Grip Strength in Adults and Children with Cystinosis

Abstract Background: Chronic kidney disease (CKD) is associated with impaired muscle strength. Cystinosis patients have increased risk for impaired muscle strength due to early development of CKD and cystinosis-induced myopathy. This study assesses muscle strength in cystinosis patients and investigates risk factors of decreased muscle strength. Methods: Adult and pediatric patients were recruited from Cystinosis Research Network conferences and a large pediatric nephrology clinic between 2017 and 2019. Patients and caregivers completed questionnaires on demographic characteristics, disease course, daily physical activity, and neuro-muscular symptoms. Grip strength was assessed using a dynameter and calculated z-scores for age and sex were assessed for associations with patient characteristics. Results: We included 76 patients with a mean grip strength z-score of -2.1 (SD 1.1), which was lower than seen in CKD patients without cystinosis. Male sex and delayed cysteamine initiation were independently associated with impaired grip strength. Among adults, a low level of physical activity was associated with lower grip strength z-score, but no association was found in children. A third of the patients reported neuro-muscular symptoms, with swallowing issues associated with lower grip strength. There was no significant correlation between eGFR and grip strength z-score. Conclusion: Cystinosis patients have impaired muscle strength compared to healthy controls and CKD patients. This impairment is greater in male patients and in patients with late initiation of cysteamine therapy, and is associated with lower physical activity. Further studies investigating the effect of different types of physical activities, optimizing cysteamine therapy and other interventions are needed.

Download Full-text

Muscle Strength, Physical Activity, and Functional Limitations in Older Adults with Central Obesity

Journal of Aging Research ◽

10.1155/2016/8387324 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Cassandra M. Germain ◽

John A. Batsis ◽

Elizabeth Vasquez ◽

Douglas R. McQuoid

Keyword(s):

Physical Activity ◽

Older Adults ◽

Muscle Strength ◽

Grip Strength ◽

Functional Impairment ◽

Central Obesity ◽

Functional Limitations ◽

Logistic Models ◽

Community Dwelling ◽

Increased Risk

Background.Obesity and muscle weakness are independently associated with increased risk of physical and functional impairment in older adults. It is unknown whether physical activity (PA) and muscle strength combined provide added protection against functional impairment. This study examines the association between muscle strength, PA, and functional outcomes in older adults with central obesity.Methods.Prevalence and odds of physical (PL), ADL, and IADL limitation were calculated for 6,388 community dwelling adults aged ≥ 60 with central obesity. Individuals were stratified by sex-specific hand grip tertiles and PA. Logistic models were adjusted for age, education, comorbidities, and body-mass index and weighted.Results.Overall prevalence of PL and ADL and IADL limitations were progressively lower by grip category. Within grip categories, prevalence was lower for individuals who were active than those who were inactive. Adjusted models showed significantly lower odds of PL OR 0.42 [0.31, 0.56]; ADL OR 0.60 [0.43, 0.84], and IADL OR 0.46[0.35, 0.61] for those in the highest grip strength category as compared to those in the lowest grip category.Conclusion.Improving grip strength in obese elders who are not able to engage in traditional exercise is important for reducing odds of physical and functional impairment.

Download Full-text

The Childhood Growth of Twin Children

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000001586 ◽

1995 ◽

Vol 44 (3-4) ◽

pp. 169-178 ◽

Cited By ~ 16

Author(s):

B. Luke ◽

S. Leurgans ◽

L. Keith ◽

D. Keith

Keyword(s):

