Blanca Rueda-Medina

The Effects of Body Composition, Dietary Intake, and Physical Activity on Calcaneus Quantitative Ultrasound in Spanish Young Adults

Identifying modifiable factors that influence bone gain during early adulthood in order to maximize peak bone mass (PBM) is a potential primary strategy in the prevention of osteoporosis in later life. The present study examined the relationships between body composition, dietary intake and physical activity (PA), and bone health measured by quantitative ultrasound (QUS) at the right calcaneus. The study population consisted of 781 Spanish men and women (age 19.1 ± 3.6). Body composition, dietary intake, PA, and bone strength were assessed. Calcaneus QUS was significantly correlated with age, height, weight, body mass index, lean mass, fat mass, protein intake, and moderate and high PA. No significant correlation between calcium intake and broadband ultrasound attenuation (BUA, dB/MHz) was detected. Linear regression analyses revealed that independent variables accounted for 18.8% of the total variance of calcaneus BUA (p = .000). Lean mass and high PA were significant predictors of BUA variance in young adults (p = .000 and p = .045, respectively). Results indicate that lifestyle choices and their consequences during early adulthood could influence bone mass, particularly PA and lean mass. Furthermore, this study provides novel data about bone mass as indicated by the QUS measurements at the time of PBM acquisition.

Genetic association analysis of vitamin D receptor gene polymorphisms and obesity-related phenotypes

Vitamin D has been established as a key factor in the development of obesity through the vitamin D receptor (VDR). The aim of this study was to investigate the contribution of the VDR gene to obesity-related phenotypes in a population of Caucasian young adults. The study population consisted of 701 healthy Spanish young adults (mean age 20.41±2.48). Three single-nucleotide polymorphisms (SNPs) of VDR (TaqI, BsmI and FokI) were selected as genetic markers. Body composition measurements including weight, body mass index (BMI), fat mass (FM), percentage of fat mass (PFM), fat-free mass (FFM) and visceral fat level (VFL) were analysed. Differences in obesity traits across the genotypes were determined using analysis of covariance (ANCOVA). The FokI polymorphism showed a significant association with PFM across the whole population after adjusting for age and sex (p=0.022). Age-adjusted analysis revealed an association between body weight and the TaqI and BsmI SNPs in males (p=0.033 and p=0.028, respectively). However, these positive findings did not remain significant after applying the Bonferroni correction for multiple testing. Our findings suggest that VDR genetic variants are unlikely to play a major role in obesity-related phenotypes in a population of Caucasian young adults.

Waist circumference shows the highest predictive value for metabolic syndrome, and waist-to-hip ratio for its components, in Spanish adolescents

Both waist circumference (WC) and waist-to-hip ratio (WHR) have been proposed as predictors of metabolic syndrome (MetS) in adolescents, but no consensus has been reached to date. This study hypothesizes that WC provides a greater predictive value for MetS in Spanish adolescents than WHR. A cross-sectional study was performed on 1001 adolescents (13.2 ± 1.2 years) randomly recruited from schools in southeast Spain. Anthropometric measures were correlated with the components of MetS (triglycerides, glucose, blood pressure, and high-density lipoprotein cholesterol) as well as inflammation markers (interleukin-6 and tumor necrosis factor-alpha , C-reactive protein, and ceruloplasmin). Receiver-operator curves were created to determine the predictive value of these variables for MetS. Boys had higher values of all anthropometric parameters compared with girls, but the prevalence of MetS was significantly higher in girls. WHR was the only parameter that correlated significantly with all biochemical and inflammatory variables in boys. In girls, WHR, body mass index, waist-to-height ratio, WC, and body fat percentage correlated only with plasma insulin levels, systolic and diastolic pressures, and ceruloplasmin. In both groups, all anthropometric measures were able to predict MetS (area under the curve > 0.94). In particular, WC was able to predict MetS with area under the curve = 1.00. However, WHR was able to predict a higher number of components of MetS. WHR was the anthropometric index that showed the highest predictive value for MetS components, whereas WC was the one that best predicted the MetS among the population of adolescents studied. These findings justify the need to incorporate WHR and WC determinations into daily clinical practice to predict the MetS.

