The inverse relationship between bone status and blood pressure among Polish men.

PRIMARY OBJECTIVE: An evaluation of relationships between bone density and blood pressure in healthy men. RESEARCH DESIGN: A cross-sectional population-based survey. METHODS AND PROCEDURES: An ethnically homogeneous sample of 208 men, aged 35-63, healthy and occupationally active inhabitants of the city of Wroclaw, Lower Silesia, Poland were studied. Trabecular, cortical and total bone mineral content (BMC) at the ultra-distal radius of the non-dominant hand were assessed by peripheral Quantitative Computed Tomography (pQCT: Stratec 960 apparatus). Body mass index (BMI) was used as a measure of general obesity. Systolic and diastolic blood pressure (BP) were measured using an MPC-350 sphygmomanometer. Multiple linear regression was used to evaluate the relationships between BP and BMC. A two-way analysis of covariance was carried out to test for the significance of inter-group differences in BMC with regard to age and BP with BMI as a contiuous covariable. Multiple logistic regression was used to verify whether some select factors (age, BMI, systolic and diastolic BP) could significantly predict male bone status. RESULTS: Systolic BP was not related to bone status at the ultra-distal radius. There were no differences in any BMC between systolic hyper- and normotensive subjects. Additionally, systolic hypertension did not affect the probability of an occurrence of male osteopenia (independently of age and BMI). In contrast, there were significant negative relationships between diastolic BP, and trabecular and total (but not cortical) BMC (even when controlled for age and BMI). Moreover, diastolic hypertensive men had reduced BMC at the ultra-distal radius when compared with normotensive subjects. It is noteworthy that Polish men of diastolic BP exceeding 90 mmHg had an approximately 1.50-fold increased relative risk of being osteopenic when compared with normotensive subjects (even when controlled for age, BMI and systolic BP). CONCLUSIONS: In the light of the inverse relationship between BMC and diastolic BP, Polish men with elevated diastolic BP seem to be more prone to the excessive age-related bone loss.

Are general obesity and visceral adiposity in men linked to reduced bone mineral content resulting from normal ageing? A population-based study.

Associations between fat accumulation and distribution and bone mineral status in men have not been comprehensively established, and available results are inconsistent. The aims of this study were as follows: (1) to evaluate relationships between anthropometric parameters of general obesity (body mass index, BMI) and fat distribution (waist/hip ratio, WHR) and bone mineral content (BMC), and (2) to compare BMC (a) between obese men (BMI >or= 27) and nonobese men and (b) between abdominally obese men (WHR >or= 0.95) and men without visceral adiposity, in a population-based sample of Polish men. The sample comprised a group of 272 men, aged 20-60, randomly selected from healthy and occupationally active inhabitants of Wroclaw, Lower Silesia, Poland. Trabecular, cortical and total BMC at the ultra-distal radius of the nondominant hand were assessed by pQCT using the Stratec 960 apparatus. BMI and WHR were used as parameters of general obesity and fat distribution, respectively. The relationships among the analysed variables were established using a multiple linear regression. The differences in BMC depending on BMI and WHR values were tested using an analysis of covariance (ancova). BMI was positively related only to trabecular BMC (r = 0.17; P = 0.03). Only trabecular BMC was higher in men with BMI >or= 27 compared to nonoverweight subjects (F = 5.38; P = 0.02). WHR was inversely related to trabecular (r = - 0.30; P < 0.001), cortical (r = - 0.30; P < 0.001) and total BMC (r = - 0.34; P < 0.001). All densitometric parameters were lower in males with WHR >or= 0.95 than in normal men (results of ancova: for trabecular BMC, F = 6.33, P = 0.01; for cortical BMC, F = 5.52, P = 0.02, and for total BMC, F = 7.73, P = 0.006). In the healthy Polish male population, BMI was of minor significance as a predictor of BMC at the ultra-distal radius, whereas visceral adiposity (assessed by WHR) was significantly linked to reduced bone mass in men.

Bone mineral status of Polish men in the course of normal ageing.

