Silvina R. Mastaglia

Increase in android fat mass with age in healthy women with normal body mass index.

Body fat distribution is gender specific: men tend to accumulate adipose tissue in the android region, whereas women tend to do so in the gynoid region. The aim of the study was to assess total fat mass (TFM), android fat (AF), and gynoid fat (GF) mass in a selected group of healthy adult women with normal body mass index (BMI) to evaluate variations in fat distribution. Seventy-seven women (20--69yr of age) with BMI values between ≥18.5 and ≤24.9kg/m(2) were included. TMF, AF, GF, and the AF to GF ratio (A:G) were assessed using dual-energy X-ray absorptiometry. Results showed an increase in AF after the fifth decade of life (D), which reached statistical significance in the sixth and seventh decades (p<0.05--0.008), a 33% increase in kg of AF between the fourth and seventh and a 20% increase in A:G between the third and the seventh, with no significant changes in TFM and GF. In normal BMI women, age appears to be associated with changes in fat mass distribution with an increase in AF, which might have potential deleterious health consequences, after the fifth D.

Resultados de una campaña de detección de población en riesgo para desarrollar osteoporosis y fracturas

Introduccion La osteoporosis es la enfermedad del metabolismo mineral mas frecuente del mundo occidental pero la mas subdiagnosticada y subtratada. Objetivo Detectar la poblacion en riesgo de sufrir osteoporosis y fracturas de cadera en sujetos de edad igual o superior a 50 anos. Materiales y metodos Se efectuaron charlas diarias organizadas por la Seccion Osteopatias Medicas y entrega de folletos informativos sobre osteoporosis a los concurrentes de la campana. Se realizaron densitometrias de radio (Lunar-Pixi Dual, DXA) en las participantes de 65 anos en adelante. De acuerdo a la edad, sexo y a la presencia de factores de riesgo (fracturas osteoporoticas, menopausia temprana y/o corticoterapia) los participantes se dividieron en: Grupo 1: mujeres entre 50 y 64 anos y hombres de edad igual o superior a 50 anos sin factores de riesgo; Grupo 2: igual que grupo 1, pero con factores de riesgo, y Grupo 3: mujeres de 65 anos o mas con o sin factores de riesgo. Resultados Participaron 1.305 personas de edad igual o superior a 50 anos (1.202 mujeres y 103 hombres). Grupo 1: total 364 (281 mujeres y 83 hombres); Grupo 2: total 315 (295 mujeres y 20 hombres), y Grupo 3: total 626 mujeres (52% del total de mujeres participantes). Ciento ochenta y cuatro participantes presentaron antecedentes de fracturas osteoporoticas. De estos, solo el 7% recibian o habian recibido tratamientos antirresortivos asociados a calico y/o vitamina D, el 14% solo calcio y el 5% calcio y vitamina D. El 84% de los participantes que realizaron densitometria de radio distal presentaban baja masa osea (T-score Conclusiones El 74% de las participantes con fracturas osteoporoticas previas no habian realizado o realizaban ningun tratamiento para osteoporosis y solo el 7% habia recibido medicacion antirresortiva. Mas de la mitad de las participantes mayores de 65 anos presentaron baja masa osea.

High Prevalence of Sarcopenia in Women with Osteoporotic Fractures

The aim of the present study was to assess the prevalence of sarcopenia in women with osteopenia/osteoporosis with or without fragility fractures. Patients and methods: 112 ambulatory women with osteopenia/osteporosis were included. Body composition was determined by DXA. Weight, height, body mass index (BMI), bone mineral density (BMD) of the total skeleton, total lean mass (LM), appendicular lean mass (ALM) and the index: appendicular lean mass/height² (ALM/h²) were determined. Grip strength and self-selected gait speed were assessed. Results: Average (X ± SD) results were: age 70.9 ± 8.2 years, BMI: 23.1 ± 3.3 kg/h², total skeleton BMD T-Score:-1.7 ± 0.8, total LM 33.3 ± 3.8 kg, ALM 14.4 ±2.1 kg and ALM/h²: 5.86 ± 0.68 kg/h². Walking speed 0.96±0.21m/s and handgrip: 18.8 ± 4.8 kg. The prevalence of sarcopenia was: 24.7% (International Working Group criteria). Values for BMI, LM, ALM, ALM/h², gait speed and hand grip were significantly lower in sarcopenic vs. non-sarcopenic patients. 29 patients, average age: 70.5 ± 8.0 years had osteoporotic fragility fractures (Fx). The prevalence of sarcopenia in the group of patients with Fx was 41.4% vs. 19.3% in the non-Fx patients (n=83) (p<0.018). Conclusion: The prevalence of sarcopenia in women with osteopenia/osteoporosis was higher compared to that usually reported in non-selected patients of similar age. Those with bone fractures had a significantly higher prevalence of sarcopenia compared to the non-fracture patients. The assessment of muscle mass and function in patients with osteopenia/osteoporosis is recommended.

Effect of Time of Administration of Teriparatide on Bone Mineral Density in Glucocorticoid-Induced Osteoporosis

Teriparatide (TPTD) (recombinant DNA origin human parathormone [1-34]) is approved for the treatment of glucocorticoid-induced osteoporosis (GIO). There are reports of factors that affect the response to TPTD in GIO treatment. This work describes the case of a 71-yr-old woman diagnosed with lupus nephropathy treated with 40 mg/d of meprednisone, and who suffered multiple vertebral fractures. Despite treatment with a single 5 mg dose of zoledronic acid, the patient continued to have vertebral fractures. Treatment with 20 µg/d of subcutaneous TPTD (PTH1-34, Forteo; Eli Lilly Co., Indianapolis, IN) was initiated. Nine months after the onset of treatment, bone mineral density (BMD) assessment showed a 5% decrease in lumbar spine BMD. Factors potentially affecting the results were analyzed. The patient reported injecting TPTD at night and was instructed to inject TPTD in the morning before breakfast. After changing the time of TPTD administration and 22 mo after initiating treatment, BMD assessment was repeated and showed an 18% increase at the lumbar spine and no new vertebral fractures. The time of TPTD administration might affect the response to TPTD in GIO treatment.