RANKL/RANK/OPG Polymorphisms and Heel Quantitative Ultrasound in Young Adults

Background The receptor activator of the nuclear factor-kappa B ligand (RANKL), the receptor activator of nuclear factor-kappa B (RANK), and the osteoprotegerin (OPG) signaling pathway play an important role in the regulation of bone remodeling and osteoclast differentiation. Quantitative ultrasound (QUS) is a relatively recent and noninvasive method providing structural information on microstructure, bone elasticity, and connectivity. However, in contrast to bone mineral density measurements, the possible association of the RANKL/RANK/OPG pathway with heel QUS has not been analyzed. Objectives The aim of this study was to assess, for the first time, the contribution of the RANKL/RANK/OPG pathway genes in the genetic background of heel QUS parameters. Methods Ten single-nucleotide polymorphisms (SNPs) of RANKL (rs9594759, rs12585014, rs7988338, rs2148073), RANK (rs1805034, rs12458117, rs3018362), and OPG (rs4355801, rs3102735, rs2073618) were selected as genetic markers and genotyped using Open Array technology in 575 self-reported Caucasian individuals aged 18–25. Bone mass in the right calcaneus was estimated with QUS to obtain the broadband ultrasound attenuation (BUA) measurement (dB/MHz). Linear regression analyses were performed to test the possible association between the SNPs and BUA. Results Linear regression analysis of all the tested SNPs revealed no significant association with the BUA parameter after adjusting for age, gender, weight, height, physical activity, and calcium intake. The lowest p-value was observed for the rs9594759 RANKL polymorphism and heel QUS (p = .06; b* = −.075, 95% CI [−0.960, 0.028]). Conclusion Our results suggest that the polymorphism of the RANKL, RANK, and OPG genes does not make a significant genetic contribution to heel ultrasound measurements in a population of young Caucasian adults. Further studies replicating the results in independent populations are needed to support these initial findings.

Dietary inflammatory index and cardiovascular risk factors in Spanish children and adolescents

Dietary inflammatory potential is an established risk factor for adverse cardiovascular events. In this study we analyzed the relation between the Dietary Inflammatory Index (DII) and cardiovascular risk factors, based on anthropometric, body composition, blood pressure, and heart rate parameters in children and adolescents. We conducted a cross-sectional study of 428 Spanish schoolchildren (mean age 12.32 ± 1.84), whose DII was calculated, based on a 24-hr diet recall over 3 days. Anthropometric measurements were taken, and body composition analyzed by bioelectrical impedance analysis. Blood pressure and heart rate parameters were assessed with an automatic monitor. Pubertal stage was assessed based on Tanner criteria. We analyzed the DII both as a continuous variable and as a category variable based on quartiles. Linear regression analysis revealed that the DII was significantly associated with waist to height ratio (WHtR) (p = .026; B = 0.128, 95% CI [.001-.016]) after adjusting for age, sex, total energy intake, and Tanner stage. All macro- and micronutrient intakes were found to be higher in the DII Q1 (anti-inflammatory diet) except for caffeine. This study provides preliminary evidence of a significant association between the DII and WHtR, an index of cardiovascular risk. The results obtained indicate that the inflammatory potential of the diet may play a role in children and adolescents becoming overweight or developing obesity. Future studies in young people should be conducted to validate and further explore these relationships.

AKAP11 gene polymorphism is associated with bone mass measured by quantitative ultrasound in young adults

Background: Due to the increased prevalence of osteoporosis and direct health care cost of osteoporosis-related fractures, there is a growing interest in identifying genetic markers associated with osteoporosis phenotypes in order to develop genetic screening strategies. We aimed to analyze the possible associations between calcaneal Quantitative ultrasound (QUS), a valuable screening tool for assessing bone status in clinical practice, and ZBTB40 (rs7524102, rs6426749), SP7 (rs2016266) and AKAP11 (rs9533090) genes. Methods: A cross-sectional study was conducted on 550 healthy individuals of Caucasian ancestry (381 females and 169 males, median age 20.46±2,69). Bone mass was assessed through QUS to determine broadband ultrasound attenuation (BUA, dB/MHz). Single-nucleotide polymorphisms (SNPs) in ZBTB40 (rs7524102, rs6426749), SP7 (rs2016266) and AKAP11 (rs9533090) were selected as genetic markers and genotyped using TaqMan OpenArray® technology. Results: Linear regression analysis revealed that rs7524102 and rs6426749 in ZBTB40, and rs9533090 in AKAP11 were significantly associated with the calcaneal QUS parameter after adjustments for age, sex, weight, height, physical activity, and calcium intake (p=0.038, p=0.012 and p=0.008, respectively). After applying the Bonferroni correction for multiple testing (p=0.012), only the association of rs9533090 in AKAP11 remained significant. Conclusion: AKAP11 gene (rs9533090) influences QUS trait in a population of Caucasian young adults. The rs9533090 SNP may be considered a factor affecting peak bone mass acquisition.

