36 results on '"Douglas P Kiel"'
Search Results
2. Accumulation in Visceral Adipose Tissue Over 6 Years Is Associated With Lower Paraspinal Muscle Density
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Ching-Ti Liu, Timothy Tsai, Brett T Allaire, Mary L Bouxsein, Marian T Hannan, Thomas G Travison, and Douglas P Kiel
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Endocrinology ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,Biochemistry - Abstract
Context Visceral adipose tissue (VAT) has been recognized to be a metabolically active fat depot that may have paracrine effects on surrounding tissues, including muscle. Since many adults accumulate VAT as they age, the effect of changes in VAT on muscle is of interest. Objective We determined the association between 6-year changes in VAT and paraspinal muscle density, an indicator of fatty infiltration. Methods This study included 1145 participants from the Framingham Study third-generation cohort who had both quantitative computed tomography scans of the spine at baseline and 6-year's follow-up, on whom muscle density was measured along with VAT. We implemented multiple regression to determine the association of muscle density at follow-up as primary outcome measure with changes in VAT (follow-up minus baseline divided by 100), adjusting for VAT at baseline, age, sex, height, menopausal status, presence of diabetes, and physical activity. Analyses were performed in men and women separately. Results After adjustment for covariates, individuals with the greatest accumulation of VAT over 6 years had significantly lower paraspinal density at the follow-up with an estimated 0.302 (95% CI, −0.380 to −0.224) and 0.476 (95% CI: −0.598 to −0.354) lower muscle density (HU) per 100-cm3 increase in VAT (both P values < .001) in men and women, respectively. Conclusion These results highlight that age-related accumulation of VAT in men and women is associated with lower muscle density. VAT may represent a modifiable risk factor for poor musculoskeletal outcomes with aging.
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- 2022
3. Dietary and supplemental intake of vitamins C and E is associated with altered DNA methylation in an epigenome-wide association study meta-analysis
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Amena Keshawarz, Roby Joehanes, Jiantao Ma, Gha Young Lee, Ricardo Costeira, Pei-Chien Tsai, Olatz M. Masachs, Jordana T. Bell, Rory Wilson, Barbara Thorand, Juliane Winkelmann, Annette Peters, Jakob Linseisen, Melanie Waldenberger, Terho Lehtimäki, Pashupati P. Mishra, Mika Kähönen, Olli Raitakari, Mika Helminen, Carol A. Wang, Phillip E. Melton, Rae-Chi Huang, Craig E. Pennell, Therese A. O’Sullivan, Carolina Ochoa-Rosales, Trudy Voortman, Joyce B.J. van Meurs, Kristin L. Young, Misa Graff, Yujie Wang, Douglas P. Kiel, Caren E. Smith, Paul F. Jacques, Daniel Levy, Epidemiology, and Internal Medicine
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Cancer Research ,SDG 3 - Good Health and Well-being ,ddc:610 ,Molecular Biology - Abstract
BACKGROUND: Dietary intake of antioxidants such as vitamins C and E protect against oxidative stress, and may also be associated with altered DNA methylation patterns. METHODS: We meta-analysed epigenome-wide association study (EWAS) results from 11,866 participants across eight population-based cohorts to evaluate the association between self-reported dietary and supplemental intake of vitamins C and E with DNA methylation. EWAS were adjusted for age, sex, BMI, caloric intake, blood cell type proportion, smoking status, alcohol consumption, and technical covariates. Significant results of the meta-analysis were subsequently evaluated in gene set enrichment analysis (GSEA) and expression quantitative trait methylation (eQTM) analysis. RESULTS: In meta-analysis, methylation at 4,656 CpG sites was significantly associated with vitamin C intake at FDR ≤ 0.05. The most significant CpG sites associated with vitamin C (at FDR ≤ 0.01) were enriched for pathways associated with systems development and cell signalling in GSEA, and were associated with downstream expression of genes enriched in the immune response in eQTM analysis. Furthermore, methylation at 160 CpG sites was significantly associated with vitamin E intake at FDR ≤ 0.05, but GSEA and eQTM analysis of the top most significant CpG sites associated with vitamin E did not identify significant enrichment of any biological pathways investigated. CONCLUSIONS: We identified significant associations of many CpG sites with vitamin C and E intake, and our results suggest that vitamin C intake may be associated with systems development and the immune response.
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- 2023
4. Association of Vascular Health Measures and Physical Function: A Prospective Analysis in the Framingham Heart Study
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Shivani Sahni, Alyssa B Dufour, Na Wang, Douglas P Kiel, Marian T Hannan, Paul F Jacques, Emelia J Benjamin, Ramachandran S Vasan, Joanne M Murabito, Anne B Newman, Roger A Fielding, Gary F Mitchell, and Naomi M Hamburg
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Aging ,Geriatrics and Gerontology - Abstract
Background Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study. Methods The cross-sectional study (1998–2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least 1 measure of aortic stiffness (carotid–femoral pulse wave velocity, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and mean arterial pressure [MAP]) assessed by tonometry and brachial artery ultrasound. The longitudinal study included participants with ≥1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates. Results In cross-sectional analyses (n = 2 498, age 61 ± 10 years; 56% women), higher resting brachial artery diameter (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = .01) and MAP (β ± SE: 0.39 ± 0.17, p = .02) were associated with higher grip strength. Higher brachial pulse pressure (β ± SE: −0.02 ± 0.01, p = .07) was marginally associated with slower gait speed. In longitudinal analyses (n = 2 157), higher brachial pulse pressure (β ± SE: −0.19 ± 0.07, p = .005), was associated with slowing of gait speed but not with grip strength. Conclusions Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.
