Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A baixa relação de ômega-6/ômega-3 esta relacionada com propriedades benéficas para a saúde óssea. No entanto, a dieta rica nestes compostos pode levar a obesidade. Adipócitos e osteoblastos derivam de células progenitoras comuns, e o consumo de óleo de canola pode ter ação adipogênica e osteogênica. Nosso objetivo foi avaliar a adiposidade abdominal, insulina e estrutura óssea em ratos tratados com dieta contendo baixa relação ômega-6/ômega-3, proveniente do óleo de canola. Após desmame, os ratos foram divididos em grupos alimentados com dieta normocalórica: Controle (S) e experimental (C), contendo 7ml/100g de óleo de soja ou de canola e grupos tratados com dieta rica em lipídios: Controle (7S) ou hiperlipídico contendo 19ml/100g de óleo de soja (19S) ou de canola (19C), até completarem 60 dias de idade. Os dados foram significativos com P<0,05. No primeiro modelo, o grupo C apresentou redução de: Massa e área do adipócito intra-abdominal; Colesterol; Insulina; Densidade mineral (DMO) e massa óssea total e na coluna vertebral; Massa do fêmur; Espessura da diáfise; DMO do fêmur e das vértebras lombares e radiodensidade da cabeça do fêmur. No segundo modelo, os grupos 19S e 19C apresentaram maior ingestão calórica, densidade corporal, massa de gordura intra-abdominal, e maior massa e comprimento do fêmur e da coluna lombar. O grupo 19S apresentou maior área e menor número de adipócitos da região retroperitoneal. Glicose e a insulina foram aumentadas no grupo 19C vs. 7S. A tomografia do fêmur revelou maior radiodensidade na região proximal e da coluna lombar, no grupo 19C. Sugerimos que a quantidade e o tipo de lipídio consumido, após o desmame, induzem não somente o desenvolvimento corporal e os depósitos de gordura, além de afetarem a resistência insulínica e a saúde óssea / The lower ratio of omega-6 to omega-3 polyunsaturated fatty acids is associated with healthy bone properties. However, fat diets can induce obesity. Adipocytes and osteoblasts derive from a common progenitor, and canola oil intake may have an adipogenic and osteogenic effect. Our objective was to evaluate the intra-abdominal adiposity, insulin and bone growth in rats fed diet containing lower ratio of omega-6 to omega-3, provided in canola oil. After weaning, rats were divided into groups fed with normocaloric diet: control (S) and experimental (C), containing 7ml/100g soybean or canola oil, respectively and groups fed with fat diet: control (7S) or fat diets containing 19ml/100g soybean oil (19S) or canola oil (19C), until they 60 days old. Differences were considered significant with P<0,05. In normocaloric diet model, C group showed a significant reduction in: Intra-abdominal fat mass; Area of adipocyte; Cholesterol; Insulin; Total body and spine bone mineral content and bone area; Femur mass; Width of the diaphysis; Femur and lumbar vertebrae bone mineral density and radiodensity of femoral head. To high-fat diet model, 19S and 19C groups showed higher energy intake, body density growth, intra-abdominal fat mass and higher femur mass and, lumbar vertebrae mass and length. 19S showed higher area and lower number of retroperitoneal adipocytes. Glucose and insulin were significantly increased in 19C compared to 7S group. Computed tomography of femur revealed higher radiodensity in proximal femoral epiphysis and lumbar vertebrae of 19C. We suggest that the amount and the source of fat used in the diet, after weaning, induce not only the body and fat depots growth, besides affecting the insulin resistance and the bone health

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A baixa relação de ômega-6/ômega-3 esta relacionada com propriedades benéficas para a saúde óssea. No entanto, a dieta rica nestes compostos pode levar a obesidade. Adipócitos e osteoblastos derivam de células progenitoras comuns, e o consumo de óleo de canola pode ter ação adipogênica e osteogênica. Nosso objetivo foi avaliar a adiposidade abdominal, insulina e estrutura óssea em ratos tratados com dieta contendo baixa relação ômega-6/ômega-3, proveniente do óleo de canola. Após desmame, os ratos foram divididos em grupos alimentados com dieta normocalórica: Controle (S) e experimental (C), contendo 7ml/100g de óleo de soja ou de canola e grupos tratados com dieta rica em lipídios: Controle (7S) ou hiperlipídico contendo 19ml/100g de óleo de soja (19S) ou de canola (19C), até completarem 60 dias de idade. Os dados foram significativos com P<0,05. No primeiro modelo, o grupo C apresentou redução de: Massa e área do adipócito intra-abdominal; Colesterol; Insulina; Densidade mineral (DMO) e massa óssea total e na coluna vertebral; Massa do fêmur; Espessura