Dietary inflammatory index, bone health and body composition in a population of young adults: a cross-sectional study

Abstract Diet quality has been postulated as a relevant factor in disorders like obesity and osteoporosis as it modulates inflammatory biomarkers. The aim of this study was to investigate whether the dietary inflammatory index (DII) is associated with bone health status and body composition parameters in a population of young adults. The study population consisted of 599 young adults (aged 20.41 ± 2.72). Linear regression analysis revealed that weight and fat-free mass (FFM) were significantly associated with the DII after adjustments for age, sex and total energy (β = −0.91, 95% CI −1.782, −0.213, p = .013 and β = −0.059, 95% CI −0.842, −0.107, p = .011, respectively). Our results suggest that the inflammatory potential of diet, measured using the DII, is associated with obesity-related parameters such as FFM and weight, although it may not contribute to osteoporosis in early adulthood.

SOX6 rs7117858 polymorphism is associated with osteoporosis and obesity-related phenotypes

SOX6 has been recently proposed as a pleiotropic gene for obesity and osteoporosis. The aim of this study was to investigate whether the rs7117858 genetic variant in SOX6 was associated with bone mass assessed by quantitative ultrasound (QUS) and obesity‐related measures in a population of young adults.

Dietary intake and nutritional status in patients with systemic lupus erythematosus

INTRODUCTION Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease. Despite the influence of diet on inflammation, dietary habits in patients with systemic lupus erythematosus (SLE) are not well established. The study objective was to assess dietary intake and nutritional status in SLE patients. PATIENTS AND METHODS A cross-sectional study was conducted in 92 patients with SLE. Nutritional status was determined by body mass index (BMI) and energy/nutrient distribution of diet was analyzed and compared to a control group. Dietary reference intakes (DRIs) issued by the Spanish Societies of Nutrition, Feeding and Dietetics (FESNAD) and the Spanish Society of Community Nutrition (SENC) were used as reference. RESULTS Body mass index was normal in 53.26% of patients, while 43.48% had excess weight. Energy, protein, and fat intake was significantly lower in the SLE group (p=0.003, p=0.000, and p=0.001 respectively). Protein and fat contribution to total energy was higher, while that of carbohydrate and fiber was lower than recommended. Most patients did not reach the recommended intake for iron (88%), calcium (65.2%), iodine (92.4%), potassium (73.9%), magnesium (65%), folate (72.8%), and vitamins E (87%) and D (82.6%), but exceeded the recommendations for sodium and phosphorus. CONCLUSIONS Spanish SLE patients have an unbalanced diet characterized by low carbohydrate/fiber and high protein/fat intakes. Significant deficiencies were seen in micronutrient intake. Dietary counseling to improve nutrition would therefore be advisable in management of SLE.

Estrogen Receptor 1 (ESR1) Gene Polymorphisms and Obesity Phenotypes in a Population of Young Adults

Obesity is considered an increasingly serious health problem determined by multiple genetic and environmental factors. Estrogens have been found to play a major role in body weight and adiposity regulation through estrogen receptor 1 (ESR1). The aim of this study was to determine whether genotype and haplotype frequencies of ESR1 polymorphisms are associated with body composition measures in a population of 572 young adults. A lack of significant association between genotypes of ESR1 gene polymorphisms and obesity phenotypes was seen after adjustment for confounding factors. Linkage disequilibrium (LD) analysis identified a single LD block for the ESR1 gene including PvuII and XbaI single-nucleotide polymorphisms (SNPs) (pairwise r2 = .66). None of the haplotypes identified revealed statistically significant associations with any of the obesity phenotypes. Our results suggest that polymorphisms of the ESR1 gene do not contribute significantly to the genetic risk for obesity phenotypes in a population of young Caucasian adults.