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Consommation chronique d'alcool, exercice physique et tissu osseux : modifications densitométriques, architecturales, biomécaniques et métaboliques chez le rat / Chronic alcohol consumption, physical exercise and bone tissue : densitometric, microarchitectural, biomechanic and metabolic changes in the ratMaurel, Delphine 24 November 2011 (has links)
La consommation d’alcool a des effets sur le tissu osseux. L’alcoolisme est une des causes d’ostéoporose secondaire chez l’homme. Dans ce travail nous avons mené différentes expérimentations chez le rat afin d’étudier les effets d’une consommation chronique d’alcool combinée ou non à un entraînement aérobie sur le tissu osseux. Nous avons montré qu’une faible dose d’alcool administrée pendant une période courte peut avoir un effet positif sur la densité minérale osseuse et l’épaisseur trabéculaire. En revanche, la combinaison activité physique et consommation modérée d’alcool n’a pas d’effet additif sur la potentialisation du tissu osseux. Nous avons également démontré un effet dose de l’alcool indiquant des effets délétères majorés sur la densité minérale osseuse (DMO), la microarchitecture corticale et la résistance osseuse avec des apports croissants (25%, 30% et 35% v/v). La modification de DMO s’accompagne d’un changement de composition corporelle et d’une diminution de la leptine systémique. Cependant, le nombre d’adipocytes augmente dans la moelle osseuse. Nous avons mis en évidence dans ce modèle d’ostéoporose secondaire due à l’alcool une augmentation de l’apoptose des ostéocytes, corrélée à la diminution de la DMO et à l’augmentation de l’adiposité médullaire. Nous avons de plus mis en évidence une incorporation de lipides dans les ostéocytes, incorporation fortement corrélée à l’apoptose de ces cellules. Enfin, nos résultats montrent qu’un exercice physique régulier combiné à une consommation chronique et excessive d’alcool permet de prévenir les effets délétères de l’alcool sur les paramètres osseux (porosité corticale, épaisseur corticale) et limite la diminution de la DMO. Cette diminution est associée à une régulation de l’apoptose des ostéocytes. / Heavy chronic alcohol consumption has deleterious effects on bone tissue. It is one of the major causes of secondary osteoporosis in men. In this work, we draw several experimentations to assess the effects of chronic alcohol consumption on bone, combined or not to an aerobic training in the rat. We showed that light to moderate chronic alcohol consumption during a short time lead to an increase of bone mineral density (BMD) and trabecular thickness, whith no additive effects of physical exercise on bone tissue. When the alcohol doses were increased, we showed deleterious effects on BMD, microarchitecture, bone resistance with a dose effect with increasing alcohol doses (25%, 30% and 35% v/v): the more alcohol was concentrated and the more the bone parameters were decreased. The BMD decrease was associated with a change in body composition, and with a decrease in serum leptin. However, the number of lipid droplets in the bone marrow was increased dramatically. We demonstrated that there was a huge increase in osteocyte apoptosis with alcohol (35% v/v) in this alcohol-induced osteoporosis model, which was correlated with BMD and bone marrow adiposity. We have also shown that there was lipid incorporation in bone micro vessels and in osteocytes, which was correlated with osteocyte apoptosis. Lastly, we showed that when regular exercise was associated with heavy chronic alcohol consumption, the bone parameters were normal (trabecular, cortical thickness, femur length) and the BMD was less decreased compared to alcohol-fed and sedentary rats. These effects were associated with a regulation of osteocyte apoptosis.
