Body composition in patients with classical homocystinuria: body mass relates to homocysteine and choline metabolism

Introduction

Classical homocystinuria is a rare genetic disease caused by cystathionine β-synthase deficiency, resulting in homocysteine accumulation. Growing evidence suggests that reduced fat mass in patients with classical homocystinuria may be associated with alterations in choline and homocysteine pathways. This study aimed to evaluate the body composition of patients with classical homocystinuria, identifying changes in body fat percentage and correlating findings with biochemical markers of homocysteine and choline pathways, lipoprotein levels and bone mineral density (BMD) T-scores.

Methods

Nine patients with classical homocystinuria were included in the study. Levels of homocysteine, methionine, cysteine, choline, betaine, dimethylglycine and ethanolamine were determined. Body composition was assessed by bioelectrical impedance analysis (BIA) in patients and in 18 controls. Data on the last BMD measurement and lipoprotein profile were obtained from medical records.

Results

Of 9 patients, 4 (44%) had a low body fat percentage, but no statistically significant differences were found between patients and controls. Homocysteine and methionine levels were negatively correlated with body mass index (BMI), while cysteine showed a positive correlation with BMI (p < 0.05). There was a trend between total choline levels and body fat percentage (r = 0.439, p = 0.07). HDL cholesterol correlated with choline and ethanolamine levels (r = 0.757, p = 0.049; r = 0.847, p = 0.016, respectively), and total cholesterol also correlated with choline levels (r = 0.775, p = 0.041). There was no association between BMD T-scores and body composition.

Conclusions

These results suggest that reduced fat mass is common in patients with classical homocystinuria, and that alterations in homocysteine and choline pathways affect body mass and lipid metabolism.     

Bioelectrical impedance underestimates total and truncal fatness in abdominally obese women

Objective: To compare estimates of total and truncal fatness from eight‐electrode bioelectrical impedance analysis equipment (BIA₈) with those from DXA in centrally obese women. The secondary aim was to examine BMI and waist circumference (WC) as proxy measures for percentage total body fat (%TBF) and truncal body fat percentage (tr%BF). Research Methods and Procedures: This was a cross‐sectional study of 136 women (age, 48.1 ± 7.7 years; BMI, 30.4 ± 2.9 kg/m²; %TBF_DXA, 46.0 ± 3.7%; WC, 104 ± 8 cm). Fatness was measured by DXA and Tanita BC‐418 equipment (Tanita Corp., Tokyo, Japan). Agreement among methods was assessed by Bland‐Altman plots, and regression analysis was used to evaluate anthropometric measures as proxies for total and abdominal fatness. Results: The percentage of overweight subjects was 41.9%, whereas 55.9% of the subjects were obese, as defined by BMI, and all subjects had a WC exceeding the World Health Organization cut‐off point for abdominal obesity. Compared with DXA, the BIA₈ equipment significantly underestimated total %BF (?5.0; ?3.6 to ?8.5 [mean; 95% confidence interval]), fat mass (?3.6; ?3.9 to ?3.2), and tr%BF (?8.5; ?9.1 to ?7.9). The discrepancies between the methods increased with increasing adiposity for both %TBF and tr%BF (both p < 0.001). Variation in BMI explained 28% of the variation in %TBF_DXA and 51% of %TBF_BIA8. Using WC as a proxy for truncal adiposity, it explained only 18% of tr%BF_DXA variance and 27% of tr%BF_BIA8 variance. The corresponding figures for truncal fat mass were 49% and 35%, respectively. No significant age effects were observed in any of the regressions. Discussion: BIA₈ underestimated both total and truncal fatness, compared with DXA, with higher dispersion for tr%BF than %TBF. The discrepancies increased with degree of adiposity, suggesting that the accuracy of BIA is negatively affected by obesity.     

