Dynamic not isometric training blunts osteo-renal disease by the sclerostin/FGF23/Klotho axis in maintenance hemodialysis patients: a randomized clinical trial

2020 ◽  
Author(s):  
Rodrigo V.P. Neves ◽  
Hugo Luca Corrêa ◽  
Lysleine Alves de Deus ◽  
Andrea Lucena Reis ◽  
Michel Kendy Souza ◽  
...  
Keyword(s):  
Body Mass ◽  
Bone Markers ◽  
Training Session ◽  
Maintenance Hemodialysis ◽  
Dynamic Resistance ◽  
Clinical Effects ◽  
Mineral Density ◽  
Group 14 ◽  
Dialysis Adequacy ◽  
Osteogenic Factors

This study compared the effectiveness of dynamic resistance training (DRT) versus isometric RT (IRT) on osteogenesis and hormonal mechanisms involved in maintenance hemodialysis (MHD) patients. One hundred and ninety-three MHD patients were randomized into three groups: control (CTL; n=60), DRT (n=66), and IRT (n=67). A first visit was required for an anamnesis to evaluate the number of medications, biochemical and anthropometric measurements (dialysis adequacy, creatinine, urea, body mass, height, and body mass index). Grip strength, bone mineral density (BMD), and renal-bone markers were assessed pre- and post-protocol. The DRT and IRT training was six months with a frequency of three times per week, on alternate days. Each training session consisted of 3 sets of 8 to 12 repetitions at lower and moderate intensities. Both training sessions were prescribed approximately one-hour prior to dialysis. Statistical significances were adopted with p<0.05. There was a greater dropout in the IRT group (24%) as compared with the DRT group (14%), which in turn had less adverse clinical effects (67%, 24%, 61% for CTL, DRT, IRT, respectively). DRT promoted gains in BMD in different body locations, in addition to increasing pro-osteogenic factors (Klotho and calcitriol), and reducing those related to bone loss, such as sclerostin, FGF23, and PTH. There was an improvement in Ca × PO43 for DRT, while these benefits did not occur in the IRT group (p<0.05). These novel findings suggest that the DRT generates biopositive adaptations in bone tissue in MHD and can be used as a non-pharmacological strategy to improve BMD.

scholarly journals Serum Osteoprotegerin Level Is Negatively Associated with Bone Mineral Density in Patients Undergoing Maintenance Hemodialysis

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 762
Author(s):  
Chia-Wen Lu ◽  
Chih-Hsien Wang ◽  
Bang-Gee Hsu ◽  
Jen-Pi Tsai
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Body Mass ◽  
Bone Mineral ◽  
Reduction Rate ◽  
Maintenance Hemodialysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Stepwise Logistic Regression ◽  
Mineral Density ◽  
Potential Biomarker

Background and Objectives: Osteoprotegerin (OPG), a potent osteoclast activation inhibitor, decreases bone resorption and plays a role in mediating bone mineral density (BMD). Our aim was to evaluate the relationship between BMD and serum OPG in maintenance hemodialysis (MHD) patients. Materials and Methods: Fasting blood samples were obtained from 75 MHD patients. BMD was measured by dual-energy X-ray absorptiometry in lumbar vertebrae (L2–L4). The WHO classification criteria were applied to define osteopenia and osteoporosis. A commercial enzyme-linked immunosorbent assay was used to measure serum OPG values. Results: Among all MHD patients, seven (9.3%) and 20 patients (26.7%) were defined as osteoporosis and osteopenia, respectively. Female patients had lower lumbar BMD than males (p = 0.002). Older age (p = 0.023), increased serum OPG (p < 0.001) urea reduction rate (p = 0.021), Kt/V (p = 0.027), and decreased body mass index (p = 0.006) and triglycerides (p = 0.020) were significantly different between the normal, osteopenia, and osteoporosis groups. Lumbar spine BMD was positively correlated with body mass index (BMI) (p < 0.001) but negatively correlated with OPG (p < 0.001) and age (p = 0.003). After grouping patients into T scores < −1 and < −2.5, female sex and OPG (adjusted odds ratio [aOR] 1.022, 95% confidence interval [C.I.] 1.011–1.034, p < 0.001) were predictors of T scores < −1, whereas only OPG was predictive of T scores < −2.5 (aOR 1.015, 95% C.I. 1.005–1.026, p = 0.004) by multivariate stepwise logistic regression analysis. The areas under the curve for predicting T scores < −1 or < −2.5 were 0.920 (95% C.I. 0.834–0.970, p < 0.001) and 0.958 (95% C.I. 0.885–0.991, p < 0.001), respectively. Conclusions: Increased serum OPG negatively correlated with lumbar BMD and could be a potential biomarker predictive of osteoporosis in MHD patients.

