Influence of Sarcopenia on Bone Health Parameters in a Group of Elderly Lebanese Men

International audienceSarcopenia is a disease characterized by the loss of muscle mass and strength. The aim of the current study was to explore the influence of sarcopenia on bone health parameters in a group of elderly Lebanese men. To do so, we compared bone health parameters (Bone Mineral Content (BMC), Bone Mineral Density (BMD) and femoral neck geometry indices) in a group of elderly men with sarcopenia and a group of elderly men with normal Skeletal Muscle mass Index (SMI). 23 sarcopenic men (SMI 7 kg/m 2) participated in our study. Body composition and bone variables were measured by Dual-energy X-ray Absorptiometry (DXA). DXA measurements were completed for the Whole Body (WB), Lumbar spine (L1-L4), Total Hip (TH) and Femoral Neck (FN). Hip geometry parameters including Cross-Sectional Area (CSA), Cross-Sectional Moment of Inertia (CSMI), section modulus (Z), Strength Index (SI) and Buckling Ratio (BR) were derived by DXA. Age and height were not significantly different between the two groups. Weight, Body Mass Index (BMI), lean mass, fat mass, appendicular lean mass, SMI, WB BMC, TH BMD, FN BMD, CSA, CSMI and Z were significantly higher in non-sarcopenic men compared to sarcopenic men. In the whole population , lean mass was the strongest determinant of bone health parameters. After adjusting for lean mass, there were no significant differences regarding bone health parameters between the two groups. In conclusion, the present study suggests that sarcopenia negatively influences bone health parameters in elderly Lebanese men

Relationships Between Muscular Power and Bone Health Parameters in a Group of Young Lebanese Adults

International audienceThe aim of the current study was to explore the relationships between lower limb muscular power and bone variables (bone mineral content (BMC), bone mineral density (BMD), hip geometry indices and trabecular bone score (TBS)) in a group of young Lebanese adults. 29 young Lebanese men and 31 young Lebanese women whose ages range between 18 and 32 years participated in this study. Body weight and height were measured, and body mass index (BMI) was calculated. Body composition and bone variables were measured by DXA. DXA measurements were completed for the whole body (WB), lumbar spine (L2–L4), total hip (TH) and femoral neck (FN). Hip geometry parameters including cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (Z), strength index (SI) and buckling ratio (BR) were derived by DXA. Trabecular bone score was also derived by DXA. Horizontal jump (HJ), vertical jump, vertical jump maximum power, force-velocity maximum power and 20-m sprint performance were measured or calculated by using validated fitness tests. In men, fat mass percentage was negatively correlated to TH BMD, FN BMD, CSA, CSMI, Z and SI. In women, weight, BMI, lean mass and fat mass were positively correlated to WB BMC, CSMI and Z. Regarding physical performance variables, horizontal jump performance and force-velocity maximal power were positively correlated to TH BMD, FN BMD, CSA and Z in men. Vertical jump maximal power was positively correlated to WB BMC in women. 20-m sprint performance was negatively correlated to FN BMD, CSA, Z and SI in men. In conclusion, the current study suggests that force-velocity maximum power is a positive determinant of BMD and hip geometry indices in men but not in women

