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Physical activity can reduce the prevalence of gallstone disease among males: An observational study.
Kwon, OS, Kim, YK, Her, KH, Kim, HJ, Lee, SD
Medicine. 2020;99(26):e20763
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Gallstone disease (GD) is one of the most common digestive disorders and can cause acute abdominal pain, jaundice, and abnormal liver function due to stones deposited in the gallbladder or bile ducts. Metabolic syndrome is a known risk factor for GD and physical activity (PA) can reduce the incidence of metabolic syndrome. The aim of this observational study was to evaluate whether PA can reduce the risk of GD in a Korean population. 8908 subjects were included in this study, GD was diagnosed by ultrasound and PA was defined as moderate-intensity aerobic PA for at least 150 minutes, or vigorous-intensity activity for at least 75 minutes throughout the week. Participants underwent physical investigation and had blood samples taken to establish metabolic syndrome markers. In men, PA, old age and higher AST (aspartate aminotransferase, a liver enzyme) were independent risk factors for GD, whilst in women only a history of non-alcoholic fatty liver disease, but not PA, was independently associated with GD.
Abstract
Several previous studies have reported that physical activity (PA) levels can independently affect the prevalence of gallstone disease (GD) in Western countries. However, this association has not been reported in Eastern countries. Therefore, this study aimed to determine whether PA is an independent determinant of GD prevalence in a Korean population, according to the World Health Organizations Global Recommendations on PA for Health.A total of 8908 subjects who completed a questionnaire underwent medical examination and ultrasound scanning at the Health Promotion Center of the Jeju National University Hospital between January 2009 and December 2018. GD and fatty liver disease were diagnosed by abdominal ultrasound. Biochemical parameters and body mass index were determined, and metabolic syndrome status, age, and PA levels were extracted from medical records. Univariate and multivariate analyses were performed to identify independent factors affecting GD.The estimated rates of PA and GD among male subjects were 23.7% and 4.6%, whereas the rates among females were 18.4% and 4.2%, respectively. Multivariate analysis suggested that no PA, old age, and higher aspartate aminotransferase level in males and nonalcoholic fatty liver disease status in females were independent factors affecting GD.In our study, PA was associated with a reduction in GD among males but not females.
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A cross-sectional study: Associations between sarcopenia and clinical characteristics of patients with type 2 diabetes.
Cui, M, Gang, X, Wang, G, Xiao, X, Li, Z, Jiang, Z, Wang, G
Medicine. 2020;99(2):e18708
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Sarcopenia is characterised by the loss of muscle mass, decrease of muscle strength and decline of physical performance and is related to reduced physical ability, impaired cardiorespiratory function, disability and death in the elderly. Type 2 diabetics are at higher risk of developing sarcopenia. The aim of this cross-sectional study was to evaluate clinical characteristics of sarcopenia in elderly type 2 diabetics in the Northeast of China. 132 participants completed the study which was based on self-reported medical and lifestyle history, and clinical evaluations including measurements of weight, height and muscle strength, imaging to establish sarcopenia and blood tests. 28.8% of participants had sarcopenia. Age, increased truncal fat mass and increased free thyroxine increased the risk of sarcopenia, whilst regular exercise, being female, taking metformin, a higher body mass index and increased trunk skeletal mass were associated with a lower risk of sarcopenia. The authors point out that limitations include the small sample size and that, as this is a cross-sectional study, cause and effect cannot be established.
