Marie-Louise Ayoub

DXA-based variables and osteoporotic fractures in Lebanese postmenopausal women

INTRODUCTION The aim of this study was to assess DXA-based variables (bone mineral density, bone mineral apparent density, compressive strength index of the femoral neck and trabecular bone score) in Lebanese postmenopausal women having presented a previous fracture. MATERIALS AND METHODS One thousand Lebanese postmenopausal women between 45 and 89 years participated in this study. The women were recruited by advertisements offering bone mineral density measurements at a reduced cost. Subjects with previous history of radiotherapy or chemotherapy were excluded. Informed written consent was obtained from all the participants. RESULTS Femoral neck compressive strength index (FN CSI) was significantly (P<0.001) associated with the presence of fracture using a simple logistic regression (odds ratio=0.51 [0.385-0.653]). When a multivariate logistic regression analysis was performed with the presence of fracture as a dependent variable and each of age, FN BMD and FN CSI as independent variables, only FN BMD (P=0.005) and FN CSI (P=0.004) were found to be associated with the presence of fracture. CONCLUSION This study suggests that FN CSI is associated with history of osteoporotic fractures in postmenopausal women. The use of FN CSI in clinical practice may help to identify patients with high risk of fracture. LEVEL OF EVIDENCE Epidemiological study, level IV.

Physical Performance Variables and Bone Mineral Density in a Group of Young Overweight and Obese Men

The aim of this study was to explore the relationships between performances obtained in different physical tests and bone parameters (bone mineral density [BMD], bone mineral content, hip geometry indices, and trabecular bone score [TBS]) in a group of young Lebanese overweight and obese adult men. Fifty-two overweight and/or obese (body mass index > 25 kg/m2) young men whose ages range from 18 to 35 yr participated in this study. Weight and height were measured, and body mass index was calculated. Body composition, BMD, cross-sectional area and section modulus (Z) of the femoral neck (FN), and TBS were measured by dual-energy X-ray absorptiometry. Maximum oxygen consumption (VO2 max, in liter per minute) was determined by direct measurement while exercising on a medical treadmill. One-repetition-maximum half-squat and maximum power (P max) of the lower limbs were measured using validated exercises. Lean mass was a positive determinant of whole-body bone mineral content (r = 0.71, p < 0.001), FN cross-sectional area (r = 0.51, p < 0.001), and FN Z (r = 0.58, p < 0.001). VO2 max (in liter per minute) was a positive determinant of whole-body BMD (r = 0.47, p < 0.001), total hip BMD (r = 0.43, p < 0.01), and FN BMD (r = 0.42, p < 0.01). VO2 max (in milliliter per minute per kilogram) was a positive determinant of TBS (r = 0.30, p < 0.05). One repetition maximum was a positive determinant of L1-L4 BMD (r = 0.33, p < 0.05). This study suggests that VO2 max (in liter per minute) is a positive determinant of BMD, and VO2 max (in milliliter per minute per kilogram) is a positive determinant of TBS in overweight and obese men.

Physical performance and trabecular bone score in a group of young Lebanese women.

Recent studies have shown that trabecular bone score (TBS) is related to fractures in elderly subjects (1,2). Furthermore, we have recently shown in a study conducted on 4907 Lebanese women that the correlation between lumbar spine bone mineral density (BMD) and TBS is low (r5 0.39; p! 0.001) suggesting that these two parameters reflect different bone properties (3). Identifying simple determinants of TBS may be useful for the prevention and early detection of osteoporotic fractures. The main aim of this study was to identify the determinants of TBS in a group of young Lebanese women. A total of 26 Lebanese adult women whose ages range between 18 and 28 yr participated in this study.Weight and height were measured, and body mass index (BMI) was calculated. Body composition, lumbar spine (L1eL4) BMD, and TBS were evaluated by dual-energy X-ray absorptiometry (Lunar iDXA, GE Healthcare; Madison, WI). Daily calcium intake (DCI) and daily protein intake (DPI) were evaluated using validated questionnaires. Serum vitamin D was assessed. Maximum oxygen consumption (VO2 max; L/min) was measured while exercising on a bicycle ergometer. Performances in vertical jump, horizontal jump, 3-jump test, 5-jump test, and 1⁄2 squat were also measured as previously described (4). Age, weight, height, BMI, lean mass, fat mass, DCI, DPI, and serum vitamin D were not correlated to TBS. The VO2 max (L/min) and performances in vertical jump, horizontal jump, 3-jump test, 5-jump test, and 1⁄2 squat were positively correlated to TBS ( p! 0.05). To our knowledge, this is the first study to show positive correlations between physical performance variables and TBS in young women. Morphological characteristics (weight, lean mass, and BMI) were not positively correlated to TBS. This result is in accordance with that of our previous study conducted on Lebanese women (3). However, our results showed a positive correlation between VO2 max (L/min) and TBS. This is the first study

Decreased Composite Indices of Femoral Neck Strength in Young Obese Men

The aim of the current study was to compare compression strength index (CSI), bending strength index (BSI) and impact strength index (ISI) among obese, overweight and normal-weight young women. 117 young women (20 obese, 36 overweight and 61 normal-weight) whose ages range from 18 to 35 years participated in this study. Body composition and BMD were evaluated by dual-energy X-ray absorptiometry (DXA). CSI, BSI and ISI values were significantly lower in obese and overweight women compared to normal-weight women (p < 0.001). In the whole population (n = 117), body mass index (BMI) was negatively correlated to CSI (r = −0.66; p < 0.001), BSI (r = −0.56; p < 0.001) and ISI (r = −0.54; p < 0.001). This study suggests that obesity is associated with lower CSI, BSI and ISI values in young women.

Trabecular Bone Score in Overweight and Normal-Weight Young Women

The aim of this study was to compare Trabecular Bone Score (TBS) in overweight and normal-weight young women. This study included 14 overweight (BMI > 25 kg/m2) and 42 normal-weight (BMI < 25 kg/m2) young Lebanese women whose ages range from 18 to 32 years. Body composition, Bone Mineral Content (BMC), Bone Mineral Density (BMD), and lumbar spine (L1–L4) TBS were assessed by dual-energy X-ray asborptiometry (DXA). The DXA measurements were completed for the whole body (WB), the lumbar spine (L1–L4), the total hip (TH) and the femoral neck (FN). Physical activity, daily calcium intake, daily protein intake and sleep quality index were evaluated using validated questionnaires. Maximal oxygen consumption (VO2 max in l/mn) was measured whilst exercising on a bicycle ergometer using a specialized device. Weight, height, BMI, lean mass, fat mass, WB BMC, WB BMD, TH BMD and FN BMD were significantly higher in overweight women compared to normal-weight women. Trabecular Bone Score (TBS) was not significantly different between the two groups (overweight and normal-weight). In the whole population (n = 56), weight, height, BMI, lean mass and fat mass were positively correlated to BMC and BMD values but not to TBS values. VO2 max (l/mn) was positively correlated to BMC, BMD and TBS (p < 0.05). This study suggests that being overweight is not associated with higher trabecular bone score values in young women.