da diáfise; DMO do fêmur e das vértebras lombares e radiodensidade da cabeça do fêmur. No segundo modelo, os grupos 19S e 19C apresentaram maior ingestão calórica, densidade corporal, massa de gordura intra-abdominal, e maior massa e comprimento do fêmur e da coluna lombar. O grupo 19S apresentou maior área e menor número de adipócitos da região retroperitoneal. Glicose e a insulina foram aumentadas no grupo 19C vs. 7S. A tomografia do fêmur revelou maior radiodensidade na região proximal e da coluna lombar, no grupo 19C. Sugerimos que a quantidade e o tipo de lipídio consumido, após o desmame, induzem não somente o desenvolvimento corporal e os depósitos de gordura, além de afetarem a resistência insulínica e a saúde óssea / The lower ratio of omega-6 to omega-3 polyunsaturated fatty acids is associated with healthy bone properties. However, fat diets can induce obesity. Adipocytes and osteoblasts derive from a common progenitor, and canola oil intake may have an adipogenic and osteogenic effect. Our objective was to evaluate the intra-abdominal adiposity, insulin and bone growth in rats fed diet containing lower ratio of omega-6 to omega-3, provided in canola oil. After weaning, rats were divided into groups fed with normocaloric diet: control (S) and experimental (C), containing 7ml/100g soybean or canola oil, respectively and groups fed with fat diet: control (7S) or fat diets containing 19ml/100g soybean oil (19S) or canola oil (19C), until they 60 days old. Differences were considered significant with P<0,05. In normocaloric diet model, C group showed a significant reduction in: Intra-abdominal fat mass; Area of adipocyte; Cholesterol; Insulin; Total body and spine bone mineral content and bone area; Femur mass; Width of the diaphysis; Femur and lumbar vertebrae bone mineral density and radiodensity of femoral head. To high-fat diet model, 19S and 19C groups showed higher energy intake, body density growth, intra-abdominal fat mass and higher femur mass and, lumbar vertebrae mass and length. 19S showed higher area and lower number of retroperitoneal adipocytes. Glucose and insulin were significantly increased in 19C compared to 7S group. Computed tomography of femur revealed higher radiodensity in proximal femoral epiphysis and lumbar vertebrae of 19C. We suggest that the amount and the source of fat used in the diet, after weaning, induce not only the body and fat depots growth, besides affecting the insulin resistance and the bone health

Excessive accumulation of body fat is detrimental to people's health, so it is important to check the amount and distribution of body fat by assessing body composition. Taking into account the importance of assessing body composition and the lack of studies that indicate the most appropriate method to overweight and obesity, this study aims to examine the relationship and the agreement of different methods of assessing body composition to estimate body fat of overweight or obese. The data used in the study group were extracted Kinanthropometry Lab database (Labcine) of the Center for Physical Education and Sports (CEFD) of the Federal University of Santa Maria (UFSM), which were selected 78 overweight or obese , 49 women and 29 men between 35 and 68 years old. For the determination of body composition were used the following evaluation methods: anthropometry (weight, height, skinfold thickness and circumferences), bioelectrical impedance and dual-energy x-ray absorptiometry (DXA) (reference method). Descriptive statistics were used to characterize the study group and the normality of the data was verified by the Kolgomorov-Smirnov test. The difference between the means was verified by paired t test. We used the Pearson correlation coefficient to determine the degree of association between the evaluative methods of body composition and the Bland and Altman test to verify the agreement of the results, adopting a 5% significance level. To carry out the analysis, we used the statistical program SPSS 14.0. / O acúmulo excessivo de gordura corporal acarreta prejuízos à saúde das pessoas, por isso torna-se importante a verificação da quantidade e distribuição da gordura corporal por meio da avaliação da composição corporal. Levando em conta a importância da avaliação da composição corporal e a escassez de estudos que indiquem o método mais adequado para indivíduos com sobrepeso e obesidade, o presente estudo tem por objetivo analisar a relação e a concordância de diferentes métodos de avaliação da composição corporal para estimar a gordura corporal de indivíduos com sobrepeso ou obesidade. Os dados utilizados no grupo de estudo foram extraídos do banco de dados do Laboratório de Cineantropometria (Labcine) do