Influence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis

Despite known positive association between body mass and bone mineral density (BMD), relative contribution of fat and lean tissue to BMD remains under debate. We aimed at investigating the effect of selected anthropometric parameters, including fat content and lean body mass (LBM) on BMD in postmenopausal, osteoporotic women with body mass index (BMI) > 20 kg/m². The study involved 92 never-treated women (mean age 69.5 ± 7.3). L1-L4 and femoral neck (FN) BMD were measured by dual energy X-ray absorptiometry (DEXA). Absolute (kg) and relative (%) fat and LBM were assessed by means of electric bioimpedance method. We showed both FN and L1-L4 BMD were positively correlated with body mass, waist circumference (WC), hip circumference (HC) and LBM (kg). Fat content correlated with FN BMD (r = 0.36, p < 0.001). Regression analysis revealed the only predictor of L1-L4 BMD was LBM (R² = 0.18, p < 0.05), for FN - both LBM and fat (R² = 0.18, p < 0.05 and p < 0.001, respectively). Of the women, 44.5% were overweight, 18.4% obese. Obese women displayed the highest BMD. Both L1-L4 and FN BMD were higher in women with WC > 80 cm. In postmenopausal osteoporotic women with BMI > 20 kg/m² both fat and lean tissue might contribute to BMD. Positive association between body mass and BMD does not make obesity and osteoporosis mutually exclusive.     

Relationship between body composition and age, menopause and its effects on bone mineral density at segmental regions in Central Southern Chinese postmenopausal elderly women with and without osteoporosis

We aimed at evaluating the relationship between lean mass and fat mass with age, menopausal age (MA) and years since menopause (YSM) and their effects on bone mineral density (BMD) at segmental regions in postmenopausal elderly women with and without osteoporosis. After using a dual-energy X-ray absorptiometry (DXA) methodology to measure body composition and BMD at posteroanterior spine and hip in 244 postmenopausal elderly non-osteoporotic (Non-OP) women (65.5 ± 4.3 years) and 298 postmenopausal elderly osteoporotic (OP) women (67.1 ± 4.4 years), we found that in postmenopausal elderly Non-OP women, there was no correlation between lean mass with age, MA, and YSM, as well as no correlation between fat mass with age (all, p > 0.05); leg fat (LF) mass (r = 0.187; p < 0.01), whole body fat (WF) mass (r = 0.151; p < 0.05), and trunk fat (TRF) mass (r = 0.141; p < 0.05) were positively correlated with MA; LF (r = −0.131; p < 0.05) and WF (r = −0.127; p < 0.05) were negatively associated with YSM; WF and whole body lean (WL) mass were the most important body composition components influencing BMD at the third lumbar spine (L3), total first to fourth lumbar spine (L1-4) and hip, respectively; TRF was the most significant determinant of BMD at both L2 and L4. In postmenopausal elderly OP women, there was no relationship between body composition with MA (p > 0.05); Trunk lean (TRL) mass (r = −0.183; p < 0.05), leg lean (LL) mass (r = −0.136; p < 0.01), and WL mass (r = −0.162; p < 0.01) were negatively correlated with age; TRL mass (r = −0.132; p < 0.05), LL mass (r = −0.152; p < 0.01), WL mass (r = −0.170; p < 0.01) were also negative with YSM; WF was the most important factor influencing BMD at lumbar spine and hip. These data suggest in postmenopausal elderly Non-OP women, fat mass (TRF, LF, and WF) was more related with MA; WF and WL mass were the most important body composition components influencing BMD at L1-4 and hip, respectively; in postmenopausal elderly OP women, body composition was not correlated with MA; lean mass (TRL, LL, and WL) was more age-related negatively; WF mass was the most significant factor affecting BMD at lumbar spine and hip.     

