Beta-blockers reduce bone resorption marker in early postmenopausal women

BACKGROUND: There is evidence to suggest that beta-blockers used in the management of cardiovascular disease may also modulate bone metabolism and reduce bone fragility. AIM: The study aimed to determine the association between beta-blocker use, serum markers of bone turnover and bone loss in early postmenopausal women. SUBJECTS AND METHODS: In this observational study, we evaluated beta-blocker exposure in association with serum levels of C-telopeptide and bone-specific alkaline phosphatase, and rates of bone loss. Beta-blocker use, concomitant therapy and lifestyle were documented for 197 women (50-59 years), 175 of whom had changes in whole body bone mineral density monitored over a 2-year period. RESULTS: Twenty-four beta-blocker users were identified at baseline. After controlling for concomitant use of hormone therapy, C-telopeptide levels were 6.7% lower among beta-blocker users (p=0.02). No association was detected between bone-specific alkaline phosphatase and beta-blocker use. Analysis of 15 beta-blocker users and 152 non-users identified 2 years post-baseline showed that levels of C-telopeptide but not bone-specific alkaline phosphatase were predictors of adjusted rates of bone loss (p=0.008 and p>0.05, respectively). Adjusted rates of bone loss were-0.001+/-0.026 g cm(-2) over 2 years for the users and-0.004+/-0.025 g cm(-2) over 2 years for non-users, but this difference was not significant. CONCLUSION: Beta-blockers might suppress bone resorption with relative preservation of bone formation. A study with greater power is required to determine whether ss-blocker use is associated with lower rates of bone loss.     

Body mass index and gynecological factors as determinants of bone mass in healthy Moroccan women

Several studies have shown that low body mass index (BMI) is associated with low BMD and fractures. However, the results that have been published from studies on reproductive factors and BMD are extremely controversial, with some demonstrating a beneficial effect, while others show a detrimental impact of these factors on bone mass.

Objective

To study the influence of several gynecological factors (years since menopause (YSM), age at menarche and gynecological age or reproductive life) simultaneously with anthropometric factors as determinants of bone mineral density (BMD) in healthy women older than 40.

Methods

BMD was determined by dual energy X-ray absorptiometry (DXA) at the lumbar spine and femurs in women aged >40 randomly chosen from the population of Rabat with a cluster sampling method.

Results

Four hundred and twenty-two healthy women older than 40 years were included in the study. The mean age was 57.2 years (8.4) [40–79] and the mean number of parities was 4.42 (2.9) [0–14]. Osteoporosis according to the classification of WHO (T-score ≤ −2.5) was observed in 133 women (32.2%). The increase in the number of parities was associated to a larger body mass index and a lower BMD as well in the hips and the lumbar spine after adjustment for age. The comparison of groups of patients according to the age at menarche, the age at menopause or the period of fertility did not highlight an association with BMD. BMD at the lumbar spine and the hips was correlated negatively with age, YSM and parity and positively with BMI. Multivariate analysis showed that the determinant of BMD are BMI (OR = 0.88; 95% CI: 0.83–0.92), parity (OR = 1.10; 1.01–1.56) and YSM (OR = 1.06; 1.03–1.10).

Conclusion

Bone loss in women older than 40 is a function of aging, parity and years since menopause; and there is a definite bone-protective effect of body mass weight. Further studies are required to evaluate the role of these parameters in the fracture risk.     

Body mass index distribution in climacteric women

Body Mass Index (BMI) was calculated in 2481 climacteric women selected from among the outpatients attending the Menopause Clinic at Bologna University in absence of hormonal replacement therapy and diseases that could cause weight gain. Analysis of variance of the W/H² (weight/height squared) distribution in different age and climacteric situations demonstrates that the pre-menopause is a weight-gain inducing state and that ageing seems to cause a progressive increase in W/H².     

Salicylic acid-derived poly(anhydride-esters) inhibit bone resorption and formation in vivo

The objective of this study was to investigate the effects of a novel polymer that biodegrades into salicylic acid (SA) on the healing of critical sized long bone defects. Microspheres of the homopolymer, or a copolymer containing 50% less of the SA, were packed into 5-mm mid-diaphyseal defects in rat femurs. Control animals received collagen sponge implants. After 4 and 8 weeks of implantation, bone healing was evaluated using microradiography and quantitative histomorphometry. Four weeks postsurgery, significantly less new bone was formed in both of the polymer groups (p<0.038). Reduced bone loss was also noted with the polymers at this time, although it was not statistically significant. However, at 8 weeks postsurgery, a statistically significant reduction in bone loss was observed in both of the polymer groups compared with controls (p<0.0072). Both polymers seemed to elicit identical tissue responses because there were no differences detected between the homopolymer and copolymer materials at either time point. These results indicate that locally released SA can significantly reduce both bone loss and bone formation in this animal model.     

