Introdução: A osteoporose requer estratégias para prevenir sua progressão, garantindo melhores condições de vida aos pacientes. Padrões alimentares fornecem informações sobre a influência da dieta global, contribuindo para o cuidado desses indivíduos. Objetivo: Investigar a associação entre o padrão alimentar e a densidade mineral óssea de mulheres menopausadas com osteoporose. Métodos: Trata-se de estudo transversal com 156 mulheres (> 45 anos), atendidas em ambulatório da cidade de São Paulo, Brasil. Densidade Mineral Óssea (DMO; g/cm2) da coluna (CL), fêmur total (FT), colo do fêmur (CF) e corpo total (CT) foram obtidas por absorciometria de feixe duplo. Peso (kg), estatura (m), Índice de Massa Corporal (IMC; kg/m2), gordura corporal (g), massa magra (g) e informações sobre os hábitos de vida também foram obtidos. A dieta foi avaliada por registro alimentar de 3 dias. Os padrões alimentares (PA) foram derivados via análise fatorial por componentes principais a partir de 13 grupos de alimentos. Utilizou-se regressão linear múltipla ajustada para ingestão energética e de cálcio, idade, tempo de menopausa e massa magra. Também foi conduzida ANOVA Two-way para avaliar a associação integrada dos PA com o IMC sobre a DMO, seguida de regressão linear estratificada pelas categorias de IMC. Adotou-se significância de 5 por cento . Resultados: Obteve-se 5 PA: 1) Saudável (frutas, hortaliças, tubérculos e raízes); 2) Carne vermelha e cereais refinados; 3) Laticínios magros; 4) Doces, café e chás; e 5) Ocidental (sucos artificiais, refrigerantes, snacks, pizzas, tortas e gorduras). O padrão Doces, café e chás foi inversamente associado à DMO do FT ( = -0.178; CI 95 por cento : -0.039 - -0.000) e à DMO do CT ( = -0,320; CI 95 por cento : -0,059 - -0,017). O padrão Saudável apresentou associação positiva com a DMO do FT entre as mulheres com IMC normal ( = 0,251; CI 95 por cento : 0,002 0,056). Conclusão: Uma dieta com elevada ingestão de doces, café e chás teve associação negativa com a DMO do fêmur e corpo total, enquanto o PA Saudável foi positivamente associado à DMO do fêmur entre aquelas com IMC normal. / Introduction: Osteoporosis claims for strategies to preventing disease progression, ensuring a better quality of life to patients. Dietary patterns could provide information about the influence of overall diet on osteoporosis treatment, contributing to osteoporotic care. Objective: To investigate the association between dietary patterns and bone mineral density in postmenopausal women with osteoporosis. Methods: This cross-sectional study included 156 postmenopausal osteoporotic women, over 45 y, attended in an outpatient clinic in Sao Paulo, Brazil. Bone Mineral Density (BMD; g/cm2) of Lumbar Spine (LS), Total Femur (TF), Femoral Neck (FN), and Total Body (TB) were obtained by dual-energy X-ray absorptiometry. Weight (kg), height (m), Body Mass Index (BMI; kg/m2), body fat (g), lean mass (g) and lifestyle information were also assessed. Dietary intake was evaluated using a 3-day food diary. Dietary patterns were obtained by principal component factor in the 13 previously formed food groups. Adjusted linear regression analysis was applied in order to evaluate the predict effect of dietary patterns on BMD. Two-way ANOVA was used to investigate the association between dietary patterns and BMI with BMD, followed by a linear regression model stratified by BMI categories. Significance level was set as 5 per cent . Results: Five patterns were retained: 1) Healthy (vegetables, fruits, tubers, and tuberous roots); 2) Red meat and refined cereals; 3) Low-fat dairy; 4) Sweets, coffee and tea; and 5) Western (fats, snacks, pizzas, pies, soft drinks, and fruit drinks). The Sweets, coffee, and tea pattern was inversely associated with TF BMD ( = -0.178; CI 95 per cent : -0.039 - -0.000) and with TB BMD ( = -0.320; CI 95 per cent : -0.059 - -0.017), whereas the Healthy pattern was positively associated with TF BMD only among those who were in the normal BMI category ( = 0.251; CI 95 per cent : 0.002 0.056). Conclusions: A diet with higher intake of Sweets, coffee, and tea was a negatively associated with TF and TB BMD, whereas a Healthy pattern showed a positive association with TF BMD among the women with normal BMI.