Influence of body composition on bone mass in postmenopausal osteoporotic women

We aimed at evaluating the relationship of lean and fat mass to bone mass in osteoporotic postmenopausal women. We invited 65 women who were being treated at the São Paulo Hospital osteoporosis outpatients’ clinic to participate. Body composition and bone mineral density (BMD) measurements were performed using Dual-energy X-ray absorptiometry methodology (DXA). The mean age and weight were 69.7 ± 6.4 years and 56.3 ± 7.6 kg, respectively. Accordingly to the body mass index (BMI), 52.8% were of normal weight and 47.1% of the patients were overweight. Overweight women had significantly higher bone mass. Similarly, skeletal muscle index (SMI) showed a positive effect on BMD measurements and women with sarcopenia had significantly lower BMD measurements in total femur and femoral neck. In multiple regression analysis only lean mass and age, after adjustments to fat mass and BMI, were able to predict total body bone mineral content (BMC) (R² = 28%). Also lean mass adjusted to age and BMI were able to predict femoral neck BMD (R² = 14%). On the other hand, none of the components of the body composition (lean mass or fat mass) contributed significantly to explaining total femur BMD and neither body composition measurements were associated with spine BMD. These findings suggest that lean mass has a relevant role in BMC and BMD measurements. In addition, lower BMI and lean mass loss (sarcopenia) is associated to lower BMC and BMD of femoral neck and total femur and possible higher risk of osteoporotic fracture.     

Effects of high-resistance circuit training in an elderly population

The aim of this study was to determine the efficacy of a program of high-resistance circuit (HRC) training, and to compare the effects of HRC to traditional heavy strength (TS) training on strength, muscle size, body composition and measures of cardiovascular fitness in a healthy elderly population. Thirty-seven healthy men and women (61.6 ± 5.3 years) were randomly assigned to HRC (n = 16), TS (n = 14), or a control group (CG, n = 7). Training consisted of weight lifting twice a week for 12 weeks. Before and after the training, isokinetic peak torque in the upper and lower body, and body composition (dual X-ray absorptiometry) were determined. In addition, cardiovascular parameters were evaluated during an incremental treadmill test. Both HRC and TS groups showed significant increases in isokinetic strength (p < 0.001), and the increase was significantly greater in the experimental groups than in CG (p < 0.03). There were significant increases in lean mass (HRC, p < 0.001; TS, p = 0.025) and bone mineral density (HRC, p = 0.025; TS, p = 0.018) in the experimental groups. Only HRC showed a significant decrease in fat mass (p = 0.011); this decrease was significantly greater in HRC than in CG (p = 0.039). There were significant improvements in walking economy in the HRC group (p < 0.049), although there were no statistical differences between groups. There were no changes in any variables in CG. Hence, HRC training was as effective as TS for improving isokinetic strength, bone mineral density and lean mass. Only HRC training elicited adaptations in the cardiovascular system and a decrease in fat mass.     

Comparison of sarcopenic status between elderly leprosy survivors and general population

Because of chronicity and poor environments, elderly leprosy survivors might be at greater risk of developing obesity and sarcopenia than healthy individuals. This study aimed to investigate whether body composition and the prevalence of obesity and sarcopenia among elderly leprosy survivors with no or mild physical impairment differ from those of the general population. A total of 36 leprosy survivors aged 65–90 years with no or mild physical impairment were recruited. Individuals matched for sex, age, and height were selected as a control group from the Fourth Korea National Health and Nutrition Examination Survey. Anthropometric characteristics, body composition, appendicular skeletal muscle mass (ASM), modified skeletal muscle mass index (SMI), and the prevalence of obesity and sarcopenia were compared between the leprosy survivors and the control group. Compared to the control group, the leprosy survivors had higher body weight, BMI, total fat mass, and total fat percentage. The leprosy survivor group also had lower ASM (P = 0.035) and SMI (P < 0.001) values. Comparison of the composition of regional body parts showed that the lean body mass of the legs was lower in the leprosy survivor group even though this group had higher body weight. The leprosy survivor group also had a significantly higher prevalence of sarcopenia than the control group (38.7% vs. 5.6%; P = 0.002). These findings suggest that leprosy survivors are at greater risk of developing obesity and sarcopenia than healthy individuals. Further researches are required to investigate causes and mechanisms of sarcopenia in leprosy survivors.     

Comparison of the effects of cows' milk, fortified soy milk, and calcium supplement on weight and fat loss in premenopausal overweight and obese women

Background and aims

Recent studies suggest that calcium metabolism and perhaps other components of dairy products may contribute to shifting the energy balance and thus play a role in weight regulation. We compared the effects of cows' milk, calcium fortified soy milk and calcium supplement on weight and body fat reduction in premenopausal overweight and obese women.

