Detraining Effects on Muscle Quality in Older Men with Osteosarcopenia. Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

The present study aimed to determine the effect of detraining on muscle quality (MQ) in older men with osteosarcopenia. Forty-three community-dwelling older men (78 ± 4 years) were randomly allocated to a consistently supervised high-intensity resistance exercise training (HIRT) group (n = 21) or a control group (CG, n = 22). The HIRT scheduled a periodized single set protocol twice weekly. After the intervention, the men were subjected to six months of detraining. Muscle quality (MQ), defined as maximum isokinetic hip/leg extensor strength per unit of mid-thigh intra-fascia volume, was determined by magnetic resonance imaging (MRI) or per unit of thigh muscle mass assessed by dual-energy X-ray absorptiometry (DXA). Intention-to-treat analysis with multiple imputations was applied. We observed significant exercise effects for MQ (p = 0.001). During detraining, the HIRT group lost about one-third of the intervention-induced gain and displayed significantly (p = 0.001) higher MQ reductions compared to the CG. Nevertheless, after training and detraining, the overall intervention effect on MQ remained significant (p ≤ 0.004). In summary, six months of absence from HIRT induce a significant deleterious effect on MQ in older osteosarcopenic men. We conclude that intermitted training programs with training breaks of six months and longer should be replaced by largely continuous exercise programs, at least when addressing MQ parameters.     

Evaluation of Body Composition,Physical Activity,and Food Intake in Patients with Inborn Errors of Intermediary Metabolism

Children with inborn errors of intermediary metabolism (IEiM) must follow special diets that restrict their intake of essential nutrients and may compromise normal growth and development. We evaluated body composition, bone mineral density, physical activity, and food intake in IEiM patients undergoing dietary treatment. IEiM patients (n = 99) aged 5–19 years and healthy age- and sex-matched controls (n = 98) were recruited and underwent dual-energy X-ray absorptiometry to evaluate anthropometric characteristics and body composition. Data on food intake and physical activity were also collected using validated questionnaires. The height z-score was significantly lower in IEiM patients than controls (−0.28 vs. 0.15; p = 0.008), particularly in those with carbohydrate and amino acid metabolism disorders. Significant differences in adiposity were observed between patients and controls for the waist circumference z-score (−0.08 vs. −0.58; p = 0.005), but not the body mass index z-score (0.56 vs. 0.42; p = 0.279). IEiM patients had a significantly lower total bone mineral density (BMD) than controls (0.89 vs. 1.6; p = 0.001) and a higher risk of osteopenia (z-score < −2, 33.3% vs. 20.4%) and osteoporosis (z-score < −2.5, 7.1% vs. 0%), but none presented fractures. There was a significant positive correlation between natural protein intake and BMD. Our results indicate that patients with IEiM undergoing dietary treatment, especially those with amino acid and carbohydrate metabolism disorders, present alterations in body composition, including a reduced height, a tendency towards overweight and obesity, and a reduced BMD.     

Obesity and Circulating Levels of Vitamin D before and after Weight Loss Induced by a Very Low-Calorie Ketogenic Diet

Background: Vitamin D plays a pivotal role in calcium and phosphorus metabolism, also influencing bone tissue. Several studies have reported that vitamin D blood levels were significantly lower in people with obesity, probably due to its uptake by the adipose tissue. Clinical studies that investigated the changes of circulating levels of vitamin D following weight loss reported controversial data. A very low-calorie ketogenic diet is acknowledged as a reliable treatment to achieve a rapid weight loss. Therefore, we investigated the effect of weight loss, consequent to a very low-calorie ketogenic diet, on vitamin D blood concentrations. Methods: A cohort of 31 people with obesity underwent a very low-calorie ketogenic diet for 10–12 weeks. The serum concentrations of vitamin D, parathormone, calcium and phosphorous were measured before and after weight loss; they were compared to a control group of 20 non-obese, non-diabetic, age- and gender-matched persons. Results: Patients with obesity had a higher habitual intake of vitamin D than the control group (p < 0.05). However, the vitamin D blood levels of the obese group were significantly lower than those of the control group (p < 0.005) and they increased after weight loss (p < 0.001). At baseline, vitamin D blood concentrations of the persons with obesity were significantly correlated with both fat mass–kg (r = −0.40; p < 0.05) and body mass index (r = −0.47; p < 0.01). Following very low-calorie ketogenic diet, the change in vitamin D serum concentrations was correlated only with the change in fat mass–kg (r = −0.43; p < 0.01). Conclusion: This study confirmed that patients with obesity have lower vitamin D levels that normalize after significant weight loss, supporting the hypothesis that vitamin D is stored in the adipose tissue and released following weight loss.     

Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women

Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.     

Postoperative Paenibacillus thiaminolyticus Wound Infection,Switzerland

Paenibacillus thiaminolyticus is a nonvirulent organism found in human and ruminant microbiota. However, P. thiaminolyticus can act as an opportunistic pathogen in humans. We describe a case of abdominal wall hematoma secondarily infected by P. thiaminolyticus. Our findings emphasize the risk for unusual Paenibacillus infections in otherwise healthy persons.     

