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No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

A new self-administered bone-specific physical activity questionnaire (bsPAQ) aimed at older Scottish women was developed in order to examine the influence of habitual physical activity (PA) on bone mineral density (BMD).  The ability of the Aberdeen bsPAQ to estimate both the metabolic and mechanical component of self-reported PA was tested amongst 127 women (mean age (SD): 61.4 (6.0) y) from the Aberdeen area.  The estimated metabolic and mechanical component was compared to total and vertical acceleration, respectively, from a triaxial accelerometer (RT3, Stayhealthy, Inc.).  the agreement between the bsPAQ and the objective measure of physical activity used in this investigation ranged from fair to moderate for the different self-reported physical activity variables, making the Aberdeen bsPAQ a useful tool for accessing PA in older women with musculoskeletal diseases. The Aberdeen bsPAQ was used to examine the effect of lifestyle PA on BMD amongst Scottish postmenopausal women who had taken part in a large population-based screening study [North of Scotland Osteoporosis Study (NOSOS)].  BMD was measured using dual X-ray absorptiometry (LUNAR PRODIGY^TM X-ray scanner, Lunar Corporation, GE Medical Systems) at the lumbar spine and left and right hip.  One thousand two hundred and fifty-four (n=1254) postmenopausal women (mean age (SD): 69.3 ± 5.5y) from the Aberdeen and Inverness area completed the bsPAQ (overall return rate 68.7%). Classification of women according to self-reported PA revealed that those in the highest tertiles had a greater BMD than those in the lowest tertiles and this remained significant for the majority of the self-reported PA outcome variables after adjusting for a variety of confounding factors.  The observed differences were biologically significant if maintained through life, as they could substantially reduce the relative risk of hop fractures in this group of older postmenopausal women. Current levels of physical activity had a small but significant independent effect of current BMD especially at the total hip site.  The mechanical component explained more of the BMD variation (1.3% of the left hip and 0.6% of the right hip) than the metabolic component (0.2% of the left and right hip).  The addition of simple self-assessed anthopometric measurements into the regression model improved the prediction model. Significant interactions were identified between dietary calcium and the mechanical (but not the metabolic) component of PA, with the presence of the mechanical component of PA being more important at low and medium intakes of dietary calcium.  Finally, an association was also found between past PA and current BMD.

Patients with inflammatory bowel disease (IBO), comprising Crohn's disease (CD) and ulcerative colitis (UC) are at increased risk of osteoporosis with associated fracture and morbidity, particularly at a younger age. Numerous studies in the literature have shown that disease activity and glucocorticoid (GC) use are major contributing factors. Individuals can vary in their response to GC as reflected by their Iymphocyte steroid sensitivity (LSS) in vitro and the sensitivity of bone to effects of GC can vary as well. The observation that rapid bone loss at Ward's triangle occurred in a cohort of CD patients treated for a disease relapse with a single course of glucocorticoid therapy lead to the interventional randomised control trial that formed the basis of this project and the prospective and cross-sectional investigations described in this thesis. The RCT was designed to determine whether risedronate could prevent bone loss in CD and UC patients treated with a short course of GC for a relapse. Patients recruited to the RCT provided serum and urine samples at regular intervals which were used to measure Iymphocyte steroid sensitivity (LSS), bone turnover markers (P1 NP and CTX), cytokine concentrations and 11 hydroxysteroid dehydrogenase (11BHSD1). The aim of the project was to explore mechanisms which determine the extent of bone loss in patients with IBD and to determine whether the degree of bone loss is related to individual steroid sensitivity or the extent of systemic inflammation or both of these mechanisms. Hence skeletal changes measured by DXA and bone turnover markers were related to LSS, cytokines concentrations and disease activity scores. We determined whether 11 BHSD1 could predict change in BMD or bone markers. Risedronate was effective at reducing bone loss at WT shown to our knowledge for the first time during a short course of steroid therapy. 11BHS01 did not predict bone loss but this had not been explored in' the context of IBD previously. The cross-sectional data for LSS revealed some intriguing results but may not predict clinical steroid responsiveness in all patients. Clarifying the pathogenesis of bone loss may inform strategies to minimise bone loss, but there is no clear method of predicting which patients are most susceptible to the deleterious effects of GC.

There is growing evidence that females in the Middle East are not obtaining sufficient amounts of vitamin D, the perceived reason being their unhealthy lifestyle. This situation is a cause for concern particularly for adolescent females, because adequate vitamin D status has been shown to promote bone mineral accrual in adolescence. Achieving a high peak bone mass (PBM) may help decrease the risk of postmenopausal osteoporosis and fragility fractures. The aim of this study was to assess the vitamin D status among Kuwaiti adolescent girls and to assess its impact and those of lifestyle, on their bone mass.