Anthropometric measures, body composition, body fat distribution, and knee osteoarthritis in women

Objective: Increased BMI is a well‐recognized risk factor for radiographic knee osteoarthritis (rKOA); however, the contributions of the components of body composition, body fat distribution, and height to this association are not clear. Research Methods and Procedures: We examined 779 women ≥45 years of age from the Johnston County Osteoarthritis Project. Body composition was assessed using DXA, and rKOA was defined as Kellgren‐Lawrence grade ≥2. Logistic regression models examined the association between rKOA and the fourth compared with the first quartiles of anthropometric, body composition, and fat distribution measures adjusting for age, ethnicity, and prior knee injury. Results: The adjusted odds ratios and 95% confidence interval of BMI and weight were 5.27 (3.05, 9.13) and 5.28 (3.05, 9.16), respectively. In separate models, higher odds of rKOA were also found for fat mass [4.54 (2.68, 7.69)], percent fat mass [3.84 (2.26, 6.54)], lean mass [3.94 (2.22, 6.97)], and waist circumference [4.15 (2.45, 7.02)]. Waist‐to‐hip ratio was not associated with rKOA [1.45 (0.86, 2.43)], and percent lean mass was associated with lower odds [0.20 (0.11, 0.35)]. Taller women had higher odds of rKOA after adjustment for BMI [1.77 (1.05, 3.00)]. Discussion: This study confirms that BMI and weight are strongly associated with rKOA in women and suggests that precise measurements of body composition and measures of fat distribution may offer no advantage over the more simple measures of BMI or weight in assessment of risk of rKOA.     

Comparison of Two Software Versions for Assessment of Body‐Composition Analysis by DXA

Objective: To compare two software versions provided by Lunar Co. for assessment of body composition analysis by DXA. Research Methods and Procedures: Soft‐tissue phantoms for lean tissue (water) and fat tissue (methanol) were repeatedly scanned using DXA machines (DPX‐L; Lunar Co., Madison, WI) and analyzed using software version 1.33 and the updated year 2000‐compatible version 1.35. For the intersoftware comparison, the phantoms were scanned 10 times (each scan was analyzed once) with both software versions using all three scanning modes (slow, medium, and fast) for a total of 60 scans and analyses. For the intermachine comparison, the same phantoms were scanned three times (each scan was analyzed once) with a second machine from the same manufacturer using all three scanning modes and version 1.35 only. Percentage of fat was the variable of interest. Results: For version 1.33, fat was 9.9 ± 0.4%, 10.0 ± 0.5%, and 11.0 ± 0.5% (mean ± SD) for the lean‐tissue phantom and 50.8 ± 0.3%, 50.9 ± 0.5%, and 51.1 ± 0.6% for the fat‐tissue phantom using the slow, medium, and fast scanning modes, respectively. For version 1.35, the respective fat values were 9.8 ± 0.7%, 9.9 ± 0.4%, and 10.3 ± 0.7%, and 50.6 ± 0.5%, 50.9 ± 0.6%, and 50.8 ± 0.8%, respectively. For the lean‐tissue phantom, the estimation of percentage of fat was significantly (p < 0.05) affected by scanning mode but not by software version. For the fat‐tissue phantom, the estimation of percentage of fat was not affected by either scanning mode or software version. The use of version 1.35 did not effect intermachine variability. Discussion: Versions 1.33 and 1.35 of the Lunar body composition software appear to be comparable. Soft‐tissue phantoms, such as the ones described in this paper, may be useful in monitoring the reproducibility of body composition analyses within and between DXA machines, particularly in longitudinal studies.     

In vivo body composition in autochthonous and conventional pig breeding groups by dual-energy X-ray absorptiometry and magnetic resonance imaging under special consideration of Cerdo Ibérico