Centro de Educação Física e Desportos (CEFD) da Universidade Federal de Santa Maria (UFSM), no qual foram selecionados 78 indivíduos com sobrepeso ou obesidade, sendo 49 mulheres e 29 homens, entre 35 e 68 anos de idade. Para a determinação da composição corporal foram utilizados os seguintes métodos avaliativos: antropometria (massa corporal, estatura, dobras cutâneas e perímetros), impedância bioelétrica e absorciometria de raios-X de dupla energia (DXA), sendo este o método de referência. Foi utilizada a estatística descritiva para a caracterização do grupo de estudo e a normalidade dos dados foi verificada por meio do teste de Kolgomorov-Smirnov. A diferença entre as médias foi verificada através do Teste t pareado. Utilizou-se o coeficiente de correlação de Pearson para determinar o grau de associação entre os métodos avaliativos da composição corporal e o teste de Bland e Altman para verificar a concordância dos resultados, adotando um nível de significância de 5%. Para a realização das análises, utilizou-se o programa estatístico SPSS 14.0.

Dual Energy X-ray Absorptiometry (DXA)-based finite element (FE) modelling has emerged as a potential tool for better assessment of osteoporotic hip fracture risk. Automation of this complex and computationally-intense procedure is the prime requirement for its clinical applicability. The aim of this study was to develop a fully automatic DXA-based finite element tool and assess its discrimination ability and short-term repeatability. The proximal femur was automatically segmented from clinical hip DXA scan and the subject-specific FE model was constructed for simulating sideways fall. Hip fracture risk indices (HFRIs) were calculated using two ways (along a femur cross-section and over a region of interest, ROI). Hip fracture discriminability increased when moved from femur cross-section based to ROI based HFRI calculation. A significant increase in hip fracture discriminability from baseline femoral neck and total hip bone mineral density (BMD) was achieved with ROI based HFRIs. Promising short-term repeatability was observed for HFRIs (coefficient of variation, CV, 3~3.5%). After removing representative poor cases, CVs were less than 3%. These preliminary results establish the potential of the proposed automatic tool for hip fracture risk assessment and justify large-scale clinical evaluation of its ability to predict incident hip fractures. / February 2017

Introduction: Puberty is a crucial period for rapid changes in bone mineral, size, geometry, and microarchitecture. The mechanostat theory postulates that increased mechanical loading will affect bone phenotype and strength during development and in later life. Individuals with cystic fibrosis (CF) have an increased risk of developing osteoporosis and fragility fractures in young adulthood, which may be caused by poor growth. The aim was to investigate whether sex and disease status modified the relationship between: 1) puberty and bone, and 2) muscle and bone. This would contribute to the understanding of how sex (males vs. females) and disease group (CF vs.controls) alters the relationship between bone and muscle in children and adolescents as they transition through puberty and who, on a population level, differ in the prevalence of osteoporosis and risk of fracture in later life. Methods and Analyses: This observational study used novel imaging and muscle assessment techniques to measure bone and muscle parameters in White Caucasian children and adolescents, aged 8 to 16 years, living in the UK, with children with CF (n=65) and controls (n=151). Anthropometry and pubertal status were assessed. Dual energy X-ray absorptiometry, peripheral quantitative computed tomography (pQCT), high-resolution pQCT, and jumping mechanography were used to measure bone and muscle outcomes. ANCOVA with Scheffé post hoc and multiple linear regression tests were performed. Data were adjusted according to the research aims and included covariates; sex, disease group, pubertal stage, age, quadratic age, height, weight, maximum force (Fmax), and maximum power (Pmax). Data are presented as beta-coefficient (%) and p-value, with the significance level set to p < 0.05. Results: In height adjusted analyses, among healthy participants, females had smaller bones and lower bone density compared to males. With pubertal maturation, females had lower apparent gains in the distal and proximal total area (Tt.Ar and CSA), distal cortical porosity (Ct.Po) and proximal bone strength (SSI) but higher apparent gains in distal and proximal cortical bone density(Ct.BMD, Ct.TMD, vBMD). Females had consistently lower distal total area (total CSA) and density (total vBMD), distal