Age-related changes in the bone mineral content (BMC) of men are conditioned by both genetic and environmental factors distinctive for particular populations. This results in considerable differences between various populations concerning the prevalence of osteopenia and osteoporosis, and the occurrence of normal variability in BMC among adult and elderly men. The aim of the study was to evaluate the variation of BMC with age in an ethnically homogenous sample of 405 healthy men, aged 20-60 years, all occupationally active inhabitants of the city of Wroclaw, Lower Silesia, Poland. Trabecular and total BMC at the ultradistal radius of the nondominant hand were assessed by peripheral quantitative computerized tomography using the Stratec 960 densitometer. Among Polish men a distinct phase of maximal BMC values (around the age of 30) was distinguished, with a subsequent, quite rapid decline in bone mass. For example, the peak value of trabecular BMC decreased by approximately 13.2% per decade. In Polish men up to 30-34 years old trabecular and total BMC even exceeded reference values by 10%; however, from 35 years onwards their BMC was lower than standard values. This unfavourable phenomenon of BMC decline was augmented with age, and finally BMC values in men aged 55 and over were 30-35% lower than reference values. The significant discrepancies found between the data presented in this study and reference values probably result from inter-populational differences in the lifestyles of healthy ageing men. The results also confirm that bone density (with its age-related changes in the course of normal male ageing) is one of the biological features characteristic of this particular regional population.

Variation in body mass index among Polish adults: effects of sex, age, birth cohort, and social class.

Variation in the body mass index (BMI) among occupationally active inhabitants of one Polish urban center was studied by means of a three-factor ANOVA. The material is cross-sectional and comprises 32,750 men and women aged 22-60 years, examined in five successive surveys between 1983-1999. The factors considered in each sex were: 1) age category, 2) year of examination, and 3) social class. The increase of BMI with age is markedly greater among women than among men. No sustained intergeneration trend towards increased BMI was detectable in either sex. The BMI means rise regularly with decreasing position on the social scale in both sexes, but this effect is much more dramatic in women. The latter finding suggests that the condition of being situated low on the social scale is conducive to growth of fatness with age, markedly more so in women than in men. The absence of a secular trend in BMI means during the period considered contrasts with results reported for a number of other countries. This finding is intriguing, because Poland underwent abrupt and profound socio-economic transformation in the early 1990s.

Effects of long-term testosterone substitutive therapy on bone mineral content in men with hypergonadotrophic hypogonadism.

Hypogonadism is one of the crucial risk factors for male osteopenia and osteoporosis. There are few studies on the effects of long-term and consistently administered testosterone substitutive therapy on bone mineral density in men with gonadal androgen deficiency, and their results have been susceptible to various interpretations. The aim of our study was an evaluation of bone mineral content in 26 men, aged 18-57 years, with hypergonadotrophic hypogonadism who underwent long-lasting androgen re-placement therapy with testosterone esters (Omnadren 250), which conditioned proper psychosomatic androgenization. The control group comprised 405 healthy men, aged 20-60 years, a representative sample of the local male population. Among all examined men and in the control group, trabecular, cortical and total bone mineral content at the distal radius of the nondominant hand were assessed by peripheral quantitative computed tomography using the Stratec 960 apparatus. In 11 hypogonadal men (42.3%), the trabecular bone mineral content was found to be within normal ranges; in 15 patients (57.7%) its values were below -1 standard deviation (SD) (osteopenia). In six patients (23.1%), the cortical bone mineral content was between +1 SD and the arithmetic mean, X; in 13 examined men (50%), the cortical bone mineral content was below X and above -1 SD. Osteopenia was diagnosed in six hypogonadal males, whereas osteoporosis was found in one man (cortical bone mineral content below -2.5 SD). Only in seven of the examined men (26.9%) was the total bone mineral content found within normal ranges, whereas in 19 men (73.1%) the total bone mineral content was below -1 SD (osteopenia). Despite the testosterone replacement in hypogonadal men, the greatest reduction of bone mineral content was found in its trabecular and total values. Among all the men examined, the trabecular and total bone mineral contents were below the mean of our own reference values. The results show that long-term and consecutively administered testosterone replacement in conventional doses, despite the normalization of serum androgen levels and the promotion of proper somatic development, does not simultaneously eliminate hypogonadal osteopenia in every case. The individually differentiated response to exogenous androgens is a characteristic feature of male hypogonadism. This study emphasizes the necessity of regular measurements of bone mineral density in hypogonadal men, as the densitometric parameters should be accepted as an osteologic (and very important) marker of androgenization of the male organism.

