M. Revilla

Body composition in children and Tanner's stages: A study with dual-energy x-ray absorptiometry☆

Total body bone mineral content (TBBM), body fat content (BF), and fat-free mass (FFM) were measured in 154 children using dual-energy x-ray absorptiometry (DEXA). Total body calcium level (TBCa) was calculated from TBBM. Children were divided into groups according to Tanners stages 1, 2, 4, and 5. Children in stage 3 were not included in the study in order to better differentiate between prepubertal and postpubertal individuals. We did not find differences in TBBM, TBCa, BF, and FFM between Tanners stages 1 and 2 or between sexes. TBBM and TBCa in stages 4 and 5 were lower in girls than in boys (P < .001 and P < .01, respectively); no differences were observed between girls of both groups, although boys showed significant differences (P < .05). FFM for both sexes was lower in stages 1 and 2 than in stages 4 and 5. Girls showed lower FFM (P < .001) than boys in stages 4 and 5; FFM was higher in boys in stage 5 than in those in stage 4 (P < .005), and the same was true for girls (P < .002). Boys in stage 4 had less BF than girls (P < .005), and the same was true for stage 5 (P < .001). Girls in stages 4 and 5 had greater BF than those in stages 1 and 2 (P < .001). These differences suggest that as boys go through puberty, both TBBM and FFM continue to increase, while in girls only BF and FFM increase. These data indicate clear sex differences in somatic postpubertal development.

TOTAL AND REGIONAL BONE MINERAL CONTENT AND FRACTURE RATE IN POSTMENOPAUSAL OSTEOPOROSIS TREATED WITH SALMON CALCITONIN : A PROSPECTIVE STUDY

Seventy-two postmenopausal osteoporotic women having more than one nontraumatic vertebral crush fracture were studied. Thirty-six of them, aged 68.8±1.2 years (18±4 YSM-years since menopause), were treated with 100 IU/day of salmon calcitonin i.m. plus 500 mg of elemental calcium for 10 days each month. The remaining 36 patients, aged 69.6±1.4 years (19±3 YSM), were given only 500 mg of elemental calcium for 10 days each month. All patients underwent clinical and analytical evaluation every 3 months. Radiological evaluation, assessment of vertebral deformities, and metacarpal radiogrammetry were done every 6 months. Densitometric measurements of total and regional bone mass were made every 12 months. At 24 months, the calcitonin group showed a 60% reduction in the number of new fractures and the group receiving only calcium had a 45% increase (P<0.001). The incidence of vertebral fractures was 0.07 per patient-year in the group treated with calcitonin and 0.45 per patient-year in the group treated with calcium (P<0.001). At 2 years, the calcitonin group showed a 12% increase in cortical bone mass on metacarpal radiogrammetry, a 16% increase in the axial skeleton on trunk densitometry, a 3.5% increase in total body bone mineral content, a 30.7% increase in pelvic bone mineral content, and a 6.2% increase in arm bone mineral content (all P<0.001). In the group treated with calcium alone there was a loss of bone mass in every region. These findings suggest that salmon calcitonin is effective in the treatment of osteoporosis and show that it acts on cortical and trabecular bone.

Effect of Lead on Bone Development and Bone Mass: A Morphometric, Densitometric, and Histomorphometric Study in Growing Rats

Abstract. The effect of exposure to lead on the longitudinal development of bone and on bone mass was studied in rats. A group of 35, 50-day-old female Wistar rats was divided into a control group of 15 rats and an experimental group of 20 rats fed a diet supplemented with 17 mg of lead acetate per kg feed for 50 days. Total body bone densitometry (TBBMC) was performed the day before ending the 50-day experiment. On day 50, all rats were killed and their right femur and 5th lumbar vertebra were dissected. The bones were cleaned of soft tissue and femoral length and vertebral length were measured with a caliper and all bones were weighed on a precision scale. Final body weight (P < 0.05), TBBMC (P < 0.005), and femur weight (P < 0.005) were significantly lower in the control group. Femur length did not differ between groups, but the length of the 5th lumbar vertebra was greater in the control group (P < 0.05). Histomorphometry of the femur showed that Cn-BV/TV, Tb-N, Tb-Th were lower (P < 0.05 in all) and Tb-Sp was higher (P < 0.05) in the group given the lead-supplemented diet. These findings suggested lead-induced inhibition of axial bone development and a histomorphometric decrease in bone mass, produced mainly by enhanced resorption, and a densitometric increase in bone mass, produced by lead accumulation in bone.

