Rawad El Hage

Relative Importance of Lean Mass and Fat Mass on Bone Mineral Density in a Group of Lebanese Postmenopausal Women

The aim of this study was to determine the relative importance of lean mass and fat mass on bone mineral density (BMD) in a group of Lebanese postmenopausal women. One hundred ten Lebanese postmenopausal women (aged 65-84 yr) participated in this study. Age and years since menopause were recorded. Body weight and height were measured and body mass index (BMI) was calculated. Body composition (lean mass, fat mass, and fat mass percentage) was assessed by dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) of the whole body (WB) and BMD of the WB, the lumbar spine (L1-L4), the total hip (TH), the femoral neck (FN), the ultra distal (UD) Radius, and the 1/3 Radius were measured by DXA. The expressions WB BMC/height and WB BMD/height were also used. Weight, BMI, fat mass, and lean mass were positively correlated to WB BMC, WB BMC/height, WB BMD/height, and to WB, L1-L4, TH, FN, UD Radius, and 1/3 Radius BMD. However, using multiple linear regression analyses, fat mass was more strongly correlated to BMC and to BMD values than lean mass after controlling for years since menopause. This study suggests that fat mass is a stronger determinant of BMC and BMD than lean mass in Lebanese postmenopausal women.

Bone mineral content and density in obese, overweight, and normal-weighted sedentary adolescent girls.

PURPOSE The aim of this study was to compare the whole body (WB) bone mineral content (BMC) and bone mineral density (BMD) in obese, overweight, and normal-weighted adolescent sedentary girls. METHODS This study included 17 obese, 27 overweight, and 21 normal-weighted adolescent (aged, 12-20) sedentary (practicing less than 2 hours of physical activity/week) girls. The three groups (obese, overweight, and normal) were matched for age and maturation index (years since menarche). BMC, bone mineral area (BMA), BMD, and body composition were assessed by dual-energy X-ray asborptiometry. Bone mineral apparent density (BMAD) was calculated for the WB. RESULTS Obese girls had higher BMC values than overweight and normal-weighted girls (p < .05 and p < .001, respectively). Overweight girls had higher BMC values than normal-weighted girls (p < .05). BMD values were not different among the three groups. However, obese and overweight girls had lower BMAD and higher BMC/height values in comparison with normal-weighted girls (p < .05). Finally, after adjustment for lean mass, BMC, BMA, BMD, and BMAD were not different among the three groups. CONCLUSION In this population, overweight and obesity are associated with higher BMC, BMC/height, and lower BMAD of the WB. This study suggests that BMD, BMC, BMA, and BMAD of the WB are not significantly different among the three groups (obese, overweight, and normal) after adjustment for lean mass. Therefore, our results suggest that the skeleton of the overweight and the obese girls adapts to the increased lean mass.

Influence of the weight status on bone mineral content and bone mineral density in a group of Lebanese adolescent girls

AIM The aim of this study was to determine the influence of being overweight on whole-body (WB) bone mineral content (BMC) and bone mineral density (BMD) in a group of Lebanese adolescent girls. METHODS This study included 32 overweight (BMI>25 kg/m2) adolescent girls (15.3+/-2.3 years old) and 24 maturation-matched (15.7+/-1.7 years old) controls (BMI<25 kg/m2). Bone mineral area (BMA), BMC, BMD at the WB and body composition (lean mass and fat mass) were assessed by dual-energy X-ray absorptiometry (DXA). Calculation of the ratio BMC/height and bone mineral apparent density (BMAD) were completed for the WB. RESULTS Expressed as crude values, BMA, BMC and the ratio BMC/height were higher in overweight adolescent girls compared to controls. After adjusting for body weight, there were no differences in BMC or in the ratio BMC/height between the two groups. However, BMA was lower in overweight girls compared to controls. After adjusting for either lean mass or fat mass, there were no significant differences between the two groups regarding these variables: BMC, BMA, BMD, BMC/height and BMAD. CONCLUSION This study suggests that the positive effect of overweight on BMC is due to body weight. In fact, the difference in BMC between the overweight and the control girls disappears after adjusting for body weight. In contrast, overweight girls have lower BMA compared to controls when values are adjusted to body weight.

Geometric Indices of Hip Bone Strength in Obese, Overweight, and Normal-Weight Adolescent Girls

The aim of this study was to compare hip bone strength indices in obese, overweight, and normal-weight adolescent girls using hip structure analysis (HSA). This study included 64 postmenarcheal adolescent girls (14 obese, 21 overweight, and 29 normal weight). The 3 groups (obese, overweight, and normal weight) were matched for maturity (years since menarche). Body composition and bone mineral density (BMD) of whole body, lumbar spine, and proximal femur were assessed by dual-energy X-ray absorptiometry (DXA). To evaluate hip bone strength, DXA scans were analyzed at the femoral neck (FN) at its narrow neck (NN) region, the intertrochanteric (IT), and the femoral shaft (FS) by the HSA program. Cross-sectional area and section modulus were measured from hip BMD profiles. Total hip BMD and FN BMD were significantly higher in obese and overweight girls in comparison with normal-weight girls (p < 0.05). However, after adjusting for weight, using a one-way analysis of covariance, there were no significant differences among the 3 groups regarding HSA variables. This study suggests that in obese and overweight adolescent girls, axial strength and bending strength indices of the NN, IT, and FS are adapted to the increased body weight.

