The Relation between Visceral and Subcutaneous Fat to Bone Mass among Egyptian Children and Adolescents

BACKGROUND: The relation between fat distribution and bone mass is still being debated in children and adolescents.AIM: To verify the influence of both visceral and subcutaneous fat on bone mass among Egyptian children and adolescents.SUBJECTS AND METHODS: The study involved 78 (38 boys and 40 girls) individuals from children (42) and adolescents (36), aged 8-17 years. They were divided into 2 age groups: children group (20 boys and 22 girls) aged 8-12 years and adolescent group (18 boys and 18 girls) aged 13-17 years. Anthropometric measurements, visceral and subcutaneous fat (measured by ultrasound), body composition, BMD and BMC (Measured by DXA), were attempted.RESULTS: Among children, significant positive correlations between visceral fat; in males; and subcutaneous fat; in females; with total BMC, BMD and its Z-score were revealed. After exclusion of age effect, the association between visceral fat in females with total BMD and its Z-score and lumbar BMD-Z-score became significant.  For adolescents, no correlation was observed between either visceral or subcutaneous fat with any parameter of bone mass.CONCLUSIONS: Visceral and subcutaneous fat had significant positive association with bone mass in children; males and females respectively. On the contrary such association disappeared during adolescence

Different Tools for the Assessment of Bone Mass among Egyptian Adults

BACKGROUND: Several tools such as, dual X-ray absorptiometry (DXA), quantitative computed tomography (QCT) and self-assessment tool (OST), are being used for diagnosis of osteoporosis.OBJECTIVE: to compare the sensitivity and specify detection rate of bone mineral density (BMD) changes for DXA versus QCT and OST among a sample of Egyptian adults of both sexes.SUBJECTS AND METHODS: This study is a cross sectional one, which included 62 Egyptians, aged 20-65 years.  Each individual was assessed for BMD using DXA at femur and spine sites; QCT and OST which take into account body weight and age. Accordingly they were diagnosed as either osteoporotic/osteopenic or normal.RESULTS: The highest prevalence of osteopenia or osteoporosis was diagnosed among menopause women. DXA at femur has diagnosed more cases of osteoporosis (both osteopenic and osteoporotic) as compared to spine DXA or QCT, but OST is out of rang; as it failed to diagnose any case.CONCLUSION: DXA has been found to be more efficacious than QCT scan in the diagnosis of osteoporosis. DXA in femur is better than DXA-spine and QCT. Generally, DXA is the "gold standard" when assessing osteoporosis. Further studies are needed to modify the equation of OST and confirm its efficiency in Egyptians population

Reliability of Contrast CT and Positron Emission Tomography in Post-Surgical Colorectal Cancer and Its Association with Obesity

BACKGROUND: Post-surgical recurrence of cancer colon occurs in one-third of patients within the first two years, so early detection is important. The assessment of the therapeutic response is important to change protocol strategy. Positron emission tomography/computed tomography PET/CT, a valuable tool gives both metabolic and anatomic information for whole-body regions. Obesity is an important risk factor for colorectal cancer. AIM: To evaluate post-surgical and therapeutic colorectal cancer by PET/CT and study obesity association to its prognosis. METHODS: This was a prospective study involved 93 patients with, post-surgical colorectal cancer examined by PET/CT, then follow up after 4-6 months. RESULTS: There was a statistically significant difference between PET/CT and contrast CT. The sensitivity& the specificity were (96.4%-100% & 92.3%-98.2%) for PET/CT and (84.2%-90.2% & 76.5%-85.4%) for contrast CT respectively. Post-therapeutic follow up showed; progressive course (24.5%), stationary course (26.4%), partial regression (28.3%) and complete regression course (20.8%). Obesity is a risk factor for progression with highly statistically significant to treatment response. Obese patients had a progressive or stationary course of the disease. Also, there was a highly statistically significant association between total abdominal fat & visceral abdominal fat areas with good response of treatment. CONCLUSION: PET/CT is the most appropriate imaging technique to detect any recurrence or metastases in post-surgical colorectal cancer with high sensitivity and specificity comparing to CT. Obesity is a predictor risk factor for prognosis of the disease, as generally and abdominally (total & visceral fat) had an association with therapeutic response

25-Hydroxy Vitamin D, Adiponectin Levels and Cardiometabolic Risk Factors in a Sample of Obese Children