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Correlação entre Densidade Radiográfica - DR e Absorciometria por Raios-X de Duas Energias - DXA: Estudo “in vitro” / Correlation between Radiographic Density - RD and Dual-energy X-ray Absorptiometry - DXA "in vitro" studyFernandes, Rodrigo Antonio 18 January 2019 (has links)
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Previous issue date: 2019-01-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo desse estudo foi inferir a Densidade Mineral óssea (DMO) a partir da imagem radiográfica (Raios-X) usando como referência a DMO de uma escada de alumínio mensurada por Absorciometria por de Duas-Energias (DXA). Para isso foram utilizadas 30 amostras de tecido ósseo cortical e 30 amostras de tecido ósseo trabecular de osso bovino “in vitro”. Foram mensurados neste estudo a Densidade Mineral Óssea (DMO), o Conteúdo Mineral Ósseo (CMO) ambos obtidos pelo densitômetro LUNAR®–DPX ALPHA; a Quantidade Mineral Óssea (QMO) massa das cinzas após a calcinação das amostras; a densidade real das amostras (dReal=massa/volume). Foram feitas 10 tomadas de RX com as 60 amostras, entremeadas pela escada de alumínio (referencial densitométrico). A correlação entre as técnicas (DR-tons de cinza e DXA g/cm2) gerou equações de regressão para cada uma das dez radiografias e permitiu inferir a densidade mineral óssea (DMODR), obtida através da conversão dos tons de cinza em densidade radiográfica pelo software ImageJ® para cada uma das 10 tomadas radiográficas; calculou-se então a média da densidade mineral óssea calculada pela densitometria radiográfica (XDMODR) de todas as dez radiografias. Foi observado que a média da densidade real das amostras foi de 2,2±0,23g/cm2 e 1,05±0,09g/cm2 enquanto que a média da densidade mensurada pelo DXA foi de 0,73±0,11g/cm2 e 0,22±0,11g/cm2, observou que a media da DMODR ficou em 0,93±0,11g/cm2 e 0,34±0,14 g/cm2 para o osso cortical e trabecular respectivamente. A média da CMO foi de 0,19±0,9g e 0,08±0,02g e a media da QMO 0,14±0,04g e 0,05±0,03g para o osso cortical e trabecular respectivamente. Foi possível obter bons coeficientes de determinação entre todas as variáveis estudadas: CMO e QMO, R2 =0,747; DMO e dReal com R2 = 0,765; dReal e DMODR; DMO e XDMODR, respectivamente 0,764 e 0,856. Para as correlações foram usadas amostras de dois tecidos ósseos cortical e trabecular, o que sugere distinção entre as amostras com as metodologias utilizadas / The aim of this study was to infer the bone mineral density (BMD) from the radiographic image (X-X) with reference to the BMD of an aluminum step wedge measured by absorptiometry Dual-energy (DXA). For this we used 30 samples of cortical bone 30 and cancellous bone tissue samples of bovine bone "in vitro". Were measured in this study Bone Mineral Density (BMD), bone mineral content (BMC) both obtained by densitometer LUNAR® DPX-ALPHA; Volume Bone Mineral (QMO) mass of ash after calcination of the samples; the real density of the samples (dReal = mass / volume). 10 taken RX were made with the samples 60, interspersed by aluminum step wedge (densitometric reference). The correlation between the techniques (gray DR-tones and DXA g / cm 2) generated regression equations for each of the ten X-rays and allowed to infer bone mineral density (DMODR) obtained by converting grayscale radiographic density by ImageJ® for each of the 10 radiographic taken. It was then calculated average bone mineral density calculated by X-ray densitometry (XDMODR) radiographs of all ten. Was observed that the average true density of the samples was 2.2±0.23g/cm2 and 1.05±0.09g/cm2 while the average density measured by DXA was 0.73±0.11g/cm2 and 0.22±0.11g/cm2 interesting that the average DMODR was 0.93±0.11g/cm2 and 0.34±0.14g/cm2 for cortical and cancellous bone respectively. The average of the BMC was 0.19±0.08g and 0.9±0.02g, and the average QMO 0.14±0.04g and 0.05±0 03g for cortical and cancellous bone respectively. It was possible to obtain good determination coefficients between all variables: BMC and QMO, R2 = 0.747; BMD and dReal with R2 = 0.765; dReal and DMODR; BMD and XDMODR respectively 0.764 and 0.856. For correlations were used two samples of cortical and cancellous bone tissues, suggesting a difference between the samples with the methodologies used.
