11 research outputs found
Sarcopenia in patients with diabetes mellitus.
IntroductionDiseases such as diabetes mellitus may be associated with adverse changes in body composition. Sarcopenia is characterized by a progressive and generalized loss of skeletal muscle mass and functionality.AimTo investigate the relationship between type 2 diabetes mellitus (T2DM) and sarcopenia.Materials and methodsIn a retrospective, non-randomized study, 35 T2DM patients, aged 20-80 years, were assessed for sarcopenia prevalence compared to controls (n=16). Appendicular skeletal mass (ASM) (kg) was measured, and sarcopenia was defined as SMI ResultsIncidence of sarcopenia was significantly higher in T2DM patients vs. controls (27% vs. 20%, p=0.01) and elderly vs. young participants (40% vs. 12%, pConclusionsA moderate prevalence of sarcopenia in patients with type 2 diabetes mellitus was observed, which appeared to increase significantly in older men. Finally, incidence of T2DM displayed decreased physical performance in both genders
Association of physical exercise and calcium intake with bone mass measured by quantitative ultrasound
<p>Abstract</p> <p>Background</p> <p>Interventions other than medications in the management of osteoporosis are often overlooked. The purpose of this study was to investigate the association of physical activity and calcium intake with bone parameters.</p> <p>Methods</p> <p>We measured the heel T-score and stiffness index (SI) in 1890 pre- and postmenopausal women by quantitative ultrasound (QUS) and assessed physical activity and dietary calcium intake by questionnaire. Participants were divided according to their weekly physical activity (sedentary, moderately active, systematically active) and daily calcium consumption (greater than or less than 800 mg/day).</p> <p>Results</p> <p>SI values were significantly different among premenopausal groups (p = 0.016) and between sedentary and systematically active postmenopausal women (p = 0.039). QUS T-scores in systematically active premenopausal women with daily calcium intake > 800 mg/day were significantly higher than those in all other activity groups (p < 0.05) independent of calcium consumption.</p> <p>Conclusions</p> <p>Systematic physical activity and adequate dietary calcium intake are indicated for women as a means to maximize bone status benefits.</p
Bone And Soft Tissue Changes In Patients With Spinal Cord Injury And Multiple Sclerosis
In patients with spinal cord injury and multiple sclerosis, deterioration of body composition (changes in bone, fat and muscle mass) is associated with increased risk for diseases such as coronary artery heart disease, non-insulin dependent diabetes mellitus, lipid metabolism abnormalities, and osteoporotic fractures in these patients. Immobility leads to a changing pattern of loading in the paralyzed areas, and secondary alteration in structure. However, bone and soft tissue changes in these patients are usually neglected. The purpose of this article is to update on the pathophysiological mechanisms leading to bone and soft tissue changes, and to increase the awareness of the treating physicians with respect to bone, muscle and fat loss and their consequences aiming to obtain measures to prevent bone and soft tissue loss in these patients
Efficacy of Antiosteoporotic Medications in Patients With Rebound-Associated Fractures After Denosumab Discontinuation
Denosumab discontinuation results in rapid bone loss and increased risk
of multiple rebound-associated vertebral fractures (RAVFs). The optimal
treatment for patients who have sustained such fractures is currently
unknown. We aimed to investigate the bone mineral density (BMD) changes
achieved with various regimens in postmenopausal women who had sustained
RAVFs after denosumab discontinuation in everyday clinical practice. In
this multicenter, retrospective observational study, 39 Greek
postmenopausal women from six regional bone centers throughout Greece
with RAVFs after denosumab discontinuation were included. We collected
BMD and fracture data before and 1 year after treatment with denosumab
(n = 20), teriparatide (n = 8), zoledronate (n = 8) or
teriparatide/denosumab combination (n = 3). Both lumbar spine (LS)- and
femoral neck (FN)-BMD were preserved with all regimens used. With the
exception of zoledronate, a trend towards increase was observed with all
regimens in LS-BMD. Three patients sustained additional fractures
despite treatment reinstitution (2 with zoledronate and 1 with
teriparatide). Among patients with RAVFs following denosumab
discontinuation both antiresorptive (zoledronate and denosumab) and
anabolic (teriparatide) treatment as well as the combination of