trabecular density(BV/TV) and number(Tb.N), and proximal cortical area(CSA) compared to males, across all stages of puberty. With increasing muscle force (Fmax), females had higher apparent gains in total body less head bone mineral (TBLH BMC) and bone area(BA), distal total and trabecular density (total and trab vBMD) compared to males. In contrast, with increasing muscle power (Pmax), females had higher apparent gains in distal total and cortical densities (D100, Ct.BMD and Ct.TMD), and distal trabecular thickness (Tb.Th), and proximal cortical density (cortical vBMD) but lower apparent gains in distal cortical porosity (Ct.Po) and trabecular number (Tb.N) compared to males. In height adjusted analyses, participants with CF had smaller bones and lower bone density compared to controls. With increasing pubertal maturation, participants with CF had lower apparent gains in total body less head bone mineral and bone area, and in distal trabecular density, cortical porosity, and trabecular thickness compared to controls. Participants with CF had consistently lower distal total and cortical area, distal total and trabecular densities and proximal bone strength compared to controls, across all stages of puberty. With increasing muscle force, participants with CF had lower apparent gains in total body less head bone mineral and bone area, distal total density, trabecular density, and trabecular number. In contrast, with increasing muscle power (Pmax), participants with CF had higher apparent gains in distal trabecular density (BV/TV) and trabecular number (Tb.N) compared to controls. Conclusion: These findings suggests that sex and disease status do modify the relationships between puberty and bone, and between muscle function and bone. Skeletal adaptation to muscle differs between sexes and in populations with chronic disease, which may explain sex and disease group differences in risks of osteoporosis and fracture. Bone adaptation to muscle in children with CF is altered, which may lead to narrow, under-mineralised bones, with lower bone strength in later life. Understanding better impairments in muscle functions may provide targets for intervention to improve skeletal health in later life.

Introdução: Irisina é uma adipocina / miocina, descrita pela primeira vez em 2012 e parece estar envolvida na termogênese do tecido adiposo e na homeostase metabólica. A síndrome dos ovários policísticos (PCOS) é reconhecida como um distúrbio endocrinológico prevalente em mulheres com idade reprodutiva, e está frequentemente associado à obesidade abdominal, resistência à insulina, dislipidemia e hipertensão arterial. Objetivos: Determinar os níveis circulantes de irisina numa amostra de mulheres com PCOS e controles ovulatórias não hirsutas e verificar se os níveis séricos de irisina estão associados com variáveis hormonais, metabólicas e de composição corporal nestas participantes. Métodos: Neste estudo caso-controle foram incluídas 49 mulheres com PCOS e 33 mulheres controles ovulatórias não-hirsutas com idade e índice de massa corporal (IMC) semelhantes. Variáveis demográficas, antropométricas, hormonais e metabólicas foram obtidas através de dados da história médica, exame físico e dosagens bioquímicas e hormonais convencionais. A composição corporal foi avaliada por absorciometria de raios-X de dupla energia (DXA). Os níveis séricos de irisina foram mensurados por um kit ELISA humano. Resultados: A pressão arterial sistólica, HOMA, testosterona total e índice de androgênios livres (IAL) foram significativamente maiores e a SHBG foi menor nas PCOS. Após a estratificação por IMC, massa gorda e razão massa gorda / massa magra foram menores em mulheres com peso normal do que em mulheres com sobrepeso / obesidade. O grupo PCOS com peso normal apresentou menos massa magra total do que o grupo PCOS com sobrepeso / obesidade e subgrupos controles. A proporção de massa magra apendicular / IMC foi significativamente maior nas controles de peso normal que em controles com sobrepeso / obesidade, mas os subgrupos de PCOS foram semelhantes entre si e com as controles de peso normal e obesas. Os níveis séricos de irisina foram significativamente maiores nas pacientes 8 PCOS com sobrepeso / obesidade em comparação com as controles de peso normal. A irisina circulante correlacionou-se positivamente com o HOMA. Observou-se também correlação positiva da irisina com massa magra total e razão massa gorda /massa magra em mulheres com PCOS, mesmo após ajuste para IAL. Conclusão: Os dados do presente estudo sugerem uma associação de irisina com variáveis de composição corporal. / Introduction: Irisin is an adipokine / myokine, first described in 2012 and appears to be involved in