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- 2023
5. Higher abdominal adiposity is associated with higher lean muscle mass but lower muscle quality in middle-aged and older men and women: the Framingham Heart Study
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Rachana Raghupathy, Robert R. McLean, Douglas P. Kiel, Marian T. Hannan, and Shivani Sahni
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Aging ,Geriatrics and Gerontology - Published
- 2023
6. A Fracture Risk Assessment Tool for High Resolution Peripheral Quantitative Computed Tomography
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Danielle E. Whittier, Elizabeth J. Samelson, Marian T. Hannan, Lauren A. Burt, David A. Hanley, Emmanuel Biver, Pawel Szulc, Elisabeth Sornay‐Rendu, Blandine Merle, Roland Chapurlat, Eric Lespessailles, Andy Kin On Wong, David Goltzman, Sundeep Khosla, Serge Ferrari, Mary L. Bouxsein, Douglas P. Kiel, and Steven K. Boyd
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Endocrinology, Diabetes and Metabolism ,Orthopedics and Sports Medicine - Published
- 2023
7. Global Epidemiology of Hip Fractures
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Chor‐Wing Sing, Tzu‐Chieh Lin, Sharon Bartholomew, J Simon Bell, Corina Bennett, Kebede Beyene, Pauline Bosco‐Levy, Brian D. Bradbury, Amy Hai Yan Chan, Manju Chandran, Cyrus Cooper, Maria de Ridder, Caroline Y. Doyon, Cécile Droz‐Perroteau, Ganga Ganesan, Sirpa Hartikainen, Jenni Ilomaki, Han Eol Jeong, Douglas P. Kiel, Kiyoshi Kubota, Edward Chia‐Cheng Lai, Jeff L. Lange, E. Michael Lewiecki, Julian Lin, Jiannong Liu, Joe Maskell, Mirhelen Mendes de Abreu, James O'Kelly, Nobuhiro Ooba, Alma B. Pedersen, Albert Prats‐Uribe, Daniel Prieto‐Alhambra, Simon Xiwen Qin, Ju‐Young Shin, Henrik T. Sørensen, Kelvin Bryan Tan, Tracy Thomas, Anna‐Maija Tolppanen, Katia M.C. Verhamme, Grace Hsin‐Min Wang, Sawaeng Watcharathanakij, Stephen J Wood, Ching‐Lung Cheung, Ian C.K. Wong, and Medical Informatics
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SDG 3 - Good Health and Well-being ,Endocrinology, Diabetes and Metabolism ,Orthopedics and Sports Medicine - Abstract
In this international study, we examined the incidence of hip fractures, postfracture treatment, and all-cause mortality following hip fractures, based on demographics, geography, and calendar year. We used patient-level healthcare data from 19 countries and regions to identify patients aged 50 years and older hospitalized with a hip fracture from 2005 to 2018. The age- and sex-standardized incidence rates of hip fractures, post-hip fracture treatment (defined as the proportion of patients receiving anti-osteoporosis medication with various mechanisms of action [bisphosphonates, denosumab, raloxifene, strontium ranelate, or teriparatide] following a hip fracture), and the all-cause mortality rates after hip fractures were estimated using a standardized protocol and common data model. The number of hip fractures in 2050 was projected based on trends in the incidence and estimated future population demographics. In total, 4,115,046 hip fractures were identified from 20 databases. The reported age- and sex-standardized incidence rates of hip fractures ranged from 95.1 (95% confidence interval [CI] 94.8–95.4) in Brazil to 315.9 (95% CI 314.0–317.7) in Denmark per 100,000 population. Incidence rates decreased over the study period in most countries; however, the estimated total annual number of hip fractures nearly doubled from 2018 to 2050. Within 1 year following a hip fracture, post-hip fracture treatment ranged from 11.5% (95% CI 11.1% to 11.9%) in Germany to 50.3% (95% CI 50.0% to 50.7%) in the United Kingdom, and all-cause mortality rates ranged from 14.4% (95% CI 14.0% to 14.8%) in Singapore to 28.3% (95% CI 28.0% to 28.6%) in the United Kingdom. Males had lower use of anti-osteoporosis medication than females, higher rates of all-cause mortality, and a larger increase in the projected number of hip fractures by 2050. Substantial variations exist in the global epidemiology of hip fractures and postfracture outcomes. Our findings inform possible actions to reduce the projected public health burden of osteoporotic fractures among the aging population.
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- 2023
8. Higher intake of dietary flavonols, specifically dietary quercetin, is associated with lower odds of frailty onset over 12 years of follow-up among adults in the Framingham Heart Study
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Steven Oei, Courtney L. Millar, Thuy Nga Nguyen Lily, Kenneth J. Mukamal, Douglas P. Kiel, Lewis A. Lipsitz, Marian T. Hannan, and Shivani Sahni
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Nutrition and Dietetics ,Medicine (miscellaneous) - Published
- 2023
9. Development and validation of the <scp>fall‐related</scp> injury risk in nursing homes ( <scp>INJURE‐NH</scp> ) prediction tool
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Matthew S. Duprey, Andrew R. Zullo, Natalia A. Gouskova, Yoojin Lee, Alyssa Capuano, Douglas P. Kiel, Lori A. Daiello, Dae Hyun Kim, and Sarah D. Berry
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Geriatrics and Gerontology - Published
- 2023
10. Epigenetic Age Acceleration and Change in Frailty in MOBILIZE Boston
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Benjamin J Seligman, Sarah D Berry, Lewis A Lipsitz, Thomas G Travison, and Douglas P Kiel
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Male ,THE JOURNAL OF GERONTOLOGY: Biological Sciences ,Aging ,Frailty ,Acceleration ,Humans ,Female ,DNA Methylation ,Geriatrics and Gerontology ,Boston ,Epigenesis, Genetic - Abstract
Age-associated changes in DNA methylation have been implicated as 1 mechanism to explain the development of frailty; however, previous cross-sectional studies of epigenetic age acceleration (eAA) and frailty have had inconsistent findings. Few longitudinal studies have considered the association of eAA with change in frailty. We sought to determine the association between eAA and change in frailty in the MOBILIZE Boston cohort. Participants were assessed at 2 visits 12–18 months apart. Intrinsic, extrinsic, GrimAge, and PhenoAge eAA were assessed from whole-blood DNA methylation at baseline using the Infinium 450k array. Frailty was assessed by a continuous frailty score based on the frailty phenotype and by frailty index (FI). Analysis was by correlation and linear regression with adjustment for age, sex, smoking status, and body mass index. Three hundred and ninety-five participants with a frailty score and 431 with an FI had epigenetic and follow-up frailty measures. Mean (standard deviation) ages were 77.8 (5.49) and 77.9 (5.47) for the frailty score and the FI cohorts respectively, and 232 (58.7%) and 257 (59.6%) were female. All participants with epigenetic data identified as White. Baseline frailty score was not correlated with intrinsic or extrinsic eAA, but was correlated with PhenoAge and, even after adjustment for covariates, GrimAge. Baseline FI was correlated with extrinsic, GrimAge, and PhenoAge eAA with and without adjustment. No eAA measure was associated with change in frailty, with or without adjustment. Our results suggest that no eAA measure was associated with change in frailty. Further studies should consider longer periods of follow-up and repeated eAA measurement.
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- 2022
11. Author response for 'A Fracture Risk Assessment Tool for High Resolution Peripheral Quantitative Computed Tomography'
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null Danielle E. Whittier, null Elizabeth J. Samelson, null Marian T. Hannan, null Lauren A. Burt, null David A. Hanley, null Emmanuel Biver, null Pawel Szulc, null Elisabeth Sornay‐Rendu, null Blandine Merle, null Roland Chapurlat, null Eric Lespessailles, null Andy Kin On Wong, null David Goltzman, null Sundeep Khosla, null Serge Ferrari, null Mary L. Bouxsein, null Douglas P. Kiel, and null Steven K. Boyd
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- 2022
12. Abdominal aortic calcification on lateral spine images captured during bone density testing and late-life dementia risk in older women: A prospective cohort study
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Tenielle Porter, Marc Sim, Richard L. Prince, John T. Schousboe, Catherine Bondonno, Wai H. Lim, Kun Zhu, Douglas P. Kiel, Jonathan M. Hodgson, Simon M. Laws, and Joshua R. Lewis
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Psychiatry and Mental health ,Infectious Diseases ,Health Policy ,Pediatrics, Perinatology and Child Health ,Public Health, Environmental and Occupational Health ,Internal Medicine ,Obstetrics and Gynecology ,Geriatrics and Gerontology - Abstract
Dementia after the age of 80 years (late-life) is increasingly common due to vascular and non-vascular risk factors. Identifying individuals at higher risk of late-life dementia remains a global priority.In prospective study of 958 ambulant community-dwelling older women (≥70 years), lateral spine images (LSI) captured in 1998 (baseline) from a bone density machine were used to assess abdominal aortic calcification (AAC). AAC was classified into established categories (low, moderate and extensive). Cardiovascular risk factors and apolipoprotein E (At baseline women were 75.0 ± 2.6 years, 44.7% had low AAC, 36.4% had moderate AAC and 18.9% had extensive AAC. Over 14.5- years, 150 (15.7%) women had a late-life dementia hospitalisation (In community-dwelling older women, those with more advanced AAC had higher risk of late-life dementia, independent of cardiovascular risk factors andKidney Health Australia, Healthway Health Promotion Foundation of Western Australia, Sir Charles Gairdner Hospital Research Advisory Committee Grant, National Health and Medical Research Council of Australia.