Association of the calcitonin gene (CA) polymorphism with bone mass and bone responsiveness to hormone therapy in postmenopausal Korean women

OBJECTIVE: To evaluate the relationship between cytosine-adenine (CA) polymorphism of the calcitonin gene, serum calcitonin levels, bone mineral density (BMD) and bone responsiveness to hormone therapy (HT). DESIGN: Calcitonin (CA) polymorphism, serum calcitonin, and BMD at the lumbar spine and proximal femur were determined in 430 postmenopausal Korean women. In all, 181 women were treated with sequential HT for 2 years. RESULTS: Four major calcitonin alleles were present with a frequency greater than 5%: 122 base pair (bp) 61.3%, 108 bp 25.1%, 110 bp 7.0%, and 124 bp 6.2%. There were no differences in the BMD at the lumbar spine and proximal femur in postmenopausal women with zero, one, or two copies of major alleles. Serum calcitonin levels in women with two copies of the 108 bp allele were significantly higher than those in women with zero or one copy of the 108 bp allele. The annual rate of positive change of BMD at the femoral neck after HT was significantly higher in women homozygous for the 108 bp allele than in women with zero or one copy of the 108 bp allele, but the number of copies of the major calcitonin alleles was not significantly associated with HT-responsiveness. CONCLUSION: The calcitonin (CA) polymorphism is one of the genetic factors that may affect BMD changes at the femoral neck after HT in Korean women.     

Lean body mass and bone mineral density in physically exercising postmenopausal women

OBJECTIVES: To investigate whether the relative contribution of body composition (lean and fat mass component) to postmenopausal bone mineral density (BMD) differs between women participating in physical exercise and sedentary women. METHODS: Subjects were 45 postmenopausal women participating in regular physical exercise and 89 sedentary controls aged 50-60 years. Baseline characteristics included age, height, weight, body mass index (BMI, Wt/Ht(2)), age at menopause, and years since menopause (YSM). Body fat mass, percentage of body fat, lean body mass, and lumbar spine BMD (L2-4) were measured by dual-energy X-ray absorptiometry. RESULTS: Although age, height, weight, BMI, and YSM did not differ between the two groups, lean body mass and lumbar spine BMD were significantly higher (P<0.05 and <0.001, respectively), while body fat mass and percentage of body fat mass were significantly lower in exercising women than in sedentary controls (P<0.05 and <0.05, respectively). In exercising women, BMD was positively correlated with lean body mass (r=0.415, P<0.01) but not with body fat mass (r=0.155, NS). Conversely, in sedentary controls, BMD was correlated with body fat mass (r=0.251, P<0.05) and lean body mass (r=0.228, P<0.05). CONCLUSIONS: Lean body mass is a more significant determinant of postmenopausal BMD in physically exercising women than in sedentary women.     

Body mass index and sleep in women aged 40 to 64 years

A questionnaire study was carried out in 6000 randomly selected women in the County of Jämtland in Sweden. The response rate was 61.2%. Questions were asked about general health, height and body weight, sleep, menstruation and menopausal complaints. There were also questions about visits to doctors and the use of sleeping pills and hormone preparations. A deterioration of the night's sleep after the age of 60 years was associated especially with a low body mass index (BMI). In the subgroup with a BMI below 20 (kg m⁻²), frequent awakenings were reported 4 times more often in women 60–64 years old than in those aged 40–44 years. No such difference was found with a BMI ≥ 30. In the age group 60–64 years twice as many women with BMI ≥ 30 as women with BMI < 20 slept without waking up at night. BMI was similar in women with and without oestrogen therapy before the menopause. After the menopause the BMI in these two groups was 25.0 ± 3.1 (mean ± S.D.) and 25.6 ± 3.8, respectively (P < 0.05). Oestrogen-treated women had fewer sleep disorders than other women of the same age. Of the premenopausal women, 3.4% used sleeping pills, compared with 8.0% after the menopause. Before the menopause the use of sleeping pills was not related to BMI, but after the menopause this use was twice as common among women with BMI < 20 kg m⁻² than among those with BMI ≥ 30kg m⁻².     