adipose tissue thermogenesis and metabolic homeostasis. The polycystic ovary syndrome (PCOS) is recognized as a frequent endocrine disorder in women of reproductive age, and is often associated with abdominal obesity, insulin resistance, dyslipidemia, and hypertension. Objectives: To determine the circulating levels of irisin in women with PCOS and non-hirsute ovulatory control women, and to evaluate whether serum irisin levels are associated with hormone, metabolic and body composition variables in these participants. Methods: In this case-control study, 49 women with PCOS and 33 nonhirsute ovulatory controls women with similar age and body mass index (BMI) were enrolled. Demographic, anthropometric, hormone and metabolic variables were assessed by medical history, physical examination and conventional biochemical and hormon determinations. Body composition was assessed by double-energy X-ray absorptiometry (DXA). Serum irisin levels were measured by a human ELISA kit. Results: Systolic blood pressure, HOMA, total testosterone and FAI were higher and SHBG was lower in PCOS. After stratification by BMI, fat mass and fat mass / lean mass ratio were lower in women of normal weight in overweight / obese women. The PCOS group at normal weight had less total lean mass than the overweight / obese PCOS group and control subgroups. The lean appendicular mass / BMI ratio was significantly higher in normal weight controls than in overweight / obese controls, but PCOS subgroups were similar between them and with normal and obese weight controls. Serum irisin levels were significantly higher in overweight / obese PCOS patients than in normal weight controls. Circulating irisin was positively correlated with HOMA. A positive correlation was also observed between irisin 10 and total lean mass and fat mass / lean mass ratio in women with PCOS, even when adjusted for FAI. Conclusion: Our data suggest an association of irisin and body composition variables.

The LeanScreenTM app uses photographs and touchscreen technology of an iPad or iPhone to estimate body composition using the Department of Defense (DoD) prediction equations that use cirumference measurements of the neck, abdomen, waist, and hips. The purpose of this study was to determine the validity and reliability of the LeanScreenTM app in 148 weight-stable adults (82 men, 66 women) who were normal weight, overweight, or obese as defined by body mass index. The percent body fat (%BF) of each subject was estimated during one visit using dual-energy x-ray absorptiometery (DXA) as the criterion measure, and three field methods: the LeanScreenTM app, manually measured circumferences, and an OMRON bioelectical impedance (BIA) device. The %BF of each subject was determined once using DXA. Each of two administrators assessed the %BF of each subject twice using the LeanScreenTM app, manually measured circumferences, and the OMRON BIA device. When using the LeanScreenTM app, administrators assessed body composition using photographs they had taken and the photographs taken by the other administrator. Validity was established by comparing estimates of %BF from the LeanScreenTM app, manually measured circumferences, and the OMRON BIA device to %BF values obtained from DXA. Inter- and intrarater reliability was determined using mutliple measurements taken by each of two administrators. The three field methods were compared to DXA using mixed model ANOVA and Bland-Altman analyses. Analysis of the data revealed that the LeanScreenTM app, manually measured circumferences, and the OMRON BIA device significantly underestimated (p < 0.05) the %BF determined by DXA by an average of -3.26 ± 3.57 %BF, -4.82 ± 3.45 %BF, and -8.45 ± 3.48 %BF, respectively. Limits of agreement (LOA) for the LeanScreenTM app (6.99 %BF), manually measured circumferences (6.76 %BF), and the OMRON BIA device (6.82 %BF) were large. Slopes of the line-of-best-fit through the data in the Bland-Altman plots indicate that bias of %BF estimates using the LeanScreenTM app (slope = 0.06; p = 0.008) and the OMRON BIA device (slope = 0.15; p < 0.0001) increased as %BF increased. For each method of assessment, minimal variance could be attributed to different administrators peforming the assessment and each administrator performing multiple assessments. All inter- and intrarater reliability coefficients of the LeanScreenTM app, manually measured circumferences, and OMRON BIA estimates of %BF exceeded 0.99. The results of this study indicate that all three field methods of body composition assessments were highly reliable, however, these field measures are not recommended for use in the assessments of %BF due to a significant bias and large limits of agreements.