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- 2022
13. Clonal hematopoiesis of indeterminate potential, DNA methylation, and risk for coronary artery disease
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M d Mesbah Uddin, Ngoc Quynh H. Nguyen, Bing Yu, Jennifer A. Brody, Akhil Pampana, Tetsushi Nakao, Myriam Fornage, Jan Bressler, Nona Sotoodehnia, Joshua S. Weinstock, Michael C. Honigberg, Daniel Nachun, Romit Bhattacharya, Gabriel K. Griffin, Varuna Chander, Richard A. Gibbs, Jerome I. Rotter, Chunyu Liu, Andrea A. Baccarelli, Daniel I. Chasman, Eric A. Whitsel, Douglas P. Kiel, Joanne M. Murabito, Eric Boerwinkle, Benjamin L. Ebert, Siddhartha Jaiswal, James S. Floyd, Alexander G. Bick, Christie M. Ballantyne, Bruce M. Psaty, Pradeep Natarajan, and Karen N. Conneely
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Multidisciplinary ,Humans ,General Physics and Astronomy ,Coronary Artery Disease ,General Chemistry ,Clonal Hematopoiesis ,DNA Methylation ,Hematopoietic Stem Cells ,General Biochemistry, Genetics and Molecular Biology ,Hematopoiesis - Abstract
Age-related changes to the genome-wide DNA methylation (DNAm) pattern observed in blood are well-documented. Clonal hematopoiesis of indeterminate potential (CHIP), characterized by the age-related acquisition and expansion of leukemogenic mutations in hematopoietic stem cells (HSCs), is associated with blood cancer and coronary artery disease (CAD). Epigenetic regulators DNMT3A and TET2 are the two most frequently mutated CHIP genes. Here, we present results from an epigenome-wide association study for CHIP in 582 Cardiovascular Health Study (CHS) participants, with replication in 2655 Atherosclerosis Risk in Communities (ARIC) Study participants. We show that DNMT3A and TET2 CHIP have distinct and directionally opposing genome-wide DNAm association patterns consistent with their regulatory roles, albeit both promoting self-renewal of HSCs. Mendelian randomization analyses indicate that a subset of DNAm alterations associated with these two leading CHIP genes may promote the risk for CAD.
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- 2022
14. Author response for 'High Bone Mass Disorders: New Insights from Connecting the Clinic and the Bench'
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null Dylan J.M. Bergen, null Antonio Maurizi, null Melissa M. Formosa, null Georgina L.K. McDonald, null Ahmed El‐Gazzar, null Neelam Hassan, null Maria‐Luisa Brandi, null José A. Riancho, null Fernando Rivadeneira, null Evangelia Ntzani, null Emma L. Duncan, null Celia L. Gregson, null Douglas P. Kiel, null M. Carola Zillikens, null Luca Sangiorgi, null Wolfgang Högler, null Ivan Duran, null Outi Mäkitie, null Wim Van Hul, and null Gretl Hendrickx
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- 2022
15. High Bone Mass Disorders: New Insights from Connecting the Clinic and the Bench
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Dylan J.M. Bergen, Antonio Maurizi, Melissa M. Formosa, Georgina L.K. McDonald, Ahmed El‐Gazzar, Neelam Hassan, Maria‐Luisa Brandi, José A. Riancho, Fernando Rivadeneira, Evangelia Ntzani, Emma L. Duncan, Celia L. Gregson, Douglas P. Kiel, M. Carola Zillikens, Luca Sangiorgi, Wolfgang Högler, Ivan Duran, Outi Mäkitie, Wim Van Hul, Gretl Hendrickx, and Universidad de Cantabria
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ANABOLICS ,Endocrinology, Diabetes and Metabolism ,CAUDAL FIN ,GENETIC ANIMAL MODELS ,ENZYME REPLACEMENT ,Osteoclasts ,Omics ,Endocrinology & Metabolism ,Rare Diseases/genetics ,SDG 3 - Good Health and Well-being ,OSTEOCYTES ,Orthopedics and Sports Medicine ,CELL ,DYSPLASIA ,Bone ,PARACRINE PATHWAYS ,IN-VIVO ,Science & Technology ,MUTATIONS ,Osteoblast ,Bones -- Diseases -- Genetic aspects ,Genomics ,RELATED TO BONE ,TISSUE SIGNALING ,SOST GENE ,DEFICIENCY ,Tissues ,DISEASES AND DISORDERS OF ,ANIMAL MODELS ,AUTOSOMAL-DOMINANT OSTEOPETROSIS ,THERAPEUTICS ,Human medicine ,Life Sciences & Biomedicine ,STEM-CELLS ,GENETIC RESEARCH - Abstract
Monogenic high bone mass (HBM) disorders are characterized by an increased amount of bone in general, or at specific sites in the skeleton. Here, we describe 59 HBM disorders with 50 known disease-causing genes from the literature, and we provide an overview of the signaling pathways and mechanisms involved in the pathogenesis of these disorders. Based on this, we classify the known HBM genes into HBM (sub)groups according to uniform Gene Ontology (GO) terminology. This classification system may aid in hypothesis generation, for both wet lab experimental design and clinical genetic screening strategies. We discuss how functional genomics can shape discovery of novel HBM genes and/or mechanisms in the future, through implementation of omics assessments in existing and future model systems. Finally, we address strategies to improve gene identification in unsolved HBM cases and highlight the importance for cross-laboratory collaborations encompassing multidisciplinary efforts to transfer knowledge generated at the bench to the clinic., peer-reviewed
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- 2022
16. Osteoporosis in the USA: prevention and unmet needs
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Sundeep, Khosla, Nicole C, Wright, Ann L, Elderkin, and Douglas P, Kiel
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Endocrinology ,Endocrinology, Diabetes and Metabolism ,Internal Medicine - Published
- 2023
17. Osteoporosis Medications Prevent Subsequent Fracture in Frail Older Adults
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Tanchanok Chattaris, Gahee Oh, Natalia A Gouskova, Dae Hyun Kim, Douglas P Kiel, and Sarah D Berry
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Bone Density Conservation Agents ,Frailty ,Endocrinology, Diabetes and Metabolism ,Frail Elderly ,Medicare ,United States ,Fractures, Bone ,Humans ,Osteoporosis ,Orthopedics and Sports Medicine ,Female ,Osteoporotic Fractures ,Aged ,Retrospective Studies - Abstract
Frailty is common in older adults with fractures. Osteoporosis medications reduce subsequent fracture, but limited data exist on medication efficacy in frail individuals. Our objective was to determine whether medications reduce the risk of subsequent fracture in frail, older adults. A retrospective cohort of Medicare fee-for-service beneficiaries was conducted (2014-2016). We included adults aged ≥65 years who were hospitalized with fractures without osteoporosis treatment. Pre-fracture frailty was defined using claims-based frailty index (≥0.2 = frail). Exposure to any osteoporosis treatment (oral or intravenous bisphosphonates, denosumab, and teriparatide) was ascertained using Part B and D claims and categorized according to the cumulative duration of exposure: none, 1-90 days, and 90 days. Subsequent fractures were ascertained from Part A or B claims. Cause-specific hazard models with time-varying exposure were fit to examine the association between treatment and fracture outcomes, controlling for relevant covariates. Among 29,904 patients hospitalized with fractures, 15,345 (51.3%) were frail, and 2148 (7.2%) received osteoporosis treatment (median treatment duration 183.0 days). Patients who received treatment were younger (80.2 versus 82.2 years), female (86.5% versus 73.0%), and less frail (0.20 versus 0.22) than patients without treatment. During follow-up, 5079 (17.0%) patients experienced a subsequent fracture. Treatment with osteoporosis medications for90 days compared with no treatment reduced the risk of fracture (hazard ratio [HR] = 0.82; 95% confidence interval [CI] 0.68-1.00) overall. Results were similar in frail (HR = 0.85; 95% CI 0.65-1.12) and non-frail (HR = 0.80; 95% CI 0.61-1.04) patients but not significant. In conclusion, osteoporosis treatment90 days was associated with similar trends in reduced risk of subsequent fracture in frail and non-frail persons. Treatment rates were very low, particularly among the frail. When weighing treatment options in frail older adults with hospitalized fractures, clinicians should be aware that drug therapy does not appear to lose its efficacy. © 2022 American Society for Bone and Mineral Research (ASBMR).
