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Obesity (Silver Spring, Md.) Jun 2024The study objective was to assess the relationship between insulin sensitivity and changes in total lean mass (LM) and appendicular LM (ALM) during weight loss. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The study objective was to assess the relationship between insulin sensitivity and changes in total lean mass (LM) and appendicular LM (ALM) during weight loss.
METHODS
Individuals were randomly assigned to either a standard or a moderately reduced carbohydrate diet for 16 weeks. Body composition was assessed using dual-energy x-ray absorptiometry and insulin sensitivity index (S) using an intravenous glucose tolerance test. Multiple linear regression was used to determine whether baseline S was predictive of changes in total LM and ALM.
RESULTS
Participants (n = 57; baseline BMI 32.1 ± 3.8 kg/m) lost an average of 6.8 ± 3.2 kg of body weight (p < 0.001), with 1.5 ± 2.6 kg coming from LM (p < 0.05) and 0.5 ± 0.73 kg from ALM (p < 0.05). Multiple regression analysis demonstrated that S was inversely associated with changes in total LM (kilograms; β = 0.481, p < 0.001), after adjusting for baseline LM, fat mass, acute insulin response to glucose, and weight loss. Similar results were seen when assessing ALM loss (β = 0.359, p < 0.05).
CONCLUSIONS
Identifying individuals with low insulin sensitivity prior to weight loss interventions may allow for a personalized approach aiming at minimizing LM loss.
Topics: Humans; Weight Loss; Insulin Resistance; Male; Female; Body Composition; Absorptiometry, Photon; Adult; Middle Aged; Glucose Tolerance Test; Body Mass Index; Obesity; Insulin; Diet, Carbohydrate-Restricted; Blood Glucose; Linear Models
PubMed: 38803306
DOI: 10.1002/oby.24022 -
Nutrients May 2024Although malnutrition is frequently observed in patients with heart failure (HF), this diagnosis should be performed carefully since HF itself is associated with...
Differences in the Evaluation of Malnutrition and Body Composition Using Bioelectrical Impedance Analysis, Nutritional Ultrasound, and Dual-Energy X-ray Absorptiometry in Patients with Heart Failure.
BACKGROUND
Although malnutrition is frequently observed in patients with heart failure (HF), this diagnosis should be performed carefully since HF itself is associated with increased inflammatory activity, which affects body weight, functionality, and some nutritional parameters; thus, its isolated interpretation can erroneously identify surrogate markers of severity as markers of malnutrition. In this context, we aimed to evaluate the prevalence of malnutrition using different classification systems and perform a comprehensive nutritional evaluation to determine the reliability of different diagnostic techniques.
PATIENTS AND METHODS
Eighty-three patients with a recent hospital admission due to HF were evaluated. GLIM diagnosis criteria and subjective global assessment (SGA) were performed; a comprehensive anthropometric, functional, and biochemical nutritional evaluation was performed, in which bioelectrical impedance analysis (BIA), nutritional ultrasound, and dual-energy X-ray absorptiometry (DXA) were performed. Additionally, mortality and additional admissions due to HF were determined after a mean follow up of 18 months.
RESULTS
Malnutrition according to the GLIM criteria (54%) accurately distinguished patients with impaired functionality, lower lean mass, skeletal mass index, and appendicular muscle mass (BIA), as well as lower trunk fat mass, trunk lean mass, fat-free mass (DXA), and decreased albumin and increased C-reactive protein serum levels. According to SGA, there were significant changes in body composition parameters determined by BIA, muscle ultrasound, and functional tests between well-nourished patients and patients with risk of malnutrition (53.7%) or who had malnutrition (7.1%), but not when the last two groups were compared. BIA and DXA showed strong correlations when evaluating muscle and fat mass in HF patients, but correlations with nutritional ultrasound were limited, as well as functional tests. A multivariate analysis showed that no significant association was observed between body composition and mortality, but preperitoneal fat was associated with an increased risk of new hospital admissions (OR: 0.73).
