E. Rogucka

Are general obesity and visceral adiposity in men linked to reduced bone mineral content resulting from normal ageing? A population-based study.

Summary. Associations between fat accumulation and distribution and bone mineral status in men have not been comprehensively established, and available results are inconsistent. The aims of this study were as follows: (1) to evaluate relationships between anthropometric parameters of general obesity (body mass index, BMI) and fat distribution (waist/hip ratio, WHR) and bone mineral content (BMC), and (2) to compare BMC (a) between obese men (BMI ≥ 27) and nonobese men and (b) between abdominally obese men (WHR ≥ 0.95) and men without visceral adiposity, in a population‐based sample of Polish men. The sample comprised a group of 272 men, aged 20–60, randomly selected from healthy and occupationally active inhabitants of Wrocław, Lower Silesia, Poland. Trabecular, cortical and total BMC at the ultra‐distal radius of the nondominant hand were assessed by pQCT using the Stratec 960 apparatus. BMI and WHR were used as parameters of general obesity and fat distribution, respectively. The relationships among the analysed variables were established using a multiple linear regression. The differences in BMC depending on BMI and WHR values were tested using an analysis of covariance (ancova). BMI was positively related only to trabecular BMC (r = 0.17; P = 0.03). Only trabecular BMC was higher in men with BMI ≥ 27 compared to nonoverweight subjects (F = 5.38; P = 0.02). WHR was inversely related to trabecular (r = − 0.30; P < 0.001), cortical (r = − 0.30; P < 0.001) and total BMC (r = − 0.34; P < 0.001). All densitometric parameters were lower in males with WHR ≥ 0.95 than in normal men (results of ancova: for trabecular BMC, F = 6.33, P = 0.01; for cortical BMC, F = 5.52, P = 0.02, and for total BMC, F = 7.73, P = 0.006). In the healthy Polish male population, BMI was of minor significance as a predictor of BMC at the ultra‐distal radius, whereas visceral adiposity (assessed by WHR) was significantly linked to reduced bone mass in men.

Social contrasts in the incidence of obesity among adult large-city dwellers in Poland in 1986 and 1996

The incidence of obesity, defined as the fraction of persons with BMIs exceeding 30-0, was examined in two birth cohorts of 40-50-year-old occupationally active inhabitants of the city of Wrocław, Poland. In both cohorts and both genders obesity increased monotonically with decreasing position on a three-level educational scale. During the 1986-1996 decade obesity increased dramatically among males with trade school education only; concomitant shifts were much smaller or absent in the college-educated groups. The contrast in obesity between the opposite ends of the educational scale has widened markedly in both genders; and the between-gender gap has declined somewhat.

Social class differences in rates of premature mortality among adults in the city of Wrocław, Poland

Mortality rates among adult men and women, inhabitants of the city of Wrocław, were studied within 5‐year age classes between 20 and 64 years of age relative to two social variables: education and marital status of the deceased. Age‐ and sex‐specific mortality rates reveal a systematic social gradient. They are highest among persons with primary or “basic vocational” school education, lower among those with secondary school education, and lowest among those with college education. This gradient consistently appears in each of the age classes of males and females, although it is more pronounced among males. In both sexes, married persons have lower rates of mortality than those who have never married or were divorced or widowed. Among females, marital status appears to have a stronger effect on age‐specific rates of mortality than educational status; the reverse is the case among males.

Variation in bone mineral density in adults in Poland: age and sex differences

The decline of mineral bone density with age can lead in more extreme cases to osteopenia and osteoporosis, and is therefore one of the aspects of ageing with great medical and social significance. With this idea in mind a study of age changes in the trabecular and, separately, the cortical bone density of the radius was carried out in 1218 females and 405 males, aged 22 to 60 years, all occupationally active inhabitants of the city of Wroclaw, Poland. The technique used was the peripheral Quantitative Computed Tomography (pQCT). It was found that in females bone densities remain relatively stable throughout the period between 22 and 40 years. They then begin to decline slowly, with a rapid decline after the age of 55. A distinctly different pattern was found among males, with bone densities reaching peak values, markedly higher than those in females, in the third decade of life. After this age the bone density values begin to decline at a rapid rate, so that by the age of 60 years mean trabecular and cortical densities in males have decreased to levels almost equivalent to females of equal age. In view of the small size of the male samples, especially in the older age classes, the above results should be treated with caution and confirmed using larger samples.The decline of mineral bone density with age can lead in more extreme cases to osteopenia and osteoporosis, and is therefore one of the aspects of ageing with great medical and social significance. With this idea in mind a study of age changes in the trabecular and, separately, the cortical bone density of the radius was carried out in 1218 females and 405 males, aged 22 to 60 years, all occupationally active inhabitants of the city of Wroclaw, Poland. The technique used was the peripheral Quantitative Computed Tomography (pQCT). It was found that in females bone densities remain relatively stable throughout the period between 22 and 40 years. They then begin to decline slowly, with a rapid decline after the age of 55. A distinctly different pattern was found among males, with bone densities reaching peak values, markedly higher than those in females, in the third decade of life. After this age the bone density values begin to decline at a rapid rate, so that by the age of 60 years mean trabecular and cortical densities in males have decreased to levels almost equivalent to females of equal age. In view of the small size of the male samples, especially in the older age classes, the above results should be treated with caution and confirmed using larger samples.