Methods and Results

In this clinical trial, 100 healthy overweight or obese premenopausal women were randomized to one of the following dietary regimens for 8 weeks: (1) a control diet providing a 500 kcal/day deficit, with 500-600 mg/day dietary calcium; (2) a calcium-supplemented diet identical to the control diet with 800 mg/day of calcium as calcium carbonate; (3) a milk diet providing a 500 kcal/day deficit and containing three servings of low-fat milk; (4) a soy milk diet providing a 500 kcal/day deficit and containing three servings of calcium fortified soy milk. At baseline and after 8 weeks, weight, waist circumference, and hip circumference were measured. Three 24-h dietary records and physical activity records were also taken. Comparing the mean differences in weight, waist circumference, body mass index (BMI) and waist-to-hip ratio (WHR) using repeated measure of variance analysis showed that changes in waist circumference and WHR were significant among the four groups (p = 0.029 and p = 0.015, respectively). After adjustment for baseline values, changes in weight and BMI were also significant (p = 0.017 and p = 0.019, respectively). Weight reductions in high milk, soy milk, calcium supplement and control groups were 4.43 ± 1.93 (kg), 3.46 ± 1.28 (kg), 3.89 ± 2.40 (kg) and 2.87 ± 1.55 (kg), respectively. The greatest changes were seen in the high dairy group in all variables.

Conclusion

Increasing low fat milk consumption significantly reduces the general and central obesity beyond a low calorie diet.     

Decreased Skeletal Muscle Potassium in Obesity

ABSTRACT The effect of body weight on total body potassium, skeletal muscle electrolytes and fat content was studied in seven lean and seven obese middle-aged men and seven lean and eight obese middle-aged women. Total body potassium and total body fat increased with body weight (p<0.01 and <0.05 for men, and p<0.05 and p<0.001 for women, respectively). So did muscle fat in men (p<0.01), while muscle tissue potassium was decreased in both obese men (p<0.001) and obese women (p<0.05). The skeletal muscle Na/K-ratio tended to be higher in obese men (p<0.1) but was not related to body weight in women. Skeletal muscle magnesium was higher (p<0.01) in obese men than in lean men. No differences between lean and obese women were found. Obese men had higher diastolic blood pressure (p<0.05) than lean men, while there was no difference between obese and lean women. Compared with lean subjects, obese subjects thus had lower relative skeletal muscle mass and men, especially, had more fat and less potassium in the skeletal muscle.     

Body fat changes and activity of tumor necrosis factor α system—a 5-year follow-up study

Obesity is associated with subclinical, chronic, and systemic immune activation characterized by increased serum concentration of proinflammatory cytokines released by adipose tissue. The aim of the present study was to determine the relationship between stage of development of obesity and changes in activity of tumor necrosis factor (TNF) system during 5-year follow-up observation. One hundred fifty-four women—102 obese, 24 overweight, and 28 lean—without concomitant diseases were examined for the first time from 2000 to 2001. After 5 years, 57 obese, 12 overweight, and 14 lean subjects were reexamined. In addition to anthropometric measurements, body composition was determined by the bioimpedance method; and serum concentrations of glucose, lipids, insulin, TNF-α, and soluble TNF receptors (sTNFRs) were measured. Only reexamined subjects were included in the analysis. After 5 years, fat mass increased significantly in 46 (66.7%) overweight or obese women and in all lean subjects (39.0 ± 12.3 vs 47.3 ± 13.6 kg, P < .001; 14.8 ± 3.7 vs 20.6 ± 5.4 kg, P < .01, respectively), whereas it decreased in 23 (33.3%) overweight or obese subjects (41.3 ± 12.5 vs 37.2 ± 14.0 kg, P < .005). The TNF-α levels increased significantly only in lean women (3.1 ± 3.0 vs 5.6 ± 2.0 pg/mL, P < .005), but remained unchanged in overweight and obese subjects regardless of fat mass changes. Serum concentrations of sTNFR1 and sTNFR2 decreased by 71% and 25% in obese, by 104% and 21% in overweight, and by 31% and 32% in lean group, respectively. The increase of plasma TNF-α level is an early event in abdominal fat accumulation. It seems that further fat mass gain does not enhance circulating TNF-α levels.     