CONCLUSIONS
GLIM criteria identified a lower percentage of patients with HF and malnutrition compared with SGA; thus, SGA could have a role in preventing malnutrition in HF patients. Nutritional evaluation with BIA and DXA in patients with HF showed reliable results of body composition parameters in HF, and both help with the diagnosis of malnutrition according to the GLIM or SGA criteria and could provide complementary information in some specific cases.
Topics: Humans; Electric Impedance; Malnutrition; Male; Body Composition; Female; Absorptiometry, Photon; Aged; Heart Failure; Nutrition Assessment; Ultrasonography; Middle Aged; Nutritional Status; Aged, 80 and over; Reproducibility of Results; Prevalence
PubMed: 38794773
DOI: 10.3390/nu16101535 -
Nutrients May 2024Preterm infants have increased body adiposity at term-equivalent age and risk of adverse metabolic outcomes. The aim of the study was to define how nutrient intake may...
Preterm infants have increased body adiposity at term-equivalent age and risk of adverse metabolic outcomes. The aim of the study was to define how nutrient intake may impact body composition (BC) of very low-birth weight infants fed with early progressive enteral feeding and standard fortification. Eighty-six infants with <1500 g birth weight were included in the BC study and stratified into extremely preterm (EP) and very preterm (VP) groups. Nutrient intake was calculated during the first 28 days and BC assessed by dual X-ray absorptiometry at discharge and by skinfold thickness at 12 months of corrected age (CA). Total nutrient intake did not differ between the groups. EP infants had a higher fat mass percentage at discharge than VP infants (24.8% vs. 19.4%, < 0.001); lean mass did not differ. None of the nutrients had any impact on BC of EP infants. Protein intake did not result in a higher lean mass in either group; fat intake was a significant predictor of increased fat mass percentage in VP infants at discharge ( = 0.007) and body adiposity at 12 months of CA ( = 0.021). Nutritional needs may depend on gestational age and routine fortification should be used with caution in more mature infants.
Topics: Humans; Enteral Nutrition; Infant, Very Low Birth Weight; Body Composition; Female; Male; Infant, Newborn; Infant Nutritional Physiological Phenomena; Gestational Age; Adiposity; Infant, Premature; Infant; Nutrients; Absorptiometry, Photon; Infant, Extremely Premature; Energy Intake; Food, Fortified; Skinfold Thickness
PubMed: 38794701
DOI: 10.3390/nu16101462 -
International Journal of Environmental... Apr 2024Soccer is a laterally dominant sport owing to the repetitive nature of unilateral kicking. The relationship between functional and body composition asymmetries related...
Soccer is a laterally dominant sport owing to the repetitive nature of unilateral kicking. The relationship between functional and body composition asymmetries related to limb dominance in soccer players has yet to be established. When present, asymmetries can increase the risk of injury and low back pain. Our study investigated whether lateral dominance is associated with limb asymmetries in a comprehensive body composition assessment among varsity soccer players. Twenty-seven varsity soccer players (age 20.4 ± 1.7 years old; BMI 22.6 ± 4.6 kg/m) participated in this study. Body composition was assessed through dual-energy X-ray absorptiometry scans. Results showed low lower limb asymmetry indices in both males (3.82%) and females (3.36%) compared to normal ranges. However, upper limb lean mass exhibited high asymmetry, surpassing thresholds in males (7.3%) and females (4.39%). Significant differences were found in total bone mass among males and total lean body mass among females. Male players exhibited higher asymmetry indices in both arm and trunk mass compared to females. Despite these asymmetries, no significant correlations were found between asymmetry indices and occurrences of lower limb injury or low back pain. The study suggests that while evaluating body composition for injury prevention in soccer shows potential, lateral dominance may be influenced by factors extending beyond sport-specific adaptations.