Effect Of Body Mass Index On Bone Mineral Density Is Age-specific

2021 ◽  
Author(s):  
Lavanya Cherukuri ◽  
April Kinninger ◽  
Divya Birudaraju ◽  
Suvasini Lakshmanan ◽  
Dong Li ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Density

Decreased Bone Density in Adolescent Girls With Anorexia Nervosa

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 440-447 ◽  
Author(s):  
Laura K. Bachrach ◽  
David Guido ◽  
Debra Katzman ◽  
Iris F. Litt ◽  
Robert Marcus
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Bone Density ◽  
Bone Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Whole Body ◽  
Mineral Density ◽  
Control Subjects

Osteoporosis develops in women with chronic anorexia nervosa. To determine whether bone mass is reduced in younger patients as well, bone density was studied in a group of adolescent patients with anorexia nervosa. With single- and dual-photon absorptiometry, a comparison was made of bone mineral density of midradius, lumbar spine, and whole body in 18 girls (12 to 20 years of age) with anorexia nervosa and 25 healthy control subjects of comparable age. Patients had significantly lower lumbar vertebral bone density than did control subjects (0.830 ± 0.140 vs 1.054 ± 0.139 g/cm2) and significantly lower whole body bone mass (0.700 ± 0.130 vs 0.955 ± 0.130 g/cm2). Midradius bone density was not significantly reduced. Of 18 patients, 12 had bone density greater than 2 standard deviations less than normal values for age. The diagnosis of anorexia nervosa had been made less than 1 year earlier for half of these girls. Body mass index correlated significantly with bone mass in girls who were not anorexic (P &lt; .05, .005, and .0001 for lumbar, radius, and whole body, respectively). Bone mineral correlated significantly with body mass index in patients with anorexia nervosa as well. In addition, age at onset and duration of anorexia nervosa, but not calcium intake, activity level, or duration of amenorrhea correlated significantly with bone mineral density. It was concluded that important deficits of bone mass occur as a frequent and often early complication of anorexia nervosa in adolescence. Whole body is considerably more sensitive than midradius bone density as a measure of cortical bone loss in this illness. Low body mass index is an important predictor of this reduction in bone mass.

Compromised Volumetric Bone Density and Microarchitecture in men with Congenital Hypogonadotropic Hypogonadism

2021 ◽  
Author(s):  
Agnès Ostertag ◽  
Georgios E Papadakis ◽  
Corinne Collet ◽  
Severine Trabado ◽  
Luigi Maione ◽  
...  
Keyword(s):  
Bone Markers ◽  
Bone Structure ◽  
Hypogonadotropic Hypogonadism ◽  
Quantitative Computed Tomography ◽  
Hormonal Treatment ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Trabecular Thickness ◽  
Congenital Hypogonadotropic Hypogonadism