Bone Mineral Content and Density in Overweight and Control Adolescent Boys

The aim of this study was to compare bone mineral content (BMC) and areal bone mineral density (aBMD) in overweight and control adolescent boys. This study included 27 overweight (body mass index [BMI] > 25 kg/m²) adolescent (17.1 ± 2.1 yr old) boys and 29 maturation-matched (16.7 ± 2.0 yr old) controls (BMI< 25 kg/m²). Bone mineral area (BMA), BMC, and aBMD were assessed by dual-energy X-ray absorptiometry (DXA) at the whole body (WB), lumbar spine (L2-L4), total hip (TH), femoral neck (FN), and left forearm (ultra distal [UD], mid Radius, 1/3 Radius, and total Radius). Body composition (lean mass, fat mass, and fat mass percentage) was assessed also by DXA. The expressions WB BMC/height, WB aBMD/height, and WB BMAD were used to adjust for WB bone size. WB BMC, WB BMC/height, WB BMA, L2-L4 aBMD, TH aBMD, FN aBMD, and UD aBMD were higher in overweight boys compared with controls (p < 0.05). However, WB BMAD was lower in overweight boys compared with controls (p < 0.05). After adjustment for weight, lean mass, or BMI, using a one-way analysis of covariance, there were no differences between the 2 groups (overweight and controls) regarding bone characteristics (BMC, BMA, aBMD, BMC/height, aBMD/height, and BMAD of the WB and aBMD of the lumbar spine; the TH; the FN; and the forearm). In conclusion, this study shows that after adjusting for weight, lean mass, or BMI, there are no differences between overweight and control adolescent boys regarding aBMD values.

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

Composite indices of femoral neck strength in adult female soccer players.

The incidence of hip fractures increases with age in women (1,2). Hip fractures are associated with high morbidity and mortality rates (1,2). Hernandez et al (2) suggested that peak bone mineral density (BMD) attained at the third decade may be the single most important factor for the prevention of osteoporosis later in life. Peak BMD is influenced by several factors such as genetics, nutrition, hormones, ethnicity, and mechanical factors (3e7). Mechanical loading is well known to stimulate bone formation and increase BMD (3e7). For instance, we have recently showed that soccer practice is associated with high BMD at the total hip and the femoral neck (FN) (7). Therefore, it is suggested that long-term soccer practice may prevent hip fractures later in life (7). BMD is usually considered as the single most important determinant of fracture risk (1,2,7). Karlamangla et al (8) have examined the prediction of incident hip fracture risk by composite indices of FN strength, constructed from dual-energy X-ray absorptiometry (DXA) scans of the hip. These indices integrate FN size and body size with bone density and reflect the structure’s ability to withstand axial compressive forces and bending forces and the ability to absorb energy in an impact (8e10). Several studies have shown that these indices have the potential to improve hip fracture risk assessment (8,9). These indices have also been used to explore the influence of physical activity on bone strength (10). The aim of this study was to compare composite indices of FN strength in adult female soccer players and controls. Nineteen female soccer players and 13 female sedentary subjects whose ages ranged between 18 and 30 yr participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. FN BMD was measured by DXA. FN compressive strength index (CSI), FN bending strength index, and FN impact strength index (ISI) were calculated. Compressive ([FN BMD FN width/weight]) and bending strength ([FN BMD FN width]/[hip axis length weight]) express the forces that the femoral neck has to withstand in weight bearing, whereas impact

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.

Performances in Vertical Jump and Horizontal Jump Tests Are Positive Determinants of Hip Bone Mineral Density in a Group of Young Adult Men

Although osteoporosis is known to mainly affect postmenopausal women, there is enough evidence to support substantial bone losswith aging inmen aswell (1,2). Bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is the best single predictor of fracture risk in elderly subjects (1,2). Among all fragility fractures, hip fractures are the most important in terms of morbidity andmortality (1,2). Highermortality rates after hip fracture have been reported in men compared with women (3). Peak BMD attained at the third decade of life is a strong predictor of fracture risk later in life (4). An increase in peak BMD of 10% would delay the onset of osteoporosis by 13 yr (4). Long-term practice of weight-bearing physical activities stimulates bone formation and enhances BMD of stressed sites (5,6). According to the mechanostat hypothesis, bones adapt their strength tomechanical loads generated fromvoluntarymechanical usage (7). This has been supported bymany animal-based studies (8,9). In humans, it has been shown that body weight and lean mass are the strongest predictors of BMD in both sexes (10,11). Other human-based studies have shown that BMD is correlated to the performances done in some physical tests (12,13). Identifying simple determinants of BMD may be useful for the prevention and early detection of osteoporosis and/or osteopenia. The aim of this study was to explore the relationships between performances in different physical tests (vertical jump [counter-movement jump], standing long jump test, 3-jump test, and 5-jump test) and BMD of the total hip in a group of young adult men. We hypothesized that the objective measures of muscular strength would be correlated to BMD of the hip because hip BMD is strongly correlated to mechanical factors on one hand and the physical tests, which were used in our study to measure the strength and the power of the lower limbs, on the other hand. Ten healthy Lebanese males whose ages ranged from 18 to 30 yr participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. Daily calcium intake, daily protein intake (DPI), and sleep quality were evaluated using