scholarly journals Bone Mineral Densities in Individuals with Gilbert’s Syndrome: A Cross-Sectional, Case-Control Pilot Study

2009 ◽  
Vol 23 (6) ◽  
pp. 431-436 ◽  
Author(s):  
GY Minuk ◽  
R Greenberg ◽  
J Uhanova ◽  
K Hawkins ◽  
WD Leslie
Keyword(s):  
Pilot Study ◽  
Bone Mineral ◽  
Case Control ◽  
Unconjugated Bilirubin ◽  
Cross Sectional ◽  
Gilbert’S Syndrome ◽  
Control Subjects ◽  
Gilbert's Syndrome ◽  
Z Scores ◽  
Total Body

BACKGROUND: Unconjugated bilirubin inhibits osteoblastic proliferative activity in vitro, raising the possibility that Gilbert’s syndrome (GS) patients are at increased risk of osteoporosis.OBJECTIVES: To compare bone mineral density (BMD), serum parathyroid hormone (PTH), C-telopeptide (CTX) and osteocalcin levels in GS subjects versus matched controls in a cross-sectional, case-control study.METHODS: BMD determinations were obtained with central dual-energy x-ray absorptiometry. Serum PTH, CTX and osteocalcin levels were measured by enzyme immunoassay.RESULTS: A total of 17 GS and 30 control subjects were studied. Overall, there were no significant differences in BMD, PTH, CTX or osteocalcin levels between the two groups. However, when older (older than 40 years of age) and younger (40 years of age and younger) cohorts were considered separately, the older GS cohort had significantly decreased total hip BMD, T scores and Z scores, and femoral neck BMD, T scores and Z scores (P<0.005 for each parameter, respectively) compared with older control subjects. Serum osteocalcin levels were lower in the older versus younger GS cohort (P=0.006). An inverse correlation existed between all subjects’ serum unconjugated bilirubin levels and total body BMD determinations (r=−0.42; P=0.04). On univariate analysis, the association between serum unconjugated bilirubin and total body BMD was not significant (P=0.066), nor was serum unconjugated bilirubin identified as a risk factor for low BMD when entered into multivariate analyses.CONCLUSIONS: The results of the present pilot study warrant further research involving larger numbers of subjects and longitudinal measurements to determine whether GS is associated with decreased BMD, particularly in older GS subjects.

scholarly journals The Positive Relationship between Moderate-to-Vigorous Physical Activity and Bone Mineral Content Is Not Mediated by Free Leptin Index in Prepubertal Children: The PANIC Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5365
Author(s):  
Annie M. Constable ◽  
Josie E. Porter ◽  
Danielle Benger ◽  
Dimitris Vlachopoulos ◽  
Alan R. Barker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Content ◽  
Bone Mineral ◽  
Mineral Content ◽  
Vigorous Physical Activity ◽  
Normal Weight ◽  
Cross Sectional ◽  
Prepubertal Children ◽  
Total Body ◽  
The Relationship

Purpose: Moderate-to-vigorous physical activity (MVPA) positively influences bone mineral content (BMC) in prepubertal children, but it is unknown whether this relationship is partially mediated by free leptin index. The aim of this study was to examine whether the relationship between MVPA and total body less head (TBLH) BMC is mediated or moderated by free leptin index in prepubertal children. Methods: We performed a cross-sectional analysis on 401 children (194 girls) from baseline examinations of the Physical Activity and Nutrition in Childhood Study. We applied the four-way decomposition mediation analysis method to assess whether free leptin index, measured from fasted blood samples, mediated the relationship between accelerometer-measured MVPA and TBLH BMC measured by dual-energy X-ray absorptiometry. Results: MVPA had a positive controlled direct effect on TBLH BMC in girls and boys (β = 0.010 to 0.011, p < 0.05). There was no mediation or interaction between MVPA, free leptin index and TBLH BMC in girls or boys (β = −0.000 to 0.001, p > 0.05). Conclusion: Our study indicates that MVPA positively influences TBLH BMC through pathways not related to free leptin index in predominantly normal-weight prepubertal children, likely primarily through mechanical loading. The relationships between MVPA, free leptin index and TBLH BMC may be influenced by other factors such as pubertal status and adiposity, so it is unknown whether these observations extend to overweight and obese children at different stages of puberty.