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- 2022
18. Author response for 'Osteoporosis Medications Prevent Subsequent Fracture in Frail Older Adults'
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null Tanchanok Chattaris, null Gahee Oh, null Natalia A Gouskova, null Dae Hyun Kim, null Douglas P Kiel, and null Sarah D Berry
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- 2022
19. Dairy Food Intake Is Not Associated With Frailty in Adults From the Framingham Heart Study
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Anna C. Siefkas, Courtney L. Millar, Alyssa B. Dufour, Douglas P. Kiel, Paul F. Jacques, Marian T. Hannan, and Shivani Sahni
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Nutrition and Dietetics ,General Medicine ,Food Science - Abstract
Nutrients, including protein, calcium, and fat may be associated with risk of frailty, yet specific contributions from whole dairy foods rich in these nutrients remain understudied.To determine associations between dairy intake (milk, yogurt, cheese, total (milk + yogurt + cheese), low-fat and high-fat dairy, and servings per week) and frailty onset and frailty phenotype components.Prospective cohort study. All dairy intake exposures (servings per week) were assessed via a food frequency questionnaire.Participants (aged 33 to 86 years) from the Framingham Offspring Study who were not frail at baseline (1998-2001) completed a food frequency questionnaire and had 1 or 2 follow-up frailty assessments (2005-2008 and 2011-2014) were included.Frailty was defined as the presence of ≥3 Fried frailty phenotype components: unintentional weight-loss, exhaustion, slowness (gait speed), weakness (grip strength), and low physical activity. Individuals with zero to two components were considered nonfrail.Repeated measures logistic regression estimated odds ratios and 95% CIs for frailty onset. Logistic (exhaustion and weight loss) and linear regression (gait speed, grip strength, and physical activity) estimated the association between baseline dairy intake and each frailty component at follow-up, adjusting for baseline values for age, sex, energy intake (residual analysis), current smoking, and multivitamin use. Models were further adjusted for health status in a secondary analysis.Mean baseline age ± SD was 61 ± 9 years (range = 33 to 87 years), and 54% were women. Of 2,550 nonfrail individuals at baseline, 8.8% (2005-2008) and 13.5% (2011-2014) became frail. Higher yogurt intake was associated with decreased odds of frailty (odds ratio 0.96, 95% CI 0.93 to 0.99; P = 0.02). Each additional serving of yogurt (β ± SE) .004 ± .001; P0.01) and low-fat dairy (β ± SE) .001 ± .0006; P = 0.04) was associated with significantly faster follow-up gait speed. Dietary intakes of high-fat dairy were associated with increased odds of frailty (odds ratio 1.02, 95% CI 1.00 to 1.04; P = 0.05), but the P value was of borderline significance. No associations were observed for other dairy foods. After adjusting for health status, the associations of high-fat dairy and yogurt with frailty became nonsignificant, although the magnitudes of the associations did not change. The association between yogurt and gait speed decreased in magnitude after adjusting for health status (β ± SE) .002 ± .001; P = 0.01).Dietary intakes of yogurt were modestly associated with reduced frailty onset and dietary intakes of high-fat dairy had a borderline association with increased odds of frailty, but other dairy food intakes showed no association in this study of healthy adults. Some dairy food intakes were modestly associated with follow-up gait speed. However, effect sizes were small, and the clinical importance of these associations remains undetermined.
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- 2023
20. Association of Abdominal Aortic Calcification with Peripheral Quantitative Computed Tomography Bone Measures in Older Women: The Perth Longitudinal Study of Ageing Women
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Jack Dalla Via, Marc Sim, John T. Schousboe, Douglas P. Kiel, Kun Zhu, Jonathan M. Hodgson, Abadi K. Gebre, Robin M. Daly, Richard L. Prince, and Joshua R. Lewis
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Aged, 80 and over ,Aging ,Tibia ,Endocrinology, Diabetes and Metabolism ,Radius ,Endocrinology ,Absorptiometry, Photon ,Bone Density ,Humans ,Orthopedics and Sports Medicine ,Calcium ,Female ,Longitudinal Studies ,Tomography, X-Ray Computed ,Aged - Abstract
We have previously shown that abdominal aortic calcification (AAC), a marker of advanced atherosclerotic disease, is weakly associated with reduced hip areal bone mineral density (aBMD). To better understand the vascular–bone health relationship, we explored this association with other key determinants of whole-bone strength and fracture risk at peripheral skeletal sites. This study examined associations of AAC with peripheral quantitative computed tomography (pQCT)-assessed total, cortical and trabecular volumetric BMD (vBMD), bone structure and strength of the radius and tibia among 648 community-dwelling older women (mean ± SD age 79.7 ± 2.5 years). We assessed associations between cross-sectional (2003) and longitudinal (progression from 1998/1999–2003) AAC assessed on lateral dual-energy X-ray absorptiometry (DXA) images with cross-sectional (2003) and longitudinal (change from 2003 to 2005) pQCT bone measures at the 4% radius and tibia, and 15% radius. Partial Spearman correlations (adjusted for age, BMI, calcium treatment) revealed no cross-sectional associations between AAC and any pQCT bone measures. AAC progression was not associated with any bone measure after adjusting for multiple comparisons, despite trends for inverse correlations with total bone area at the 4% radius (rs = − 0.088, p = 0.044), 4% tibia (rs = − 0.085, p = 0.052) and 15% radius (rs = − 0.101, p = 0.059). Neither AAC in 2003 nor AAC progression were associated with subsequent 2-year pQCT bone changes. ANCOVA showed no differences in bone measures between women with and without AAC or AAC progression, nor across categories of AAC extent. Collectively, these finding suggest that peripheral bone density and structure, or its changes with age, are not associated with central vascular calcification in older women.