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Calcificação prematura de artérias coronárias no lúpus eritematoso sistêmico: associação com duração de doença e densidade mineral óssea / Premature coronary artery calcification is associated with disease duration and bone mineral density in young female systemic lupus erythematosusGiovana Gomes Ribeiro 13 March 2009 (has links)
Objetivo: Avaliar a relevância de fatores de risco tradicionais para doença cardiovascular (FRC), fatores relacionados ao lúpus e densidade mineral óssea (DMO) na calcificação prematura de artérias coronárias (CAC) em mulheres jovens com lúpus eritematoso sistêmico (LES). Métodos: Noventa e quatro pacientes lúpicas do sexo feminino com duração de doença 5 anos e idade menor que 45 anos foram selecionadas consecutivamente para este estudo. Os fatores de risco cardiovascular analisados foram: diabetes mellitus, hipertensão arterial sistêmica, dislipoproteinemia, fumo, índice de massa corpórea (IMC), insuficiência ovariana e renal. Fatores de risco relacionados ao LES estudados foram: duração de doença, critérios ACR, SLICC/ACR modificado (excluindo escores relacionados à aterosclerose), SLEDAI, tratamento com glicocorticóide e ciclofosfamida. A densidade mineral óssea de corpo inteiro, coluna lombar e colo do fêmur foram realizadas por densitometria de dupla emissão de fontes de raios-X (DXA). Calcificação de artérias coronárias foi determinada usando tomografia computadorizada com 16 multidetectores. Resultados: Calcificação prematura de artérias coronárias foi identificada em 12 (12,7%) dos pacientes, havendo associação com maior freqüência de pacientes com FRC (p=0,008), maior número de FCR (p=0,003), idade (p=0,025), duração de doença (p=0,011) e SLICC (p=0,011). A análise individual dos FRC demonstrou que a presença de menopausa (p=0,036), dislipidemia (p=0,003) e hipertensão (p=0,006) foram significativamente associados com calcificação coronariana. Análise de regressão logística múltipla usando FRC, idade, duração de doença, SLICC e DMO de corpo inteiro revelou que apenas duração de doença (p=0,042) e DMO de corpo inteiro (p=0,023) permaneceram fatores significantes para calcificação coronariana. Conclusão: Identificamos que duração de doença e DMO reduzida são preditores independentes para calcificação coronariana prematura em mulheres jovens com LES, sugerindo um mecanismo subjacente comum / Objective: To evaluate the relevance of traditional cardiovascular risk factors (CVR), disease-related risk factors and bone mineral density (BMD) for premature coronary artery calcification (CAC) in young female systemic lupus erythematosus (SLE). Methods: Ninety-four female SLE patients 5 years disease duration and age <45 years were consecutively selected for this study. Cardiovascular risks (CVR) analyzed were: diabetes mellitus, arterial hypertension, dyslipoproteinemia, smoking, body mass index (BMI), ovarian and renal insufficiency. SLE-related risk factors evaluated were: disease duration, ACR criteria, modified SLICC/ACR (excluding atherosclerosis-related scores), SLEDAI, glucocorticoid and cyclophosphamide treatment. Bone mineral density (BMD) in whole body, lumbar spine and femoral neck was assessed by dual X ray absorptiometry (DXA). Coronary artery calcification was determined using the 16-slice multidetector computed tomography. Results: Premature coronary artery calcification was identified in 12 (12.7%) patients and was associated with a higher frequency of patients with CVR (p=0.008), a higher mean number of CVR (p=0.003), mean age (p= 0.025), mean disease duration (p=0.011) and mean SLICC (p=0.011). Individual analysis of CVR demonstrated that the presence of menopause (p= 0.036), dyslipidemia (p= 0.003) and hypertension (p=0.006) were significantly associated with coronary calcification. Additionally, premature calcification was associated with a lower whole body BMD (p=0.013). Multiple logistic regression analysis using CVR, age, disease duration, SLICC and whole body BMD revealed that only disease duration (p=0.042) and whole body BMD (p=0.023) remained significant factors for coronary calcification. Conclusion: We have identified that disease duration and decreased BMD are independent predictors for premature coronary calcification in young women with SLE, suggesting a common underlying mechanism