Gestational Age ◽

Growth Retardation ◽

Z Score ◽

Cross Sectional ◽

Childhood Growth ◽

Severe Stunting ◽

Increased Risk ◽

Z Scores ◽

Twin Children ◽

Current Weight

AbstractThe objective of this study was to assess the childhood growth of twin children in terms of the effects of intrauterine growth retardation (IUGR) and discordancy at birth on the incidence and severity of stunting and discordancy in current height and weight. The study was part of a cross-sectional field project conducted at the Annual Twins Days Festival in Twinsburg. Ohio, USA, during 1990, 1991, and 1993, and including all twin children between 2 and 12 years of age. Mothers of twins were interviewed regarding their children's birthweights and gestational age; the twin children were measured for their current heights and weights. The study population included 990 twin children, including 555 boys and 435 girls, of which there were 254 boy pairs and 194 girl pairs. Birthweight for gestational age and current weight and height were each converted into Z-scores and characterized as severe (Z-score <−2,0), or moderate IUGR or stunting (Z-score > −2.0 and < −1.2). For the present study discordancy in birthweight, and current height and weight was calculated for like-gender twin pairs. Only twin children with severe IUGR at birth showed an increased risk of stunting in their current height or weight, and this risk was only for moderate, not severe, stunting. Boy twins with severe IUGR at birth were at increased risk of moderate stunting in their current weight (OR 2.67, 95% CI 1.55, 4.58, P = 0.002), while girl twins with severe IUGR at birth were at increased risk of moderate stunting in their current height (OR 4,09, 95% CI 1.49, 10.99, p = 0.003). Among like-gender twin pairs, there were no differences in mean or categories of birthweight or current weight discordancy, but boy twin pairs did show a significantly greater proportion of current weight discordancy compared to girl twin pairs (p = 0.005). Overall, there was a significant tendency for differences in height and weight between like-gender twin pairs to disappear over time, with the effect being greater for boy twin pairs. We conclude from these findings that twin children tend to overcome growth retardation and discordancy present at birth, and although children who had severe IUGR or discordancy at birth were more likely to have some residual moderate stunting or discordancy in height or weight, they still tended to be within normal values for their gender and current age.

Download Full-text

Do differences in compositional time use explain ethnic variation in the prevalence of obesity in children? Analyses using 24-hour accelerometry

10.26686/wgtn.12830837.v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

RW Taylor ◽

JJ Haszard ◽

VL Farmer ◽

R Richards ◽

Lisa Te Morenga ◽

...

Keyword(s):

Physical Activity ◽

Ethnic Differences ◽

Time Use ◽

Vigorous Physical Activity ◽

Obesity Prevalence ◽

Z Score ◽

Movement Data ◽

Increased Risk ◽

Prevalence Of Obesity ◽

Log Ratio

© 2019, Springer Nature Limited. Background/Objectives: Whether variation in sleep and physical activity explain marked ethnic and socioeconomic disparities in childhood obesity is unclear. As time spent in one behaviour influences time spent in other behaviours across the 24-hour day, compositional analyses are essential. The aims of this study were to determine how ethnicity and socioeconomic status influence compositional time use in children, and whether differences in compositional time use explain variation in body mass index (BMI) z-score and obesity prevalence across ethnic groups. Methods: In all, 690 children (58% European, 20% Māori, 13% Pacific, 9% Asian; 66% low-medium deprivation and 34% high deprivation) aged 6–10 years wore an ActiGraph accelerometer 24-hours a day for 5 days yielding data on sedentary time, sleep, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Height and weight were measured using standard techniques and BMI z-scores calculated. Twenty-four hour movement data were transformed into isometric log-ratio co-ordinates for multivariable regression analysis and effect sizes were back-transformed. Results: European children spent more time asleep (predicted difference in minutes, 95% CI: 16.1, 7.4–24.9) and in MVPA (6.6 min, 2.4–10.4), and less time sedentary (−10.2 min, −19.8 to −0.6) and in LPA (−12.2 min, −21.0 to −3.5) than non-European children. Overall, 10% more sleep was associated with a larger difference in BMI z-score (adjusted difference, 95% CI: −0.13, −0.25 to −0.01) than 10% more MVPA (−0.06, −0.09 to −0.03). Compositional time use explained 35% of the increased risk of obesity in Pacific compared with European children after adjustment for age, sex, deprivation and diet, but only 9% in Māori and 24% in Asian children. Conclusions: Ethnic differences in compositional time use explain a relatively small proportion of the ethnic differences in obesity prevalence that exist in children.