A baixa densidade mineral óssea é um indicador de risco de fratura por osteoporose, importante e crescente problema de saúde pública. O consumo deficiente de cálcio acarreta menor mineralização óssea. O presente estudo teve por objetivo identificar as relações entre consumo de cálcio dietético e densidade mineral óssea na coluna lombar, colo do fêmur e conteúdo de cálcio corporal total. É um estudo transversal, abrangendo 296 homens com idade média de 62,5 anos (DP=7,9). O consumo de cálcio dietético foi avaliado no momento atual, correspondente ao período de coleta de dados, e ao longo da vida, pelo método de registro alimentar (três dias) e questionário retrospectivo de freqüência de consumo de leite e derivados fontes de cálcio. Para análise da densidade mineral óssea foi realizado o exame de densitometria por emissão dupla de raios X. A análise da densidade mineral óssea foi feita de forma comparativa com os grupos conforme consumo de cálcio dietético, sendo calculado o coeficiente de correlação de Pearson e feitos os testes de diferença de médias, teste t-Student e Kruskai-Wallís. O consumo de cálcio dietético atual apresentou-se inadequado (72%) e o pregresso foi considerado adequado (65%) para maioria da população estudada. A principal fonte de cálcio dietético consumida no presente foi o leite, seguido dos derivados lácteos. Foram observadas relações entre o conteúdo de cálcio corporal total e o consumo de cálcio dietético tanto no passado como no presente. Contudo, não foi possível observar relações entre o consumo de cálcio dietético atual e pregresso e a densidade mineral óssea na coluna lombar e colo do fêmur, na população estudada de homens com mais de 50 anos. / The low bone mineral density is an indicator of osteoporotis fracture risk, an important and increasing health public concern. An insufficient calcium intake results in a lower bone mineralization. The objective of this study was to establish relationship between dietetic calcium intake and bone mineral density at the lumbar portion of the spinal column, femur neck and the total body calcium content. lt is a transversa study, including 296 men with age average of 62.5 years (standard deviation = 7.9). The dietetic calcium intake was evaluated both at the current time and throughout their lives. The data was collected using the methods of food intake record (three day) and retrospectiva questionnaire, regarding the frequency of consumption of milk and dairy products as calcium sources. Measurement of bone mineral density by dual energy x-ray absorptiometry. The bone mineral density was analysed by comparing the groups according to their dietetic calcium intake. Pearson\'s coefficient of correlation was calculated and the average differences were tested using t-Student and Kruskai-Wallis methods. The current dietetic calcium intake was inadequate (72%), whereas the past intake was considered appropriate (65%) for the major part of the studied population. The main calcium source at the current time was milk, followed by dairy products. lt was possible to establish relationship between the total body calcium content and dietetic calcium intake in the past and in the current time. However, for the bone mineral density at the lumbar portion of the spinal column and at the fêmur neck, it was not possible to stablish relationship with current and past dietetic calcium intake in the studied population of men over 50 years old.

A ocorrência de fraturas em animais e, especialmente nas espécies de grande porte, geram preocupação quanto ao custo do tratamento e a ocorrência de sequelas, pois há a possibilidade de complicações pela carga excessiva que esses animais exercem sobre os membros. Dessa forma é importante a imobilização imediata do membro e de maneira adequada, e avaliar se há necessidade de se realizar cirurgia para estabilização da fratura. Em algumas fraturas pode haver falhas ósseas, principalmente em fraturas cominutivas com extensa lesão de tecidos adjacentes, o que dificulta e prolonga o tempo de consolidação. Por essas razões vem sendo estudado, há alguns anos, o uso de substitutos ósseos na forma de cimentos ou mantas ósseas para reparar esses defeitos. O estudo com biomateriais como substitutos ósseos tem tido grande evolução nos últimos anos, e aqueles à base de quitosana, hidroxiapatita e colágeno apresentam grande vantagem, pois a quitosana estimula a regeneração óssea, a hidroxiapatita confere a dureza que o material exige, e o colágeno fornece maleabilidade. O presente projeto teve por objetivo avaliar o reparo ósseo após implante de compósito à base de quitosana, hidroxiapatita e colágeno, em falhas ósseas de tíbias de ovinos induzidas experimentalmente. Foram utilizados os métodos de imagem por densitometria ótica radiográfica e microtomografia computadorizada 3D para avaliar o grau e o tempo de reparo ósseo, assim como a densidade mineral