scholarly journals Body composition and bone mineral density in women with Cushing's syndrome in remission and the association with common genetic variants influencing glucocorticoid sensitivity

2015 ◽  
Vol 172 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Oskar Ragnarsson ◽  
Camilla A M Glad ◽  
Ragnhildur Bergthorsdottir ◽  
Erik G Almqvist ◽  
Eva Ekerstad ◽  
...  

ObjectiveAdverse body compositional features and low bone mineral density (BMD) are the characteristic of patients with active Cushing's syndrome (CS). The aim of this study was to evaluate body composition and BMD in women with CS in long-term remission and the influence of polymorphisms in genes affecting glucocorticoid (GC) sensitivity on these end-points.Design, patients and methodsThis was a cross-sectional, case–controlled study, including 50 women previously treated for CS and 50 age and gender-matched controls. Median (interquartile range) remission time was 13 (5–19) years. Body composition and BMD were measured with dual-energy X-ray absorptiometry. Five polymorphisms in four genes associated with GC sensitivity were analysed using TaqMan or Sequenom single-nucleotide polymorphism genotyping.ResultsPatients with CS in remission had increased abdominal fat mass (P<0.01), whereas BMD was not significantly different at any site between patients and controls. In patients, the NR3C1 Bcl1 polymorphism was associated with reduced total (P<0.05) and femur neck BMD (P<0.05). The polymorphism rs1045642 in the ABCB1 gene was associated with increased abdominal fat mass (P<0.05) and decreased appendicular skeletal muscle mass (P<0.05). GC replacement was associated with reduced total BMD (P<0.01), BMD at lumbar spine (P<0.05) and increased abdominal fat (P<0.01).ConclusionOngoing GC replacement therapy together with polymorphisms in two genes related with GC sensitivity is associated with abdominal obesity and adverse skeletal health in patients with CS in long-term remission.

2006 ◽  
Vol 154 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Cybèle Kristo ◽  
Rune Jemtland ◽  
Thor Ueland ◽  
Kristin Godang ◽  
Jens Bollerslev

Objective: Endogenous Cushing’s syndrome (CS) is associated with bone loss and an increased risk of fractures. However, the long-term outcome of treatment on bone health has not been adequately clarified. Design: We followed 33 patients with active CS prospectively before and twice after treatment (mean follow-up 33 (n = 25) and 71 months (n = 18), respectively). The patients were compared to age-, sex- and body mass index (BMI)-matched controls, also followed longitudinally. Methods: Bone mineral indices (bone mineral density (BMD), bone mineral content (BMC) and bone area) were evaluated in the lumbar spine (LS), femoral neck (FN), and total body (TB) by dual-energy X-ray absorptiometry (DXA). Biochemical markers of bone turnover were assessed by serum levels of osteocalcin and C-terminal telopeptides of Type-1 collagen (CTX-1). Results: Mann–Whitney rank sum tests showed that BMD of the LS, FN and TB was reduced by 14.8% (P < 0.001), 15.7% (P < 0.001), and 9.2% (P < 0.001) in CS vs. controls at baseline, with markedly reduced serum osteocalcin (P = 0.014) and increased CTX-1 (P = 0.012) levels, but no correlation between markers. At first follow-up, BMD was increased in LS (7.9%, P < 0.001) and FN (3.5%, P = 0.003) compared to baseline. The time-dependent rise in BMD (LS (r = 0.59; P = 0.002) and FN (r = 0.52; P = 0.007); Spearman’s rank correlation), in CS was paralleled by increased osteocalcin (275%, P < 0.001) and correlation between biochemical markers (r = 0.92, P < 0.001; Pearson’s correlation). TB BMD did not increase significantly before the second follow-up, when BMD Z-scores were normalized in all three compartments. Conclusion: Our observations demonstrate restoration of coupled bone remodeling and normalization of bone mineral density in all measured skeletal compartments of treated CS patients after prolonged recovery, first significant in predominantly trabecular bone (i.e. lumbar spine).


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 493.2-493
Author(s):  
N. Toroptsova ◽  
O. Dobrovolskaya ◽  
A. Feklistov ◽  
O. Nikitinskaya ◽  
A. Efremova ◽  
...  