Abstract
Sarcopenia is a geriatric syndrome and it impairs physical function. Patients with type 2 diabetes mellitus (T2DM) are at a higher risk of sarcopenia. The purpose of this study is to explore characteristics of general information and metabolic factors of sarcopenia in patients with T2DM in the northeast of China, and provide information for the prevention and treatment of sarcopenia in clinical practice.Patients with T2DM aged ≥65 were recruited in Changchun from March 2017 to February 2018. Questionnaires of general information, physical examination, laboratory and imaging examination were conducted. The patients were assigned into sarcopenia group and non-sarcopenia group according to the diagnostic criteria proposed by Asian working group for sarcopenia (AWGS), and the differences between 2 groups were analyzed.A total of 132 participants were included in this study, of which, 38 (28.8%) were diagnosed with sarcopenia. 94 (71.2%) were with no sarcopenia. Logistic regression analysis showed that age (OR: 1.182, 95%CI: 1.038-1.346), trunk fat mass (TFM) (OR: 1.499, 95%CI: 1.146-1.960) and free thyroxine (FT4) (OR: 1.342, 95%CI: 1.102-1.635) were independent risk factors for sarcopenia. BMI (body mass index) (OR: 0.365, 95%CI: 0.236-0.661), exercise (OR: 0.016, 95%CI: 0.001-0.169), female (OR: 0.000, 95%CI: 0.00-0.012), metformin (OR: 0.159, 95%CI: 0.026-0.967) and TSM (trunk skeletal muscle mass) (OR: 0.395, 95%CI: 0.236-0.661) were protective factors for sarcopenia.Sarcopenia in patients with T2DM is associated with increased age, increased TFM and increased FT4 level. Regular exercise, female, metformin administrations, high BMI and increased TSM are associated with lower risk of sarcopenia.
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Association of resting heart rate with nonalcoholic fatty liver disease in postmenopausal women.
Kim, HB, Lee, YJ
Medicine. 2020;99(14):e19529
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Non-alcoholic fatty liver disease (NAFLD) is characterised by accumulation of fats in the liver and is particularly prevalent in postmenopausal women, due to a decrease in oestrogen, which leads to weight gain. Higher than normal resting heart rate has been shown to be a predictor of heart disease, however studies that look at the relationship between heart rate and NAFLD are lacking. This cross-sectional, observation study of 1315 postmenopausal women aimed to look at the relationship between resting heart rate and NAFLD. The results showed that the overall prevalence of NAFLD was increased with increased resting heart rate. It was concluded that resting heart rate was associated with NAFLD in postmenopausal women and it could be used as an additional predictor for risk of the disease. This study could be used by healthcare practitioners to understand the possible relationship between resting heart rate and the risk of developing NAFLD.
Abstract
Resting heart rate, a simple and useful indicator of autonomic function, and its imbalance has emerged as an independent predictor of cardio metabolic diseases. Nonalcoholic fatty liver disease (NAFLD) is increasingly being diagnosed worldwide and is strongly associated with the features of cardiometabolic diseases. This study aimed to examine the association between resting heart rate and NAFLD in postmenopausal women.The cross-sectional study included 1017 postmenopausal women aged ≥46 years, who attended a health examination program. Resting heart rate and NAFLD were measured in all subjects who underwent a medical examination. Resting heart rate quartiles were categorized as follows: Q1: 56 to 65, Q2: 66 to 71, Q3: 72 to 78, and Q4: 79 to 99 beats/min. The odds ratios and 95% confidence intervals for NAFLD were calculated after adjusting for confounding variables across resting heart rate quartiles using multiple logistic regression analysis.The prevalence of NAFLD increased with increasing resting heart rate quartiles: 28.2% for Q1, 31.5% for Q2, 33.4% for Q3, and 38.1% for Q4 (P < .001). Compared to the 1st quartile, the odds ratio (95% confidence intervals) of NAFLD in the 4th quartile of resting heart rates was 2.11 (1.17-3.42) after adjusting for age, body mass index, cigarette smoking, regular exercise, blood pressure, total cholesterol, triglyceride, aspartate aminotransferase, and alanine aminotransferase levels.Resting heart rate was positively associated with NAFLD in postmenopausal women, suggesting that it could be a useful additional measure to assess the risk for NAFLD in postmenopausal women.
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Adherence to the Mediterranean Diet and Its Association with Body Composition and Physical Fitness in Spanish University Students.