Topics: Humans; Soccer; Body Composition; Low Back Pain; Male; Absorptiometry, Photon; Young Adult; Female; Universities; Athletic Injuries; Adolescent
PubMed: 38791774
DOI: 10.3390/ijerph21050559 -
Meat Science Sep 2024Dual energy x-ray absorptiometry (DXA) devices were installed at two Australian abattoirs to predict computed tomography (CT) determined fat % and lean % of lamb...
Dual energy x-ray absorptiometry (DXA) devices were installed at two Australian abattoirs to predict computed tomography (CT) determined fat % and lean % of lamb carcasses. This study tested three algorithms developed for these devices, termed β1, β2 and β3, and assessed their accuracy and precision in predicting CT composition. Algorithm β3 included the use of a plastic phantom calibration block scanned by both DXA devices to adjust prediction equations, resulting in superior accuracy to the algorithms without phantom calibration (β1 and β2). When compared to the gold-standard CT composition, the bias of the DXA predictions was lowest when using algorithm β3 at the two sites (-1.17%, -0.49% for fat %, 0.11%, -0.37% for lean %). The difference of DXA composition predictions between sites was lowest when using algorithm β3, which demonstrated between site differences of 0.59 CT fat %, and 0.46 CT lean%. In contrast, algorithm β1 and β2 produced differences of 23.7% and 30.8% for CT fat, and 17.3% and 21.9% for CT lean between the two DXA devices. There was a small difference of 0.78% between the fat predictions of the first DXA image compared to the second DXA image for each carcass. The precision of predictions improved slightly using algorithm β3. This work demonstrates that the in-line DXA systems can produce comparable results across sites.
Topics: Animals; Calibration; Absorptiometry, Photon; Phantoms, Imaging; Abattoirs; Red Meat; Algorithms; Body Composition; Adipose Tissue; Tomography, X-Ray Computed; Sheep, Domestic; Australia
PubMed: 38788245
DOI: 10.1016/j.meatsci.2024.109537 -
Diseases (Basel, Switzerland) May 2024Fabry disease (FD) is an X-linked lysosomal storage disorder, characterised by the cellular accumulation of globotriaosylceramide due to impaired alpha-galactosidase A...
Fabry disease (FD) is an X-linked lysosomal storage disorder, characterised by the cellular accumulation of globotriaosylceramide due to impaired alpha-galactosidase A enzyme activity. FD may manifest with multisystem pathology, including reduced bone mineral density (BMD). Registry data suggest that the introduction of Fabry-specific therapies (enzyme replacement therapy or chaperone therapy) has led to significant improvements in overall patient outcomes; however, there are limited data on the impact on bone density. The aim of this study was to describe the effect of Fabry-specific therapies on longitudinal changes in bone mineral density (BMD) in FD. We performed a retrospective observational study analysing bone densitometry (DXA) in patients with genetically confirmed FD. Patients were grouped based on the use of Fabry-specific therapies. The between-group longitudinal change in BMD Z-score was analysed using linear mixed effects models. A total of 88 FD patients were analysed (50 untreated; 38 treated). The mean age at first DXA was 38.5 years in the untreated group (84% female) and 43.7 years in the treated group (34% female). There was no significant longitudinal between-group difference in the BMD Z-score at the lumbar spine. However, the Z-score per year at the total hip (β = -0.105, < 0.001) and femoral neck (β = -0.081, = 0.001) was significantly lower over time in the treated than the untreated group. This may reflect those receiving therapy having a more severe underlying disease. Nevertheless, this suggests that Fabry-specific therapies do not reverse all disease mechanisms and that the additional management of BMD may be required in this patient population.