óssea durante a cicatrização. As falhas ósseas foram confeccionadas nas tíbias de ovelhas, em ambos os membros, onde foi implantado o biomaterial em um deles, e o membro contralateral mantido como controle. Posteriormente, os animais foram submetidos a exames radiográficos, quinzenalmente, até 90 dias de pós operatório. Após este período, os animais foram submetidos à eutanásia e fragmentos das tíbias foram colhidos para avaliação por microtomografia computadorizada 3D. Observou-se, pelos resultados qualitativos das imagens radiográficas e dos dados estatísticos, que houve absorção gradativa do biomaterial, e que não houve diferença estatística em relação à densidade mineral óssea entre os dois grupos estudados, embora a DMO tenha sido maior nos membros com o biomaterial. Este método mostrou-se prático e eficaz, além de ser uma técnica não invasiva. A microtomografia computadorizada 3D revelou importantes informações quanto à porosidade óssea e volume ósseo entre os dois grupos. As imagens em 3D mostraram detalhes do osso que não eram possíveis de visualizar por meio das radiografias. Dessa forma é uma técnica bastante eficaz e detalhada, mas é necessária padronização de todas as amostras para poder quantificar os valores adequadamente. O estudo estatístico não mostrou diferenças entre os grupos com biomaterial e controle para os parâmetros de volume ósseo, grau de porosidade e porcentagem de volume ósseo. Porém, pelas imagens em 3D observa-se nitidamente maior quantidade de poros nas amostras controle em relação às amostras com biomaterial. Conclui-se com este estudo que as técnicas de densitometria óssea por raios-X e µCT 3D são bastante eficazes para avaliar a cicatrização óssea em ovinos / The occurrence of fractures in animals and, especially, in large animals are conditions that generate concern about the cost of treatment and the occurrence of future complications because there is the possibility of complications due to excessive load that these animals receive in their limbs. Thus, it is important the limb immobilization immediately and appropriately and assess whether it is necessary to perform surgery to stabilize the fracture. In some kinds of fractures, it might have large bone defects, mainly in comminuted fractures with extensive damage to surrounding tissue, which makes it more difficult and prolongs the consolidation time. For these reasons, scientists have been studied the use of bone substitutes in the form of bone cements to repair these defects. The study of biomaterials as bone substitutes has had great progress in last years, and those based on chitosan, hydroxyapatite and collagen had great advantage because chitosan stimulates bone regeneration, hydroxyapatite confers the hardness that the material requires, and collagen provides flexibility to the material. This project aims to assess bone repair after deploying a composite of chitosan, collagen and hydroxyapatite in bone defects experimentally induced in sheep tibiae. For assessing the degree and the time of bone healing, it was used imaging techniques like radiographic bone densitometry and 3D micro-computed tomography. Bone defects were made in the sheep tibiae in both limbs where the biomaterial was deployed in one of them, and the control was the contralateral limb. After the surgeries, the animals were submitted to radiographic exams every two weeks until 90 days postoperatively. After this period, the animals were euthanized and harvested tibiae fragments for evaluation by 3D micro-computed tomography. Through the qualitative results of images and statistical data, it was observed, radiographically, that there was a gradual absorption of the biomaterial, and also that there was no statistical difference in relation to bone mineral density between the two groups. The method of determining the X-ray BMD proved to be practical and effective, and it is a noninvasive technique. 3D micro-computed tomography revealed important information about bone porosity and bone volume between the two groups. The 3D images showed bone details that were not possible to visualize through radiographs. Thus it is a highly effective and detailed technique, but it requires patterning of all the samples in order to quantify the amounts properly. Statistical analysis showed no differences between the groups for bone volume parameters, degree of porosity and percentage of bone volume. However in the 3D images, it can be observed clearly larger amount of pores in the control samples in comparison to those with biomaterial. It is concluded from this study that the techniques of bone densitometry X-ray and 3D µCT are very effective to evaluate bone healing in sheep. Bone mineral density was higher in limbs with biomaterial and there was a higher bone volume and lower degree of porosity in the samples with biomaterial compared to the control group

No description available.