Effects of long-term testosterone substitutive therapy on bone mineral content in men with hypergonadotrophic hypogonadism

Summary.  Hypogonadism is one of the crucial risk factors for male osteopenia and osteoporosis. There are few studies on the effects of long‐term and consistently administered testosterone substitutive therapy on bone mineral density in men with gonadal androgen deficiency, and their results have been susceptible to various interpretations. The aim of our study was an evaluation of bone mineral content in 26 men, aged 18–57 years, with hypergonadotrophic hypogonadism who underwent long‐lasting androgen re‐placement therapy with testosterone esters (Omnadren 250), which conditioned proper psychosomatic androgenization. The control group comprised 405 healthy men, aged 20–60 years, a representative sample of the local male population. Among all examined men and in the control group, trabecular, cortical and total bone mineral content at the distal radius of the nondominant hand were assessed by peripheral quantitative computed tomography using the Stratec 960 apparatus. In 11 hypogonadal men (42.3%), the trabecular bone mineral content was found to be within normal ranges; in 15 patients (57.7%) its values were below −1 standard deviation (SD) (osteopenia). In six patients (23.1%), the cortical bone mineral content was between +1 SD and the arithmetic mean, X; in 13 examined men (50%), the cortical bone mineral content was below X and above −1 SD. Osteopenia was diagnosed in six hypogonadal males, whereas osteoporosis was found in one man (cortical bone mineral content below −2.5 SD). Only in seven of the examined men (26.9%) was the total bone mineral content found within normal ranges, whereas in 19 men (73.1%) the total bone mineral content was below −1 SD (osteopenia). Despite the testosterone replacement in hypogonadal men, the greatest reduction of bone mineral content was found in its trabecular and total values. Among all the men examined, the trabecular and total bone mineral contents were below the mean of our own reference values. The results show that long‐term and consecutively administered testosterone replacement in conventional doses, despite the normalization of serum androgen levels and the promotion of proper somatic development, does not simultaneously eliminate hypogonadal osteopenia in every case. The individually differentiated response to exogenous androgens is a characteristic feature of male hypogonadism. This study emphasizes the necessity of regular measurements of bone mineral density in hypogonadal men, as the densitometric parameters should be accepted as an osteologic (and very important) marker of androgenization of the male organism.

Effect of education and marital status on premature mortality among urban adults in Poland 1988-1989.

Mortality rates among adults 25–64 years of age (premature mortality) in 1988 and 1989 were compared by educational status (a four‐level scale) and marital status (married vs. nonmarried) in three Polish cities situated in ecologically different regions of Poland. Each of the two social factors has a significant influence on mortality after the effect of the other is controlled statistically. The risk of premature death increases regularly with an individuals decreasing position on the educational scale; also, the risk is higher among nonmarried than among married persons. This is true in all three urban populations, at all age levels considered, and in both genders. However, the effects of education and of marital status on premature mortality are more dramatic in males than in females. At middle age, the condition of having no spouse and of being poorly educated each expose males to a greater risk of premature mortality than females. Am. J. Hum. Biol. 11:397–403, 1999.

