Comparisons of Bone Mineral Density, Body Composition and Isokinetic Muscle Function in Elite Alpine and Cross-country Ski Athletes

ContextGlucocorticoid excess exhibits multiple detrimental effects by its catabolic properties. Metformin was recently suggested to protect from adverse metabolic side-effects of glucocorticoid treatment. Whether metformin is beneficial in patients with endogenous glucocorticoid excess has not been clarified.ObjectiveTo evaluate the phenotype in patients with endogenous Cushing’s syndrome (CS) treated with metformin at the time of diagnosis.Patients and MethodsAs part of the German Cushing’s Registry we selected from our prospective cohort of 96 patients all 10 patients who had been on pre-existing metformin treatment at time of diagnosis (CS-MET). These 10 patients were matched for age, sex and BMI with 16 patients without metformin treatment (CS-NOMET). All patients had florid CS at time of diagnosis. We analyzed body composition, metabolic parameters, bone mineral density and bone remodeling markers, muscle function and quality of life.ResultsAs expected, diabetes was more prevalent in the CS-MET group, and HbA1c was higher. In terms of comorbidities and the degree of hypercortisolism, the two groups were comparable. We did not observe differences in terms of muscle function or body composition. In contrast, bone mineral density in metformin-treated patients was superior to the CS-NOMET group at time of diagnosis (median T-Score -0.8 versus -1.4, p = 0.030). CS-MET patients showed decreased β-CTX levels at baseline (p = 0.041), suggesting reduced bone resorption under metformin treatment during glucocorticoid excess.ConclusionThis retrospective cohort study supports potential protective effects of metformin in patients with endogenous glucocorticoid excess, in particular on bone metabolism.

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Racial/ethnic differences in bone mineral density, muscle function and fat mass in young women

Brazilian Journal of Health and Biomedical Sciences ◽

10.12957/bjhbs.2019.53500 ◽

2019 ◽

Vol 18 (2) ◽

pp. 103-113

Author(s):

Japneet Kaur ◽

Ryan Miller ◽

Eduardo Freitas ◽

Debra Bemben ◽

Michael Bemben

Keyword(s):

Bone Mineral Density ◽

Body Composition ◽

South Asian ◽

Bone Mineral ◽

Ethnic Differences ◽

Fat Mass ◽

Lean Mass ◽

Muscle Function ◽

Mineral Density ◽

Racial Ethnic

Background: Racial/ethnic differences in bone mineral density(BMD) result in increased susceptibility of some ethnic groupsto fragility fractures in comparison to others. Conventionally,both lean mass and fat mass provide mechanical loadingto the skeleton and increase BMD, however, increase in fatmass beyond a certain level without a concurrent increasein muscle mass/strength, is detrimental to the skeleton. Theaim of this study was to determine racial/ethnic differencesin BMD, muscle function and fat mass in 18-30-year-oldwomen of Caucasian, East-Asian, South-Asian, Hispanic andAfrican-American backgrounds. Materials and methods: Forty-six women participated in the study. The visits includedsigning a written informed consent and questionnaires toassess health status, menstrual history, physical activity andcalcium intake. Body composition (fat mass, bone free leanbody mass (BFLBM), and bone mineral content (BMC)) andtotal and regional BMD were measured using Dual EnergyX-Ray Absorptiometry, while handgrip test, jump test, 1Repetition-Maximum leg press test, and bilateral isokinetic testingof knee flexors and extensors were used to quantify lower limbmuscle strength and power. Results: African-American womenhad a higher BMD at the left and right trochanter (p=0.03) andhigher BMC at several sites in comparison to South-Asians(p=0.02) and Hispanics (p=0.03). South-Asian women had ahigher fat mass (p=0.04) and percent body fat (p=0.003), andlower BFLBM (p=0.04) and strength (p=0.003) than East-Asiansand Caucasians. Conclusion: This type of research is essentialto identify at-risk minorities and fundamental for creatingawareness, developing ethnicity-specific diagnostic criteria,and preventative and therapeutic strategies.Keywords: DXA; Osteoporosis; Body composition;Premenopausal; Lean mass; Muscle strength.