Global vitamin D status and determinants of hypovitaminosis D

The aim of the study was to compare the structural and functional parameters of the myocardium in different genotypes of polymorphic markers BsmI (B/b) (rs1544410) and FokI (F/f) (rs2228570) of the vitamin D receptor gene (VDR) in individuals with cardiovascular diseases (CVD). Materials and Methods. We examined 198 patients with CVD. BsmI and FokI of the VDR gene were determined by the polymerase chain reaction. The blood levels of parathyroid hormone, 25(OH)D total, endothelin-1, plasma renin activity were revealed by the method of enzyme immunoassay. The calcium and phosphorus level in the blood was defined by the colorimetric method. Echocardiography was performed by GE Logic P5 Premium (Korea) with a phased sector sensor with a frequency of 2–4 MHz in the modes M-, B-, PW, CW. Results. All participants were divided into groups according to genotypes of FokI and BsmI of the VDR gene. For each polymorphism, the groups were comparable in age, CVD, blood pressure, heart rate, body mass index and levels of the estimated biomarkers. Significant differences (p < 0.05) in the sizes of the aorta and the left atrium (LA), in the sizes and volumes of the left ventricle (LV) and its walls, the diameter of the LV outlet tract and the ejection fraction between the groups with the genotypes of FF and ff were established. In addition, differences (p < 0.05) were found in the aorta size, LA and interventricular septum between the groups with the genotypes of ff and Ff. According to the genotypes of BsmI of the VDR gene, the groups did not differ significantly in the estimated structural and functional parameters of the myocardium and aorta. Hypertrophy of the LV is diagnosed in 78.6 % of participants. Conclusions. Polymorphism of FokI, but not of BsmI of the VDR gene is associated with structural and functional parameters of the myocardium and aorta in individuals with CVD in the Grodno region of Belarus. With the greatest frequency, LV hypertrophy occurs with Ff (37.9 %) and Bb (33.8 %).Цель исследования – сравнение структурно-функциональных показателей миокарда при разных генотипах полиморфных маркеров BsmI (B/b) (rs1544410) и FokI (F/f) (rs2228570) гена рецептора витамина D (VDR) у лиц с сердечно-сосудистыми заболеваниями (ССЗ). Материалы и методы. Обследовано 198 пациентов с ССЗ. Определение BsmI и FokI гена VDR проводили методом полимеразной цепной реакции. Содержание в крови паратиреоидного гормона, 25(OH)D общего, эндотелина-1, активность ренина плазмы определяли методом иммунофер- ментного анализа. Определение в крови уровня кальция и фосфора проводилось колориметрическим методом. Эхо- кардиография выполнялась аппаратом GE Logic P5 Premium (Корея) фазированным секторным датчиком с частотой 2–4 мГц в режимах М-, В-, PW, CW. Результаты. Все обследованные были разделены на группы по генотипам FokI и BsmI гена VDR. При каждом полиморфизме группы были сопоставимы по возрасту, ССЗ, значениям артериального давления, частоте сердечных сокращений, индексу массы тела и уровням оцененных биомаркеров. Установлены достоверные (p < 0,05) отличия по размерам отделов аорты, левого предсердия (ЛП), размерам и объемам левого желудочка (ЛЖ) и его стенок, диаметром выходного тракта ЛЖ и фракцией выброса между группами с генотипом FF и ff. Кроме того, установлены отличия (p < 0,05) по размерам отделов аорты, ЛП и толщиной межжелудочковой перегородки между группами с генотипом ff и Ff. По генотипам BsmI гена VDR группы достоверно не отличались по оцененным структурно-функциональным показателям миокарда и аорты. Гипертрофия ЛЖ диагностирована у 78,6 % обследованных. Заключение. Полиморфизм FokI, но не BsmI гена VDR ассоциирован со структурно-функциональными показателями миокарда и аорты у лиц с ССЗ у жителей Гродненского региона Беларуси. С наибольшей частотой гипертрофия ЛЖ встречается при Ff (37,9 %) и Bb (33,8 %) генотипах.

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective

Postmenopausal osteoporosis and osteoporosis in elderly men are major health problems, with a significant medical and economic burden. Although osteopenia and osteoporosis are more common locally than in the West, fracture rates are generally less than in Western countries. Vitamin D deficiency is common in the region and contributes adversely to bone health. Vitamin D deficiency should be suspected and treated in all subjects with ostopenia or osteoporosis. The use of risk factors to determine fracture risk has been adopted by the World Health Organization and many international societies. Absolute fracture risk methodology improves the use of resources by targeting subjects at higher risk of fractures for screening and management. The King Faisal Specialist Hospital Osteoporosis Working Group recommends screening for women 65 years and older and for men 70 years and older. Younger subjects with clinical risk factors and persons with clinical evidence of osteoporosis or diseases leading to osteoporosis should also be screened. These guidelines provide recommendations for treatment for postmenopausal women and men older than 50 years presenting with osteoporotic fractures for persons having osteoporosis—after excluding secondary causes—or for persons having low bone mass and a high risk for fracture. The Working Group has suggested an algorithm to use at King Faisal Specialist Hospital that is based on the availability, cost, and level of evidence of various therapeutic modalities. Adequate calcium and vitamin D supplement are recommended for all. Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy. Alternatives to alendronate are raloxifene or strontium ranelate. Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures