.8% were overweight and obese. The SMI cut-offs were 6.46 kg/m for the predictive equation and 7.66 kg/m for BIA, with high sensitivity and specificity. There was an excellent agreement in the identification of SMM by the predictive equation (0.89 [0.824-0.917], p < 0.001) and BIA (0.92 [0.883-0.945], p < 0.001), in reference to DXA. The prevalence of sarcopenia was 0.9%, 1.8%, and 2.7% according to BIA, DXA, and the predictive equation, respectively.
CONCLUSION
The predictive equation showed the expected agreement in estimating skeletal muscle mass in postmenopausal women, offering a viable and accurate alternative.
Topics: Humans; Female; Sarcopenia; Cross-Sectional Studies; Postmenopause; Aged; Muscle, Skeletal; Middle Aged; Absorptiometry, Photon; Electric Impedance; Anthropometry
PubMed: 38765537
DOI: 10.61622/rbgo/2024AO09 -
Osteoporosis International : a Journal... Jul 2024Little is known about the incidence of osteoporosis testing and treatment in individuals with schizophrenia, who may be more likely to fracture. Using competing risk...
UNLABELLED
Little is known about the incidence of osteoporosis testing and treatment in individuals with schizophrenia, who may be more likely to fracture. Using competing risk models, we found that schizophrenia was associated with lower incidence of testing or treatment. Implications are for understanding barriers and solutions for this disadvantaged group.
PURPOSE
Evidence suggests that individuals with schizophrenia may be more likely to experience hip fractures than the general population; however, little is known about osteoporosis management in this disadvantaged subpopulation. Our study objective was to compare bone mineral density (BMD) testing and pharmacologic treatment in hip fracture patients with versus without schizophrenia.
METHODS
This was a retrospective population-based cohort study leveraging health administrative databases, and individuals aged 66-105 years with hip fracture between fiscal years 2009 and 2018 in Ontario, Canada. Schizophrenia was ascertained using a validated algorithm. The outcome was a composite measure of (1) pharmacologic prescription for osteoporosis; or (2) a BMD test. Inferential analyses were conducted using Fine-Gray subdistribution hazard regression, with mortality as the competing event.
RESULTS
A total of 52,722 individuals aged 66 to 105 years who sustained an index hip fracture in Ontario during the study period were identified, of whom 1890 (3.6%) had schizophrenia. Hip fracture patients with vs without schizophrenia were more likely to be long-term care residents (44.3% vs. 18.1%; standardized difference, 0.59), frail (62.5% vs. 36.5%; standardized difference, 0.54) and without a primary care provider (9.2% vs. 4.8%; standardized difference, 0.18). In Fine-Gray models, schizophrenia was associated with a lower incidence of testing or treatment (0.795 (0.721, 0.877)).
CONCLUSIONS
In this population-based retrospective cohort study, a schizophrenia diagnosis among hip fracture patients was associated with a lower incidence of testing or treatment, after accounting for mortality, and several enabling and predisposing factors. Further research is required to investigate barriers to osteoporosis management in this disadvantaged population.
Topics: Humans; Hip Fractures; Aged; Ontario; Retrospective Studies; Female; Male; Aged, 80 and over; Osteoporotic Fractures; Osteoporosis; Bone Density; Schizophrenia; Bone Density Conservation Agents; Incidence; Absorptiometry, Photon; Databases, Factual
PubMed: 38760503
DOI: 10.1007/s00198-024-07123-3 -
Calcified Tissue International Jul 2024Studies have found associations between sleep, nap duration, and bone mineral density (BMD). However, the longitudinal relationship between sleep, nap duration, and BMD...
Studies have found associations between sleep, nap duration, and bone mineral density (BMD). However, the longitudinal relationship between sleep, nap duration, and BMD has not been explored. We evaluated the association between the change in sleep and nap duration and BMD in Mexican adults. Data come from 1,337 adult participants of the Health Workers Cohort Study (341 were men and 996 were women, including 450 women < 45 years old and 546 ≥ 45 years old), with two study waves. At each wave, sleep and nap duration was assessed using self-administered questionnaires and BMD in g/cm was determined by dual X-ray absorptiometry. We used fixed-effect regression models stratified by sex and adjusted for BMI, diet, physical activity, vitamin supplements, and hormone replacement therapy. Women who changed from < 7 to ≥ 7 h/day of sleep from baseline to follow-up were associated with increases in the total hip (β = 0.012 g/cm; 95% CI: 0.002, 0.022) and lumbar spine BMD (β = 0.024 g/cm; 95% CI: 0.009, 0.039). Furthermore, most of these associations were observed in women ≥ 45 years. For women, a changing from 0 to > 60 min/day of napping was associated with a significant increase in total hip BMD of 0.012 g/cm (95% CI: 0.004, 0.024) and lumbar spine BMD of 0.027 g/cm (95% CI: 0.009, 0.045). No significant associations were observed for men. Our results suggest that increased sleep and nap duration are associated with gains in BMD in Mexican women, emphasizing sleep's role in promoting bone health and supporting established recommendations.