denosumab with teriparatide seem to be effective in terms of BMD
response
Robust Bioinformatics Approaches Result in the First Polygenic Risk Score for BMI in Greek Adults
Quantifying the role of genetics via construction of polygenic risk scores (PRSs) is deemed a resourceful tool to enable and promote effective obesity prevention strategies. The present paper proposes a novel methodology for PRS extraction and presents the first PRS for body mass index (BMI) in a Greek population. A novel pipeline for PRS derivation was used to analyze genetic data from a unified database of three cohorts of Greek adults. The pipeline spans various steps of the process, from iterative dataset splitting to training and test partitions, calculation of summary statistics and PRS extraction, up to PRS aggregation and stabilization, achieving higher evaluation metrics. Using data from 2185 participants, implementation of the pipeline enabled consecutive repetitions in splitting training and testing samples and resulted in a 343-single nucleotide polymorphism PRS yielding an R2 = 0.3241 (beta = 1.011, p-value = 4 × 10−193) for BMI. PRS-included variants displayed a variety of associations with known traits (i.e., blood cell count, gut microbiome, lifestyle parameters). The proposed methodology led to creation of the first-ever PRS for BMI in Greek adults and aims at promoting a facilitating approach to reliable PRS development and integration in healthcare practice
Teriparatide Treatment in Patients with Pregnancy- and Lactation-Associated Osteoporosis
Pregnancy- and lactation-associated osteoporosis (PLO) is a rare
disease, presenting in most cases with severe back pain due to low
energy vertebral fractures (VFs). Our purpose was to assess the effect
of teriparatide (TPTD) vs. conventional management on areal bone mineral
density (aBMD) and trabecular bone score (TBS) in patients with PLO. A
multicenter retrospective cohort study concerning premenopausal women
with PLO. Nineteen women were treated with TPTD (20 mu g/day) (group A)
plus calcium and vitamin D and eight women with calcium and vitamin D
only (group B) for up to 24 months. The primary end-point was between
group differences in lumbar spine (LS) and total hip (TH) aBMD, and TBS
at 12 and 24 months. Patients in group A had sustained a median of 4.0
VFs (3-9) vs. 2.5 VFs (1-10) in group B (p = 0.02). At 12 months,
patients on TPTD vs. controls achieved a mean aBMD increase of 20.9 +/-
11.9% vs. 6.2 +/- 4.8% at the LS (p < 0.001), 10.0 +/- 11.6% vs. 5.8
+/- 2.8% at the TH (p = 0.43), and 6.7 +/- 6.9% vs. 0.9 +/- 3.7% in
TBS (p = 0.09), respectively. At 24 months, seven patients on TPTD and
six controls achieved a mean LS aBMD increase of 32.9 +/- 13.4% vs.
12.2 +/- 4.2% (p = 0.001). P1NP levels during the first month of TPTD
treatment were positively correlated with the 1-year LS aBMD change (r =
0.68, p = 0.03). No new clinical fractures occurred while on-treatment.
In patients with PLO, TPTD treatment resulted in significantly greater
increases in LS aBMD compared with calcium and vitamin D supplementation
at 12 and 24 months
S1 Guidelines on Bone Impairment in Spinal Cord Injury
During the acute and chronic phase of spinal cord injury (SCI) bone
turnover and structure are affected. Bone mineral density of lower limbs
is decreased up to 28%-50% below that of age-matched peers at 12-18 mo
post injury. Coexisting secondary etiologies of osteoporosis may be
present, and during ageing additional loss of bone occurs. All these
compose a complex canvas of bone impairment after spinal cord injury and
make the therapeutical approach challenging. The risk of fragility
fractures is increased after the 2nd decade post SCI affecting the
functionality and quality of life of individuals with SCI. Diagnostic
flaws, lack of a ranking system to categorize the degree of bone
impairment similar to the one of World Health Organization, and
evidence-based clinical guidelines for management in SCI requires
interdisciplinary cooperation and appropriate planning of future
research and interventions. Spinal Cord Section of Hellenic Society of
Physical Rehabilitation Medicine convened an expert panel working group
on bone and spinal cord injury at the Pan-Hellenic Congress 2018 of PRM
in Athens Greece, to establish an evidence-based position statement for
bone loss in individuals with SCI of traumatic or non-traumatic
etiology. This was reviewed by an International Task Force and used to
create S1 Guidelines. This first version S1 guideline will work towards
to provide help with prophylactic basic osteoporosis therapy diagnostic
and therapeutic decisions in acute and chronic phase and rehabilitation
countermeasures against osteoporosis related with spinal cord injury