PubMed: 38785757
DOI: 10.3390/diseases12050102 -
The Orthopedic Clinics of North America Jul 2024This report provides an updated analysis for patients with osteoporosis following total hip arthroplasty (THA). The comorbidities of alcohol abuse, chronic kidney... (Review)
Review
This report provides an updated analysis for patients with osteoporosis following total hip arthroplasty (THA). The comorbidities of alcohol abuse, chronic kidney disease, cerebrovascular disease, obesity, and rheumatoid arthritis continue to be significant risk factors for periprosthetic femur fracture (PPFFx) and aseptic loosening in the population with osteoporosis. Patients with dual-energy x-ray absorptiometric (DEXA) scans were at risk for PPFFx regardless of femoral fixation method, and patients with DEXA scans with cementless fixation were at risk of aseptic loosening after THA. The patient population with severe osteoporosis may have higher risks for aseptic loosening and PPFFx than previously recognized.
Topics: Humans; Arthroplasty, Replacement, Hip; Periprosthetic Fractures; Osteoporosis; Prosthesis Failure; Risk Factors; Femoral Fractures; Female; Male; Aged; Hip Prosthesis; Absorptiometry, Photon; Middle Aged
PubMed: 38782503
DOI: 10.1016/j.ocl.2024.02.001 -
Archives of Osteoporosis May 2024This study established FRAX-based age-specific assessment and intervention thresholds for ten Middle Eastern countries where FRAX is currently available, but the lack of...
UNLABELLED
This study established FRAX-based age-specific assessment and intervention thresholds for ten Middle Eastern countries where FRAX is currently available, but the lack of specific thresholds has limited its usefulness. The intervention thresholds ranged from 0.6 (Saudi Arabia) to 36.0% (Syria) at the ages of 40 and 90 years, respectively.
INTRODUCTION
Developing fracture risk assessment tools allows physicians to select patients for therapy based on their absolute fracture risk instead of relying solely on bone mineral density (BMD). The most widely used tool is FRAX, currently available in ten Middle Eastern countries. This study aimed to set FRAX-derived assessment and intervention thresholds for individuals aged 40 or above in ten Middle Eastern countries.
METHODS
The age-specific 10-year probabilities of a major osteoporotic fracture (MOF) for a woman with a BMI of 25.0 kg/m, without BMD and clinical risk factors except for prior fracture, were calculated as intervention Threshold (IT). The upper and lower assessment thresholds were set at 1.2 times the IT and an age-specific 10-year probability of a MOF in a woman with a BMI of 25.0 kg/m, without BMD, prior fracture, and other clinical risk factors, respectively. IT is utilized to determine treatment or reassurance when BMD facilities are unavailable. However, with BMD facilities, assessment thresholds can offer treatment, reassurance, or bone densitometry based on MOF probability.
RESULTS
The age-specific IT varied from 0.9 to 11.0% in Abu Dhabi, 2.9 to 10% in Egypt, 2.7 to 14.0% in Iran, 1.0 to 28.0% in Jordan, 2.7 to 27.0% in Kuwait, 0.9 to 35.0% in Lebanon, 1.0 to 16.0% in Palestine, 4.1 to 14% in Qatar, 0.6 to 3.7% in Saudi Arabia, and 0.9 to 36.0% in Syria at the age of 40 and 90 years, respectively.
CONCLUSIONS
FRAX-based IT in Middle Eastern countries provides an opportunity to identify individuals with high fracture risk.
Topics: Humans; Middle Aged; Female; Risk Assessment; Aged; Adult; Middle East; Osteoporotic Fractures; Aged, 80 and over; Osteoporosis; Male; Bone Density; Risk Factors
PubMed: 38780743
DOI: 10.1007/s11657-024-01397-0 -
JCI Insight May 2024Caloric restriction improves metabolic health but is often complicated by bone loss. We studied bone parameters in humans during a 10-day fast and identified candidate...