Cortical versus trabecular bone mass: Influence of activity on both bone components

Motivated by the controversy in the literature concerning the influence of activity on bone mass and on its cortical and trabecular components, a study was made using computed peripheral tomography (Stratec XCT 900) of the total, cortical, and trabecular bone mass of the dominant and nondominant upper extremities of 50 apparently normal subjects (average age 26±6 years). No differences were observed in the trabecular bone compartment, but the cortical compartment was greater (P<0.001) in the dominant extremity. There was also a significantly greater total bone mass in the dominant extremity which we attributed to greater cortical mass (P<0.025) given the highly significant correlation (r2=0.904, P=0.0001) between total and cortical bone mass and the less significant correlation between total and trabecular bone mass (r2=0.479, P=0.0001).

Determinants of total-body and regional bone mineral content and density in postpubertal normal women☆

Some investigators consider body fat the main determinant of bone mass in women, and others, weight. Although genetics may be the primary determinant of peak bone mass, modifiable secondary factors such as nutrition and hormone exposure may significantly affect bone mass accretion during the second decade of life. To determine the principal determinants of bone mass, we analyzed total and regional bone mass (by dual-energy x-ray absorptiometry), weight, height, percentage body fat, and lean body mass in a group of 50 young women ranging in age from 14 to 18 years. Total-body bone mineral content, total-body bone mineral density, and total-body bone mineral density corrected for height, analyzed by multiple correlation, were not related to percentage body fat, although percentage body fat did correlate with the regional bone mineral content of the trunk (P < .001), legs (P < .01), and pelvis (P < .001). Lean body mass correlated with total-body bone mineral content and density, total-body bone mineral density corrected for height (P < .001), and regional bone mineral content of the trunk (P < .05), arms (P < .01), and legs (P < .001), but not with regional bone mineral content of the pelvis and head. Weight correlated significantly (P < .001) with all bone mass measurements except regional bone mineral content of the head, where the significance was P less than .05. Similar results were obtained by multiple regression analysis. These results indicate that weight, not body fat, is the main determinant of bone mass in postpubertal women.

Age-related differences in total and regional bone mass: A cross-sectional study with DXA in 429 normal women

Total body bone mineral content (TBBMC), total body bone mineral density (TBBMD) and regional bone mineral content (BMC) and density (BMD) were assessed by dual-energy X-ray absorptiometry (DXA) in 429 normal women aged 15–83 years, of whom 242 were premenopausal and 187 postmenopausal. The population was divided into 5-year age groups. In the premenopausal women no changes in TBBMC, TBBMD or regional BMC and BMD were observed with age, and TBBMC and TBBMD values correlated well with body weight (p<0.001). Postmenopausal women showed an overall reduction in bone mass (p<0.001), more marked at the axial level than peripherally (1.6% vs. 0.8%/year). The values of TBBMC and TBBMD correlated well with chronological age, time since the onset of menopause and body weight (p<0.001). In these women age did not correlate with body weight, which suggests that postmenopausal bone mass loss depends more on chronological age and time since the onset of menopause than on other variables. The stability observed in bone mass values from ages 15–19 to menopause highlights the importance of stimulating the acquisition of an appropriate peak bone mass in women before adolescence begins.

Sex differences in the acquisition of total bone mineral mass peak assessed through dual-energy X-ray absorptiometry

SummaryDual energy X-ray absorptiometry evaluation of total body bone mineral content (TBBM), total bone mineral density (TBMD), and regional bone mineral content (BMC) (head, trunk, arms, and legs) was carried out in order to assess sex differences of bone in 120 women and 121 men aged 15–29 years. Subjects from both sexes were divided into 5-year groups (15 through 19, 20 through 24, and 25 through 29 years old, respectively). Significantly higher values for TBBM, TBMD, and regional BMC were observed in males compared with females in the 20 to 24 and 25 to 29-year-old groups (P<0.001), but not in the group aged 15–19. After adjusting TBBM for lean body mass (LBM), we observed significantly lower values of TBBM/LBM in the males compared with females in all the age groups. A positive and significant correlation was observed between TBBM and age in the males of all the groups (r=0.624, P<0.001), but not in the females. These data suggest that total bone mass peak acquisition takes place earlier in women than in men, leading to more reduced bone mass value, which in turn may be an osteoporosis predisposing factor.

Effects on bone loss of manganese alone or with copper supplement in ovariectomized rats. A morphometric and densitomeric study.