Association of cardiorespiratory fitness with insulin sensitivity in overweight and obese postmenopausal women: a Montreal Ottawa New Emerging Team study

The purpose of this study was to examine the relation between insulin sensitivity and cardiorespiratory fitness in overweight and obese postmenopausal women. The study population consisted of 127 overweight and obese postmenopausal women (age, 57.7 ± 4.8 years; body mass index, 32.7 ± 4.7 kg/m²). Subjects were classified by dividing the entire cohort into tertiles (T) based on insulin sensitivity expressed per kilograms of lean body mass (LBM) (T1, <10.9; T2, 10.9-12.9, T3, >12.9 mg/min per kilogram of LBM, respectively). Outcome measures were body composition (dual-energy x-ray absorptiometry), visceral adipose tissue (computed tomography), insulin sensitivity (hyperinsulinemic-euglycemic clamp), cardiorespiratory fitness (indirect calorimetry), lower-body muscle strength (1 maximal repetition), physical activity energy expenditure (doubly labeled water), fasting lipids, and inflammatory profile. We found a significant positive relationship between insulin sensitivity and cardiorespiratory fitness (r = 0.25, P = .005). Moreover, cardiorespiratory fitness was higher in the T3 group compared to the T1 group (36.2 ± 6.1 vs 33.1 ± 5.0 mL/kg LBM per minute, respectively; P = .028). However, the difference was no longer significant after controlling for visceral adipose tissue or muscle strength. Finally, cardiorespiratory fitness was an independent predictor of insulin sensitivity. High levels of cardiorespiratory fitness are associated with higher levels of insulin sensitivity in overweight and obese postmenopausal women. Moreover, visceral adipose tissue accumulation or muscle strength may be potential mediators of this relationship.     

Inhibition of 11β-hydroxysteroid dehydrogenase type 1 reduces food intake and weight gain but maintains energy expenditure in diet-induced obese mice

Aims/hypothesis The 11β-hydroxysteroid dehydrogenase type-1 inhibitor BVT.2733 lowers blood glucose and insulin in mutant mouse models of obesity and diabetes. Its effects on energy balance and body composition, and their contribution to improved glucose homeostasis have received little attention.Materials and methods BVT.2733 (100 mg/kg, orally) was given twice daily to lean and diet-induced obese mice for 16 or 17 days. A group of obese mice was pair-fed to the amounts consumed by BVT.2733-treated mice.Results In both obese and lean mice, BVT.2733 reduced food intake and weight gain, but increased water intake. Pair-feeding caused almost as great a decrease in body weight as BVT.2733. Energy expenditure was 38±8% higher in the BVT.2733-treated obese mice than in the pair-fed mice. Terminal plasma corticosterone was raised, lean body weight reduced and percentage fat unchanged in the pair-fed mice (control, 47.8±2.6%; pair-fed, 47.1±1.9%), whereas BVT.2733 did not reduce lean mass, but did reduce percentage fat (40.9±2.0%). BVT.2733 but not pair-feeding reduced both the glucose tolerance AUC and the plasma insulin concentration 30 min after giving glucose.Conclusions/interpretation BVT.2733 reduced food intake but prevented a concomitant reduction in lean body mass and energy expenditure. The latter effects may have contributed to improved glucose tolerance.     

Dietary intake and physical performance in healthy elderly women: A 3-year follow-up

Background

Aging is generally accompanied by changes in body composition, muscle mass and strength, leading to a decline in motor and functional performance. Physical activity and eating habits could be involved in modulating this paraphysiological deterioration. Aim of our study was to investigate changes in body composition, diet and physical performance in healthy, elderly females over a 3-year follow-up.

Methods

92 healthy elderly females (70.9 ± 4.0 years) attending a twice-weekly mild fitness program were eligible for the study. They were assessed at baseline and again after 3 years in terms of clinical history, diet, body composition by DEXA, resting energy expenditure, handgrip strength, knee extensor isometric/isotonic strength, and functional performance measured using the Short Physical Performance Battery (SPPB).

Results

After 3 years, women had a significant decline in muscle strength (? isotonic: − 1.4 ± 4.3 kg, ? isokinetic: − 2.0 ± 6.3 kg, ? handgrip: − 3.2 ± 5.0 kg; p < 0.001) and physical performance (? walking time: 0.71 ± 0.9 s, ? walking speed: − 0.25 ± 0.35 m/s; p < 0.001), while their weight and body composition parameters did not change, except for a small decrease in appendicular skeletal muscle mass (− 0.4 ± 1.4 kg). There was a significant drop in calorie (?:− 345.7 ± 533.1 kcal/d; p < 0.001) and protein intake (?:− 0.14 ± 0.23 g/d; p < 0.001), while resting energy expenditure remained stable. ? calorie intake correlated with the variation in 4-meter walking time (r: 0.34; p < 0.01).