The inverse relationship between bone status and blood pressure among Polish men

Primary objective : An evaluation of relationships between bone density and blood pressure in healthy men. Research design : A cross-sectional population-based survey. Methods and procedures : An ethnically homogeneous sample of 208 men, aged 35-63, healthy and occupationally active inhabitants of the city of Wroclaw, Lower Silesia, Poland were studied. Trabecular, cortical and total bone mineral content (BMC) at the ultra-distal radius of the non-dominant hand were assessed by peripheral Quantitative Computed Tomography (pQCT; Stratec 960 apparatus). Body mass index (BMI) was used as a measure of general obesity. Systolic and diastolic blood pressure (BP) were measured using an MPC-350 sphygmomanometer. Multiple linear regression was used to evaluate the relationships between BP and BMC. A two-way analysis of covariance was carried out to test for the significance of inter-group differences in BMC with regard to age and BP with BMI as a continuous covariable. Multiple logistic regression was used to verify whether some select factors (age, BMI, systolic and diastolic BP) could significantly predict male bone status. Results : Systolic BP was not related to bone status at the ultra-distal radius. There were no differences in any BMC between systolic hyper- and normotensive subjects. Additionally, systolic hypertension did not affect the probability of an occurrence of male osteopenia (independently of age and BMI). In contrast, there were significant negative relationships between diastolic BP, and trabecular and total (but not cortical) BMC (even when controlled for age and BMI). Moreover, diastolic hypertensive men had reduced BMC at the ultra-distal radius when compared with normotensive subjects. It is noteworthy that Polish men of diastolic BP exceeding 90 mmHg had an approximately 1.50-fold increased relative risk of being osteopenic when compared with normotensive subjects (even when controlled for age, BMI and systolic BP). Conclusions : In the light of the inverse relationship between BMC and diastolic BP, Polish men with elevated diastolic BP seem to be more prone to the excessive age-related bone loss.

Body mass index, waist/hip ratio and androgen—estrogen activity in younger versus older Polish men

This study was performed to evaluate the associations between estradiol, dehydroepiandrosterone sulfate (DHEAS), free and total testosterone levels, and anthropometric parameters of general adiposity (body mass index, BMI) and fat distribution (waist/hip ratio, WHR), separately in two subgroups of healthy Polish men: younger (aged 22–39 years, n = 95) and older (aged 40 years and over, n = 141) subjects. Sex steroid levels were assessed using radioimmunoassay (RIA). BMI was used as a measure of general adiposity. WHR was used to estimate distribution of adipose depots. The relationships between sex steroids, BMI, WHR and age were evaluated by use of non-parametric statistics (Spearman coefficients). Aging was related to a reduction of all hormone levels (correlation coefficients with age: free testosterone r = -0.52, p < 0.001; total testosterone r = -0.25, p < 0.001; estradiol r = -0.18, p < 0.001; DHEAS r = -0.45, p < 0.001) and an increase of BMI and WHR for BMI r = 0.23, p < 0.001; for WHR r = 0.47, p < 0.001). A one way analysis of co-variance (ANCOVA) was applied separately in the two subgroups of subjects to assess the relationships between hormonal and anthropometric variables. In men aged 22–39 years, the total (but not free) testosterone and DHEAS (when controlled for age) significantly differentiated BMI values. In subjects aged 40 years and over, no associations between sex steroids and BMI were revealed. In younger males DHEAS differentiated WHR values (even when controlled for age and BMI), whereas after the age of 40 years an increased WHR was accompanied by increases in both estradiol and DHEAS levels. The associations between the androgen—estrogen activity and the anthropometric parameters of adiposity vary in younger versus older healthy men.

An assessment of biological age of males in Poland

Background: Studies carried out in Poland have shown that some important indices of growth and maturation in children, of the biological well-being during adulthood and the rates of premature mortality depend strongly upon the individuals position on the social scale. Aim : The study considers whether adult males of higher educational status differ from their chronological age-matches of lower educational status in biological age. Subjects and methods : The data of 2800 occupationally active men, aged 25-65 from the 1994/1995 Polish Health Surveys were used. Twenty-two different measures were used. Biological age was assessed by the method of Borkan and Norris (Journal of Gerontology, 35, 177-184, 1980). Results: A comparison of biological age profiles of two groups of males based on their educational status showed that in 13 of the 22 characteristics, better-educated men were biologically younger than their poorer educated peers (p < 0.05). Conclusion: Better education is associated with the slowing down of the process of ageing, probably because it produces a healthier life-style.

Fitness of professionals and skilled workers in Poland

Simple measures of the biological fitness of adult men aged 25-65 years, inhabitants of the city of Wroclaw, Poland, were studied in two well-defined social groups: professionals and skilled workers. It was found that the manual workers, compared to professionals, have higher systolic and diastolic blood pressure, lower relative vital capacity, inferior flexibility of spine, poorer eye-hand co-ordination, and poorer hearing acuity. These social differences appear consistently at each age level between 25 and 65 years and tend to increase with age to the disadvantage of skilled workers.