Caloric restriction improves metabolic health but is often complicated by bone loss. We studied bone parameters in humans during a 10-day fast and identified candidate metabolic regulators of bone turnover. Pro-collagen 1 intact N-terminal pro-peptide (P1NP), a bone formation marker, decreased within 3 days of fasting. Whereas dual-energy x-ray absorptiometry measures of bone mineral density were unchanged after 10 days of fasting, high-resolution peripheral quantitative CT demonstrated remodeling of bone microarchitecture. Pathway analysis of longitudinal metabolomics data identified one-carbon metabolism as fasting dependent. In cultured osteoblasts, we tested the functional significance of one-carbon metabolites modulated by fasting, finding that methionine - which surged after 3 days of fasting - affected markers of osteoblast cell state in a concentration-dependent manner, in some instances exhibiting a U-shaped response with both low and high concentrations driving putative antibone responses. Administration of methionine to mice for 5 days recapitulated some fasting effects on bone, including a reduction in serum P1NP. In conclusion, a 10-day fast in humans led to remodeling of bone microarchitecture, potentially mediated by a surge in circulating methionine. These data support an emerging model that points to a window of optimal methionine exposure for bone health.
Topics: Methionine; Animals; Humans; Bone Remodeling; Fasting; Mice; Male; Female; Bone Density; Osteoblasts; Procollagen; Middle Aged; Adult; Absorptiometry, Photon; Peptide Fragments; Caloric Restriction
PubMed: 38780544
DOI: 10.1172/jci.insight.177997 -
Frontiers in Endocrinology 2024To determine whether there are alterations in marrow fat content in individuals first-time diagnosed with type 1 diabetes mellitus (T1DM) and to explore the associations...
PURPOSE
To determine whether there are alterations in marrow fat content in individuals first-time diagnosed with type 1 diabetes mellitus (T1DM) and to explore the associations between marrow fat fraction and MRI-based findings in trabecular bone microarchitecture.
METHOD
A case-control study was conducted, involving adults with first-time diagnosed T1DM (n=35) and age- and sex-matched healthy adults (n=46). Dual-energy X-ray absorptiometry and 3 Tesla-MRI of the proximal tibia were performed to assess trabecular microarchitecture and vertebral marrow fat fraction. Multiple linear regression analysis was used to test the associations of marrow fat fraction with trabecular microarchitecture and bone density while adjusting for potential confounding factors.
RESULTS
In individuals first-time diagnosed with T1DM, the marrow fat fraction was significantly higher ( < 0.001) compared to healthy controls. T1DM patients also exhibited higher trabecular separation [median (IQR): 2.19 (1.70, 2.68) vs 1.81 (1.62, 2.10), < 0.001], lower trabecular volume [0.45 (0.30, 0.56) vs 0.53 (0.38, 0.60), = 0.013], and lower trabecular number [0.37 (0.26, 0.44) vs 0.41 (0.32, 0.47), = 0.020] compared to controls. However, bone density was similar between the two groups ( = 0.815). In individuals with T1DM, there was an inverse association between marrow fat fraction and trabecular volume ( = -0.69, < 0.001) as well as trabecular number ( = -0.55, < 0.001), and a positive association with trabecular separation ( = 0.75, < 0.001). Marrow fat fraction was independently associated with total trabecular volume (standardized β = -0.21), trabecular number (β = -0.12), and trabecular separation (β = 0.57) of the proximal tibia after adjusting for various factors including age, gender, body mass index, physical activity, smoking status, alcohol consumption, blood glucose, plasma glycated hemoglobin, lipid profile, and bone turnover biomarkers.
CONCLUSIONS
Individuals first-time diagnosed with T1DM experience expansion of marrow adiposity, and elevated marrow fat content is associated with MRI-based trabecular microstructure.
Topics: Humans; Male; Female; Diabetes Mellitus, Type 1; Magnetic Resonance Imaging; Cancellous Bone; Adult; Case-Control Studies; Bone Marrow; Bone Density; Absorptiometry, Photon; Adipose Tissue; Middle Aged; Young Adult
PubMed: 38774224
DOI: 10.3389/fendo.2024.1287591