Topics: Humans; Bone Density; Female; Male; Middle Aged; Sleep; Mexico; Adult; Absorptiometry, Photon; Aged; Cohort Studies
PubMed: 38758431
DOI: 10.1007/s00223-024-01224-1 -
Methods in Molecular Biology (Clifton,... 2024Melanin is a complex dark pigment synthetized by the phenoloxidase enzyme laccase in Cryptococcus neoformans. In vitro, this enzyme oxidizes exogenous catecholamines to...
Melanin is a complex dark pigment synthetized by the phenoloxidase enzyme laccase in Cryptococcus neoformans. In vitro, this enzyme oxidizes exogenous catecholamines to produce melanin that may be secreted or incorporated into the fungal cell wall. This pigment has multiple roles in C. neoformans virulence during its interaction with different hosts and probably also in protecting fungal cells in the environment against predation and oxidative and radiation stresses, among others. However, it is important to note that laccase also has melanin-independent roles in C. neoformans interactions with host cells. In this chapter, we describe a quantitative laccase assay and a method for evaluating the kinetics of melanin production in C. neoformans colonies.
Topics: Cryptococcus neoformans; Laccase; Melanins; Enzyme Assays
PubMed: 38758323
DOI: 10.1007/978-1-0716-3722-7_17 -
Archives of Osteoporosis May 2024In the longitudinal, retrospective study, the ability of the FRAX, Garvan, and POL-RISK algorithms to predict osteoporotic fractures was compared in a group of 457... (Comparative Study)
Comparative Study
UNLABELLED
In the longitudinal, retrospective study, the ability of the FRAX, Garvan, and POL-RISK algorithms to predict osteoporotic fractures was compared in a group of 457 women. Using the rigid threshold of 10% showed a significant discrepancy in sensitivity and specificity of all tools. New thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds allow for improving the diagnostic accuracy of all three calculators.
INTRODUCTION
The aim of the longitudinal, retrospective study was to compare three tools designed to assess fracture risk: FRAX, Garvan, and POL-RISK in their prediction of fracture incidence.
MATERIAL
The study group consisted of 457 postmenopausal women with a mean age of 64.21 ± 5.94 years from the Gliwice Osteoporosis (GO) Study. Comprehensive data on clinical factors related to fractures were collected for all participants. Bone densitometry was performed at the proximal femur using the Prodigy device (GE, USA). Fracture risk was established using the FRAX, Garvan, and POL-RISK algorithms. Data on the incidence of osteoporotic fractures were collected over the last 10 years.
RESULTS
During the period of observation 72, osteoporotic fractures occurred in 63 subjects. For a preliminary comparison of the predictive value of analyzed diagnostic tools, the fracture risk threshold of 10% was used. For FRAX, the fracture probability exceeding 10% was observed only in 11 subjects who experienced fractures; thus, the fracture was properly predicted only in 22.9% of women. For Garvan, the respective value was 90.5%, and for POL-RISK, it was 98.4%. That gave a very low true positive value for FRAX and a very high false positive value for Garvan and POL-RISK. Based on ROC curves, new thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds improve the diagnostic accuracy of all compared fracture prediction tools.
CONCLUSION
The current study showed that different fracture risk assessment tools, although having similar clinical purposes, require different cut-off thresholds for making therapeutic decisions. Better identification of patients requiring therapy based on such an approach may help reduce the number of new fractures.
Topics: Humans; Female; Algorithms; Osteoporotic Fractures; Middle Aged; Risk Assessment; Aged; Retrospective Studies; Osteoporosis, Postmenopausal; Longitudinal Studies; Bone Density; Postmenopause; Risk Factors; Incidence; Sensitivity and Specificity; Absorptiometry, Photon
PubMed: 38755326
DOI: 10.1007/s11657-024-01392-5 -
PloS One 2024End-stage renal disease (ESRD) patients often experience accelerated bone turnover, leading to osteoporosis and osteopenia. This study aimed to determine the prevalence...
BACKGROUND
End-stage renal disease (ESRD) patients often experience accelerated bone turnover, leading to osteoporosis and osteopenia. This study aimed to determine the prevalence of osteoporosis in Peritoneal Dialysis (PD) patients using bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DEXA) scan and to explore any possible associations with clinical and biochemical factors.