The aim of the study was to investigate the association between depression and low bone mineral density (BMD) in premenopausal females. The rationale for the study was that depression is often characterized by cortisol hypersecretion. The role of cortisol includes effects on bone metabolism and the immune system: cortisol is a bone resorption agonist through its support of osteoclastogenesis. The release of pro-inflammatory cytokines, (especially IL-1, IL-6 and TNF-alpha) which induce cortisol secretion, also pushes the balance of bone remodelling in favour of resorption, consequently causing loss of bone mineral density. Significant results have been reported in studies of various groups across the USA, Europe and Asia, indicating a causal role for depression in osteoporosis. However, some studies could not support this association. With both osteoporosis and depression representing growing public health concerns in South Africa, the aim of this study was to examine the association between depression and loss of BMD in a South African sample with varying levels of depression. The study was approached from two starting points: the first used low BMD as the departure point and the second was undertaken from the diagnosis of depression. This was achieved by first investigating women where the primary concern was possible low BMD (referred to as Study 1) and secondly by assessing women whose primary diagnosis was clinically confirmed major depression (Study 2). Study 1 involved investigation of BMD in a volunteer-based sample of 40 premenopausal women drawn from three different sources. All volunteers underwent a DEXA scan, were assessed for depression and supplied saliva for cortisol analysis. Study 2 examined the BMD of five psychiatric patients diagnosed with severe, recurrent major depression and four healthy controls. These volunteers were required to undergo the same testing as subjects in Study 1. In addition, blood and urine samples were taken to examine bone turnover markers (bone specific alkaline phosphate, osteocalcin, urine pyridinoline cross-linked C-telopeptide and deoxypyridinoline). The pro-inflammatory status of the psychiatric patients was compared to reference ranges. The latter served as a small exploratory study and an introduction to further avenues of research. Study 1 revealed no clear general association between depression and bone density on DEXA scores. However, a correlation was found between left femoral neck BMD and depression in those women with low BMD only. Significant differences were found though between subjects with normal and low BMD in terms of body mass index (BMI) and contraception use. Study 2 on the other hand, indicated a trend of association between depression and low BMD: subjects suffering with severe major depression were noted to have lower bone density (on DEXA) and higher bone turnover (as measured by markers of bone turnover) as well as higher cortisol levels than healthy controls. In addition, depressed subjects exhibited elevated IL-1-alpha levels but normal TNF-alpha levels when compared to normative data. In conclusion, the study indicated that the effect of depression on bone density is dependent on the intensity and duration of depression. IL-1-alpha and cortisol may be instrumental in this loss of BMD. / Dissertation (MSc)--University of Pretoria, 2008. / Physiology / unrestricted

Menopause is an important period for bone health in women. Objective: To assess the determinants of bone mineral density (BMD) changes in women transitioning to menopause. Method: A secondary data analysis of the MONET (Montreal-Ottawa New Emerging Team) study. Outcome measures included yearly assessment of menopause status, body composition, BMD, physical activity energy expenditure (PAEE) and dietary calcium and vitamin D intakes. Results: 84 of the original 102 women had complete data for the purpose of the present study. Repeated measures analysis revealed significant decreases in lumbar spine and femoral neck BMD (P< 0.01). Regression analysis revealed that baseline femoral neck BMD, changes in PAEE and trunk fat explained 31% of the variation of BMD changes at the femoral neck, while changes in both PAEE and trunk fat account for 27% of BMD change at lumbar spine. Conclusion: Baseline femoral neck and changes in physical activity energy expenditure and trunk fat are determinants of the reduction of bone mineral density in women transitioning to menopause.