An assessment of biological age of males in Poland.

BACKGROUND: Studies carried out in Poland have shown that some important indices of growth and maturation in children, of the biological well-being during adulthood and the rates of premature mortality depend strongly upon the individual's position on the social scale. AIM: The study considers whether adult males of higher educational status differ from their chronological age-matches of lower educational status in biological age. SUBJECTS AND METHODS: The data of 2800 occupationally active men, aged 25-65 from the 1994/1995 Polish Health Surveys were used. Twenty-two different measures were used. Biological age was assessed by the method of Borkan and Norris (Journal of Gerontology, 35, 177-184, 1980). RESULTS: A comparison of biological age profiles of two groups of males based on their educational status showed that in 13 of the 22 characteristics. better-educated men were biologically younger than their poorer educated peers (p < 0.05). CONCLUSION: Better education is associated with the slowing down of the process of ageing, probably because it produces a healthier life-style.

[Bone mineral density of adults living in the city of Wroclaw compared with the reference ranges]. / Gestosc mineralna koscca obwodowego doroslych mieszkanców Wroclawia na tle wartosci referencyjnych aparatu STRATEC 960.

Certain elements of lifestyles (distinctive for the particular population) are presumed to influence on bone metabolism. This fact results in considerable differences between various populations, concerning both the occurrence of the normal variability of BMD (bone mineral content) among adult and elderly men and women, and also the prevalence of osteopenia or osteoporosis. The purpose of the study was to evaluate the variability of BMD in a group of healthy and occupationally active inhabitants of the city of Wroclaw, Poland (426 men aged 20-59 and 1218 women aged 20-62) and to compare our results with the reference ranges provided by the producer of the Stratec 960 apparatus. Trabecular and total BMD at the distal radius of the nondominant hand were assessed by peripheral Quantitative Computed Tomography (pQCT) using the Stratec 960 apparatus. BMD of Polish men and women significantly differ from the reference ranges of Stratec 960. The unfavourable phenomenon of the greater BMD decline with age, as compared to the standard values provided by the producer of the device, occurred. It should also be stressed that this reduction is more intense with age and it is marked among men older than 36. Taking into consideration the fact, that our material comprises only occupationally active subjects, the revealed differences would be probably greater, if they were evaluated in Polish population as a whole (our sample does not include persons, who are retired from the healthy conditions). Considering those significant discrepancies between our data and the Stratec reference population, one should be careful when using the normative database provided by Stratec for the densitometric diagnosis of osteoporosis among Polish women and men. Additionally the present study reveals that BMD (and its age-related changes during normal aging) is one of the features characteristic for the particular regional population, which is due to inter-populational differences of those elements of lifestyle, which can influence both general health condition and bone mineral density.

Variation in bone mineral density in adults in Poland: age and sex differences.

The decline of mineral bone density with age can lead in more extreme cases to osteopenia and osteoporosis, and is therefore one of the aspects of ageing with great medical and social significance. With this idea in mind a study of age changes in the trabecular and, separately, the cortical bone density of the radius was carried out in 1218 females and 405 males, aged 22 to 60 years, all occupationally active inhabitants of the city of Wroclaw, Poland. The technique used was the peripheral Quantitative Computed Tomography (pQCT). It was found that in females bone densities remain relatively stable throughout the period between 22 and 40 years. They then begin to decline slowly, with a rapid decline after the age of 55. A distinctly different pattern was found among males, with bone densities reaching peak values, markedly higher than those in females, in the third decade of life. After this age the bone density values begin to decline at a rapid rate, so that by the age of 60 years mean trabecular and cortical densities in males have decreased to levels almost equivalent to females of equal age. In view of the small size of the male samples, especially in the older age classes, the above results should be treated with caution and confirmed using larger samples.

[The effect of smoking tobacco and drinking of alcohol and coffee on bone mineral density of healthy men 40 years of age]. / Wplyw palenia tytoniu, picia alkoholu i kawy na gestosc mineralna koscca obwodowego zdrowych mezczyzn po 40 roku zycia.