Quantitative ultrasound (QUS) of bone in the management of postmenopausal women

OBJECTIVES: Postmenopausal osteoporosis is becoming a major problem for healthcare institutions as it has a growing social and economic impact. The incidence of osteoporotic fractures is constantly increasing due to the increase in life expectancy. The gynaecologist plays an important role in establishing a "biological zero" in each perimenopausal patient, and controlling the rate of bone loss during postmenopausal period. RESULTS: Dual energy X-ray absorptiometry (DXA) has been widely used for the diagnosis and management of osteoporosis and represents a strong risk factor for fractures, but it presents several limitations with regards to diagnosis, treatment follow-up and differential diagnosis of secondary osteoporosis. In these last years quantitative ultrasound (QUS) technique has been introduced for the evaluation of bone status in postmenopausal women and several in vitro and clinical studies have demonstrated the reliability of the examination in terms of: reproducibility, evaluation of fracture risk, treatment follow-up, differential diagnosis. QUS has proven to be equally capable in the prediction of future osteoporosis related fractures in comparison to DXA. Large-scale cross-sectional and longitudinal studies have demonstrated the applicability of QUS in screening the female population during the climacteric period. QUS technique seems to be very efficient in identifying "fast losers", identifying subjects at risk for osteoporosis requiring second-level investigation (DXA, X-ray), diagnosing secondary osteoporosis. CONCLUSION: If QUS is used in a systematic and rational manner in clinical practice, it is a valid technique for the prevention of osteoporosis in postmenopausal women.     

Body mass index and the prediction of percentage body fat in Australian Chinese women

Background: Body mass index (BMI) is frequently related to percentage body fat. Nevertheless, the relationship between BMI and fat mass/height² (FM/H²), theoretically, should be more appropriate.

Aim: This study seeks to evaluate the relationship between BMI and both percentage body fat and FM/H² in a group of Chinese Australian females.

Subjects and methods: Forty subjects took part in the study and all were Chinese females resident in Brisbane, Australia. Body mass index was calculated from height and weight. Percentage body fat and fat mass were calculated from measurements of total body water.

Results: The use of BMI to predict FM/H² accounted for double the variance of that found when BMI was used to predict percentage body fat.

Conclusions: As a consequence, it is possible that the use of BMI to predict FM/H² and not percentage body fat in the first instance may prove to be more useful in a number of adult populations. Nevertheless, with a relatively small sample size it is difficult, if not impossible, to test the developed equations on a validation group and further investigation into the findings described in this paper needs to be undertaken.

Hintergrund: Der Body Mass Index (BMI) wird häufig mit dem prozentualen Körperfett in Verbindung gebracht. Jedoch erscheint das Verhältnis zwischen BMI und Fettmasse/Körpergröße² (FM/H²) theoretisch angemessener zu sein. Ziel: Diese Studie versucht, sowohl das Verhältnis zwischen BMI und prozentualem Körperfett als auch FM/H² in einer Gruppe von australischen Frauen chinesischer Abstammung auszuwerten. Material und Methoden: Vierzig Frauen chinesischer Abstammung, die in Brisbane (Australien) ansässig waren nahmen an der Studie teil. Der BMI wurde aus Körpergröße und Gewicht errechnet. Das prozentuale Körperfett und die Fettmasse wurden anhand von Messungen des Gesamtkörperwassers errechnet. Ergebnisse: Bei der Verwendung des BMI zur Bestimmung von FM/H² kommt es zu einer Verdopplung der Varianz gegenüber der Verwendung des BMI zur Vorhersage des prozentualen Körperfettes. Schlußfolgerungen: Es ist möglich, daß bei einer Vielzahl von Erwachsen die Verwendung des BMI zur Vorhersage von FM/H² nützlicher sein kann als zur Bestimmung des prozentualen Körperfettes. Es ist jedoch schwierig, wenn nicht sogar unmöglich, anhand der verhältnismäßig kleinen Stichprobe die entwickelten Gleichungen zu prüfen. Es sollten weitere Untersuchungen im Hinblick auf die hier gemachten Befunde erfolgen.