L’objectif de ce travail était d’examiner chez la rate adulte ovariectomisée les effets osseux et sur le métabolisme lipidique de l’acide zolécronique et de l’exercice physique. Dans une première étude, les effets individuels et combinés de l’acide zolédronique 20 µg/kg une injection unique et de l’exercice physique (course dur tapis roulant pendant 12 semaines) ont été examinés sur la densité osseuse au corps entier et au fémur, l’analyse de la microarchitecture trabéculaires, les propriétés biomécaniques et le remodelage osseux. Les résultats montrent globalement que l’acide zolédronique prévient la dégradation microarchitecturale et l’hyperresorption induite par l’ovariectomie, que l’exercice physique maintient partiellement les propriétés biomécaniques et agit sur le remodelage osseux en augmentant la formation osseuse mais qu’aucun bénéfice additionnel ou synergique n’est trouvé sur le squelette osseux de la combinaison des deux interventions. La deuxième étude s’est intéressée aux effets sur le profil lipidique de l’action spécifique et combinée des deux interventions ci-dessus mentionnées. Si l’acide zolédronique et l’exercice de course sur tapis roulant modifient les taux de cholestérol total et de HDL cholestérol dans le sens d’une amélioration du risque d’athérosclérose, leurs effets associés ne sont pas synergiques et ont eu un effet paradoxal inverse possiblement expliqué par un effet pro-inflammatoire de la combinaison des deux interventions. / The aim of this study was to investigate in mature ovariectomized rats the effects on bone tissue and on the lipids metabolism of zoledronic acid and physical exercise. In this first study, the individual and combined effects of zoledronic acid (20 µg/kg a single injection) and physical exercise (treadmill running exercise during twelve week) have been examined on whole body and femur bone mineral density, on trabecular microarchitecture analysis, on bone strength parameters and on bone turnover. Results showned globally that zoledronic acid prevented the trabecular microarchitectural changes and the increase in resorption induced by ovariectomy. Treadmill running exercise particully maintained the bone strength and exerted its action by an increase in bone formation. However we dit not found any additive or synergistic effect of the two interventions combined on the rat skeletal status. The second study aimed to assess the specific and combined effects of zoledronic acid and treadmill running exercise on the lipid profile in this model of ovariectomized mature rats. If both zoledronic acid and treadmill running exercise modified total cholesterol and HDL cholesterol with an improvement of the atherosclerosis risk, their combined effects were not synergistic and furthermore they produced a paradoxical inverse effect possibly explained by a pro-inflammatory effect of the two interventions combined.

As propriedades anti-inflamatórias e imunossupressoras dos glicocorticoides (GC) justificam o uso destes esteroides em diversas condições clínicas, apesar dos seus importantes efeitos adversos. A osteoporose induzida por glicocorticoide (OIG) é considerada a causa mais importante de osteoporose secundária. Trata-se de uma doença multifatorial que envolve alterações sistêmicas, teciduais e da sinalização das células ósseas. Além disso, o hipercortisolismo também se associa à obesidade, redistribuição de gordura, resistência insulínica e diabetes mellitus. Curiosamente, nestes distúrbios metabólicos em que a massa óssea está preservada, há maior fragilidade óssea. Nos últimos anos, diversas evidências mostram complexa interação entre o metabolismo mineral e o energético, em particular entre o tecido adiposo e ósseo. Neste cenário, a doença de Cushing (DC) é um modelo clínico conveniente para avaliar diversos mecanismos envolvidos no complexo processo de desenvolvimento de osteoporose. O objetivo deste trabalho foi avaliar, em um estudo basal e em um estudo prospectivo, diversos aspectos da interação entre o metabolismo mineral e energético em mulheres com DC e o seu possível impacto sobre a massa óssea, bem como a associação entre a massa óssea e os diversos tipos de tecido adiposo. No estudo basal, avaliamos três grupos de indivíduos, pareados por sexo e idade: grupo controle (C; n=27), grupo obeso (O; n=16) e grupo doença de Cushing (DC; n=16). No estudo prospectivo, avaliamos o grupo DC em três momentos: pré-operatório (Pré-op; n=11), 6º mês pós-operatório (6º mês PO; n=10) e 12º mês pósoperatório (12º mês PO; n= 10). No estudo basal, os grupos O e DC diferiram em relação ao C quanto ao peso e IMC (p<0,05). O grupo DC apresentou valores significativamente maiores de glicemia, insulinemia, hemoglobina glicosilada (HbA1c), HOMA-IR e leptina em relação aos grupos C e O (p<0,05). Adicionalmente, o grupo DC