The aim of the study was to evaluate the effects of smoking, alcohol and coffee drinking on bone mineral content (BMC) in a group of 258 healthy men, aged 40-63, occupationally active inhabitants of Wroclaw. Trabecular, cortical and total BMC at the distal radius of the non-dominant hand were measured by pQCT method using the Stratec apparatus. The data concerning smoking, alcohol and coffee intake were obtained through a questionnaire. The significance of BMC differences between groups were tested using a one-way analysis of variance ANOVA. The extent of alcohol intake did not differentiate BMC values at the distal radius, whereas the significant detrimental effects of both smoking and coffee drinking on trabecular (but not cortical and total) BMC were revealed. Among healthy Polish males coffee drinking was associated with a significant reduction of trabecular BMC. Simultaneously, smokers and ex-smokers (when compared to never-smokers) had lower trabecular BMC.

Relationships between age-related changes of sex steroids, obesity and body fat distribution among healthy Polish males.

During the process of aging in males a trend toward an unfavourable body fat accumulation, especially within the visceral depots, is observed. This fact is presumed to be associated with the age-related decline in androgen levels among aging men. The aim of this study was to determine the relationships between sex steroid levels (DHEAS, estradiol, free and total testosterone) and BMI, percent fat mass, WHR values in 190 healthy and professionally active men, aged 22-67, inhabitants of the city of Wroclaw, Poland. Hormonal levels were measured using standard immunoassays. BMI was used as a measurement of obesity. Obesity was also assessed using percent fat mass equations according to the Crook formula. WHR was used as an index of fat distribution. All the correlations between sex steroids, BMI, WHR, percent fat mass and age were evaluated using statistical non-parametric analyses (Spearman coefficient) in the entire group of examined subjects, and in two age-specific groups: a) younger males (aged 22-39) and b) older males (aged 40-67). The aging of Polish males is accompanied by both a significant increase of BMI, percent fat mass and WHR values, and by a decline in estradiol, gonadal and adrenal androgen levels. In the younger group only total testosterone levels were significantly negatively related to BMI, percent fat mass and WHR. Within the group of older men both estradiol and DHEAS levels are significantly positively related to WHR. The sex steroids seem to be associated with indices of overall obesity and distribution of fat in men, but these relationships differ considerably when they are evaluated in younger and older age categories. Worthy of notice is the fact that free testosterone levels are not related to any anthropometric parameters in any age category, although free testosterone (not total testosterone) is commonly recognised as a reliable and sensitive endocrinological indicator of the general psycho-physical status of an aging man.

Body mass index, waist/hip ratio and androgen-estrogen activity in younger versus older Polish men.

This study was performed to evaluate the associations between estradiol, dehydroepiandrosterone sulfate (DHEAS), free and total testosterone levels, and anthropometric parameters of general adiposity (body mass index, BMI) and fat distribution (waist/hip ratio, WHR), separately in two subgroups of healthy Polish men: younger (aged 22-39 years, n = 95) and older (aged 40 years and over, n = 141) subjects. Sex steroid levels were assessed using radioimmunoassay (RIA). BMI was used as a measure of general adiposity. WHR was used to estimate distribution of adipose depots. The relationships between sex steroids, BMI, WHR and age were evaluated by use of non-parametric statistics (Spearman coefficients). Aging was related to a reduction of all hormone levels (correlation coefficients with age: free testosterone r = -0.52, p < 0.001; total testosterone r = -0.25, p < 0.001; estradiol r = -0.18, p < 0.001; DHEAS r = -0.45, p < 0.001) and an increase of BMI and WHR for BMI r = 0.23, p < 0.001; for WHR r = 0.47, p < 0.001). A one way analysis of co-variance (ANCOVA) was applied separately in the two subgroups of subjects to assess the relationships between hormonal and anthropometric variables. In men aged 22-39 years, the total (but not free) testosterone and DHEAS (when controlled for age) significantly differentiated BMI values. In subjects aged 40 years and over, no associations between sex steroids and BMI were revealed. In younger males DHEAS differentiated WHR values (even when controlled for age and BMI), whereas after the age of 40 years an increased WHR was accompanied by increases in both estradiol and DHEAS levels. The associations between the androgen-estrogen activity and the anthropometric parameters of adiposity vary in younger versus older healthy men.