METHODS
In this cross-sectional study, we enrolled 76 peritoneal dialysis patients from the dialysis center at An-Najah National University Hospital in Nablus, Palestine. We used the DEXA scan to measure BMD at the lumbar spine and hip, with values expressed as T-scores. We conducted a multivariate analysis to explore the relationship between BMD and clinical and biochemical parameters.
RESULTS
Over half (52.6%) of the PD patients had osteoporosis, with a higher prevalence observed among patients with lower BMI (p<0.001). Higher alkaline phosphatase levels were found among osteoporotic patients compared to non-osteoporotic patients (p = 0.045). Vitamin D deficiency was also prevalent in this population, affecting 86.6% of patients. No significant correlation was found between 25 vitamin D levels and BMD. No significant correlation was found between Parathyroid hormone (PTH) levels and BMD.
CONCLUSION
A notable proportion of PD patients experience reduced BMD. Our study found no correlation between vitamin D levels and BMD, but it highlighted the significant vitamin D deficiency in this population. Furthermore, our analysis indicated a positive correlation between BMI and BMD, especially in the femoral neck area. This underscores the significance of addressing bone health in PD patients to mitigate the risk of fractures and improve their overall well-being.
Topics: Humans; Bone Density; Peritoneal Dialysis; Female; Male; Middle Aged; Osteoporosis; Cross-Sectional Studies; Absorptiometry, Photon; Adult; Kidney Failure, Chronic; Parathyroid Hormone; Prevalence; Aged; Vitamin D; Vitamin D Deficiency; Lumbar Vertebrae
PubMed: 38753845
DOI: 10.1371/journal.pone.0301814 -
PloS One 2024Loss of lean muscle mass and accumulation of adipose tissue are changes associated with aging. Previous studies have documented various components of body composition as...
Loss of lean muscle mass and accumulation of adipose tissue are changes associated with aging. Previous studies have documented various components of body composition as predictors for insulin resistance. The objective of this study was to investigate whether components of body composition-appendicular lean mass (ALM) and/or abdominal fat mass (AFM)-correlate with insulin resistance in older men and women. This was a cross-sectional study of 92 older men and women. Weight was classified according to body mass index (BMI)-normal (BMI <25), overweight (BMI 25-30), and obese (BMI >30). All body composition data was determined by dual energy x-ray absorptiometry (DEXA), and insulin resistance was assessed by the homeostatic model assessment of insulin resistance (HOMA-IR). Multivariable regression models with two-way interaction terms were employed to assess whether the associations between components of body composition and log HOMA varied by BMI categories. Adjusted regression showed that log HOMA was significantly associated with AFM (estimate ± standard error: 0.055 ± 0.026) and ALM (0.057 ± 0.029) for the overweight participants (p-values <0.05). Additionally, the adjusted associations between log HOMA and ALM were significantly greater for participants who were either obese or overweight compared to those with a normal BMI (p<0.002). Less consistent relationships were observed between insulin resistance and abdominal fat mass across BMI categories, whereas more consistent associations were observed between insulin resistance and appendicular lean mass in individuals with greater BMI. Further research is needed to clarify if lipid deposition within muscle tissue promotes muscle dysfunction and thereby increases risk for insulin resistance.
Topics: Humans; Insulin Resistance; Male; Female; Cross-Sectional Studies; Aged; Adiposity; Body Mass Index; Body Composition; Absorptiometry, Photon; Abdominal Fat; Middle Aged; Obesity; Aged, 80 and over
PubMed: 38753649
DOI: 10.1371/journal.pone.0303874 -
Postgraduate Medicine May 2024This study sought to investigate the relationship between the systemic inflammatory response index (SIRI) and bone mineral density (BMD), osteoporosis, and future...
OBJECTIVES
This study sought to investigate the relationship between the systemic inflammatory response index (SIRI) and bone mineral density (BMD), osteoporosis, and future fracture risk in elderly hypertensive patients.
METHODS
Elderly hypertensive patients (age ≥60 years) who attended our hospital between January 2021 and December 2023 and completed BMD screening were included in the study. Analyses were performed with multivariate logistic and linear regression.
RESULTS
The multiple linear regression indicated that SIRI levels were significantly negatively correlated with lumbar 1 BMD (β = -0.15, 95% CI: -0.24, -0.05), lumbar 2 BMD (β = -0.15, 95% CI: -0.24, -0.05), lumbar 3 BMD (β = -1.35, 95% CI: -0.23, -0.02), lumbar 4 BMD (β = -0.11, 95% CI: -0.30, -0.10), femur neck BMD (β = -0.11, 95% CI: -0.18, -0.05) and Ward's triangle BMD (β = -0.12, 95% CI: -0.20, -0.05) among elderly hypertensive patients, after fully adjusting for confounders. Furthermore, we observed that SIRI was positively associated with future fracture risk in elderly hypertensive patients. Specifically, SIRI was associated with an increased risk of major osteoporotic fractures (β = 0.33) and hip fractures (β = 0.25). The logistic regression analysis indicated that there is an association between the SIRI level and an increased risk of osteoporosis (OR = 1.60, 95% CI = 1.37, 1.87), after fully adjusting for confounders.