mostrou níveis baixos de osteocalcina em relação aos grupos C e O (p<0,05) e também de PTH, 25-OH vitamina D (25(OH)D) e adiponectina em relação ao grupo C (p<0,05). Não houve diferença entre os grupos em relação às dosagens de IGF-I e preadipocyte factor 1 (Pref-1). O grupo DC apresentou menor massa óssea em coluna lombar em relação aos grupos C e O (p<0,05) e menor massa óssea em corpo total quando comparado ao grupo O (p<0,05). O Trabecular bone score (TBS) foi capaz de evidenciar prejuízo na qualidade óssea nos grupos O e DC, mostrando comprometimento maior no grupo DC (p<0,05). A adiposidade de medula óssea (AMO) de L3 foi significativamente maior no grupo DC em relação aos grupos C e O (p<0,05). O grupo DC apresentou maior teor de tecido adiposo subcutâneo (SAT), visceral (VAT), relação VAT/SAT e de lipídeos intra-hepáticos (IHL) em relação ao grupo C (p<0,05). Adicionalmente, o grupo DC apresentou maior teor de VAT em relação ao grupo O (p<0,05). A osteocalcina se correlacionou de maneira positiva com TBS (r=0,5, p<0,0001) e negativa com HOMA-IR (r=-0,4, p<0,01) e AMO de L3 (r=-0,4, p<0,01). O TBS apresentou correlação negativa com HOMA-IR (r=-0,6, p<0,0001) e AMO de L3 (r=-0,5, p<0,001). A AMO de L3 se correlacionou positivamente com IMC (r=0,4, p<0,01), HOMA-IR (r=0,3, p<0,05), leptina (r=0,3, p<0,05), relação VAT/SAT (r=0,6, p<0,0001) e IHL (r=0,5, p<0,05). No estudo prospectivo, houve redução do peso e IMC e dos níveis de glicemia, insulinemia, HOMA-IR, hemoglobina glicada e leptina (p<0,05). Adicionalmente, houve aumento dos níveis de 25(OH)D, osteocalcina e deoxipiridinolina (p<0,05). Não houve diferenças significativas entre os níveis de Pref-1 e adiponectina. O TBS manteve-se estável e não houve aparecimento de novas fraturas pelo vertebral fracture assessment (VFA). Na composição corporal por dual-energy X-ray absorptiometry (DXA), houve redução da massa gorda total e melhora no índice de massa magra apendicular pelo Foundation for the National Institutes of Health (FNIH) (p<0,05). A AMO de L3 reduziu significativamente no 6º mês PO, mantendo-se estável no 12º mês PO (p<0,05). Houve redução significativa do VAT, relação VAT/SAT e IHL no seguimento prospectivo (p<0,05). O presente estudo reafirma dados anteriores que mostram que o hipercortisolismo endógeno exerce profundo efeito negativo sobre o esqueleto, em particular sobre o osso trabecular. Além disto, é o primeiro estudo a mostrar que existe correlação negativa entre o TBS com HOMA-IR e AMO; é possível que as alterações do metabolismo energético sejam, pelo menos em parte, responsáveis pelo maior risco de fratura na DC. / The anti-inflammatory and immunosuppressive properties of glucocorticoids (GC) justify the use of these steroids in various clinical conditions, despite its significant adverse effects. Osteoporosis induced by glucocorticoids (OIG) is considered the most important cause of secondary osteoporosis. It is a multifactorial disease involving systemic, tissue and bone cell signaling changes. Furthermore, hypercortisolism is also associated with obesity, redistribution of fat, insulin resistance and diabetes mellitus. Interestingly, these metabolic disorders in which bone mass is preserved, there is increased bone fragility. In recent years, evidence shows various complex interaction between the mineral and energy metabolism, in particular between adipose tissue and bone. In this scenario, Cushing\'s disease (CD) is a desirable clinical model to evaluate various mechanisms involved in the complex process of developing osteoporosis. The objective of this study was to evaluate, in a baseline study and a prospective study, various aspects of the interaction between the mineral and energy metabolism in women with DC and their possible impact on bone mass, as well as the association between bone mass and different types of adipose tissue. In the baseline study, we evaluated three groups of individuals, matched by sex and age: control group (C, n = 27), obese (O; n = 16) and Cushing\'s disease group (CD, n = 16). In the prospective study, we evaluated the CD group at three time points: preoperative (Pre-op; n = 11), 6 months postoperative (6th month PO; n = 10) and 12 months postoperatively (12th month PO; n = 10). In the baseline study, the O and CD groups differed in relation to C as the weight and BMI (p <0.05). The CD group showed significantly higher blood glucose, insulin, glycosylated hemoglobin (HbA1c), HOMA-IR and leptin in relation to the C and O groups (p <0.05). Additionally, the CD group showed lower levels of osteocalcin in relation to the C and O groups (p <0.05) as well as PTH, 25-OH vitamin D (25 (OH) D), and adiponectin in relation to the C group (P <0.05). There was no difference between the groups regarding dosages of IGF-I and preadipocyte factor 1 (Pref-1). The