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- 2022
21. Abdominal aortic calcification, bone mineral density and fractures: a systematic review and meta-analysis of observational studies
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Abadi K Gebre, Joshua R Lewis, Kevin Leow, Pawel Szulc, David Scott, Peter R Ebeling, Marc Sim, Germaine Wong, Wai H Lim, John T Schousboe, Douglas P Kiel, Richard L Prince, and Alexander J Rodríguez
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Aging ,Geriatrics and Gerontology - Abstract
Background Abdominal aortic calcification (AAC) has been inconsistently associated with skeletal health. We aimed to investigate the association of AAC with bone mineral density (BMD) and fracture risk by pooling the findings of observational studies. Methods MEDLINE, EMBASE, Web of Science, and Google Scholar were searched (August 2021). All clinical studies that assessed the association between AAC and BMD or fracture were included. AAC was categorized into any/advanced (all higher reported groups) versus no/less advanced (lowest reported group). Pooled standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CI) were determined for BMD and fracture, respectively, using random-effects models. Results Of 2 192 articles screened, 86 (61 553 participants) were included in the review, while 42 provided data for meta-analysis. AAC was associated with lower BMD at the total hip (SMD = −1.05 [95%CI: −1.47 to −0.63]; 16 studies), femoral neck (−0.25 [−0.46 to−0.04]; 10), and lumbar spine (−0.67 [−1.21 to −0.12]; 20). AAC was associated with a greater risk of any fracture (RR = 1.73 [95%CI: 1.48–2.02]; 27). AAC was also associated with vertebral, non-vertebral, and hip fractures. In dose–response analysis, the highest AAC group had greater risks of any, vertebral and non-vertebral fractures. Conclusions AAC is associated with lower BMD and increased fracture risk at multiple sites, underscoring the potential importance of vascular disease on skeletal health. Detection of AAC at the time of BMD testing may provide clinicians with prognostic information about bone health to enhance osteoporosis screening programs and fracture risk prediction.
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- 2022
22. Analysis of the associations between the human fecal microbiome and bone density, structure and strength: the MrOS cohort
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Eric S. Orwoll, Neeta Parimi, Jack Wiedrick, Jodi Lapidus, Nicola Napoli, Jeremy E. Wilkinson, Curtis Huttenhower, Lisa Langsetmo, and Douglas P. Kiel
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Tibia ,Microbiota ,Endocrinology, Diabetes and Metabolism ,Article ,Bone and Bones ,Gastrointestinal Microbiome ,Radius ,Absorptiometry, Photon ,Bone Density ,RNA, Ribosomal, 16S ,Humans ,Osteoporosis ,Orthopedics and Sports Medicine ,Osteoporotic Fractures ,Aged - Abstract
In preclinical models, the composition and function of the gut microbiota have been linked to bone growth and homeostasis, but there are few available data from studies of human populations. In a hypothesis-generating experiment in a large cohort of community-dwelling older men (n = 831; age range, 78-98 years), we explored the associations between fecal microbial profiles and bone density, microarchitecture, and strength measured with total hip dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HRpQCT) (distal radius, distal and diaphyseal tibia). Fecal samples were collected and the 16S rRNA gene V4 hypervariable region sequenced. Sequences were bioinformatically processed through the DADA2 pipeline and then taxonomically assigned using SILVA. Generalized linear models as implemented in microbiome multivariable association with linear models (MaAsLin 2) were used to test for associations between skeletal measures and specific microbial genera. The abundances of four bacterial genera were weakly associated with bone density, structure, or strength (false discovery rate [FDR] ≤ 0.05), and the measured directions of associations of genera were generally consistent across multiple bone measures, supporting a role for microbiota on skeletal homeostasis. However, the associated effect sizes were small (log2 fold change±0.35), limiting power to confidently identify these associations even with high resolution skeletal imaging phenotypes, and we assessed the resulting implications for the design of future cohort-based studies. As in analogous examples from genomewide association studies, we find that larger cohort sizes will likely be needed to confidently identify associations between the fecal microbiota and skeletal health relying on 16S sequencing. Our findings bolster the view that the gut microbiome is associated with clinically important measures of bone health, while also indicating the challenges in the design of cohort-based microbiome studies. © 2022 American Society for Bone and Mineral Research (ASBMR).
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- 2022
23. An online human blood transcript correlation browser for easy access to the blood cell interactome
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Kaare M. Gautvik, Daniel Sachse, Alexandra C. Hinton, Ole K. Olstad, Douglas P. Kiel, Yi-Hsiang Hsu, Tor P. Utheim, Christine W. Lary, and Sjur Reppe
- Abstract
Background Physical molecular interactions are the basis of intracellular signalling and gene regulatory networks, and comprehensive, accessible databases are needed for their discovery. Highly correlated transcripts may reflect important functional associations, but identification of such associations from primary data are cumbersome. Therefore, we have constructed a user-friendly online browser supporting identification of putative macromolecular interactions in human peripheral blood based on significant correlations at the transcriptional level. Methods The blood transcriptome was characterized by quantification of 17,328 RNA species, including ~341 mature microRNAs in 105 clinically well-characterized postmenopausal women. Intercorrelation of detected transcripts signal levels generated a matrix with >150 million correlations recognizing the human blood RNA interactome. The correlations with calculated adjusted p-values were made easily accessible by a freely available online browser. Results We document that significant transcript correlations within the giant matrix reflect experimentally documented interactions between select ubiquitous blood relevant transcription factors CREB1, GATA1, and the glucocorticoid receptor (GR, NR3C1). Their responsive genes recapitulated up to 91% of these as significant correlations, and were replicated in a separate cohort of 1204 individual blood samples from the Framingham Heart Study. Furthermore, experimentally documented mRNAs/miRNA associations were also reproduced in the matrix, and their predicted functional co-expression described. The blood transcript correlation browser is freely available at http://app.uio.no/med/klinmed/correlation-browser/blood/index.php and works on all commonly used internet browsers. Conclusions The matrix and web browser ought to be a valuable tool for easy access to the human blood transcriptome and molecular interactions documented as significant correlations at the RNA-level. This application should also be useful as a hypothesis generating tool for identification of regulatory mechanisms.
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- 2022
24. Bone Microarchitecture Phenotypes Identified in Older Adults Are Associated With Different Levels of Osteoporotic Fracture Risk
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Danielle E Whittier, Elizabeth J Samelson, Marian T Hannan, Lauren A Burt, David A Hanley, Emmanuel Biver, Pawel Szulc, Elisabeth Sornay‐Rendu, Blandine Merle, Roland Chapurlat, Eric Lespessailles, Andy Kin On Wong, David Goltzman, Sundeep Khosla, Serge Ferrari, Mary L Bouxsein, Douglas P Kiel, and Steven K Boyd
- Subjects
Male ,ddc:616 ,Fracture risk ,Endocrinology, Diabetes and Metabolism ,High-resolution peripheral computed tomography ,Bone and Bones ,Article ,Absorptiometry, Photon ,Phenotype ,Bone Density ,Machine learning ,Humans ,Osteoporosis ,Orthopedics and Sports Medicine ,Female ,Bone ,Osteoporotic Fractures ,Aged - Abstract
Prevalence of osteoporosis is more than 50% in older adults, yet current clinical methods for diagnosis that rely on areal bone mineral density (aBMD) fail to detect most individuals who have a fragility fracture. Bone fragility can manifest in different forms, and a "one-size-fits-all" approach to diagnosis and management of osteoporosis may not be suitable. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides additive information by capturing information about volumetric density and microarchitecture, but interpretation is challenging because of the complex interactions between the numerous properties measured. In this study, we propose that there are common combinations of bone properties, referred to as phenotypes, that are predisposed to different levels of fracture risk. Using HR-pQCT data from a multinational cohort (n = 5873, 71% female) between 40 and 96 years of age, we employed fuzzy c-means clustering, an unsupervised machine-learning method, to identify phenotypes of bone microarchitecture. Three clusters were identified, and using partial correlation analysis of HR-pQCT parameters, we characterized the clusters as low density, low volume, and healthy bone phenotypes. Most males were associated with the healthy bone phenotype, whereas females were more often associated with the low volume or low density bone phenotypes. Each phenotype had a significantly different cumulative hazard of major osteoporotic fracture (MOF) and of any incident osteoporotic fracture (p 0.05). After adjustment for covariates (cohort, sex, and age), the low density followed by the low volume phenotype had the highest association with MOF (hazard ratio = 2.96 and 2.35, respectively), and significant associations were maintained when additionally adjusted for femoral neck aBMD (hazard ratio = 1.69 and 1.90, respectively). Further, within each phenotype, different imaging biomarkers of fracture were identified. These findings suggest that osteoporotic fracture risk is associated with bone phenotypes that capture key features of bone deterioration that are not distinguishable by aBMD. © 2021 American Society for Bone and Mineral Research (ASBMR).