How dangerous Gilbert's syndrome is

2021 ◽  
pp. 8-12
Author(s):  
Roman Petrovich Stepchenkov
Keyword(s):  
Pathological Condition ◽  
Inhibitory Effect ◽  
Unconjugated Bilirubin ◽  
Breakdown Product ◽  
Gilbert’S Syndrome ◽  
Gilbert's Syndrome ◽  
Bilirubin Metabolism ◽  
Gallbladder Dyskinesia ◽  
Conjugation Process ◽  
Loss Of Appetite

Gilbert's syndrome is a benign (functional) hyperbilirubinemia, which is based on a hereditary disorder of bilirubin metabolism, as a result of which the concentration of unbound bilirubin can increase several times. Bilirubin, being a breakdown product of hemoglobin, circulates through the bloodstream, combining with albumin molecules. Such bilirubin is called indirect. In the endoplasmic reticulum, it is conjugated; the enzyme glucuronyltransferase is responsible for this process. In Gilbert's syndrome, as a result of insufficient production of this enzyme, the conjugation process is disrupted, and, as a result, the concentration of unconjugated bilirubin increases. According to statistics, this pathological condition is observed in about 5 % of Russians. This syndrome was first described in 1901 by the French physician Augustin Nicolas Gilbert, and was subsequently named after him. The literature also contains references to this syndrome, described as «constitutional hepatic dysfunction», «familial non-hemolytic hyperbilirubinemia», «idiopathic non-conjugated hyperbilirubinemia». Gilbert's syndrome is inherited in an autosomal recessive manner; men get ill 3–4 times more often than women. A number of scientists associate this with a possible inhibitory effect of testosterone on the enzyme UDP-GT1, which breaks down bilirubin. Clinically, Gilbert's syndrome is manifested by episodes of jaundice caused by an increase in the level of unconjugated bilirubin in the blood serum. Against the background of icterus of the sclera and skin, there is increased fatigue, the appearance of a feeling of bitterness in the mouth, loss of appetite, nausea, and sometimes vomiting. The association of Gilbert's syndrome with functional disorders of the biliary tract, in particular, with gallbladder dyskinesia, is often noted.

scholarly journals Equivalence of information from single frequency v. bioimpedance spectroscopy in bodybuilders

2007 ◽  
Vol 97 (1) ◽  
pp. 182-192 ◽  
Author(s):  
Antonio Piccoli ◽  
Giordano Pastori ◽  
Marta Codognotto ◽  
Antonio Paoli
Keyword(s):  
Bioelectrical Impedance ◽  
Single Frequency ◽  
Muscle Fibres ◽  
Bioimpedance Spectroscopy ◽  
Cross Sectional ◽  
Low Frequencies ◽  
Common Path ◽  
Control Subjects ◽  
Current Path ◽  
Total Body

In bioelectrical impedance spectroscopy (BIS), it is assumed that the current path is only extracellular at the lowest frequencies and that it is both extra- and intracellular at the highest frequencies. We tested validity of BIS assumptions in bodybuilders who have an increased intracellular volume due to hypertrophy of muscle fibres. The study was observational cross-sectional in a study group of thirty professional bodybuilders compared with thirty control subjects. Resistance (R) and reactance (Xc) vector components fitting the Cole's arc with BIS (SFB3 analyser) were compared with components at 50 kHz frequency. The average Cole's arc in bodybuilders was significantly smaller and shifted to the left in the R–Xc plane (both R and Xc values were smaller at any individual frequency). The ratio of Xc at 5 kHz and Xc at the characteristic frequency was 70 % in bodybuilders and 64 % in control subjects, indicating a huge intracellular flow of the electric current at low frequencies in both groups (expected ratio close to 0 if the current path was extracellular). As a consequence of a common path, the correlation coefficient between R values at 50 kHz and at other frequencies (from 0 to infinity) was 0·94 to 1·00. The correlation between total body water estimated with BIS or with R at 50 kHz was 0·98. Hence, there was equivalence between information provided by the vector components R and Xc at 50 kHz and that provided by 496 correlated vectors that were measured with BIS.

scholarly journals Unconjugated Bilirubin and an Increased Proportion of Bilirubin Monoconjugates in the Bile of Patients with Gilbert's Syndrome and Crigler-Najjar Disease

1977 ◽  
Vol 60 (5) ◽  
pp. 970-979 ◽  
Author(s):  
Johan Fevery ◽  
Norbert Blanckaert ◽  
Karel P. M. Heirwegh ◽  
Anne-Marie Préaux ◽  
Pierre Berthelot
Keyword(s):  
Unconjugated Bilirubin ◽  
Gilbert’S Syndrome ◽  
Gilbert's Syndrome

scholarly journals Skeletal Status, Body Composition, and Glycaemic Control in Adolescents with Type 1 Diabetes Mellitus