BACKGROUND: Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardio metabolic risk factors.AIM: Evaluation of association between metabolic risk factors with both adiponectin and 25-Hydroxy vitamin D [25(OH) D] levels and that between adiponectin and [25(OH) D] among obese Egyptian children.SUBJECTS AND METHODS: This case-control cross sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25(OH) D, serum adiponectin, total cholesterol, triglycerides, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol were measured.RESULTS: The mean 25(OH)D and adiponectin levels in the obese were lower than that in control group (ð‘ƒ<0.000). 25(OH)D were inversely correlated with body mass index, triglyceride, total cholesterol and LDL-cholesterol. While adiponectin level were inversely correlated with systolic and diastolic blood pressure, and positively correlated with high-density lipoprotein-cholesterol. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample.CONCLUSION: Inspite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH)D and adiponectin levels. In obese children, There are significant negative correlations between 25(OH)D with lipid profile, and between adiponectin levels with blood pressure

Body Composition Changes after Weight-Loss Interventions among Obese Females: A Comparison of Three Protocols

AIM: To evaluate body composition changes after use of three different types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with healthy diet; aiming at achieving stable weight loss among obese Egyptian females.METHODS:  A randomized longitudinal prospective study included 76 obese adult females; aged 26 up to 55 years. Anthropometric, body composition, ultrasonographic and biochemical assessments were done.RESULTS: The three types of obesity management protocols showed significant improvement in body composition (decrease in fat% and increases in FFM and TBW) and visceral fat by US. However, nutritional intervention showed highly significant improvement in the skin fold thickness at triceps and biceps sites and peripheral adiposity index.  Acupuncture intervention showed highly significant improvement in fasting blood glucose (decreased) and lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL). Laser intervention showed highly significant improvement in all the skin fold thickness and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS: The three obesity management protocols have significant effect on body composition, but acupuncture has the best effect in improving the lipid profile and fasting blood sugar. In addition, Laser intervention was recommended to improve skin fold thickness and subcutaneous fat

Bone Mineral Density in Egyptian Children with Familial Mediterranean Fever

Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). The objective of this study was to assess BMD in Egyptian children with FMF on genetic basis. Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes in the age range between 3-16 years old. The patients were reclassified into two groups, namely group I(A) with 23 cases using colchicine for 1 month or less, and group I(B) with 22 cases using colchicine for more than 6 months. For both the patients and control groups, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at the proximal femur and lumbar spines. Results: Four frequent gene mutations were found in the patient group E148Q (35.6%), V726A (33.3%), M680I (28.9%), and M694V (2.2%). There were also four heterozygous gene mutations in 40% of the control children. Patients receiving colchicine treatment for less than 1 month had highly significant lower values of BMD at the femur and lumbar spines than the control children (P=0.007, P<0.001). Patients receiving colchicine treatment for more than 6 months had improved values of BMD at femur compared with the control, but there were still significant differences between them in lumbar spine (P=0.036). There were insignificant effect of gene mutation type on BMD and the risk of osteopenia among the patients. Conclusion: FMF had a significant effect on BMD. However, regular use of colchicine treatment improves this effect mainly at the femur

Prevalence of Pre-hypertension and Hypertension in a sample of Egyptian Adults and its Relation to Obesity

Abstract: Objective: to study the prevalence of prehypertension and hypertension in Egyptian adults and its relation to obesity. Subjects and Methods: The blood pressure of 5534 Egyptian subjects was measured (2663 females -2871 males) aged 20 to 75 years old. They represented different geographic localities and different social classes. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured. Waist to hip ratio and body mass index (BMI) were calculated. Fasting blood sugar was tested. Results: The prevalence of prehypertension and hypertension was 49.22 % (54.4 and 43.1 for males and females) and 16.84 %( 18.5% and 15.1% for males and females) respectively. There was a tendency to increase of both prehypertension and hypertension in males as compared to females. The percentages of the hypertensive individuals were increased with age and degree of obesity. Prehypertension was higher in the cases having glucose intolerance, while hypertension was increased mainly in those suffering from diabetes mellitus. Conclusion: High rates of prehypertension and hypertension were observed in the studied Egyptian adults. Overweight/obesity and diabetes are important risk factors for hypertension. Strategies that can enhance public awareness of hypertension and increase access to affordable medications are urgently needed