Social contrasts in the incidence of obesity among adult large-city dwellers in Poland in 1986 and 1996.

The incidence of obesity, defined as the fraction of persons with BMIs exceeding 30-0, was examined in two birth cohorts of 40-50-year-old occupationally active inhabitants of the city of Wroclaw, Poland. In both cohorts and both genders obesity increased monotonically with decreasing position on a three-level educational scale. During the 1986-1996 decade obesity increased dramatically among males with trade school education only; concomitant shifts were much smaller or absent in the college-educated groups. The contrast in obesity between the opposite ends of the educational scale has widened markedly in both genders; and the between-gender gap has declined somewhat.

The position of the monozygotic twins among their school class-mates in the light of results of Janusz Korczak's "Plebiscite on likes and dislikes".

Within the "Wroclaw Longitudinal Twin Study" in a part of the material the liking level of singletons (SIN) to identical twins (TMZ) and of TMZ to SIN was analysed cross-sectionally, in the period of 11th to 18th year of life. In each of the 76 classes of elementary and high schools in Wroclaw (Poland), including the investigated in 1976-7 TMZ (64 pairs), were evaluated the relations between school-mates, using the Korczak's five-degree scale of liking. The declared by TMZ and SIN liking decreased with age between pupils of the same sex, and increased between pupils of opposite sex, however, in TMZ with some delay. The liking declared by TMZ of both sexes to SIN was on average lower than that declared by SIN to TMZ. The degree of liking declared by SIN to TMZ of the same sex was average higher than in relation of SIN to SIN particularly among girls. Thus, there occurred the so-called "prima donna effect". The liking declared to pupils of opposite sex in relation of SIN to TMZ was on average lower than the analogous one in relation of SIN to SIN and in relation TMZ to SIN even worse. The higher contrast in treating pupils of the same and opposite sex in TMZ than in SIN indicates a lower social maturity in TMZ. A diverse influence of socio-economic conditions on the declared toward then liking by boys and girls was found. The low number of separated twins did not allow to make a generalisation on specificity of their position in class. The sending of TMZ to different classes appeared to be in Wroclaw elementary schools sporadic (1 repeater), and in high schools observed in 38%, from that 28% of twins went to equivalent classes, usually in different school, and in 10% of pairs one of the twins repeated the class.

Fitness of professionals and skilled workers in Poland.

Simple measures of the biological fitness of adult men aged 25-65 years, inhabitants of the city of Wroclaw, Poland, were studied in two well-defined social groups: professionals and skilled workers. It was found that the manual workers, compared to professionals, have higher systolic and diastolic blood pressure, lower relative vital capacity, inferior flexibility of spine, poorer eye-hand co-ordination, and poorer hearing acuity. These social differences appear consistently at each age level between 25 and 65 years and tend to increase with age to the disadvantage of skilled workers.

Genetic correlates of menarcheal age: a multivariate twin study.

Multivariate genetic models were fitted to data from 44 pairs of MZ and 42 pairs of DZ twin girls on weight, height, and skeletal maturation at the age of menarche, in order to obtain information on genetic relationships of those measures with the age of menarche. The relationships of all three physical measures with this age were largely genetically controlled, but a genetic system controlling skeletal maturity was identified as the only genetic determinant of menarcheal age, independent of those systems of the two remaining physical measures. Heritabilities of all individual traits considered in the study were uniformly high. Possible links of genetic information with hormonal functions determining menarche are discussed.

Timing and genetic rapport between growth in skeletal maturity and height around puberty: similarities and differences between girls and boys.

We have analyzed longitudinal twin data by using a multivariate normal model to identify and quantify genetic effects over time on two main aspects of growth, height and skeletal maturity. The largest genetic contribution to the variance in both height and skeletal maturity coincided with the respective ages of peak growth velocity. The highest genetic covariance between these two traits coincided with the age of greatest acceleration of growth in height. These findings imply the existence of regulatory or structural genes that influence growth in both height and skeletal maturity. We also found sex differences in the rapport between velocities for height and skeletal maturity. These are consistent with a predominant role of estrogen in accelerating skeletal maturation in females, and the existence of additional mechanisms in males which may promote growth in height independently of the effects of gonadal sex steroids.