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Elzbieta Wierzbicka ◽  
Anna Swiercz ◽  
Pawel Pludowski ◽  
Maciej Jaworski ◽  
Mieczyslaw Szalecki
Keyword(s):  
Diabetes Mellitus ◽  
Body Composition ◽  
Glycaemic Control ◽  
Bone Mineral ◽  
Z Scores ◽  
Total Body ◽  
Total Body Bone Mineral ◽  
Skeletal Status ◽  
Body Bone ◽  
Hba1c Levels

Background. Disturbed bone turnover, osteoporosis, and increased fracture risk are late complications of insulin-dependent diabetes mellitus. Little is known about how far and to what extent can glycaemic control of type 1 diabetes mellitus (T1DM) prevent disturbances of bone health and body composition during the growth and maturation period. Objective. The aim of this cross-sectional study was to compare the skeletal status outcomes and body composition between patients stratified by glycaemic control (1-year HbA1c levels) into well- and poorly-controlled subgroups in a population of T1DM adolescents, that is, <8% and ≥8%, respectively. Subjects and Methods. Skeletal status and body composition were evaluated in 60 adolescents with T1DM (53.3% female; mean aged: 15.1 ± 1.9 years; disease duration: 5.1 ± 3.9 years) using dual energy X-ray absorptiometry (GE Prodigy). The results were compared to age- and sex-adjusted reference values for healthy controls. The calculated Z-scores of different metabolic control subgroups were compared. Clinical data was also assessed. Results. As evidenced by Z-scores, patients with T1DM revealed a significantly lower TBBMD (total body bone mineral density), TBBMC (total body bone mineral content), S24BMD (bone mineral density of lumbar spine L2–L4), and TBBMC/LBM ratio (total body bone mineral content/lean body mass), but higher FM (fat mass) and FM/LBM ratio (fat mass/lean body mass) values compared to an age- and sex-adjusted general population. The subset (43.3% patients) with poor metabolic control (HbA1c ≥ 8%) had lower TBBMD, TBBMC, and LBM compared to respective values noted in the HbA1c < 8% group, after adjusting for confounders (mean Z-scores: −0.74 vs. −0.10, p=0.037; −0.67 vs. +0.01, p=0.026; and −0.45 vs. +0.20, p=0.043, respectively). Additionally, we found a significant difference in the TBBMC/LBM ratio (relative bone strength index) between the metabolic groups (−0.58 vs. −0.07; p=0.021). A statistically significant negative correlation between 1-year HbA1c levels and Z-scores of TBBMD, TBBMC, and LBM was also observed. In patients with longer disease duration, a significant negative correlation was established only for TBBMD, after adjusting for confounders. The relationships between densitometric values and age at onset of T1DM and sex were not significant and showed no relation to any of the analysed parameters of the disease course. Conclusion. Findings from this study of adolescents with T1DM indicate that the lower Z-scores of TBBMD, TBBMC, and LBM as well as the TBBMC/LBM ratio are associated with increased HbA1c levels. Their recognition can be crucial in directing strategies to optimise metabolic control and improve diabetes management for bone development and maintenance in adolescents with T1DM.

scholarly journals Statin Intolerance in a Patient with Gilberts Syndrome and Hypercholesterolemia

2016 ◽  
Vol 3 (01) ◽  
pp. e8-e10 ◽  
Author(s):  
I. Jialal ◽  
D. Siegel
Keyword(s):  
Ldl Cholesterol ◽  
Unconjugated Bilirubin ◽  
Familial Combined Hyperlipidemia ◽  
Statin Intolerance ◽  
Gilbert’S Syndrome ◽  
Cholesterol Levels ◽  
Gilbert's Syndrome ◽  
Cytochrome 450 ◽  
Statin Drugs

Abstract Background: Statin intolerance especially myalgias can be a serious problem. Whilst it is well know that drugs that compete for Cytochrome 450 system can result in myalgias there is sparse data on the role of glucuronidation of statins contributing to statin intolerance We report on a 60 year old male with Hypercholesterolemia (HC) who was referred for management of his HC since he had statin intolerance manifesting as myalgias and was shown to have Gilbert’s Syndrome. Case Report: Investigation of this patient revealed he had Familial Combined Hyperlipidemia with a LDL-cholesterol of 189 mg/dl. He was also diagnosed with Gilbert’s Syndrome since he had elevated unconjugated bilirubin with no evidence of liver disease or hemolysis. The combination of Niacin, Cholestyramine and ezetimibe resulted in a successful decrease in his LDL-cholesterol to 114 mg/dl. Discussion: We believe that his Gilberts Syndrome resulted in an impairment in glucuronidation of statin drugs resulting in an increase in free drug levels and myalgias. We caution that clinicians should consider this possibility when confronted with a patient with both isolated elevations of unconjugated bilirubin and increase LDL-cholesterol levels before commencing statin therapy.

scholarly journals When Should Clinicians Worry about Bone Density for Patients with Epilepsy?