CD group had lower bone mass in the lumbar spine in relation to the C and O groups (p <0.05) and lower bone mass in the total body when compared to the O group (P <0.05). The Trabecular bone score (TBS) was able to show impaired bone quality in groups O and CD, showing greater involvement in CD group (p <0.05). Bone marrow adiposity (BMA) in L3 was significantly higher in the CD group compared to the C and O groups (p <0.05). The CD group showed increased subcutaneous fat content (SAT), visceral (VAT), VAT/SAT ratio and intrahepatic lipid (IHL) in relation to the C group (p<0.05). Additionally, the CD group had a higher content of VAT in relation to the O group (p<0.05). Osteocalcin correlated positively with TBS (r = 0.5, p <0.0001) and negatively with HOMA-IR (r = -0.4, p <0.01) and AMO of L3 (r = - 0.4, p <0.01). The TBS was negatively correlated with HOMA-IR index (r = -0.6, p <0.0001) and AMO of L3 (r = - 0.5, p <0.001). The AMO of L3 positively correlated with BMI (r = 0.4, p <0.01), HOMA-IR (r = 0.3, p <0.05), leptin (r = 0.3, p < 0.05), VAT/SAT ratio (r = 0.6, p <0.0001) and IHL (r = 0.5, p <0.05). In the prospective study, there was a reduction in weight and BMI and blood glucose, insulin, HOMA-IR, glycated hemoglobin and leptin (p <0.05). Additionally, there was increased levels of 25(OH)D, osteocalcin and deoxypyridinoline (p <0.05). There were no significant differences between the levels of adiponectin and Pref-1. The TBS was stable and there was no occurance of new fractures by vertebral fracture assessment (VFA). In body composition by dual-energy X-ray absorptiometry (DXA), threre was a reduction of total fat mass and improvement in apendicular lean body mass index by Foundation for the National Institutes of Health (FNIH) (p <0.05). The BMA of L3 significantly reduced in the 6th month PO, remaining stable on the 12th month PO (p <0.05). There was a significant reduction of VAT, VAT/SAT ratio and IHL in the prospective follow-up (p <0.05). This study confirms previous data showing that endogenous hypercortisolism has a profound negative effect on the skeleton, in particular on trabecular bone. Moreover, it is the first study to show that there is a negative correlation between TBS with HOMA-IR and BMA; it is possible that changes in energy metabolism are at least partly responsible for the increased risk of fracture in DC.

Resumo: Considerando-se a falta de informações sobre a morfologia óssea da mão de ovinos, o presente trabalho teve como objetivo descrever os aspectos anatômicos e biométricos da mão de 14 ovinos, machos castrados, da raça Santa Inês como também investigar os valores densitométricos do metacarpo destes animais de diferentes idades. Para isso dissecou-se 14 mãos do membro torácico desses animais, para realização da descrição morfológica após a aplicação da técnica de maceração. A Densidade Mineral Óssea (DMO) do metacarpo foi determinada por meio da técnica de densitometria em imagens radiográficas, após a obtenção dos raios X dos animais vivos aos 12°, 13°, 14° e 15° meses de idade. Para a obtenção das medidas da DMO foi utilizado um software computacional Pró Plus, Média Cybernetics, versão 4.1. Após as análises morfológicas e biométricas das mãos pode-se verificar a semelhança das estruturas ósseas da mão dos ovinos com os bovinos, levando-se em conta o porte médio desta espécie. Além disso, foi observado que os valores densitométricos permaneceram estáveis no decorrer do período experimental. Diante disto sugere-se uma avaliação densitométrica por um período de tempo maior do que foi utilizado neste estudo / Abstract: Considering few information of bone morphology in sheep hand, this study aimed to describe the anatomy and biometric of the hand of 14 sheep, castrated male, Santa Inês also investigate the densitometric values of metacarpus in animals of different ages. For this 14 hands was dissect of the thoracic limb of these animals to the morphological description after applying the technique of maceration and the bone mineral density (BMD) of the metacarpal was determined using the technique of optical densitometry in radiographic images. To measure BMD it was used computer software Pró Plus, Media Cybernetics, version 4.1. After the morphological and biometric hands analyses was verify the similarity of the bony hand of sheep with cattle, taking into account the medium size of this species. Furthermore, it was observed that the bone mineral density values remained stable during the experimental period, it is suggested valuation for a longer period than realized in this study / Orientador: Silvana Martinez Baraldi Artoni / Coorientador: José Wanderley Cattelan / Banca: Mário Jefferson Quirino Louzada / Banca: Vanessa Sobue Franzo / Mestre

Abstract available in the Journal of Strength and Conditioning Research