OBJECTIVE The aim of this study was to examine the effect of manganese (Mn) alone and with the addition of copper (Cu) in the inhibition of osteopenia induced by ovariectomy (OVX) in rats. STUDY CONDITIONS: Four lots of 100-day-old female Wistar rats were divided into experimental groups of 15 each. One group received a diet supplemented with 40 mg/kg of Mn per kilogram of feed (OVX+Mn). The second group received the same diet as the first, but with an additional 15 mg/kg of copper (OVX+Mn+Cu). The third group of 15 OVX and the fourth group of 15 Sham-OVX received no supplements. At the conclusion of the 30-day experiment, the rats were slaughtered and their femurs and fifth lumbar vertebrae were dissected. Femoral and vertebral length were measured with caliper and bones were weighed on a precision balance. The bone mineral content (BMC) and bone density (BMD) of the femur (F-BMC, mg and F-BMD, mg/cm(2)) and the fifth lumbar vertebra (V-BMC, mg and V-BMD, mg/cm(2)) were measured separately with dual energy X-ray absorptiometry. RESULTS The F-BMD, mg/cm(2) was lower in the OVX than in the Sham-OVX group (P<0.0001) and in the other two groups receiving mineral supplements (P<0.005 in both). F-BMC, mg was significantly lower in the OVX group than in the other three (P<0.0001 in all cases). Calculations for V-BMC, mg and V-BMD, mg/cm(2) are similar to findings in the femur. CONCLUSIONS These data show that a Mn supplement is an effective inhibitor of loss of bone mass after OVX, both on the axial and the peripheral levels, although this effect is not enhanced with the addition of Cu.

Total and regional bone mineral content in women treated with GnRH agonists

SummaryChanges in bone mineral content induced by GnRH agonists were investigated by measuring total body bone mineral content (TBBM) and regional bone mineral content (BMC) (arms, legs, trunk, pelvis) and densities with dual energy X-ray absorptiometry in 25 premenopausal women before and after a 6-month treatment with gonadotropin-releasing hormone (GnRH) agonists. Biological markers of bone remodeling, estrogens, luteinizing hormone, and follicle-stimulating hormone were also measured. Weight and body mass index increased significantly after treatment (P<0.05), and TBBM, corrected for weight (TBBM/W), decreased (P<0.001). The changes in BMC that we observed ranged from +2.5% to -6.9%. The greatest decrease in regional BMC occurred in the trunk (4.4%, P<0.001), with TBBM decreasing by 2.1% (P<0.001). No significant changes were observed in the limbs. Tartrate-resistant acid phosphatase (TRAP) increased significantly after treatment (P<0.001) and a significant negative correlation between TRAP and TBBM (P<0.001) and between TRAP and estradiol (P<0.001) were observed before treatment. The lack of changes observed in the BMC of the limbs indicate that GnRH agonists cause a preferential loss of BMC in trunk osseous structures, a situation similar to that of the first years of menopause.

CORTICAL BONE RESORPTION IN OSTEOPOROSIS

Abstract. A study was made of 110 women: 35 healthy premenopausal, 40 healthy postmenopausal, and 35 women diagnosed as having postmenopausal osteoporosis. The postmenopausal women had similar ages and years since menopause (YSM). In all of the women, total bone mass was evaluated by dual-energy X-ray absorptiometry and metacarpal morphometry was evaluated by radiogrammetry on the second metacarpal of the nondominant hand, performed by computed radiography. An external metacarpal diameter of ≥7.4 mm was required as proof of having developed an adequate peak bone mass. The endosteal diameter, which is indicative of bone resorption in both groups of postmenopausal women, obtained in the postmenopausal groups was subtracted from the endosteal diameter obtained in the premenopausal group and the resulting figure was divided by the years since menopause to calculate the rate of cortical bone resorption/year for each group. The endosteal diameters values differed in the three groups studied (P < 0.0001): 3.2 ± 0.7 mm in the healthy premenopausal women; 3.9 ± 0.6 mm in the healthy postmenopausal women; and 4.7 ± 0.5 mm in the osteoporotic postmenopausal women. The rate of cortical bone resorption was 0.068 ± 0.002 mm/YSM (years since menopause) in the osteoporotic postmenopausal women and 0.033 ± 0.003 mm/YSM in the healthy postmenopausal women (P < 0.0001). These figures reflect the importance of bone resorption, as opposed to deficient bone formation, as a cause of osteoporosis.