Abstract Context Men with Congenital Hypogonadotropic Hypogonadism (CHH) and Kallmann syndrome (KS) have both low circulating testosterone and estradiol levels. Whether bone structure is affected remains unknown. Objective To characterize bone geometry, volumetric density and microarchitecture in CHH/KS. Design Cross-sectional study. Setting One tertiary academic French center. Patients and Controls 51 genotyped CHH/KS patients and 40 healthy volunteers were included. Ninety-eight percent of CHH/KS men had received testosterone and/or combined gonadotropins. Intervention(s) High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT), Dual X-ray absorptiometry (DXA) and measurement of serum bone markers. Main Outcome Volumetric bone mineral density (vBMD), cortical and trabecular microarchitecture. Results CHH and controls did not differ for age, BMI, vitamin D and PTH levels. Despite long-term hormonal treatment (10.8 ± 6.8 years), DXA showed lower areal BMD in CHH/KS at lumbar spine, total hip, femoral neck and distal radius. Consistent with persistently higher serum bone markers, HR-pQCT revealed lower cortical and trabecular vBMD as well as cortical thickness at the tibia and the radius. CHH/KS men had altered trabecular microarchitecture with a predominant decrease of trabecular thickness. Moreover, CHH/KS men exhibited lower cortical bone area, whereas total and trabecular areas were higher only at the tibia. Earlier treatment onset (before the age of 19 years) conferred a significant advantage for trabecular bone volume/tissue volume and trabecular vBMD at the tibia. Conclusion Both vBMD and bone microarchitecture remain impaired in CHH/KS men despite long-term hormonal treatment. Treatment initiation during adolescence is associated with enhanced trabecular outcomes, highlighting the importance of early diagnosis.

scholarly journals Lean Body Mass in the Prediction of Bone Mineral Density in Postmenopausal Women

2018 ◽  
Vol 7 (1) ◽  
pp. 150-158 ◽  
Author(s):  
Bolaji Lilian Ilesanmi-Oyelere ◽  
Jane Coad ◽  
Nicole Roy ◽  
Marlena Cathorina Kruger
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Density

scholarly journals Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density

2019 ◽  
Vol 29 (2) ◽  
pp. 135-143 ◽  
Author(s):  
J. Rodríguez-Carrio ◽  
A. Martínez-Zapico ◽  
I. Cabezas-Rodríguez ◽  
L. Benavente ◽  
Á.I. Pérez-Álvarez ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Subclinical Cardiovascular Disease

scholarly journals Hemodialysis Experience of a Large Group of Syrian Refugees in Turkey: All Patients Deserve Effective Treatment

2019 ◽  
Vol 44 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Meltem Gursu ◽  
Mustafa Arici ◽  
Kenan Ates ◽  
Rumeyza Kazancioglu ◽  
Pinar Guneser Yavas ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Maintenance Hemodialysis ◽  
Syrian Refugees ◽  
Dialysis Adequacy ◽  
Limited Experience ◽  
Dialysis Vintage ◽  
One Year ◽  
Age Range ◽  
Annual Mortality

Background/Aims: Refugee dialysis is a worldwide growing dilemma with limited experience. This report presents the largest hemodialysis (HD) patient registry data of Syrian refugees in Turkey. Methods: Demographic, clinical, laboratory, and dialysis practice data of 345 Syrian HD patients during one year were collected and analyzed. Results: There were 345 prevalent Syrian HD patients at the end of 2016. Majority of the patients were placed in the Southeast Anatolian Region. The majority of the patients (74.8%) are in the age range of 20-64 years. Dialysis vintage in Turkey is less than 12 months in 20.8% and less than one month in 29.3% of patients. The vascular access was arteriovenous fistula in the majority of patients (72.5%). Kt/V is over 1.7 in 57%, serum albumin is above 35 g/L in 65.8% and hemoglobin level is more than 100 g/L in %65.2 of the patients. The ratio of patients with serum phosphorus level of 1.13-1.77 mmol/L was 56.2%. Twenty Syrian HD patients (14 male, 6 female) died within the year 2016 and annual mortality rate was 5.7%. Conclusion: This study with the largest number of Syrian refugees undergoing maintenance hemodialysis showed good dialysis practices, acceptable values for dialysis adequacy and biochemical parameters along with lower mortality compared to native HD population of Turkey. Longer follow up will enrich the knowledge related to care of refugee population in all over the world.

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