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- 2022
25. Defining terms commonly used in sarcopenia research : a glossary proposed by the Global Leadership in Sarcopenia (GLIS) Steering Committee
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Peggy M. Cawthon, Marjolein Visser, Hidenori Arai, José A. Ávila-Funes, Rocco Barazzoni, Shalender Bhasin, Ellen Binder, Olivier Bruyère, Tommy Cederholm, Liang-Kung Chen, Cyrus Cooper, Gustavo Duque, Roger A. Fielding, Jack Guralnik, Douglas P. Kiel, Ben Kirk, Francesco Landi, Avan A. Sayer, Stephan Von Haehling, Jean Woo, Alfonso J. Cruz-Jentoft, Nutrition and Health, APH - Societal Participation & Health, APH - Aging & Later Life, and APH - Health Behaviors & Chronic Diseases
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Sarcopenia ,SDG 3 - Good Health and Well-being ,Geriatrics ,Terminology as Topic ,Geriatrik ,Humans ,Muscle Strength ,GLIS ,Terminology ,Standardization - Abstract
Methods The aim of this paper is to define terms commonly related to sarcopenia to enable standardization of these terms in research and clinical settings. The Global Leadership Initiative in Sarcopenia (GLIS) aims to bring together leading investigators in sarcopenia research to develop a single definition that can be utilized worldwide; work on a global definition of sarcopenia is ongoing. The first step of GLIS is to develop the common terminology, or a glossary, that will facilitate agreement on a global definition of sarcopenia as well as interpretation of clinical and research findings. Results Several terms that are commonly used in sarcopenia research are defined, including self-reported measures of function and ability; objective physical performance tests; and measures related to muscle function and size. Conclusion As new methods and technologies are developed, these definitions may be expanded or refined over time. Our goal is to promote this common language to describe sarcopenia and its components in clinical and research settings in order to increase clinical awareness and research interest in this important condition. We hope that the use of common terminology in sarcopenia research will increase understanding of the concept and improve communication around this important age-related condition. Key summary points Aim The aim of this paper is to define terms commonly related to sarcopenia to enable standardization of these terms in research and clinical settings. Findings This paper provides definitions for commonly used terminology in sarcopenia in both clinical and research settings. As new methods and technologies are developed, this terminology may be expanded or refined over time. Message We hope that the use of common terminology in sarcopenia research will increase understanding of the concept and improve communication around this important age-related condition.
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- 2022
26. In silico discovery of blood cell macromolecular associations
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Kaare M. Gautvik, Daniel Sachse, Alexandra C. Hinton, Ole K. Olstad, Douglas P. Kiel, Yi-Hsiang Hsu, Tor P. Utheim, Christine W. Lary, and Sjur Reppe
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MicroRNAs ,Blood Cells ,Medisinske Fag: 700 [VDP] ,Sequence Analysis, RNA ,Genetics ,Humans ,Health Informatics ,Female ,Gene Regulatory Networks ,RNA, Messenger - Abstract
Background Physical molecular interactions are the basis of intracellular signalling and gene regulatory networks, and comprehensive, accessible databases are needed for their discovery. Highly correlated transcripts may reflect important functional associations, but identification of such associations from primary data are cumbersome. We have constructed and adapted a user-friendly web application to discover and identify putative macromolecular associations in human peripheral blood based on significant correlations at the transcriptional level. Methods The blood transcriptome was characterized by quantification of 17,328 RNA species, including 341 mature microRNAs in 105 clinically well-characterized postmenopausal women. Intercorrelation of detected transcripts signal levels generated a matrix with > 150 million correlations recognizing the human blood RNA interactome. The correlations with calculated adjusted p-values were made easily accessible by a novel web application. Results We found that significant transcript correlations within the giant matrix reflect experimentally documented interactions involving select ubiquitous blood relevant transcription factors (CREB1, GATA1, and the glucocorticoid receptor (GR, NR3C1)). Their responsive genes recapitulated up to 91% of these as significant correlations, and were replicated in an independent cohort of 1204 individual blood samples from the Framingham Heart Study. Furthermore, experimentally documented mRNAs/miRNA associations were also reproduced in the matrix, and their predicted functional co-expression described. The blood transcript web application is available at http://app.uio.no/med/klinmed/correlation-browser/blood/index.php and works on all commonly used internet browsers. Conclusions Using in silico analyses and a novel web application, we found that correlated blood transcripts across 105 postmenopausal women reflected experimentally proven molecular associations. Furthermore, the associations were reproduced in a much larger and more heterogeneous cohort and should therefore be generally representative. The web application lends itself to be a useful hypothesis generating tool for identification of regulatory mechanisms in complex biological data sets.
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- 2022
27. The Musculoskeletal Knowledge Portal: improving access to multi-omics data
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Noël P. Burtt, Douglas P. Kiel, Lynda F. Bonewald, and Jennifer J. Westendorf
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business.industry ,MEDLINE ,Genomics ,Data science ,Article ,Access to Information ,Rheumatology ,Research community ,Medicine ,Multi omics ,Humans ,Musculoskeletal Diseases ,business - Abstract
Built by and for the research community, the Musculoskeletal Knowledge Portal (MSK-KP) offers researchers a single integrated platform on which to display, access, distill and explore results from large genomic and epigenomic studies to formulate hypotheses and accelerate the development of patient-centered therapeutics for complex, multi-factorial conditions such as osteoarthritis.