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Influência do tecido adiposo, adiposidade da medula óssea e das incretinas sobre a densidade mineral óssea de pacientes com síndrome do intestino curto / Influence of adipose tissue, bone marrow fat and incretins on bone mineral density in short bowel syndrome patientsSilva, Luciana Tabajara Parreiras e 14 March 2018 (has links)
A Síndrome do Intestino Curto (SIC) é uma doença complexa que ocorre após extensa ressecção do intestino delgado, levando a uma má absorção de nutrientes e fluidos, uma condição que pode causar diarreia, desnutrição e perda de peso graves com alto risco para o desenvolvimento da osteoporose. Estudos recentes mostram existir ampla interação fisiológica do esqueleto com os diversos sistemas, incluindo o metabolismo energético e o trato digestório. Peptídeos originados não só no tecido adiposo, mas também no intestino como as incretinas [GIP (polipeptídeo trópico insulínico dependente de glicose) e GLP1 (peptídeo 1 tipo glucagon)] modulam a atividade de remodelação óssea. O objetivo principal do atual estudo foi avaliar a relação entre os tecidos adiposos subcutâneo (TAS), visceral (TAV), lipídeos intra-hepáticos (LIH), tecido adiposo da medula óssea (TAMO), bem como do GIP, GLP1, e grelina com a densidade mineral óssea (DMO) em pacientes com SIC. Tratase de um estudo observacional prospectivo composto por dois grupos experimentais pareados por altura, idade e sexo: a) o grupo controle (GC) (n = 18; 9M,9F) e b) o grupo de pacientes com SIC, o qual foi avaliado em 2 ocasiões, com intervalo de um ano entre as análises, sendo denominados SIC0 (n = 14; 7M,7F) e SIC1 (n = 11; 6M,5F). Em comparação com o GC, pacientes com SIC ao longo do estudo apresentaram menor DMO e maior LIH e GIP (p< 0,05). Os valores de TAMO, GLP1 e grelina foram similares entre os grupos. O TAMO teve correlação negativa e significativa com DMO de L3 no GC (r= -0,6; p< 0,05), porém, no grupo SIC esta correlação foi positiva, mas sem significância estatística ao longo do estudo: SIC0 (r= 0,45; p= 0,13) e SIC1 (r= 0,45; p= 0,17). LIH associou-se negativamente com DMO do colo do fêmur (R²= 0,16; p< 0,05) e quadril total (R²= 0,27; p< 0,05). Existe alta prevalência de osteoporose em pacientes com SIC. No entanto, não se observou nem expansão de TAMO e nem relação negativa da DMO com o TAMO. O acesso a calorias parece afetar positivamente a relação entre TAMO e massa óssea. A deposição hepática de lipídeos parece afetar negativamente a massa óssea de pacientes com SIC. / Short bowel syndrome (SBS) is a complex disease that occurs after extensive resection of the small intestine leading to malabsorption of nutrients and fluids, a condition that can cause severe watery diarrhea, dehydration and acute weight loss, developing high risk for the appearance of osteometabolic disease. Studies have shown the progress on the physiological interaction of the skeleton with the various systems, including energetic metabolism and the gastrointestinal tract. Peptides originated not only in adipose tissue but also in the intestine such as incretin [GIP (Glucose-dependent insulinotropic polypeptide) and GLP1 (glucagonlike peptide 1) modulate bone remodeling activity. The main objective of the current study was to evaluate the influence of subcutaneous (SAT), visceral (VAT) adipose tissue, intrahepatic lipids (IHL), bone marrow fat adipose tissue (MAT), as well as the influence of GIP, GLP1, and ghrelin on the bone mineral density (BMD) of SBS patients. It is a prospective observational study composed by two experimental groups matched by height, age and sex: a) the control group (CG) (n = 18; 9M,9F) and b) the SBS group which were evaluated in two occasions with a period between analyzes of one year: named SBS0 (n = 14; 7M,7F) and SBS1 (n = 11; 6M,5F). Compared to CG, SBS patients throughout the study had significantly lower BMD and elevated IHL and GIP (p< 0.05). Values of MAT, GLP1 and ghrelin were similar between groups. MAT was negatively and significantly correlated with L3 BMD in the CG (r = -0.6; p< 0.05) and positively correlated, but not significant with L3 BMD in the SBS group throughout the study: SBS0 (r= 0.45; p= 0.13) and SBS1 (r= 0.45; p= 0.17). IHL was negatively and significantly associated with femoral neck BMD (R²= 0.16; p< 0.05) and total hip BMD (R²= 0.27; p< 0.05). The occurrence of osteoporosis is frequent in SBS patients, but MAT is not increased in these patients and had positive correlation with BMD, although not significant. Access to calories seems to positively affect the relationship between MAT and bone mass. IHL appear to negatively affect bone mass in SBS patients.