Contexte: L'indice de masse corporelle (IMC) est fréquemment associé au pourcentage de graisse corporelle, cependant la relation entre IMC et masse grasse/stature² (MG/H²) serait théoriquement plus appropriée. But: cette étude cherche à évaluer la relation entre l'IMC, le pourcentage de graisse corporelle ainsi que MG/H² dans un groupe de femmes australiennes d'origine chinoise. Matériel et méthode: quarante chinoises résidentes à Brisbane en Australie, ont pris part à l'étude. L'indice de masse corporelle a été calculé à partir du poids et de la stature. Le pourcentage de graisse et la masse grasse l'ont été à partir de mesures de l'eau corporelle totale. Résultats: l'utilisation de l'IMC pour prédire MG/H² fournit une variance double de celle qui est trouvée lorsque l'IMC est utilisé pour prédire le pourcentage de graisse corporelle. Conclusions: en conséquence, il est possible que l'utilisation de l'IMC pour prédire MG/H² et non le pourcentage de graisse corporelle se révèle plus utile pour nombre de populations adultes. Cependant, il est difficile sinon impossible d'éprouver les équations développées sur un groupe de validation à partir d'un échantillon de taille relativement faible, si bien que d'autres recherches sur les résultats présentés dans ce travail doivent être effectuées.     

Height,weight and body mass index (BMI) in psychiatrically ill US Armed Forces personnel

BACKGROUND: In both psychiatrically ill and psychiatrically healthy adults, the connection between health and individuals' height and weight has long been examined. Specifically, research on the idea that individuals with certain body types were prone to particular psychiatric diseases has been explored sporadically for centuries. The hypothesis that psychiatrically ill individuals were shorter and weighed less than psychiatrically healthy counterparts would correspond with the neurodevelopmental model of psychiatric disease. METHOD: To evaluate possible links between psychiatric illness and physique, the height, weight and BMI of 7514 patients and 85,940 controls were compared. All subjects were part of the National Collaborative Study of Early Psychosis and Suicide (NCSEPS). Patients were US military active duty personnel hospitalized for either bipolar disorder, major depressive disorder, or schizophrenia and controls were psychiatrically-healthy US military active duty personnel matched for date of entry into the service. RESULTS: No consistent differences in height, weight or BMI were found between patients and controls, or between patient groups. Some weak ANOVA differences were found between age at the time of entering active duty and weight, as well as BMI, but not height. CONCLUSIONS: Unlike most previous studies that have looked at the links between height and psychiatric illness, this study of the NCSEPS cohort found that, at entry into the US Armed Forces, there were no consistent decreases in height for patients with bipolar disorder, major depressive disorder or schizophrenia compared with a large control group. Furthermore, there were no consistent differences for weight or BMI.     

Relationship of head lean mass to regional bone mineral density in elderly postmenopausal women

OBJECTIVES: This study investigated the relationship of head lean mass to bone mineral density (BMD). METHOD: Subjects were 102 elderly women (> or =65-years-old) and 123 middle-aged postmenopausal women (<65-years-old) with right-side dominance. Age, height, weight, and years since menopause (YSM) were recorded. Lean mass of the head, arm, trunk, leg, and total body were measured by dual-energy X-ray absorptiometry (DEXA). BMD of the same regions were measured by DEXA. RESULTS: In elderly women, head lean mass was positively correlated with BMD of the head (r=0.389, P<0.01), left arm (r=0.235, P<0.05), right arm (r=0.280, P<0.05), lumbar spine (L2-4) (r=0.411, P<0.001), pelvis (r=0.490, P<0.001), left leg (r=0.572, P<0.001), right leg (r=0.558, P<0.001), and total body (r=0.529, P<0.001). These relationships remained significant after adjusting for age, height, and YSM. In addition, the strength of correlation of head lean mass with BMD was higher than those of other regional lean mass with respective BMD. In middle-aged women, strength of correlation of head lean mass with BMD was loose (r< or =0.238), while regional lean mass was more correlated with respective regional BMD. CONCLUSION: Factors related to lifestyle associated with higher (lower) head lean mass may contribute to higher (lower) BMD in elderly postmenopausal women.     