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- 2022
28. Association of pro-inflammatory diet with frailty onset among adults with and without depressive symptoms: results from the Framingham Offspring Study
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Courtney L Millar, Alyssa B Dufour, James R Hebert, Nitin Shivappa, Olivia I Okereke, Douglas P Kiel, Marian T Hannan, and Shivani Sahni
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Aging ,Geriatrics and Gerontology - Abstract
Background Dietary inflammation is associated with increased risk of frailty. Those with depressive symptoms may be at higher risk of frailty onset because they typically have higher levels of inflammation. The study objective was to determine the association between a proinflammatory diet and frailty onset in those with and without clinically relevant depressive symptoms. Methods This prospective study included 1 701 nonfrail individuals with self-reported baseline (1998–2001) data available for the evaluation of energy-adjusted dietary inflammatory index (E-DIITM; calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiologic Studies Depression; CES-D), and follow-up frailty measurements (2011–2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria (i.e., slow gait, weak grip strength, unintentional weightloss, low physical activity, and self-reported exhaustion). Results are presented by baseline CES-D scores Results In all study participants, mean (SD) age was 58(8) years and E-DII was −1.95 (2.20; range: −6.71 to +5.40, higher scores denote a more proinflammatory diet), and 45% were male. In those without clinically relevant depressive symptoms, 1-unit higher E-DII score was associated with 14% increased odds (95% CI: 1.05–1.24) of frailty. In those with depressive symptoms, 1-unit higher E-DII score was associated with 55% increased odds of frailty (95% CI: 1.13–2.13). Conclusions The association between inflammatory diet and increased odds of frailty appeared somewhat stronger among those with depressive symptoms. This preliminary finding warrants further investigation.
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- 2021
29. Adherence to the Mediterranean-style diet and high intake of total carotenoids reduces the odds of frailty over 11 years in older adults: Results from the Framingham Offspring Study
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Courtney L Millar, Elise Costa, Paul F Jacques, Alyssa B Dufour, Douglas P Kiel, Marian T Hannan, and Shivani Sahni
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Male ,Original Research Communications ,Nutrition and Dietetics ,Frailty ,Medicine (miscellaneous) ,Humans ,Female ,Ascorbic Acid ,Prospective Studies ,Diet, Mediterranean ,Carotenoids - Abstract
BACKGROUND: The benefit of a Mediterranean-style diet in reducing frailty is not well established in older Americans. OBJECTIVES: We sought to determine associations of a Mediterranean-style dietary pattern and related antioxidants with frailty onset and worsening of the Fried phenotype in adults. METHODS: This prospective study included 2384 nonfrail adults from the Framingham Offspring Study with a Mediterranean-style dietary pattern score (MSDPS) and data on antioxidant intakes (vitamin C, E, and total carotenoids) estimated from an FFQ at the index examination (1998–2001) and 1 prior examination (if available), as well as a frailty assessment at the index examination and at least 1 follow-up. Frailty onset was defined as ≥3 of 5 Fried frailty phenotype criteria at follow-up and the worsening of the Fried frailty phenotype was defined as an increased number of frailty criteria over follow-up (yes or no). Logistic regression with generalized estimating equations estimated ORs and 95% CIs, adjusting for confounders. Analyses were stratified by age (
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- 2021
30. Correction to: Identification of Fall-Related Injuries in Nursing Home Residents Using Administrative Claims Data
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Joel Mintz, Matthew S Duprey, Andrew R Zullo, Yoojin Lee, Douglas P Kiel, Lori A Daiello, Kenneth E Rodriguez, Arjun K Venkatesh, and Sarah D Berry
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Aging ,Geriatrics and Gerontology - Published
- 2022
31. Impact of provision of abdominal aortic calcification results on fruit and vegetable intake: 12-week randomized phase 2 controlled trial
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Simone Radavelli-Bagatini, Catherine P. Bondonno, Jack Dalla Via, Marc Sim, Abadi K. Gebre, Lauren C. Blekkenhorst, Emma L. Connolly, Nicola P. Bondonno, John T. Schousboe, Richard J. Woodman, Kun Zhu, Shelby Mullin, Pawel Szulc, Ben Jackson, James Dimmock, Markus P. Schlaich, Kay L. Cox, Douglas P. Kiel, Wai H. Lim, Mandy Stanley, Amanda Devine, Peter L. Thompson, Evan J. Williams, Lisa G. Wood, Moira Sim, Robin M. Daly, Jonathan M. Hodgson, and Joshua R. Lewis
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Science - Abstract
Abstract Provision of non-invasive vascular imaging results to individuals has been shown to improve cardiovascular disease risk factor control: its impact on diet remains uncertain. In this two-arm, single-blind, parallel, 12-week randomized controlled trial, 240 participants, 57.5% females aged 60–80 y had abdominal aortic calcification and clinical assessments performed at a hospital clinic. Participants were randomized 1:1 to receive (intervention n = 121) or not (control n = 119) their calcification results. Both groups received educational resources on cardiovascular disease risk control and were unblinded to the intervention. Outcome measures were performed at baseline and 12 weeks. The primary outcomes of the study were changes in fruit and vegetable intake measures over 12 weeks assessed using plasma carotenoid concentrations (biomarkers of FV intake) and a food frequency questionnaire. Secondary outcomes included 12-week changes in other aspects of the diet, physical activity, body weight, blood pressure, heart rate, lipid profile, glucose concentrations, estimated cardiovascular disease risk score, and medication use. Between-group differences were tested using linear mixed-effects regression. There were no between-group differences in the primary outcomes at 12 weeks: plasma carotenoids (mean difference +0.03 µg/mL [95%CI −0.06, 0.13]) and fruit and vegetable intakes (+18 g/d [−37, 72]). However, the provision of calcification results led to between-group differences in serum total (−0.22 mmol/L [−0.41, −0.04]) and non-HDL (−0.19 mmol/L [−0.35, −0.03]) cholesterol, and estimated cardiovascular disease risk score (−0.24% [−0.47, −0.02]). No between-group differences were seen for other secondary outcomes. In this work, providing vascular imaging results did not improve diet but did improve some cardiovascular disease risk factors (Australian and New Zealand Clinical Trials Registry ACTRN12618001087246).
