Relation between adipose tissue and the musculoskeletal unit in a group of postmenopausal women.

Introduction: Involutional changes observed during aging increase rapidly in the postmenopausal period. These changes include body composition by affecting bone, muscle and fat tissue. A number of studies have investigated the mutual interaction between bone and muscle tissue, whereas adipose tissue had not been studied thoroughly.The aim of the present study was to assess the relation between fat tissue parameters and the musculoskeletal unit. Material and methods: The study was conducted in a group of 120 postmenopausal women with an average age of 69 years (59-81; SD 5.3). All women had been asked to complete a questionnaire (medical history) and underwent a total body composition analysis [bone mineral density (BMD)] testing (spine and/or neck) followed by a handgrip test. Results: The study revealed strong correlations between appendicular skeletal muscle mass index - appen.lean/height2, visceral adipose tissue area (VAT) and fat/mass/height2 index (r = 0.589 and 0.658 respectively; p < 0.001). The results were not supported by muscle strength (handgrip). The authors identified correlations between the bone parameters and adipose tissue but these were identified as weak or moderate (p < 0.05). Special emphasis should be placed on the relation between the trabecular bone score (TBS) and VAT area (r = -0.385, p < 0.001). Conclusions: There is a strong dependence between muscle and adipose tissues. Despite the fact that the increase in fat is correlated with the growth of muscle tissue, it is not accompanied by better quality of the muscle (handgrip). Bone microarchitecture is more related to VAT area than neck/spine BMD.

Relation between risk of falls, sarcopenia and parameters assessing quality of skeletal muscles in a group of postmenopausal women.

INTRODUCTION: Involutional changes that occur in skeletal muscle are a feature that characterizes the aging process. In women, age-related decreases in muscle mass and function of skeletal muscles occur more rapidly with the onset of menopause. Progressive muscle dysfunction has been directly linked with an increased probability of falls, fractures, disability and mortality. AIM OF THE STUDY: To assess the relationship between the risk of falls and parameters of skeletal muscle assessment in a group of postmenopausal women together with the identification of patients with sarcopenia. MATERIAL AND METHODS: This study was carried among 122 women over 60 years of age. Patients had their muscular system tested with the emphasis on the sarcopenia diagnosis using: Total Body Composition, handgrip and physical performance tests. Patients also underwent a questionnaire survey assessing occurrence of falls. RESULTS: The analysis showed an over 2-fold increase (OR 2.4; 95% CI, 1.02-5.56) in risk of falls in a year among subjects with decreased muscle mass. No such correlation was noted with parameters such as falls in the last 12 months and decrease of muscle strength as well as physical performance. Sarcopenia is more likely to be diagnosed with European Working Group on Sarcopenia in Older People (EWGSOP1) criteria than EWGSOP2 (updated in 2018) (18% vs. 4.1% respectively). The increased risk of falls has not been proven in women with sarcopenia. CONCLUSIONS: The decrease of muscle mass is significantly correlated with the risk of falls in the last year in postmenopausal women. Impact of sarcopenia on the risk of falls depends on diagnostic criteria.

Contemporary Management of Osteoporotic Fractures.

With aging of the population, osteoporotic fractures are becoming an increasing medical problem world-wide. It has been estimated that 2,700,000 patients experienced a low energy fracture in the Polish population in 2010. On the basis of contemporary world standards and publications in the field of orthopaedics and trau-matic surgery, a summary of the principles of management of osteoporotic fractures is presented. Both general problems of fracture treatment in elderly patients as well as difficulties in surgical and conservative treatment resulting from osteoporotic bone abnormalities are discussed. Special attention is paid to preoperative and postoperative procedures in patients with proximal femur fractures. Also presented is a contemporary strategy for the treatment of fractures of the distal forearm, proximal humerus and vertebrae. General principles of diagnosis and treatment of osteoporosis are discussed.

Vertebral fracture assessment, trabecular bone score and handgrip in a group of postmenopausal women with vertebral fractures - preliminary study.