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Interventions nutritionnelles, exercice physique et perturbations métaboliques : réponses micro-architecturales, densitométrique, biomécaniques et cellulaires du tissu osseux chez le rat mâle. Induction de l'obésité et prise en charge.Gerbaix, Maude 11 June 2012 (has links)
Si l’obésité a longtemps été considérée comme protectrice pour le squelette, sa prise en charge nutritionnelle s’accompagne d’une perte osseuse. Dans le but d’étudier les mécanismes liant le tissu adipeux et le tissu osseux, des rats ont été nourris avec un régime riche en graisse et en sucre afin d’induire une obésité et ses complications métaboliques. Puis, ces rats ont suivi un programme de prise en charge de l’obésité associant un rééquilibrage nutritionnel à de l’activité physique. Des investigations de la densité, de la micro architecture trabéculaire, de la qualité corticale, des propriétés biomécaniques et des paramètres cellulaires du tissu osseux ont été réalisées sur le squelette des rats. L’obésité induite a amélioré les paramètres densitométriques et corticaux des rats. La prise en charge de l’obésité a entraîné des effets contrastés. Le rééquilibrage de l’alimentation n’a pas altéré la densité ni les paramètres biomécaniques et corticaux du tissu osseux des rats en dépit d’altérations de la micro architecture et des perturbations l’activité cellulaire osseuse. L’exercice a augmenté la densité minérale osseuse du tibia des rats. Nos résultats montrent que l’inclusion de l’exercice dans un programme de prise en charge de l’obésité permet de potentialiser la perte de masse grasse et de maintenir l’intégrité du squelette. En étudiant l’impact d’un régime obésogène et de la prise en charge de l’obésité sur le tissu osseux chez le rat, ce travail de thèse apporte sa contribution dans la compréhension des mécanismes liant le tissu adipeux et le tissu osseux. / While obesity has long been considered protective of bone tissue, its nutritional management is linked to a concomitant bone loss. In order to access these mechanisms, male rats were given a high fat / high sucrose diet to induce obesity and its resulting metabolic disorders. Then, these rats participated in a well balanced nutritional program combined, or not, with physical activity in order to treat their obesity. Investigations on density, trabecular micro-architecture, cortical quality, biomechanical properties and cellular parameters of bone tissue were performed on rat’s skeleton. Obesity had improved the bone density and cortical parameters of rats. Obesity management had induced mixed effects. The well balanced diet did alter neither the bone density nor biomechanical and cortical parameters despite the presence of alterations in the trabecular micro architecture and some disturbances of bone cellular activity. Exercise by itself had increased the tibia bone mineral density. Our results show that including exercise in obesity management allows increasing the fat mass loss and maintaining the skeleton integrity. By studying the impact of an obesogenic diet and obesity treatment on bone tissue in rats, this study brings its contribution to the understanding of the mechanisms linking adipose tissue and bone tissue.
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Type 1 diabetes mellitus: Aspects of long-term complications and body compositionIngberg, Claes-Mårten January 2003 (has links)
<p>Studies concerning social consequences, gastrointestinal and urinary tract symptoms were conducted in a population-based cohort comprising patients with long-standing type 1 diabetes and matched control persons. Three different questionnaires were sent by mail to diabetic patients and control persons. After a mean duration of 28.7±2.6 years, compared to the controls the diabetic patients showed an almost 10 times higher mortality, a lower employment rate and greater need for welfare benefits. These differences were mainly due to diabetic late complications. Education, housing conditions, life-style, civil state, alcohol and smoking habits were similar in the two groups. The prevalence of gastrointestinal symptoms was significantly higher in the diabetic patients than in the controls, and this was found to be attributable to the female diabetic patients. Female diabetic patients had been treated with antibiotics for urinary tract infections more often than controls, they experienced more social problems than controls in daily life because of urinary tract problems and used clamps to prevent wetting more often than did controls. </p><p>Body composition and bone mineral density were evaluated in parts of the cohort with long-standing type 1 diabetes and control persons in another population-based cohort comprising diabetic females aged 16-19 years with type 1 diabetes since childhood and matched controls. Besides a tendency to reduced abdominal fat mass in diabetic males, no difference was observed in fat mass, muscle mass or bone mineral density between the patients with long-standing type 1 diabetes and controls. Significant correlations were found between insulin dosage and whole body fat mass in diabetic females and between serum cholesterol levels and abdominal fat mass in diabetic males. The female adolescents had a higher body mass index than the controls, and their overweight was shown to consist almost entirely of an increased fat mass. The distribution of fat, expressed as abdominal-to-leg ratio, correlated significantly to HbA1c and daily dosage of insulin. Bone mineral density did not differ between the groups. IGF I was significantly lower both in patients with long-standing type 1 diabetes and in the adolescent diabetic females compared with their matched controls.</p>