Conclusions

With advancing age, physical performance declines even in healthy, fit females despite a spare of weight and body composition. This decline in physical activity could lead to a lower calorie intake, which would explain why there is no variation in body weight.     

Increased epicardial adipose tissue in type 1 diabetes is associated with central obesity and metabolic syndrome

Aims

The present study evaluated the relationship between metabolic syndrome (MS), body fat composition and epicardial adipose tissue (EAT) in type 1 diabetes. Epicardial adipose tissue is a new independent marker of coronary artery disease (CAD).

Methods

Forty-five type 1 diabetic women were evaluated (age 36 ± 9 years; body mass index 24.6 ± 4.4 kg/m²). Metabolic syndrome was defined by the World Health Organization criteria. Body fat composition and EAT were analyzed by dual-energy-X-ray absorptiometry and echocardiogram, respectively.

Results

Twenty patients (45%) had MS. Patients with MS had greater android (central) fat deposition than patients without MS (41.9 ± 2.0% vs. 33.7 ± 1.8%, p = 0.004). Total body fat and gynoid (peripheric) fat distribution were similar between the groups. Mean EAT was higher in patients with MS (6.15 ± 0.34 mm vs. 4.96 ± 0.25 mm; p = 0.006) and EAT was positively correlated with android (central) fat distribution (r = 0.44; p = 0.002), however no correlation was found with gynoid (peripheric) fat distribution.

Conclusions

There was a high incidence of MS in type 1 diabetes related to increased central adiposity, despite the absence of obesity. Metabolic syndrome and central obesity were associated with increased EAT. Thus, young non-obese type 1 diabetic women with central adiposity and/or MS may have increased EAT, what may predict CAD risk.     

Body composition and hip fracture type in elderly women

Many observations support the view that there are significant differences between patients sustaining trochanteric fractures and those sustaining cervical fractures of the hip. Our aim was to evaluate the association between soft tissue composition (fat and lean compartments) and the type of hip fracture sustained. Of 120 consecutive women affected by their first hip fracture admitted to our rehabilitation hospital 102 were included in this cross-sectional study. Body composition was assessed by DXA. Body fat mass was lower in the women with trochanteric fracture than in those with cervical fracture (difference between groups: 2.86 kg; 95% CI 0.10–5.61 kg; p=0.042). The percentage of fat was 30.75±8.77 (mean±SD) versus 34.75±7.29 (difference between groups: 4.00; 95% CI 0.84–7.16; p=0.014). In contrast, no meaningful differences in body lean mass were shown between the two groups. Logistic multiple regression showed that fat mass was associated with the type of fracture independently of age, height, weight, time between fracture occurrence and DEXA assessment, comorbidity, number of drugs in use, lean mass and bone mineral content. The logistic regression results were similar when fat percentage was substituted for fat mass. The data show that fat but not lean body mass is associated with the type of hip fracture, contributing to the definition of the differences between patients sustaining cervical or trochanteric fractures. We stress the importance of distinguishing the two types of fracture when clinical or epidemiological studies related to body composition, including those regarding nutrition or physical exercise, are performed.Abbreviations BMD Bone mineral density - DEXA Dual-energy X-ray absorptiometry - BMC Bone mineral content     

Association between skeletal muscle mass and radial augmentation index in an elderly Korean population

Increasing evidence supports the importance of maintaining skeletal muscle mass for cardiovascular health. However, there is limited data on the relationship between skeletal muscle mass and arterial stiffness targeting an elderly population. Thus, we investigated the association between skeletal muscle mass and arterial stiffness in an elderly Korean population. This study used data from the Korean Social Life, Health and Aging Project which started in 2011. In this cross-sectional study, 180 men (mean age 71.7) and 247 women (mean age 70.9) were included. Arm and leg muscle masses were measured by bioelectrical impedance analysis. Radial augmentation index, a noninvasive measure of arterial stiffness, was assessed by radial pulse wave analysis. The relationship between skeletal muscle mass and augmentation index was investigated by multiple linear regression analysis. In men, limb muscle mass was significantly and inversely associated with augmentation index (β = −1.07% per 1 kg muscle mass, p < 0.001) when adjusted for age. This inverse association remained after additional adjustment for body mass index, systolic blood pressure, total cholesterol, high-density lipoprotein-cholesterol, fasting glucose, insulin, smoking and alcohol intake (β = −0.69%, p = 0.019). In women, the inverse association between limb muscle mass and augmentation index was less prominent (β = −0.59%, p = 0.030), and the association disappeared when fully adjusted (β = −0.32%, p = 0.304). However, limb muscle mass was not associated with resting blood pressure either in men or women. Our results suggest that decreased skeletal muscle mass may affect arterial wall elasticity.     