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Short Bowel Patients Treated for Two Years with Glucagon-Like Peptide 2: Effects on Intestinal Morphology and Absorption, Renal Function, Bone and Body Composition, and Muscle Function

Gastroenterology Research and Practice ◽

10.1155/2009/616054 ◽

2009 ◽

Vol 2009 ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

P. B. Jeppesen ◽

P. Lund ◽

I. B. Gottschalck ◽

H. B. Nielsen ◽

J. J. Holst ◽

...

Keyword(s):

Bone Mineral Density ◽

Body Composition ◽

Renal Function ◽

Creatinine Clearance ◽

Bone Mineral ◽

Muscle Function ◽

Mineral Density ◽

Short Bowel ◽

Wet Weight ◽

Glucagon Like Peptide

Background and aims. In a short-term study, Glucagon-like peptide 2 (GLP-2) has been shown to improve intestinal absorption in short bowel syndrome (SBS) patients. This study describes longitudinal changes in relation to GLP-2 treatment for two years.Methods. GLP-2, 400 micrograms, s.c.,TID, were offered, to eleven SBS patients keeping parenteral support constant. 72-hour nutritional balance studies were performed at baseline, weeks 13, 26, 52 during two years intermitted by an 8-week washout period. In addition, mucosal morphometrics, renal function (by creatinine clearance), body composition and bone mineral density (by DEXA), biochemical markers of bone turnover (by s-CTX and osteocalcin, PTH and vitamin D), and muscle function (NMR, lungfunction, exercise test) were measured.Results. GLP-2 compliance was 93%. Three of eleven patients did not complete the study. In the remaining 8 patients, GLP-2 significantly reduced the fecal wet weight from approximately 3.0 to approximately 2.0 kg/day. This was accompanied by a decline in the oral wet weight intake, maintaining intestinal wet weight absorption and urinary weight constant. Renal function improved. No significant changes were demonstrated in energy intake or absorption, and GLP-2 did not significantly affect mucosal morphology, body composition, bone mineral density or muscle function.Conclusions. GLP-2 treatment reduces fecal weight by approximately 1000 g/d and enables SBS patients to maintain their intestinal fluid and electrolyte absorption at lower oral intakes. This was accompanied by a 28% improvement in creatinine clearance.

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Handgrip Strength: Associations with Clinical Variables, Body Composition, and Bone Mineral Density in Adults with Cystic Fibrosis

Nutrients ◽

10.3390/nu13114107 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4107

Author(s):

Victoria Contreras-Bolívar ◽

Casilda Olveira ◽

Ignacio Ruiz-García ◽

Nuria Porras ◽

Maria García-Olivares ◽

...

Keyword(s):

Bone Mineral Density ◽

Cystic Fibrosis ◽

Body Composition ◽

Bone Mineral ◽

Muscle Function ◽

Respiratory Function ◽

Handgrip Strength ◽

Fat Free Mass ◽

Mineral Density ◽

The Mean

Background: Loss of fat-free mass (FFM) is associated with an increase in morbidity and mortality in cystic fibrosis (CF) patients. Handgrip strength (HGS) measures muscle function and may be associated with clinical parameters with prognostic value. Our objectives were to evaluate muscle strength through HGS in CF patients and to determine if there are any associations with respiratory clinical variables, FFM, and bone mineral density (BMD). Methods: A cross-sectional study conducted in clinically stable patients. We evaluated muscle function through HGS, respiratory function—forced expiratory volume in 1 s (FEV1) (%), forced vital capacity (FVC) (%), bronchorrhea, annual exacerbations, and body composition (FFM and FFM index, FFMI: fat-free mass in kg/height in m2) and Bone Mineral Density (BMD) through densitometry (DXA). Results: The study included 53 CF patients (58.5% females, mean age 28.3 ± 8.1, body mass index (BMI) 21.7 ± 3.4). The mean values for dynamometry were 40.2 ± 8.1 kg in males and 23.1 ± 7.0 kg in women, being 20.8% below the 10th percentile. Patients with lower muscle strength showed significantly more exacerbations and lower FEV1% and FVC%, as well as lower BMI, worse BMD (g/cm2), T-score, and Z-score. A significant and positive correlation was found between the mean and maximum dynamometry values and age, FVC%, BMI, FFMI, FFM (kg), and BMD. Conclusions: For adults with CF, HGS is a practical tool for assessment of health status. Low values reflect poor nutritional status and are associated with poor respiratory function, low fat-free mass and low bone mineral density.

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