Download Full-text

Sleep and BMI in South African urban and rural, high and low-income preschool children

BMC Public Health ◽

10.1186/s12889-021-10591-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dale E. Rae ◽

Simone A. Tomaz ◽

Rachel A. Jones ◽

Trina Hinkley ◽

Rhian Twine ◽

...

Keyword(s):

Physical Activity ◽

Preschool Children ◽

South African ◽

Low Income ◽

Urban Environments ◽

Z Score ◽

Cross Sectional ◽

Rural And Urban ◽

Sleep Parameters ◽

Z Scores

Abstract Background The extent to which income setting or rural and urban environments modify the association between sleep and obesity in young children is unclear. The aims of this cross-sectional observational study were to (i) describe and compare sleep in South African preschool children from rural low-income (RL), urban low-income (UL) and urban high-income (UH) settings; and (ii) test for associations between sleep parameters and body mass index (BMI). Methods Participants were preschoolers (5.2 ± 0.7y, 49.5% boys) from RL (n = 111), UL (n = 65) and UH (n = 22) settings. Height and weight were measured. Sleep, sedentary behaviour and physical activity were assessed using accelerometery. Results UL children had higher BMI z-scores (median: 0.39; interquartile range: − 0.27, 0.99) than the UH (− 0.38; − 0.88, 0.11) and RL (− 0.08; − 0.83, 0.53) children (p = 0.001). The UL children had later bedtimes (p < 0.001) and wake-up times (p < 0.001) and shorter 24 h (p < 0.001) and nocturnal (p < 0.001) sleep durations than the RL and UH children. After adjusting for age, sex, setting, SB and PA, for every hour less sleep obtained (24 h and nocturnal), children were 2.28 (95% CI: 1.28–4.35) and 2.22 (95% CI: 1.27–3.85) more likely, respectively, to belong to a higher BMI z-score quartile. Conclusions Shorter sleep is associated with a higher BMI z-score in South African preschoolers, despite high levels of PA, with UL children appearing to be particularly vulnerable.

Download Full-text

Abstract 016: Muscular Strength Predicts All-Cause Mortality Independent of MVPA in Women Ages 63-99 Years

Circulation ◽

10.1161/circ.137.suppl_1.016 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Michael J LaMonte ◽

David M Buchner ◽

Cora E Lewis ◽

Eileen Rillamas-Sun ◽

John Bellettiere ◽

...

Keyword(s):