Progressive Regression of Left Ventricular Hypertrophy Two Years after Bariatric Surgery

Background

Obesity is a systemic disorder associated with an increase in left ventricular mass and premature death and disability from cardiovascular disease. Although bariatric surgery reverses many of the hormonal and hemodynamic derangements, the long-term collective effects on body composition and left ventricular mass have not been considered before. We hypothesized that the decrease in fat mass and lean mass after weight loss surgery is associated with a decrease in left ventricular mass.

Methods

Fifteen severely obese women (mean body mass index [BMI]: 46.7 ± 1.7 kg/m²) with medically controlled hypertension underwent bariatric surgery. Left ventricular mass and plasma markers of systemic metabolism, together with body mass index (BMI), waist and hip circumferences, body composition (fat mass and lean mass), and resting energy expenditure were measured at 0, 3, 9, 12, and 24 months.

Results

Left ventricular mass continued to decrease linearly over the entire period of observation, while rates of weight loss, loss of lean mass, loss of fat mass, and resting energy expenditure all plateaued at 3 months (P <.001 for all). Parameters of systemic metabolism normalized by 9 months, and showed no further change at 24 months after surgery.

Conclusions

Even though parameters of obesity, including BMI and body composition, plateau, the benefits of bariatric surgery on systemic metabolism and left ventricular mass are sustained. We propose that the progressive decrease of left ventricular mass after weight loss surgery is regulated by neurohumoral factors, and may contribute to improved long-term survival.     

Treatment of hypertension with angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers and resting metabolic rate: A cross‐sectional study

Hypertension in obese and overweight patients is associated with an elevated resting metabolic rate (RMR). The aim of this study was to determine whether RMR is reduced in hypertensive patients treated with angiotensin‐converting enzyme inhibitors (ACEI) and blockers (ARB). The RMR was determined by indirect calorimetry in 174 volunteers; 93 (46.5 %) were hypertensive, of which 16 men and 13 women were treated with ACEI/ARB, while 30 men and 19 women with untreated hypertension served as a control group. Treated and untreated hypertensives had similar age, BMI, physical activity, and cardiorespiratory fitness. The RMR normalized to the lean body mass (LBM) was 15% higher in the untreated than ACEI/ARB‐treated hypertensive women (p = .003). After accounting for LBM, whole‐body fat mass, age, the double product (heart rate x systolic blood pressure), and the distance walked per day, the RMR was 2.9% lower in the patients taking ACEI/ARB (p = .26, treatment x sex interaction p = .005). LBM, age, and the double product explained 78% of the variability in RMR (R ² = 0.78, p < .001). In contrast, fat mass, the distance walked per day, and total T4 or TSH did not add predictive power to the model. Compared to men, a greater RMR per kg of LBM was observed in untreated hypertensive overweight and obese women, while this sex difference was not observed in patients treated with ACEI or ARBs. In conclusion, our results indicate that elevated RMR per kg of LBM may be normalized by antagonizing the renin‐angiotensin system.     

Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture

Changes in body composition, including a decrease in muscle and bone mass, accompany aging. Our aim was to assess the prevalence of sarcopenia and its association with osteoporosis in hip-fracture women. We performed a Dual-Energy X-Ray Absorptiometry (DXA) scan in 313 of 340 women, 20.9 ± 6.5 (mean ± S.D.) days after hip-fracture occurrence. To adjust appendicular lean mass for body size we divided it by height squared in each woman. A total of 180 of the 313 women (58%) were sarcopenic, whereas 230 (74%) were osteoporotic. After adjustment for age and interval between fracture and DXA scan we found a significant association between sarcopenia and osteoporosis (p = 0.026). For a sarcopenic woman the adjusted odds ratio (OR) for osteoporosis was 1.80 (95%CI = 1.07-3.02). Our data shows the high prevalence of sarcopenia and its significant association with osteoporosis in a large sample of hip-fracture women. Data supports a research approach on preventive and treatment strategies for osteoporosis and sarcopenia targeting both bone and muscle tissue. Furthermore, data should be considered when the economic burden of sarcopenia is estimated, given the high proportion of sarcopenic women with bone fragility.     