Cobo-Cuenca, AI, Garrido-Miguel, M, Soriano-Cano, A, Ferri-Morales, A, Martínez-Vizcaíno, V, Martín-Espinosa, NM
Nutrients. 2019;11(11)
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The Mediterranean diet (MD) represents a dietary pattern that incorporates healthy traditional eating habits which includes high consumption of vegetables, fruit, legumes, nuts, beans, whole grains, fish, and unsaturated fats, and low consumption of red meat and dairy products. The Mediterranean Diet Adherence Screener (MEDAS-14 items) is a valid instrument for the estimation of adherence to the MD. The objectives of this study were to: 1. Estimate the prevalence of the adherence to the MD 2. Assess the association of adherence to the MD with physical fitness and body composition 3. Know the ability of each MEDAS item in the same sample to predict MD adherence. This study is a cross-sectional observational study which was performed with 310 first-year Spanish university students, aged between 18 and 30 years. Results indicate low prevalence of good adherence to the MD; and the participants with good adherence had high protein and low-fat intake compared to those with medium to low adherence. Furthermore, higher levels of physical fitness were also noticed amongst participants with good adherence to the MD. Twelve of the 14 items of the MEDAS score were associated with a high adherence to the MD. Authors conclude that MD adherence benefits both cardiorespiratory and muscular fitness amongst young adults.
Abstract
The aims of this study were to assess the association of adherence to the Mediterranean diet (MD) with physical fitness and body composition in Spanish university students and to determine the ability to predict the MD adherence of each Mediterranean Diet Adherence Screener (MEDAS) item. A cross-sectional study was performed involving 310 first-year university students. Adherence to the MD was evaluated with MEDAS-14 items. Anthropometric variables, body composition, and physical fitness were assessed. Muscle strength was determined based on handgrip strength and the standing long jump test. Cardiorespiratory fitness (CRF) was measured using the Course-Navette test. Only 24% of the university students had good adherence to the MD. The ANCOVA models showed a significant difference between participants with high adherence to the MD and those with medium and low adherence in CRF (p = 0.017) and dynamometry (p = 0.005). Logistic binary regression showed that consuming >2 vegetables/day (OR = 20.1; CI: 10.1-30.1; p < 0.001), using olive oil (OR = 10.6; CI: 1.4-19.8; p = 0.021), consuming <3 commercial sweets/week (OR = 10.1; IC: 5.1-19.7; p < 0.001), and consuming ≥3 fruits/day (OR = 8.8; CI: 4.9-15.7; p < 0.001) were the items most associated with high adherence to the MD. In conclusion, a high level of adherence to the MD is associated with high-level muscular fitness and CRF in Spanish university students.
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Walking balance is mediated by muscle strength and bone mineral density in postmenopausal women: an observational study.
Ibeneme, SC, Ekanem, C, Ezuma, A, Iloanusi, N, Lasebikan, NN, Lasebikan, OA, Oboh, OE
BMC musculoskeletal disorders. 2018;19(1):84
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Menopause is associated with changes in body composition such as an increase in body weight and body fat, and a decrease in muscle and bone mass. These changes in body composition may be partly responsible for an increased risk of falls in older women. This observational study had two aims: 1) to explore differences in body composition between premenopausal and postmenopausal women, and 2) to explore how body composition relates to walking balance in postmenopausal women. Fifty-one pre-menopausal and 50 postmenopausal women were selected to take part in this Nigerian study. The women were tested for hand grip strength (HGS), bone mineral density (BMD), percentage body fat mass (%BFM), fat mass (FM) fat-free mass (FFM) and body mass index (BMI). A test was also carried out to assess walking balance (WB) in each of the women. The researchers found that the postmenopausal women had higher BMI, %BFM, FM and lower HGS, compared to the premenopausal women. HGS was the strongest predictor of WB in postmenopausal women and BMD was also related to WB. The authors concluded that differences in body composition may adversely impact muscle strength in postmenopausal women. Muscle strength and BMD are associated with WB, but only explain a small amount of the variance for WB. Therefore, other factors in addition to musculoskeletal health are necessary to mitigate fall risk in postmenopausal women.