神经性厌食症患者体重指数的对照分析

目的 :探讨神经性厌食症患者体重指数 (BMI)的特点及疾病的临床特征。方法 :采用进食障碍调查问卷 (EDI-1)对 3 0名神经性厌食症患者和 3 0名正常对照者进行评定 ,计算EDI -1量表分、BMI。结果 :根据期望BMI和目前BMI的差值 ,厌食症患者可分为追求更瘦组和不追求更瘦组。不追求更瘦组的目前BMI最低 ,追求更瘦组的目前BMI次之 ,正常对照组目前BMI最高 ,差异具有显著性 (F =5 4 15 ,P <0 0 1) ;两病例组间期望BMI没有差异 (P >0 0 5 ) ,但都低于正常对照组。追求更瘦组EDI -1量表总分最高、不追求更瘦组次之、对照组最低 ,差异具有显著性 (P <0 0 1)。结论 :体重过低的厌食症患者可能希望体重增加。但无论患者是否希望体重增加 ,期望体重指数都低于正常 ,实际上都是怕胖的。追求更瘦的患者可能预后较差 ,这可能与患者较严重的认知偏差以及某些心理特征有关。     

Body mass index is associated with USF1 haplotype in Korean premenopausal women

The upstream stimulatory factor 1 (USF1) gene has been shown to play an essential role as the cause of familial combined hyperlipidemia, and there are several association studies on the relationship between USF1 and metabolic disorders. In this study, we analyzed two single nucleotide polymorphisms in USF1 rs2073653 (306A>G) and rs2516840 (1748C>T) between the case (dyslipidemia or obesity) group and the control group in premenopausal females, postmenopausal females, and males among 275 Korean subjects. We observed a statistically significant difference in the GC haplotype between body mass index (BMI) > or =25 kg/m2) and BMI <25 kg/m2 groups in premenopausal females ( chi2=4.23, p=0.04). It seems that the USF1 GC haplotype is associated with BMI in premenopausal Korean females.     

Body mass index and the prediction of percentage body fat in Australian Chinese women.

BACKGROUND: Body mass index (BMI) is frequently related to percentage body fat. Nevertheless the relationship between BMI and fat mass/height2 (FM/H2), theoretically, should be more appropriate. AIM: This study seeks to evaluate the relationship between BMI and both percentage body fat and FM/H2 in a group of Chinese Australian females. SUBJECTS AND METHODS: Forty subjects took part in the study and all were Chinese females resident in Brisbane, Australia. Body mass index was calculated from height and weight. Percentage body fat and fat mass were calculated from measurements of total body water. RESULTS: The use of BMI to predict FM/H2 accounted for double the variance of that found when BMI was used to predict percentage body fat. CONCLUSIONS: As a consequence, it is possible that the use of BMI to predict FM/H2 and not percentage body fat in the first instance may prove to be more useful in a number of adult populations. Nevertheless, with a relatively small sample size it is difficult, if not impossible, to test the developed equations on a validation group and further investigation into the findings described in this paper needs to be undertaken.     

Reduced bone mass detected by bone quantitative ultrasonometry and DEXA in pre- and postmenopausal women with endogenous subclinical hyperthyroidism

BACKGROUND: Although overt hyperthyroidism is a well known cause of bone loss, systemic effects of subclinical hyperthyroidism (SH) are still a matter of debate. Objective: The aim of this cross-sectional study was to evaluate the effect of endogenous SH on bone in relation to the menopausal status. METHODS: Bone mass and turnover were assessed in a group of 60 patients with endogenous SH due to multinodular goitre; 30 of them were premenopausal and 30 early postmenopausal (mean age, 40.9 +/- 7.3 and 57.7 +/- 6.75, respectively). Sixty healthy women matched for age-, BMI- and menopausal status served as controls. Three different skeletal sites were evaluated using two different techniques: lumbar spine and femoral neck were assessed by DEXA whereas the proximal phalanges were evaluated by quantitative ultrasonometry (QUS), measuring the amplitude-dependent speed of sound (Ad-SoS). Serum osteocalcin and urinary deoxypyridinoline (DPD) were also determined as markers of bone turnover. RESULTS: A significant decrease was found in femoral BMD (P < 0.05) and phalangeal Ad-SoS (P < 0.001) in pre- and postmenopausal patients compared to controls, being greater in those postmenopausal. Lumbar BMD was decreased only in postmenopausal patients (P < 0.05). Bone turnover markers were higher in patients than in controls and in post- than in the premenopausal ones. A significant negative correlation was found between femoral BMD, Ad-SoS and serum free T3 levels, the latter considered a marker of disease activity. CONCLUSIONS: A significant increase in bone turnover markers and a decrease in bone mass was found in women affected by endogenous SH, being greater in early postmenopausal patients. Cortical rich bone was mainly affected. Both QUS and the conventional DEXA technique were equally able to determine bone density decrease related to mild thyroid hormone excess and sexual hormone decrease.