OBJECTIVES: The aim of our study was to determine a possible correlation between vertebral fractures (indicated by VFA - vertebral fracture assessment), TBS (trabecular bone score) and muscle strength (measured by means of handgrip strength test results) in a group of postmenopausal women. MATERIAL AND METHODS: The study was conducted between 2014 and 2015 in a group of patients of Krakow Medical Centre (KMC). Women who participated in the study were referred to KMC by an attending physician for suspected vertebral fracture. Apart from VFA, patients were additionally tested for bone density (including TBS), muscle strength (by means of a handgrip strength test) and height loss. Altogether 35 patients with an average age of 69.7 years (49-95, SD = 10.49) were included in the study. RESULTS: In the group of 35 women, VFA analysis demonstrated vertebral fractures in 17 patients (40%). Vertebral height loss suggesting a fracture was revealed in 77 vertebrae. The mean result of the TBS was 1.195 (0.982-1.409, SD = 0.09), which suggests high risk of fracture. The majority of the subjects (65.7%) displayed major bone microarchitecture degradation (TBS < 1.23) and also the highest number of fractures (n = 62, 80.5% of all). There was no correlation between the spine bone mineral density (BMD) score and the TBS result, which confirms studies showing that subjects with the same bone density may have completely different TBS. Bone density (spine BMD) was similar (osteopenic) in groups with or without vertebral fracture (in VFA). We noted a significant correlation (r = 0.45, p < 0.05) between the number of fractured vertebrae and the handgrip score. CONCLUSIONS: VFA should be a part of a standard diagnostic procedure for patients with osteoporotic fractures. When it comes to identifying patients at risk of fracturing vertebrae, muscle strength (handgrip) may have potential use in clinical practice. The predictive value of the TBS in reference to vertebral fractures should be evaluated in bigger randomized studies.

Trabecular Bone Score (TBS) in Clinical Practice - Rewiev.

Bone mineral density (BMD) assessment is the basic method for assessing fracture risk and diagnosing osteoporosis according to the World Health Organization (WHO). Osteoporosis is diagnosed when the T-score at the proximal femur or spine is T≤-2.5; however, 70% of fractures occur in patients who do not fulfil this criterion. As BMD alone does not adequately predict fracture risk, additional methods supporting risk assessment are needed [3,4]. In 2012, the US Food and Drug Administration (FDA) adopted the Trabecular Bone Score (TBS) as another diagnostic method for osteoporosis. The aim of this study is to evaluate the use of TBS in clinical practice with particular attention to fracture risk assessment, differential diagnosis and assessment of treatment outcomes in patients suffering from primary or secondary osteoporosis. Literature analysis points to the increasing use of TBS in clinical practice. It has been found that, in different subjects with the same BMD, structural bone health is better differentiated using TBS. Additionally, it is valuable to use the DXA along with TBS analysis for improved prediction of fracture risk. Indirect assessment of bone structure with TBS is also helpful in assessing the effect of medications. In conclusion, TBS analysis is a valuable tool in the assessment of bone fracture risk and in the differential diagnosis of structural bone disorders in secondary osteoporosis.

Prevalence of the use of effective ergogenic aids among professional athletes.

BACKGROUND: Athletic performance can be substantially enhanced with supplements and functional food which are considered by scientists as efficient, safe and legal, such as protein, carbohydrate and protein-carbohydrate supplements, isotonic sports drinks, carbohydrate-protein bars, carbohydrate bars, creatine and caffeine. OBJECTIVE: The study is aimed at an analysis and evaluation of the prevalence of using effective ergogenic aids (creatine, caffeine, isotonic drinks, carbohydrates, and proteins) in a group of Polish professional athletes. MATERIAL AND METHODS: The research was conducted on 600 athletes (216 women, 384 men) practicing various sports disciplines; the younger group (18-23 years old) consisted of 307 people, while the older one (24-35 years old) was comprised of 293 subjects. A questionnaire was used with questions concerning the frequency and types of consumed supplements. RESULTS: Nearly half of the athletes (48,2%) admitted to taking supplementation, of which 36.7% consumed the supplements occasionally and 11.5% continually. The majority of the group (75.4%) claimed to be consuming isotonic drinks, which were the most commonly chosen nutritional aid enhancing physical performance, most frequently supplementing the diet in a continuous manner (41.2%). The least frequently used supplement was creatine, chosen by only one in three interviewees (34,5%). The ergogenic aids were used more often by men than women (50.5% vs. 44.1%), and so were nutrients based on proteins (51.8% vs. 32.0%), carbohydrates (60.7% vs. 46.8%), protein-carbohydrates (45.6% vs. 32.9%), as well as creatine (39.8% vs. 25.0%). The studies showed the inessential difference in the frequency of taking supplementation based on the interviewees' age (0.4%). CONCLUSIONS: Competitors who use supplements over those who choose not to, seems to reflect the continuous lack of the athletes' sufficient awareness of the effectiveness, safety, and health benefits of dietary supplementation that enhances physical performance. KEY WORDS: supplements, dietary supplementation, sport, performance-enhancing substances, athletes.