2008 ◽  
Vol 8 (6) ◽  
pp. 148-149
Author(s):  
Bassel W. Abou-Khalil
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Healthy Children ◽  
Z Score ◽  
Mineral Density ◽  
Progressive Reduction ◽  
Cross Sectional ◽  
Antiepileptic Medication ◽  
Total Body ◽  
Patients With Epilepsy

Progressive Bone Deficit in Epilepsy. Sheth RD, Binkley N, Hermann BP. Neurology 2008;70(3):170–176. OBJECTIVE: Chronic treatment with antiepileptic medication is associated with reduced bone mineral density (BMD), which may underlie the two-to sixfold increase in fracture rates observed in patients with epilepsy. The objective was to determine the timing of the BMD deficit in ambulatory children with epilepsy. METHODS: A cross-sectional evaluation was conducted in 82 ambulatory children aged 6 to 18 years (12.4 ± 3.3 years) with epilepsy for <1 year (n = 18), 1 to 5 years (n = 37), and 6 or more years (n = 27). Controls were 32 healthy children aged 12.8 ± 2.6 years. Age- and sex-corrected total body BMD Z-score was measured. RESULTS: Total BMD Z-score was lower in children with epilepsy (0.10 ± 0.96; CI = −0.08, 0.34) compared to controls (0.57 ± 0.74; CI = 0.3, 0.84; p = 0.03). Increasing duration of epilepsy was associated with a progressive reduction in BMD compared to controls (Spearman r = −0.197; p = 0.03). Compared to controls, those with epilepsy for 1 to 5 years had a mean BMD Z-score of 0.13 ± 0.78 (CI = −0.13, 0.39; p = 0.04) and in those treated for 6 or more years BMD was 0.06 ± 1.11 (CI = −0.38, 0.5; p = 0.04). For those with epilepsy for <1 year BMD was 0.23 ±1.1 (CI = −0.31, 0.77; p = 0.21). CONCLUSIONS: Children treated for epilepsy sustain significant bone mineral density (BMD) deficit compared to controls during the initial 1 to 5 years of treatment which progressively worsens thereafter. This progressive BMD deficit may be a contributing factor to the increased fracture risk observed in patients with epilepsy and may accelerate aging-related osteoporosis.

scholarly journals Associations of Polyunsaturated Fatty Acid Intake with Bone Mineral Density in Postmenopausal Women

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Margaret Harris ◽  
Vanessa Farrell ◽  
Linda Houtkooper ◽  
Scott Going ◽  
Timothy Lohman
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Secondary Analysis ◽  
Mineral Density ◽  
Dietary Pufa ◽  
Cross Sectional ◽  
Pufa Intake ◽  
Total Body

A secondary analysis of cross-sectional data was analyzed from 6 cohorts (Fall 1995–Fall 1997) of postmenopausal women (n=266;56.6±4.7years) participating in the Bone Estrogen Strength Training (BEST) study (a 12-month, block-randomized, clinical trial). Bone mineral density (BMD) was measured at femur neck and trochanter, lumbar spine (L2–L4), and total body BMD using dual-energy X-ray absorptiometry (DXA). Mean dietary polyunsaturated fatty acids (PUFAs) intakes were assessed using 8 days of diet records. Multiple linear regression was used to examine associations between dietary PUFAs and BMD. Covariates included in the models were total energy intake, body weight at year 1, years after menopause, exercise, use of hormone therapy (HT), total calcium, and total iron intakes. In the total sample, lumbar spine and total body BMD had significant negative associations with dietary PUFA intake atP<0.05. In the non-HT group, no significant associations between dietary PUFA intake and BMD were seen. In the HT group, significant inverse associations with dietary PUFA intake were seen in the spine, total body, and Ward’s triangle BMD, suggesting that HT may influence PUFA associations with BMD. This study is registered with clinicaltrials.gov, identifier:NCT00000399.

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