Physical Activity ◽

Standard Deviation ◽

Muscle Strength ◽

Grip Strength ◽

Gait Speed ◽

Muscular Strength ◽

Sedentary Time ◽

Lower Mortality ◽

Race Ethnicity ◽

Lower Mortality Risk

Background: While some studies report muscle strength is associated with mortality, independent of aerobic physical activity (PA), in older people, there are less data in women and lack of studies adjusting the association for objective measures of PA and physical performance. We prospectively examined this association in 5,061 multiethnic (White, 48.2%; Black, 34.0%; Hispanic, 17.9%) women ages 63-99 (mean 78.3) with complete information for analysis in the Objective Physical Activity and Cardiovascular Health Study. Methods: Quartile categories of dominant hand grip strength (<14, 14-18, 18.1-22.5, >22.5 kg) and EPESE categories of time to complete five consecutive unassisted chair stands (>16.6, 16.6-13.7, 13.6-11.2, <11.2 sec) were the muscle strength exposure measures. Primary covariables included age, race-ethnicity, current smoking, BMI, and number of comorbidities. Accelerometer measured moderate-to-vigorous PA (MVPA) and total sedentary time, and gait speed during a self-paced 8 meter walk test were further assessed as confounding factors. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: There were 306 (5.5%) all-cause deaths during a mean 3.3 year follow-up. Adjusting for primary covariables, significant inverse trends in mortality were observed across categories of grip strength, HR (95% CI) = 1.00 (ref), 0.70 (0.53, 0.93), 0.77 (0.56, 1.05), 0.59 (0.41, 0.87), trend p = .007, and chair stands, 1.00, 0.82 (0.62, 1.09), 0.76 (0.55, 1.04), 0.53 (0.36, 0.77), trend p <.001. Further adjustment for MVPA attenuated these associations which remained statistically significant, 1.00, 0.72, 0.81, 0.66, trend p = .032, and 1.00, 0.91, 0.88, 0.65, trend p = .033, respectively. Similarly, adding sedentary time or gait speed to the primary covariables did not eliminate significance of the inverse mortality trends with either muscle strength measure. Adjusting for primary covariables, each 1-standard deviation (6.2 sec) faster chair stand time was associated with 12% lower mortality risk (p = .004), which was attenuated to 8% risk reduction (p = .04) when further controlling for MVPA. Adjusting for primary covariables and MVPA, each 1-standard deviation (6.8 kg) increment in grip strength was associated with 13% lower mortality risk (p = .04), and this inverse association was generally consistent across subgroups defined by age (interaction p = .78), race-ethnicity (p = .19), and BMI (p = .88). Controlling for gait speed opposed to MVPA resulted in consistent findings. Conclusions: Higher muscular strength is associated with lower mortality in older women, independent of device-measured MVPA and sedentary time, and measured gait speed, an indicator of aerobic fitness. If results are confirmed, in addition to guideline recommendations regarding aerobic PA, promoting skeletal muscle strength is an important component of aging well.

Download Full-text

Grip strength among Indigenous and non-Indigenous Australian adults: a longitudinal study of the effects of birth size and current size

BMJ Open ◽

10.1136/bmjopen-2018-024749 ◽

2019 ◽

Vol 9 (4) ◽

pp. e024749

Author(s):

Timothy Howarth ◽

Belinda Davison ◽

Gurmeet Singh

Keyword(s):

Young Adults ◽

Grip Strength ◽

Lean Mass ◽

Low Birthweight ◽

Indigenous Australians ◽

Birth Size ◽

Indigenous Australian ◽

Cross Sectional ◽

Increased Risk ◽

Lower Grip

ObjectivesIndigenous Australians are born smaller than non-Indigenous Australians and are at an increased risk of early onset of frailty. This study aimed to identify the relationship between birth size, current size and grip strength, as an early marker of frailty, in Indigenous and non-Indigenous young adults.DesignCross sectional data from two longitudinal studies: Aboriginal birth cohort (Indigenous) and top end cohort (non-Indigenous).SettingParticipants reside in over 40 urban and remote communities across the Northern Territory, Australia.ParticipantsYoung adults with median age 25 years (IQR 24–26); 427 participants (55% women), 267 (63%) were remote Indigenous, 55 (13%) urban Indigenous and 105 (25%) urban non-Indigenous.Outcome measuresReliable birth data were available. Anthropometric data (height, weight, lean mass) and grip strength were directly collected using standardised methods. Current residence was classified as urban or remote.ResultsThe rate of low birthweight (LBW) in the non-Indigenous cohort (9%) was significantly lower than the Indigenous cohort (16%) (−7%, 95% CI −14 to 0, p=0.03). Indigenous participants had lower grip strength than non-Indigenous (women, −2.08, 95% CI −3.61 to –0.55, p=0.008 and men, −6.2, 95% CI −9.84 to –2.46, p=0.001). Birth weight (BW) was associated with grip strength after adjusting for demographic factors for both women (β=1.29, 95% CI 0.41 to 2.16, p=0.004) and men (β=3.95, 95% CI 2.38 to 5.51, p<0.001). When current size (lean mass and body mass index [BMI]) was introduced to the model BW was no longer a significant factor. Lean mass was a positive indicator for grip strength, and BMI a negative indicator.ConclusionsAs expected women had significantly lower grip strength than men. Current size, in particular lean mass, was the strongest predictor of adult grip strength in this cohort. BW may have an indirect effect on later grip strength via moderation of lean mass development, especially through adolescence and young adulthood.