Background:The relationship between lean mass (LM), fat mass (FM) and bone mineral density (BMD) remains controversial. Some population studies have emphasized the positive association between them, while others have found an inverse relationship. RA patients are characterized by a decrease in muscle mass and an increase in fat mass. Such changes in body composition may be associated with low BMD.Objectives:To study the relationship between BMD, LM and FM in postmenopausal women with RA.Methods:68 postmenopausal women with RA (median age 59 [54; 63] years) were included in the study. BMD and body composition were evaluated using two-energy X-ray absorptiometry. Correlation analysis between body composition parameters and BMD was performed with the Spearman method, correlation coefficients R for p<0.05 are presented.Results:The average L1-L4 BMD was 0,92±0,16 g/cm2, total hip BMD - 0,84±0,15 g/cm2 and femoral neck - 0,73±0,13 g/cm2. 33 (48.5%) women had osteopenia, and 17 (25.0%) - osteoporosis (OP). Low appendicular LM was found in 5 (7.4%) and low appendicular muscle index (appendicular LM/height2, AMI) – in 10 (14.7%) patients. Overfat was revealed in 47 (69.1%) women, but only 20 (29.4%) women had BMI corresponding to obesity. The positive correlations between BMD in L1-L4, total hip and femoral neck regions and body weight (R=0.46, R=0.56 and R=0.50, respectively), trunk fat (R=0.4, R=0.51 and R=0.37, respectively), total FM (R=0.27, R=0.43 and R=0.34, respectively), trunk LM (R=0.55, R=0.54 and R=0.51, respectively), total LM (R=0.51, R=0.50 and R=0.52, respectively), appendicular LM (R=0.31, R=0.29 and R=0.37, respectively) and AMI (R=0.26, R=0.33 and R=0.51, respectively) were found out. In the multivariate linear regression analysis total LM was associated with BMD of lumbar spine (β=0.638, p=0.001) and total hip (β=0.473, p=0.008), and AMI - with femoral neck BMD (β=0.360; p=0.014). We found that FM hadn’t a significant effect on BMD in any region.Conclusion:73.5% of patients with RA had a reduced BMD, and 14.7% women – low AMI. LM was positively associated with BMDs in different regions of interest, but FM had no effect on BMD. Further researches are needed to identify associations between body composition, inflammatory activity and bone health in patients with RA.Disclosure of Interests:None declared


2010 ◽  
Vol 8 (2) ◽  
pp. 168-174
Author(s):  
Thiago Sacchetto de Andrade ◽  
Luiz Anderson Lopes ◽  
Marcelo de Medeiros Pinheiro ◽  
Vera Lucia Szejnfeld ◽  
José Augusto de Aguiar Carrazedo Taddei

ABSTRACT Objective To evaluate bone mineral mass in adolescents with failure to thrive in relation to body composition. Methods A case control study involving 126 adolescents (15 to 19 years), in final puberty maturation being 76 eutrophic and 50 with failure to thrive (genetic or constitutional delay of growth), of matching ages, gender and pubertal maturation. The weight, height and calculated Z score for height/age and body mass index; bone mineral content, bone mineral density and adjusted bone mineral density were established for total body, lower back and femur; total fat-free mass and height-adjusted fat-free mass index, total fat mass and height-adjusted. The statistical analyses were performed using the Student's t-test (weight, height and body composition); Mann-Whitney test (bone mass) and multiple linear regression (bone mass determinants). Results weight, height and height/age Z-score were significantly higher among eutrophic subjects. Both groups did not show statistically significant differences for fat mass, percentage of fat mass, total fat mass height adjusted and fat-free mass index height sadjusted. However, total free fat maass was smaller for the failure to thrive group. Conclusions There was no statistically significant difference for bone mass measurements among adolescents with failure to thrive; however, the factors that determine bone mass formation should be better studied due to the positive correlation with free fat mass detected in these individuals.


2000 ◽  
Vol 35 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Inge M. van der Sluis ◽  
Marry M. van den Heuvel-Eibrink ◽  
Karel H�hlen ◽  
Eric P. Krenning ◽  
Sabine M.P.F. de Muinck Keizer-Schrama

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