Abstract
BACKGROUND Depletion of ovarian hormone in postmenopausal women has been associated with changes in the locomotor apparatus that may compromise walking function including muscle atrophy/weakness, weight gain, and bone demineralization. Therefore, handgrip strength (HGS), bone mineral density (BMD) and body composition [percentage body fat mass (%BFM), fat mass (FM), Fat-free mass (FFM) and body mass index (BMI)], may significantly vary and predict WB in postmenopausal women. Consequently, the study sought to 1. Explore body composition, BMD and muscle strength differences between premenopausal and postmenopausal women and 2. Explore how these variables [I.e., body composition, BMD and muscle strength] relate to WB in postmenopausal women. METHOD Fifty-one pre-menopausal (35.74 + 1.52) and 50 postmenopausal (53.32 + 2.28) women were selected by convenience sampling and studied. Six explanatory variables (HGS, BMD, %BFM, FFM, BMI and FM) were explored to predict WB in postmenopausal women: Data collected were analyzed using multiple linear regression, ANCOVA, independent t-test and Pearson correlation coefficient at p < 0.05. RESULT Postmenopausal women had higher BMI(t = + 1.72; p = 0.04), %BFM(t = + 2.77; p = .003), FM(t = + 1.77; p = 0.04) and lower HGS(t = - 3.05; p = 0.001),compared to the premenopausal women. The predicted main effect of age on HGS was not significant, F(1, 197) = 0.03, p = 0.06, likewise the interaction between age and %BFM, F(1, 197) = 0.02, p = 0.89; unlike the predicted main effect of %BFM, F(1, 197) = 10.34, p = .002, on HGS. HGS was the highest predictor of WB (t = 2.203; β=0.3046) in postmenopausal women and combined with T-score right big toe (Tscorert) to produce R2 = 0.11;F (2, 47)=4.11;p = 0.02 as the best fit for the predictive model. The variance (R2) change was significant from HGS model (R2 = 0.09;p = 0.03) to HGS + Tscorert model (R2 = 0.11;p = 0.02). The regression model equation was therefore given as: WB =5.4805 + 0.1578(HGS) + (- 1.3532) Tscorert. CONCLUSION There are differences in body composition suggesting re-compartmentalization of the body, which may adversely impact the (HGS) muscle strength in postmenopausal women. Muscle strength and BMD are associated with WB, although, only contribute to a marginal amount of the variance for WB. Therefore, other factors in addition to musculoskeletal health are necessary to mitigate fall risk in postmenopausal women.
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Inflammation and glucose homeostasis are associated with specific structural features among adults without knee osteoarthritis: a cross-sectional study from the osteoarthritis initiative.
Stout, AC, Barbe, MF, Eaton, CB, Amin, M, Al-Eid, F, Price, LL, Lu, B, Lo, GH, Zhang, M, Pang, J, et al
BMC musculoskeletal disorders. 2018;19(1):1
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Individuals with osteoarthritis (OA) typically present with greater systemic inflammation and impaired glucose homeostasis. Currently it is unclear whether these factors are associated with early-stage OA, namely bone marrow lesions and swelling. The purpose of this cross-sectional study was to investigate the role of inflammation and glucose homeostasis in early-stage OA. Using baseline data from the Osteoarthritis Initiative, 343 participants were enrolled and tested for markers of inflammation and impaired glucose homeostasis. Bone marrow lesions and swelling were also assessed through imaging results. Results indicate that among individuals without OA, those with greater systemic inflammation were more likely to have bone marrow lesions and knee swelling. According to these results, the authors conclude that systemic inflammation and glucose homeostasis are related to structural features of osteoarthritis. Future studies should explore whether these factors are predictive of OA in order to identify therapeutic targets to prevent or delay the onset of knee OA.