Download Full-text

Treatment of Gestational Diabetes Mellitus and Offspring Early Childhood Growth

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa742 ◽

2020 ◽

Author(s):

Maisa Feghali ◽

Jacqueline Atlass ◽

Kaleab Z Abebe ◽

Diane Comer ◽

Janet Catov ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Nutritional Therapy ◽

Z Score ◽

Childhood Growth ◽

Treatment Groups ◽

Increased Risk ◽

Z Scores ◽

Growth Differences

Abstract Background Gestational diabetes mellitus (GDM) is associated with fetal overgrowth, and certain treatments are associated with an increased risk of macrosomia. However, there are limited data about the long-term effect of GDM treatment on childhood growth. Methods Cohort study of 816 women with GDM and their offspring delivered between 2009 and 2012. Childhood height and weight through age 3 were collected from the medical record and z-scores and body mass index (BMI) were calculated. We assessed the association between GDM treatment and childhood growth using linear mixed modeling. Results Treatment was divided into medical nutritional therapy (MNT) (n = 293), glyburide (n = 421), and insulin (n = 102). At delivery, birthweight, z-score, and BMI were higher in the offspring of women treated with either glyburide or insulin compared to MNT. However, weight, z-score, and BMI were similar among all offspring at 6 months and 1, 2, and 3 years of age. After controlling for covariates, there were differences in the weight z-score (P = 0.01) over the 3-year period by treatment group, but no differences in weight (P = 0.06) or change in BMI (P = 0.28). Pairwise comparisons indicated that insulin was associated with more weight gain compared with MNT (0.69 kg; 95% CI, 0.10-1.28; P = 0.02) and glyburide was associated with a trend toward lower weight z-score compared with MNT (−0.24; 95% CI, −0.47 to 0.003; P = 0.05). Conclusion Despite growth differences detected at birth, we observed no meaningful differences in childhood growth from 6 months to 3 years among treatment groups, including in the offspring of women with GDM treated with glyburide.

Download Full-text

Correlates of Adiposity Among Latino Preschool Children

Journal of Physical Activity and Health ◽

10.1123/jpah.2012-0018 ◽

2014 ◽

Vol 11 (1) ◽

pp. 195-198 ◽

Cited By ~ 15

Author(s):

Jason A. Mendoza ◽

Jessica McLeod ◽

Tzu-An Chen ◽

Theresa A. Nicklas ◽

Tom Baranowski

Keyword(s):

Physical Activity ◽

Parent Education ◽

Vigorous Physical Activity ◽

Neighborhood Disorder ◽

Z Score ◽

Neighborhood Safety ◽

Tv Viewing ◽

Related Risk ◽

Z Scores ◽

Obesity Interventions

Background:Childhood obesity is at record high levels in the US and disproportionately affects Latino children; however, studies examining Latino preschool children’s obesity-related risk factors are sparse. This study determined correlates of Latino preschoolers’ (ages 3–5 years) adiposity to inform future obesity interventions and policies.Methods:Latino preschoolers (n = 96) from 4 Head Start centers in Houston, Texas were recruited. Parents reported acculturation and neighborhood safety. Children’s and parents’ height and weight were measured. Children’s television (TV) viewing was measured by TV diaries and physical activity by accelerometers. Linear regression was used with body mass index (BMI) z-score as the dependent variable and covariates sequentially added and retained in 4 blocks: 1) child age, gender, parent education, and BMI; 2) neighborhood safety and parent and child acculturation; 3) TV viewing; and 4) moderate-to-vigorous physical activity (MVPA).Results:In the final model (n = 96), only neighborhood disorder (β = 0.30, P = .005) and MVPA (β = –0.21, P = .049) were significantly associated with BMI z-score.Conclusions:Among Latino preschoolers, higher neighborhood disorder and lower MVPA were associated with greater children’s BMI z-scores.