CONCLUSIONS
Our findings indicate a potential association between SIRI and BMD, osteoporosis, and the risk of future fractures in elderly hypertensive patients. However, further studies are warranted to confirm these findings.
Topics: Humans; Bone Density; Female; Male; Aged; Osteoporosis; Hypertension; Middle Aged; Risk Factors; Osteoporotic Fractures; Risk Assessment; Aged, 80 and over; Systemic Inflammatory Response Syndrome; Lumbar Vertebrae; Absorptiometry, Photon
PubMed: 38753519
DOI: 10.1080/00325481.2024.2354158 -
Clinical Interventions in Aging 2024To explore the suitable population of CT value for predicting low bone mineral density (low-BMD).
OBJECTIVE
To explore the suitable population of CT value for predicting low bone mineral density (low-BMD).
METHODS
A total of 1268 patients who underwent chest CT examination and DXA within one-month period retrospectively analyzed. The CT attenuation values of trabecular bone were measured in mid-sagittal plane from thoracic vertebra 7 (T7). Receiver operating characteristic (ROC) curves were used to evaluate the ability to diagnose low-BMD.
RESULTS
The AUC for diagnosing low BMD was larger in women than in men (0.894 vs 0.744, p < 0.05). The AUC increased gradually with the increase of age but decreased gradually with the increase in height and weight (p < 0.05). In females, when specificity was adjusted to approximately 90%, a threshold of 140.25 HU has a sensitivity of 69.3%, which is higher than the sensitivity of 36.5% in males for distinguishing low-BMD from normal. At the age of 70 or more, when specificity was adjusted to approximately 90%, a threshold of 126.31 HU has a sensitivity of 76.1%, which was higher than that of other age groups.
CONCLUSION
For patients who had completed chest CTs, the CT values were more effective in predicting low-BMD in female, elderly, lower height, and lower weight patients.
Topics: Humans; Male; Female; Middle Aged; Aged; Tomography, X-Ray Computed; Bone Density; Retrospective Studies; Adult; ROC Curve; Absorptiometry, Photon; Aged, 80 and over; Osteoporosis; Sensitivity and Specificity; Age Factors; Mass Screening; Body Height
PubMed: 38751857
DOI: 10.2147/CIA.S461018 -
Journal of Diabetes Jun 2024Previous studies have shown that sarcopenic obesity (SO) was associated with nonalcoholic fatty liver disease (NAFLD). However, research is limited in the context of the...
Association between the skeletal muscle mass to visceral fat area ratio and metabolic dysfunction-associated fatty liver disease: A cross-sectional study of NHANES 2017-2018.
BACKGROUND AND AIMS
Previous studies have shown that sarcopenic obesity (SO) was associated with nonalcoholic fatty liver disease (NAFLD). However, research is limited in the context of the NAFLD renamed as metabolic dysfunction-associated steatotic liver disease (MASLD) defined by updated diagnostic criteria. The aim of this study was to use the index skeletal muscle mass to visceral fat area ratio (SVR) to describe SO in a large and representative US population (National Health and Nutrition Examination Survey 2017-2018) of adults and investigate their association with MASLD.
METHODS
A total of 2087 individuals were included in the analysis. SVR was calculated according to the measurement of dual-energy x-ray absorptiometry and MASLD was diagnosed with controlled attenuation parameter scores and cardiometabolic risk factors. SVR was divided into tertiles. Logistic regression adjusted for confounders was used to evaluate the association between SVR and MASLD. Several sensitivity analyses were performed to test the robustness of our findings.
RESULTS
In a multivariate logistic regression analysis, a significant association between SVR and MASLD was shown (odds ratio [OR]: 3.11, 95% confidence interval [CI]: 1.31-7.39, p = .010 for middle levels of SVR; OR: 3.82, 95% CI: 1.45-10.08, p = .007 for lowest levels of SVR). The sensitivity analyses confirmed that the association was robust.
CONCLUSION
Our findings imply that decreased SVR is linked to MASLD.
Topics: Humans; Intra-Abdominal Fat; Male; Cross-Sectional Studies; Female; Middle Aged; Muscle, Skeletal; Nutrition Surveys; Adult; Non-alcoholic Fatty Liver Disease; Sarcopenia; Absorptiometry, Photon; United States; Aged; Risk Factors
PubMed: 38751375
DOI: 10.1111/1753-0407.13569