Abstract
BACKGROUND Greater age and body mass index are strong risk factors for osteoarthritis (OA). Older and overweight individuals may be more susceptible to OA because these factors alter tissue turnover in menisci, articular cartilage, and bone via altered glucose homeostasis and inflammation. Understanding the role of inflammation and glucose homeostasis on structural features of early-stage OA may help identify therapeutic targets to delay or prevent the onset of OA among subsets of adults with these features. We examined if serum concentrations of glucose homeostasis (glucose, glycated serum protein [GSP]) or inflammation (C-reactive protein [CRP]) were associated with prevalent knee bone marrow lesions (BMLs) or effusion among adults without knee OA. METHODS We conducted a cross-sectional study using baseline data from the Osteoarthritis Initiative. We selected participants who had no radiographic knee OA but were at high risk for knee OA. Blinded staff conducted assays for CRP, GSP, and glucose. Readers segmented BML volume and effusion using semi-automated programs. Our outcomes were prevalent BML (knee with a BML volume > 1 cm3) and effusion (knee with an effusion volume > 7.5 cm3). We used logistic regression models with CRP, GSP, or glucose concentrations as the predictors. We adjusted for age, sex, body mass index (BMI), and Physical Activity Scale for the Elderly (PASE) scores. RESULTS We included 343 participants: mean age = 59 ± 9 years, BMI = 27.9 ± 4.5 kg/m2, PASE score = 171 ± 82, and 64% female. Only CRP was associated with BML prevalence (odds ratio [OR] = 1.43, 95% confidence interval [CI] = 1.09 to 1.87). For effusion, we found an interaction between BMI and CRP: only among adults with a BMI <25 kg/m2 was there a significant trend towards a positive association between CRP and effusion (OR = 1.40, 95% CI = 1.00 to 1.97). We detected a U-shaped relationship between GSP and effusion prevalence. Fasting glucose levels were not significantly associated with the presence of baseline effusion or BML. CONCLUSIONS Among individuals without knee OA, CRP may be related to the presence of BMLs and effusion among normal weight individuals. Abnormal GSP may be associated with effusion. Future studies should explore whether inflammation and glucose homeostasis are predictive of symptomatic knee OA.
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Dieting is associated with reduced bone mineral accrual in a longitudinal cohort of girls.
Hohman, EE, Balantekin, KN, Birch, LL, Savage, JS
BMC public health. 2018;18(1):1285
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Adolescence is a critical period for bone development. Maximizing bone development during adolescence (mean age of 12.5 years) may result in greater adult bone mineral content and protection against osteoporosis and fracture later in life. The objective of the study is to determine whether bone mineral content in adolescent girls is related to self-reported dieting, eating, and weight-related behaviours. The study recruited 197 non-Hispanic white 5-year-old girls who were assessed every 2-years from age 5 to age 15 years. Results show that who begin dieting in preadolescence have a higher risk of impaired bone mineral build-up compared to girls who began dieting later in adolescence or did not diet in adolescence. Authors conclude that measures of disordered eating attitudes in healthy children are associated with poorer bone health. Interventions to prevent dieting in preadolescents and adolescents may improve bone health.
Abstract
BACKGROUND Peak bone mass accrual occurs during adolescence, a time when dieting and related eating behaviors are common. Impaired bone mineral accrual is a known consequence of eating disorders in adolescents, but the effects of subclinical dieting behaviors on bone mineral content (BMC) have not been described in this age group. The goal of this analysis was to determine whether dieting behavior in preadolescence and adolescence is associated with bone mineral accrual in adolescent girls. METHODS Non-Hispanic white girls (n = 139) were followed in a longitudinal cohort study. BMC was assessed at ages 9 and 15y. Dieting to lose weight was reported every 2 years, and dietary restraint and disinhibition, eating attitudes, weight concerns, and body esteem were assessed at age 11y. Girls were classified as "early dieters" if they first dieted by age 11y (31.7%), "adolescent dieters" if they first dieted after 11y (46.8%), or non-dieters if they did not report dieting by 15 y (21.6%). The effect of dieting related variables on BMC at 15y and change in BMC from 9 to 15y was assessed using linear regression, controlling for height, weight, BMI, physical activity, and pubertal status. RESULTS Girls who first reported dieting to lose weight by age 11y had a 4.2% lower bone mineral accrual across adolescence (p = 0.02) and 3.1% lower BMC at age 15y (p = 0.005) than girls who first reported dieting after 11y or not at all. Number of weight control behaviors used, dietary restraint, and weight concerns were also negatively associated with BMC (p < 0.05). CONCLUSIONS Dieting behavior in preadolescence is associated with reduced bone mineral accrual. Strategies to promote optimal bone development should include prevention of dieting. TRIAL REGISTRATION Clinicaltrials.gov NCT03342430, November 17, 2017. Retrospectively registered.