The improvement of carcass quality is one of the main breeding goals in pig production. To select appropriate breeding animals, it is of major concern to exactly and reliably analyze the body composition in vivo. Therefore, the objective of the study was to examine whether the combination of dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) offers the opportunity to reliably analyze quantitative and qualitative body composition characteristics of different pig breeding groups in vivo. In this study, a total of 77 pigs were studied by DXA and MRI at an average age of 154 days. The pigs originated from different autochthonous or conventional breeds or crossbreeds and were grouped into six breed types: Cerdo Ibérico (Ib); Duroc × Ib (Du_Ib); White Sow Lines (WSL, including German Landrace and German Large White); Hampshire/Pietrain (Pi_Ha, including Hampshire, Pietrain × Hampshire (PiHa) and Pietrain × PiHa); Pietrain/Duroc (Pi_Du, including Pietrain × Duroc (PiDu) and Pietrain × PiDu); crossbred WSL (PiDu_WSL, including Pietrain × WSL and PiDu × WSL). A whole-body scan was performed by DXA with a GE Lunar DPX-IQ in order to measure the amount and percentage of fat tissue (FM; %FM), lean tissue (LM; %LM) and bone mineral, whereas a Siemens Magnetom Open with a large body coil was used for MRI in the thorax region between 13th and 14th vertebrae in order to measure the area of the loin (LA) and the above back fat area (FA) of both body sides. A GLM procedure using SAS 9.2 was used to analyze the data. As expected, the native breed Ib followed by Du_Ib crossbreeds showed the highest %FM (27.2%, 25.0%) combined with the smallest LA (46.2 cm², 73.6 cm²), whereas Ib had the lowest BW at an average age of 154 days. Pigs with Pi_Ha origin presented the least %FM (12.4%) and largest LA (99.5 cm²). The WSL and PiDu_WSL showed an intermediate body composition. Therefore, it could be concluded that DXA and MRI and especially their combination are very suitable methods to reliably identify differences in body composition and carcass traits among different pig lines in vivo.     

Pelvis and femur geometry: Relationships with impact characteristics during sideways falls on the hip

While metrics of pelvis and femur geometry have been demonstrated to influence hip fracture risk, attempts at linking geometry to underlying mechanisms have focused on fracture strength. We investigated the potential effects of femur and pelvis geometry on applied loads during lateral falls on the hip. Fifteen female volunteers underwent DXA imaging to characterize two pelvis and six femur geometric features. Additionally, participants completed low-energy sideways falls on the hip; peak impact force and pressure, contact area, and moment of force applied to the proximal femur were extracted. No geometric feature was significantly associated with peak impact force. Peak moment of force was significantly associated with femur moment arm (p = 0.005). Peak pressure was positively correlated with pelvis width and femur moment arm (p < 0.05), while contact area was negatively correlated with metrics of pelvis width and femur neck length (p < 0.05). This is the first study to link experimental measures of impact loads during sideways falls with image-based skeletal geometry from human volunteers. The results suggest that while skeletal geometry has limited effects on overall peak impact force during sideways falls, it does influence how impact loads are distributed at the skin surface, in addition to the bending moment applied to the proximal femur. These findings have implications for the design of protective interventions (e.g. wearable hip protectors), and for models of fall-related lateral impacts that could incorporate the relationships between skeletal geometry, external load magnitude/distribution, and tissue-level femur loads.     

Association of Lean Tissue and Fat Mass with Bone Mineral Content in Children and Adolescents

Objectives: There has been uncertainty in the adult body composition literature about whether fat mass (FM) or fat free mass is a better predictor of bone mineral content and bone mineral density. This issue has recently also been raised in the pediatric literature. Based on suggested skeletal muscle–bone relationships, this study tested the hypothesis that in children and adolescents lean tissue mass (LTM) is a better predictor of total bone mineral content (TBMC) than is FM. Research Methods and Procedures: Subjects were 133 Italian children and adolescents, 5 to 17 years of age, undergoing a routine medical screen. FM (kilograms), LTM (kilograms), and TBMC (kilograms) were measured by DXA. Multiple regression analyses tested the independent association of FM and LTM with bone mineral content. Results: Regression analyses, adjusting for pubertal status and other covariates, showed that FM and LTM were independently associated with TBMC. These associations were similar for boys and girls. TBMC was more strongly associated with LTM than FM. Discussion: These observations support the hypothesis that in children and adolescents a close association exists between LTM, a measure of skeletal muscle, and skeletal characteristics.