高效液相色谱-电感耦合等离子体质谱法测定海鱼中无机砷

目的建立测定海鱼中无机砷含量的高效液相色谱-电感耦合等离子体质谱法。方法海鱼样品经稀硝酸超声热水浴提取后,AS7阴离子交换色谱柱分离,3.5 mmol/L(NH4)2CO3+1%甲醇与100 mmol/L(NH4)2CO3+1%甲醇流动相梯度洗脱,电感耦合等离子体质谱仪测定,以保留时间定性,外标法定量。结果在1~100μg/L的线性范围,6种砷形态化合物的回归方程均呈良好的线性关系,相关系数均优于0.9996,检出限为0.05~0.25μg/L,定量限为0.17~0.84μg/L,3个浓度加标回收率为88.5%~106.4%,相对标准偏差为2.5%~4.9%。结论本方法满足海鱼中无机砷含量的测定要求,提取快速,稳定,操作简单,检出限低,方法的重现性好,灵敏度高。     

应用MALDI-TOF MS快速鉴定blaKPC-2基因型肺炎克雷伯菌

 目的 探讨基质辅助激光解析/电离飞行时间质谱(MALDI-TOF MS)对携带bla_KPC-2基因型肺炎克雷伯菌的快速鉴定能力。方法 收集2018年9月-2020年11月蚌埠医学院第一附属医院临床住院患者分离的肺炎克雷伯菌,采用纸片扩散法进行药敏试验。应用聚合酶链反应(PCR)方法筛选携带bla_KPC-2基因型肺炎克雷伯菌。MALDI-TOF MS鉴定菌株并收集携带bla_KPC-2基因型和碳青霉烯类敏感肺炎克雷伯菌(CSKP)的质谱图,各自选取其中70株菌株图谱,建立携带bla_KPC-2基因型和CSKP的超级图库(Super-Spectra)。采用超级图库鉴定除建库以外的肺炎克雷伯菌,根据耐药表型和PCR结果,判断鉴定结果是否准确。结果 共收集295株肺炎克雷伯菌,经耐药表型筛选耐碳青霉烯类肺炎克雷伯菌(CRKP)143株和CSKP 152株。CRKP中鉴定出140株携带碳青霉烯酶基因(134株检出bla_KPC-2基因,3株检出bla_KPC-18基因,2株检出bla_NDM-1基因,1株检出bla_IMP基因),3株不携带碳青霉烯酶基因;其中2株同时检出bla_KPC-2基因和bla_NDM-1基因。根据建库要求,建立携带bla_KPC-2基因型和CSKP的超级图库(Super-Spectra);设置error值<0.5,二者重合率达80%;对比图发现,4 154.4、8 310.7、10 880.8、3 579、10 079.3 m/z五个峰可作为区分携带bla_KPC-2基因肺炎克雷伯菌和CSKP的特征峰。选取除建库以外的155株肺炎克雷伯菌进行验证,准确率为92.90%(144/155);其中携带bla_KPC-2基因肺炎克雷伯菌准确率为94.52%(69/73),CSKP准确率为91.46%(75/82)。结论 通过MALDI-TOF MS建立Super-Spectra,可快速预测bla_KPC-2基因型肺炎克雷伯菌,为临床CRKP感染的诊疗及医院感染防控提供可靠的实验室依据。     

单纯性肥胖症瘦素水平的临床意义

目的 :探讨单纯性肥胖症血清瘦素 (Leptin)及其临床意义。方法 :用ELISA法检测 48例单纯性肥胖症 (体重指数≥ 2 5 )和 40例健康对照者的血清Leptin水平。结果 :肥胖症组血清瘦素水平明显高于健康对照组 (P <0 .0 0 1) ,女性几乎较男性高 2倍以上。瘦素与BMI及脂肪含量呈正相关 (相关系数r分别为男性r =0 .36 ,0 .33 ,P <0 .0 5 ;女性r =0 .90 ,0 .87,P <0 .0 5 )。结论 :单纯性肥胖症血清瘦素水平升高 ,提示瘦素抵抗存在 ,可能在肥胖的发生发展中起重要作用     

创伤性脊髓损伤患者血清和尿液的代谢组学分析

背景:创伤性脊髓损伤在临床上主要依赖于量表评估与影像学检查,但对于损伤程度的预后评估具有一定局限性,利用代谢组学技术进行生物标志物筛选,对于估计病变范围、损伤与恢复程度以及开发新疗法具有重要意义。目的:使用代谢组学技术来表征创伤性脊髓损伤患者的代谢特征,探寻潜在的生物标志物及失调的代谢途径。方法:收集20例创伤性脊髓损伤患者(观察组)和10例健康受试者(对照组)的血清和尿液样本,进行代谢物分析,然后利用多元变量统计分析进行数据处理,筛选差异代谢物。通过MetaboAnalyst软件进行代谢通路富集,应用logistic回归构建生物标志物组合模型,并分析其与美国脊髓损伤协会(ASIA)分级的关系。结果与结论:两组受试者的血清和尿液中分别检测出160种和73种具有显著差异的代谢物。通路富集分析显示,创伤性脊髓损伤后脂质代谢出现明显的紊乱,包括鞘脂类、亚油酸、α-亚麻酸和花生四烯酸代谢以及糖基磷脂酰肌醇生物合成。识别出他索沙坦和葫芦素糖苷这组生物标志物,并且二者构成的代谢物组合在血清和尿液中的水平与ASIA分级存在相关性。由此可见,代谢组学技术为进一步理解创伤性脊髓损伤病理机制、筛选治疗靶点提供帮助。识别出的代谢生物标志物组合可能为评估创伤性脊髓损伤的严重程度提供参考。     

我国男性青年人体质量的分布

目的　探讨我国男性青年人体质量的几何分布。方法　采用CT 图像分析法对 5 0例 18～ 2 3岁我国男性青年进行了全身CT横断层扫描、影像分析和测算。结果　获得了样本各环节的质量数据 ,与国外有关数据比较 ,整体质量最大绝对误差为 2 .94kg ,平均绝对误差为 0 .88kg ;最大相对误差为 5 .0 0 % ,平均相对误差为 0 .34 %。结论　为建立我国男性青年人体惯性参数模型奠定了基础。