Download Full-text

Longitudinal Follow-Up on Cardiopulmonary Exercise Capacity Related to Cardio-Metabolic Risk Factors in Children With Renal Transplants

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.688383 ◽

2021 ◽

Vol 3 ◽

Author(s):

Susanne Westphal Ladfors ◽

Ebba Bergdahl ◽

Oli Hermannsson ◽

Julius Kristjansson ◽

Tina Linnér ◽

...

Keyword(s):

Physical Activity ◽

Exercise Capacity ◽

Blood Lipids ◽

Healthy Controls ◽

Z Score ◽

Cardiopulmonary Exercise ◽

Z Scores ◽

Mean Time ◽

Over Time

Background: Children with chronic kidney disease, including those treated with kidney transplantation (KT), have an increased risk of cardiovascular disease. The aim of this study was to examine the cardiopulmonary exercise capacity after KT compared to matched controls, to relate the results to physical activity, blood pressure and biochemical findings and to follow exercise capacity over time.Methods: Patients with KT (n = 38, age 7.7–18 years), with a mean time from transplantation of 3.7 years (0.9–13.0) and mean time in dialysis 0.8 years, were examined at inclusion and annually for up to three years. Healthy controls (n = 17, age 7.3–18.6 years) were examined once. All subjects underwent a cardiopulmonary exercise test, resting blood pressure measurement, anthropometry and activity assessment. Patients also underwent echocardiography, dual-energy X-ray absorptiometry (DXA), 24-h ambulatory BP measurements (ABPM), assessment of glomerular filtration rate (GFR) and blood sampling annually.Results: As compared to healthy controls, KT patients showed decreased exercise capacity measured both as VO2peak (34.5 vs. 43.9 ml/kg/min, p < 0.001) and maximal load (2.6 vs. 3.5 W/kg, p < 0.0001), similarly as when results were converted to z-scores. No significant difference was found in weight, but the KT patients were shorter and had higher BMI z-score than controls, as well as increased resting SBP and DBP z-scores. The patient or parent reported physical activity was significantly lower in the KT group compared to controls (p < 0.001) In the combined group, the major determinants for exercise capacity z-scores were activity score and BMI z-score (β = 0.79, p < 0.0001 and β = −0.38, p = 0.007, respectively). Within the KT group, low exercise capacity was associated with high fat mass index (FMI), low activity score, low GFR and high blood lipids. In the multivariate analysis FMI and low GFR remained predictors of low exercise capacity. The longitudinal data for the KT patients showed no change in exercise capacity z-scores over time.Conclusion: Patients with KT showed decreased exercise capacity and increased BP as compared to healthy controls. Exercise capacity was associated to GFR, physical activity, FMI and blood lipids. It did not improve during follow-up.

Download Full-text

Resistance training, insulin sensitivity and muscle function in the elderly

Essays in Biochemistry ◽

10.1042/bse0420075 ◽

2006 ◽

Vol 42 ◽

pp. 75-88 ◽

Cited By ~ 66

Author(s):

Flemming Dela ◽

Michael Kjaer

Keyword(s):

Physical Activity ◽

Muscle Strength ◽

The Elderly ◽

Activity Level ◽

Elderly Individuals ◽

Healthy Elderly ◽

Age Related ◽

Increased Risk ◽

Improved Function ◽

Improve Muscle Strength

Ageing is associated with a loss in both muscle mass and in the metabolic quality of skeletal muscle. This leads to sarcopenia and reduced daily function, as well as to an increased risk for development of insulin resistance and type 2 diabetes. A major part, but not all, of these changes are associated with an age-related decrease in the physical activity level and can be counteracted by increased physical activity of a resistive nature. Strength training has been shown to improve insulin-stimulated glucose uptake in both healthy elderly individuals and patients with manifest diabetes, and likewise to improve muscle strength in both elderly healthy individuals and in elderly individuals with chronic disease. The increased strength is coupled to improved function and a decreased risk for fall injuries and fractures. Elderly individuals have preserved the capacity to improve muscle strength and mass with training, but seem to display a reduced sensitivity towards stimulating protein synthesis from nutritional intake, rather than by any reduced response in protein turnover to exercise.

Download Full-text