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Type 1 diabetes mellitus: Aspects of long-term complications and body compositionIngberg, Claes-Mårten January 2003 (has links)
Studies concerning social consequences, gastrointestinal and urinary tract symptoms were conducted in a population-based cohort comprising patients with long-standing type 1 diabetes and matched control persons. Three different questionnaires were sent by mail to diabetic patients and control persons. After a mean duration of 28.7±2.6 years, compared to the controls the diabetic patients showed an almost 10 times higher mortality, a lower employment rate and greater need for welfare benefits. These differences were mainly due to diabetic late complications. Education, housing conditions, life-style, civil state, alcohol and smoking habits were similar in the two groups. The prevalence of gastrointestinal symptoms was significantly higher in the diabetic patients than in the controls, and this was found to be attributable to the female diabetic patients. Female diabetic patients had been treated with antibiotics for urinary tract infections more often than controls, they experienced more social problems than controls in daily life because of urinary tract problems and used clamps to prevent wetting more often than did controls. Body composition and bone mineral density were evaluated in parts of the cohort with long-standing type 1 diabetes and control persons in another population-based cohort comprising diabetic females aged 16-19 years with type 1 diabetes since childhood and matched controls. Besides a tendency to reduced abdominal fat mass in diabetic males, no difference was observed in fat mass, muscle mass or bone mineral density between the patients with long-standing type 1 diabetes and controls. Significant correlations were found between insulin dosage and whole body fat mass in diabetic females and between serum cholesterol levels and abdominal fat mass in diabetic males. The female adolescents had a higher body mass index than the controls, and their overweight was shown to consist almost entirely of an increased fat mass. The distribution of fat, expressed as abdominal-to-leg ratio, correlated significantly to HbA1c and daily dosage of insulin. Bone mineral density did not differ between the groups. IGF I was significantly lower both in patients with long-standing type 1 diabetes and in the adolescent diabetic females compared with their matched controls.
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Der Effekt von 20-Hydroxyecdyson auf die Tibia orchidektomierter und ovarektomierter Ratten, gemessen mittels peripherer quantitativer Computertomographie / The effect of 20-Hydroxyecdysone on the tibia of orchidectomized and ovariectomized rats measured by peripheral quantitative computed tomographyJäckel, Katharina 07 June 2011 (has links)
No description available.
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Effects of Jump Training on Bone Mineral Density in Young Adult FemalesZagdsuren, Battogtokh 01 May 2014 (has links)
Physical activity is critical to bone health. However, not all physical activity has optimum effect on bone health and metabolism. The purpose of this study was to determine the effects of a short term progressive jumping protocol on bone mineral density in college age Asian females. Sixteen participants aged18-28 years enrolled in the study. Participants were assigned to exercise (n=9) and control (n=8) groups. The exercise group completed a two-legged depth jump from an approximate 20cm stepbench followed immediately by a maximum vertical jump using arm swings for five days per week for two weeks. Each depth jump and vertical jump was performed ten times during each session. The exercise intervention progressed from one session per day to three sessions per day in ten days. The bone mineral density (BMD) by dualenergy x-ray absorptiometry (DXA), ground reaction force (GRF), bone specific physical activity questionnaire (BPAQ), and dietary log were administered to the participants pre- and post-intervention. The data were analysed using a dependent t-test and one-way repeated measures. There were no significant changes noted in BMD value in the study. The past BPAQ showed significant correlation to BMD change of left hip (p<0.01) in exercise group. The vertical GRF showed significant increase (p<0.05) in exercise group. It can be concluded from the study that intensity of the progressive jumping was intense enough to stimulate some changes in the bone metabolism.