Evidence of proatherogenic inflammation in polycystic ovary syndrome

Women with polycystic ovary syndrome (PCOS) have chronic low-level inflammation that can increase the risk of atherogenesis. We measured circulating proatherogenic inflammatory mediators in women with PCOS (8 lean: body mass index, 18-25 kg/m²; 8 obese: body mass index, 30-40 kg/m²) and weight-matched controls (8 lean, 8 obese). Blood samples were obtained fasting and 2 hours after glucose ingestion to measure interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), monocyte chemotactic protein-1 (MCP-1), C-reactive protein (CRP), matrix metalloproteinase-2, plasminogen activator inhibitor-1 (PAI-1), and activated nuclear factor κB in mononuclear cells. Truncal fat was determined by dual-energy x-ray absorptiometry. Fasting MCP-1 levels were elevated in lean women with PCOS compared with lean controls (159.9 ± 14.1 vs 121.2 ± 5.4 pg/mL, P < .02). Hyperglycemia failed to suppress matrix metalloproteinase-2 in lean women with PCOS compared with lean controls (1.7 ± 1.2 vs −4.8 ± 1.6 pg/mL, P < .002). Among women with PCOS, obese individuals exhibited higher fasting sICAM-1 (16.1 ± 0.8 vs 10.5 ± 1.0 ng/mL, P < .03) and PAI-1 (6.1 ± 0.7 vs 3.4 ± 0.8 ng/mL, P < .03) levels. Trend analysis revealed higher (P < .005) IL-6, sICAM-1, CRP, PAI-1, systolic and diastolic blood pressures, triglycerides, fasting insulin, and homeostasis model assessment of insulin resistance index in women with PCOS compared with weight-matched controls, and the highest levels in the obese regardless of PCOS status. Fasting MCP-1 levels correlated with activated nuclear factor κB during hyperglycemia (P < .05) and androstenedione (P < .004). Truncal fat correlated with fasting IL-6 (P < .004), sICAM-1 (P < .006), CRP (P < .0009), and PAI-1 (P < .02). We conclude that both PCOS and obesity contribute to a proatherogenic state; but in women with PCOS, abdominal adiposity and hyperandrogenism may exacerbate the risk of atherosclerosis.     

Gender differences in hand grip power in the elderly

This study aimed to clarify the difference in hand grip power in elderly males and females. The subjects were 15 elderly males (mean age 65.6 ± 2.5 years, mean height 165.7 ± 6.0 cm, mean mass 63.9 ± 5.5 kg) and 15 elderly females (mean age 65.0 ± 2.6 years, mean height 155.2 ± 5.3 cm, mean mass 56.5 ± 7.3 kg). Peak velocity was measured by the dominant hand with loads of 30, 40 and 50% of maximum voluntary contraction (MVC). The MVC was significantly greater in males than in females. The peak velocity and the required time to reach peak velocity in all loads showed insignificant differences between both groups. Hand grip power was significantly greater in males than in females in all loads. In conclusion, elderly males have superior hand grip power compared to elderly females and this gender difference depends largely on MVC. The decrease in muscle contraction velocity in those main muscle groups related to hand grip movement accompanied by age may be greater in males than in females.     

Age differences in hand grip power in the elderly

This study aimed to clarify the age-level difference of hand grip power in females. The subjects were 15 healthy young females (mean age 21.5 ± 1.4 years, mean height 159.5 ± 2.9 cm, mean mass 52.6 ± 6.1 kg) and 15 elderly females (mean age 65.0 ± 2.6 years, mean height 155.2 ± 5.3 cm, mean mass 56.5 ± 7.3 kg). Peak velocity of the dominant hand was measured using three different loads of 30, 40 and 50% of maximum voluntary contraction (MVC). The MVC and hand grip power were meaningfully greater in the young group than in the elderly group. The peak velocity in all loads showed a meaningful difference between both groups and it was faster in the order of 30, 40 and 50% MVC in both groups. The required time to reach peak velocity at 50% MVC was meaningfully longer in the elderly group, but was significantly shorter at 30% MVC than at 40 and 50% MVC in both groups. In conclusion, the age-level difference in hand grip power using relative loads depends more greatly on MVC than velocity in females. The muscle tensile related to hand grip movement decreases with age.