The design of an uncemented hip arthroplasty implant affects its long-term survival. Characteristics such as the form and the finish of the implant are crucial in order to achieve the best possible conditions for long-term implant survival. In this thesis we hypothesized that different shapes of stems and cups used in primary and revision total hip arthroplasty (THA), and their finish with hydroxyapatite (HA) coating affect implant stability and thus long-term survival. In 2 prospective cohort studies the clinical outcome, the stability measured with radiostereometric analysis (RSA), and the periprosthetic changes in bone mineral density (BMD) measured with dual-energy x-ray absorptiometry (DXA) were investigated in 2 uncemented THA implants – the CFP stem and the TOP cup. In 3 register studies the effect of HA coating on uncemented THA implants used in primary and revision arthroplasty was investigated. Both implants investigated in the prospective cohort studies showed an excellent short-term clinical outcome with good primary stability, but neither their novel form nor the finish with HA protected the implants from the proximal periprosthetic demineralization that usually occurs around other uncemented THA implants. The register studies revealed that HA coating on cups used in primary and revision THA is a risk factor for subsequent revision of the implant. The use of HA coating on the stem in primary THA did not affect long-term survival. Additionally, the shape of an implant plays a crucial role for implant stability and survival. In conclusion, this thesis highlights that the finish of implants with HA coating does not prevent periprosthetic proximal femoral bone loss and can even enhance the risk of revision of both primary and secondary cups. Importantly, the shape of uncemented THA implants affect their stability, showing that the implant form is a crucial factor for the long-term survival.

The initial recommendation for the postoperative regime after uncemented total hip arthroplasty (THA) was 6-12 weeks of partial weight bearing (PWB) to obtain a stable implant position during bone ingrowth. In recent years patients with uncemented THA have increasingly practiced full weight bearing (FWB) after surgery, which has largely been based on clinical experience rather than on scientific evidence. The aim of this thesis was to investigate the effects of FWB versus PWB for 3 months on the stability of the implants and on bone mineral density (BMD), as well as body composition (BC) of the lower extremities. We used radiostereometric analysis (RSA) to measure implant micromotion and dual X-ray absorptiometry (DXA) to measure BMD and BC. Forty-six patients with strictly unilateral osteoarthritis of the hip (OAH) received uncemented THA. These patients were then randomized to the FWB or PWB groups and followed for 5 years. In a preoperative cross-sectional study the BMD of the hip and heel were compared between the OAH-affected side and the healthy side. The study showed an increase of BMD at the femoral neck and a decrease at the total hip and trochanter. The results of a RSA study of cup stability showed that there might be minimal movement in medial and proximal directions during the first postoperative week. These results indicate that the RSA baseline investigation of uncemented cups should be performed as early as possible after the first postoperative day. FWB had no adverse effects on the stability of the uncemented press-fit cups or the uncemented cementless Spotorno (CLS) femoral stems after a 5-year follow-up. There was no difference in periprosthetic BMD around the CLS stem regardless of the postoperative weight bearing regime. All zones around the femoral stem indicated a recovery in BMD toward baselines, except the calcar region, which showed progressive loss in BMD to -22% at 5 years post-surgery. FWB had no effect on the changes in BC after surgery. In conclusion, FWB is safe in uncemented THA in terms of stability, BMD and BC. Furthermore, THA apparently counteracts age-related changes in BC but not in BMD.

There is a pressing need for better assessment of bone strength as current clinical tools do not directly measure bone mechanical properties, but offer only surrogate measures of bone strength. We conducted an ex-vivo study of emu bones to examine how two investigative devices, hr-pQCT and MRTA, compare to current clinical tools (DXA and QUS) in predicting true bone mechanical properties. We found that hr-pQCT parameters were able to assess bone strength as well as DXA and better than QUS, while MRTA was able to predict bone strength well in low-density but not high-density bones. Our results suggest that both hr-pQCT, which has the unique ability to specifically assess the various determinants of bone strength, and MRTA, which measures a bone mechanical property (stiffness), have great potential for use as clinical tools that can assess various components of bone strength not measured by current devices.