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Influência do tecido adiposo, adiposidade da medula óssea e das incretinas sobre a densidade mineral óssea de pacientes com síndrome do intestino curto / Influence of adipose tissue, bone marrow fat and incretins on bone mineral density in short bowel syndrome patientsLuciana Tabajara Parreiras e Silva 14 March 2018 (has links)
A Síndrome do Intestino Curto (SIC) é uma doença complexa que ocorre após extensa ressecção do intestino delgado, levando a uma má absorção de nutrientes e fluidos, uma condição que pode causar diarreia, desnutrição e perda de peso graves com alto risco para o desenvolvimento da osteoporose. Estudos recentes mostram existir ampla interação fisiológica do esqueleto com os diversos sistemas, incluindo o metabolismo energético e o trato digestório. Peptídeos originados não só no tecido adiposo, mas também no intestino como as incretinas [GIP (polipeptídeo trópico insulínico dependente de glicose) e GLP1 (peptídeo 1 tipo glucagon)] modulam a atividade de remodelação óssea. O objetivo principal do atual estudo foi avaliar a relação entre os tecidos adiposos subcutâneo (TAS), visceral (TAV), lipídeos intra-hepáticos (LIH), tecido adiposo da medula óssea (TAMO), bem como do GIP, GLP1, e grelina com a densidade mineral óssea (DMO) em pacientes com SIC. Tratase de um estudo observacional prospectivo composto por dois grupos experimentais pareados por altura, idade e sexo: a) o grupo controle (GC) (n = 18; 9M,9F) e b) o grupo de pacientes com SIC, o qual foi avaliado em 2 ocasiões, com intervalo de um ano entre as análises, sendo denominados SIC0 (n = 14; 7M,7F) e SIC1 (n = 11; 6M,5F). Em comparação com o GC, pacientes com SIC ao longo do estudo apresentaram menor DMO e maior LIH e GIP (p< 0,05). Os valores de TAMO, GLP1 e grelina foram similares entre os grupos. O TAMO teve correlação negativa e significativa com DMO de L3 no GC (r= -0,6; p< 0,05), porém, no grupo SIC esta correlação foi positiva, mas sem significância estatística ao longo do estudo: SIC0 (r= 0,45; p= 0,13) e SIC1 (r= 0,45; p= 0,17). LIH associou-se negativamente com DMO do colo do fêmur (R²= 0,16; p< 0,05) e quadril total (R²= 0,27; p< 0,05). Existe alta prevalência de osteoporose em pacientes com SIC. No entanto, não se observou nem expansão de TAMO e nem relação negativa da DMO com o TAMO. O acesso a calorias parece afetar positivamente a relação entre TAMO e massa óssea. A deposição hepática de lipídeos parece afetar negativamente a massa óssea de pacientes com SIC. / Short bowel syndrome (SBS) is a complex disease that occurs after extensive resection of the small intestine leading to malabsorption of nutrients and fluids, a condition that can cause severe watery diarrhea, dehydration and acute weight loss, developing high risk for the appearance of osteometabolic disease. Studies have shown the progress on the physiological interaction of the skeleton with the various systems, including energetic metabolism and the gastrointestinal tract. Peptides originated not only in adipose tissue but also in the intestine such as incretin [GIP (Glucose-dependent insulinotropic polypeptide) and GLP1 (glucagonlike peptide 1) modulate bone remodeling activity. The main objective of the current study was to evaluate the influence of subcutaneous (SAT), visceral (VAT) adipose tissue, intrahepatic lipids (IHL), bone marrow fat adipose tissue (MAT), as well as the influence of GIP, GLP1, and ghrelin on the bone mineral density (BMD) of SBS patients. It is a prospective observational study composed by two experimental groups matched by height, age and sex: a) the control group (CG) (n = 18; 9M,9F) and b) the SBS group which were evaluated in two occasions with a period between analyzes of one year: named SBS0 (n = 14; 7M,7F) and SBS1 (n = 11; 6M,5F). Compared to CG, SBS patients throughout the study had significantly lower BMD and elevated IHL and GIP (p< 0.05). Values of MAT, GLP1 and ghrelin were similar between groups. MAT was negatively and significantly correlated with L3 BMD in the CG (r = -0.6; p< 0.05) and positively correlated, but not significant with L3 BMD in the SBS group throughout the study: SBS0 (r= 0.45; p= 0.13) and SBS1 (r= 0.45; p= 0.17). IHL was negatively and significantly associated with femoral neck BMD (R²= 0.16; p< 0.05) and total hip BMD (R²= 0.27; p< 0.05). The occurrence of osteoporosis is frequent in SBS patients, but MAT is not increased in these patients and had positive correlation with BMD, although not significant. Access to calories seems to positively affect the relationship between MAT and bone mass. IHL appear to negatively affect bone mass in SBS patients.
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