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- 2024
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32. Benefits and Harms of Standard Versus Reduced‐Dose Direct Oral Anticoagulant Therapy for Older Adults With Multiple Morbidities and Atrial Fibrillation
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Kaleen N. Hayes, Tingting Zhang, Dae Hyun Kim, Lori A. Daiello, Yoojin Lee, Douglas P. Kiel, Sarah D. Berry, and Andrew R. Zullo
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Editorials ,aging ,atrial fibrillation ,comparative effectiveness research ,factor Xa inhibitors ,frail elderly ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Dose reduction of direct oral anticoagulant (DOAC) medications is inconsistently applied to older adults with multiple morbidities, potentially due to perceived harms and unknown benefits of standard dosing. Methods and Results Using 2013 to 2017 US Medicare claims linked to Minimum Data Set records, we conducted a retrospective cohort study. We identified DOAC initiators (apixaban, dabigatran, rivaroxaban) aged ≥65 years with nonvalvular atrial fibrillation residing in a nursing home. We estimated inverse‐probability of treatment weights for DOAC dose using propensity scores. We examined safety (hospitalization for major bleeding) and effectiveness outcomes (all‐cause mortality, thrombosis [myocardial infarction, stroke, systemic embolism, venous thromboembolism]). We estimated hazard ratios (HRs) and 95% CIs using cause‐specific hazard‐regression models. Of 21 878 DOAC initiators, 48% received reduced dosing. The mean age of residents was 82.0 years, 66% were female, and 31% had moderate/severe cognitive impairment. After estimating inverse‐probability of treatment weights, standard dosing was associated with a higher rate of bleeding (HR, 1.18 [95% CI, 1.03–1.37]; 9.4 versus 8.0 events per 100 person‐years). Standard‐dose therapy was associated with the highest rates of bleeding among those aged >80 years (9.1 versus 6.7 events per 100 person‐years) and with a body mass index
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- 2023
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33. A two-cohort study on the association between the gut microbiota and bone density, microarchitecture, and strength
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Paul C. Okoro, Eric S. Orwoll, Curtis Huttenhower, Xochitl Morgan, Thomas M. Kuntz, Lauren J. McIver, Alyssa B. Dufour, Mary L. Bouxsein, Lisa Langsetmo, Samaneh Farsijani, Deborah M. Kado, Roberto Pacifici, Shivani Sahni, and Douglas P. Kiel
- Subjects
gut microbiome ,16S amplicon sequencing ,bone Density ,bone microarchitecture ,cohort study ,aging ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
The gut microbiome affects the inflammatory environment through effects on T-cells, which influence the production of immune mediators and inflammatory cytokines that stimulate osteoclastogenesis and bone loss in mice. However, there are few large human studies of the gut microbiome and skeletal health. We investigated the association between the human gut microbiome and high resolution peripheral quantitative computed tomography (HR-pQCT) scans of the radius and tibia in two large cohorts; Framingham Heart Study (FHS [n=1227, age range: 32 – 89]), and the Osteoporosis in Men Study (MrOS [n=836, age range: 78 – 98]). Stool samples from study participants underwent amplification and sequencing of the V4 hypervariable region of the 16S rRNA gene. The resulting 16S rRNA sequencing data were processed separately for each cohort, with the DADA2 pipeline incorporated in the16S bioBakery workflow. Resulting amplicon sequence variants were assigned taxonomies using the SILVA reference database. Controlling for multiple covariates, we tested for associations between microbial taxa abundances and HR-pQCT measures using general linear models as implemented in microbiome multivariable association with linear model (MaAslin2). Abundance of 37 microbial genera in FHS, and 4 genera in MrOS, were associated with various skeletal measures (false discovery rate [FDR] ≤ 0.1) including the association of DTU089 with bone measures, which was independently replicated in the two cohorts. A meta-analysis of the taxa-bone associations further revealed (FDR ≤ 0.25) that greater abundances of the genera; Akkermansia and DTU089, were associated with lower radius total vBMD, and tibia cortical vBMD respectively. Conversely, higher abundances of the genera; Lachnospiraceae NK4A136 group, and Faecalibacterium were associated with greater tibia cortical vBMD. We also investigated functional capabilities of microbial taxa by testing for associations between predicted (based on 16S rRNA amplicon sequence data) metabolic pathways abundance and bone phenotypes in each cohort. While there were no concordant functional associations observed in both cohorts, a meta-analysis revealed 8 pathways including the super-pathway of histidine, purine, and pyrimidine biosynthesis, associated with bone measures of the tibia cortical compartment. In conclusion, our findings suggest that there is a link between the gut microbiome and skeletal metabolism.
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- 2023
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34. Machine learning for abdominal aortic calcification assessment from bone density machine-derived lateral spine imagesResearch in context
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Naeha Sharif, Syed Zulqarnain Gilani, David Suter, Siobhan Reid, Pawel Szulc, Douglas Kimelman, Barret A. Monchka, Mohammad Jafari Jozani, Jonathan M. Hodgson, Marc Sim, Kun Zhu, Nicholas C. Harvey, Douglas P. Kiel, Richard L. Prince, John T. Schousboe, William D. Leslie, and Joshua R. Lewis
- Subjects
Vascular calcification ,Dual-energy X-ray absorptiometry ,Machine learning ,Aortovascular disease ,Cardiovascular disease ,Medicine ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Lateral spine images for vertebral fracture assessment can be easily obtained on modern bone density machines. Abdominal aortic calcification (AAC) can be scored on these images by trained imaging specialists to assess cardiovascular disease risk. However, this process is laborious and requires careful training. Methods: Training and testing of model performance of the convolutional neural network (CNN) algorithm for automated AAC-24 scoring utilised 5012 lateral spine images (2 manufacturers, 4 models of bone density machines), with trained imaging specialist AAC scores. Validation occurred in a registry-based cohort study of 8565 older men and women with images captured as part of routine clinical practice for fracture risk assessment. Cox proportional hazards models were used to estimate the association between machine-learning AAC (ML-AAC-24) scores with future incident Major Adverse Cardiovascular Events (MACE) that including death, hospitalised acute myocardial infarction or ischemic cerebrovascular disease ascertained from linked healthcare data. Findings: The average intraclass correlation coefficient between imaging specialist and ML-AAC-24 scores for 5012 images was 0.84 (95% CI 0.83, 0.84) with classification accuracy of 80% for established AAC groups. During a mean follow-up 4 years in the registry-based cohort, MACE outcomes were reported in 1177 people (13.7%). With increasing ML-AAC-24 scores there was an increasing proportion of people with MACE (low 7.9%, moderate 14.5%, high 21.2%), as well as individual MACE components (all p-trend
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- 2023
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35. Dairy food intake is not associated with spinal trabecular bone score in men and women: the Framingham Osteoporosis Study
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Courtney L. Millar, Douglas P. Kiel, Marian T. Hannan, and Shivani Sahni
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Trabecular bone score ,Dairy food ,Bone ,Older adults ,Nutrition. Foods and food supply ,TX341-641 ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background Previous studies reported that dairy foods are associated with higher areal bone mineral density (BMD) in older adults. However, data on bone texture are lacking. We determined the association of dairy food intake (milk, yogurt, cheese, milk + yogurt and milk + yogurt + cheese) with spinal trabecular bone score (TBS). Methods In this cross-sectional study, a validated semi-quantitative food frequency questionnaire was used to assess dairy food intake (servings/wk). TBS, an analysis of bone texture, was calculated from dual energy X-ray absorptiometry (DXA) scans. Sex-specific multivariable linear regression was used to estimate the association of dairy food intake (energy adjusted via residual methods) with each bone measure adjusting for covariates. Results Mean age of 4,740 participants was 49 (SD: 13) years and mean milk + yogurt + cheese intake was 10.1 (SD: 8.4) servings/week in men and 10.9 (SD: 8.0) servings/week in women. There were no associations between dairy food intake and spinal TBS in adjusted models. Conclusions In this cohort of primarily healthy adults, dairy intake was not associated with bone texture.
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- 2022
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36. Dairy Food Intake Is Not Associated with Measures of Bone Microarchitecture in Men and Women: The Framingham Osteoporosis Study
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Courtney L. Millar, Douglas P. Kiel, Marian T. Hannan, and Shivani Sahni
- Subjects
HR-pQCT ,dairy food ,bone ,older adults ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Previous studies reported that dairy foods are associated with higher areal bone mineral density (BMD) in older adults. However, data on bone strength and bone microarchitecture are lacking. We determined the association of dairy food intake (milk, yogurt, cheese, milk + yogurt, and milk + yogurt + cheese, servings/week) with high resolution peripheral quantitative computed tomography (HR-pQCT) measures of bone (failure load, cortical BMD, cortical thickness, trabecular BMD, and trabecular number). This cross-sectional study included participants with diet from a food frequency questionnaire (in 2005–2008 and/or 1998–2001) and measurements of cortical and trabecular BMD and microarchitecture at the distal tibia and radius (from HR-pQCT in 2012–2015). Sex-specific multivariable linear regression estimated the association of dairy food intake (energy adjusted) with each bone measure adjusting for covariates. Mean age was 64 (SD 8) years and total milk + yogurt + cheese intake was 10.0 (SD 6.6) and 10.6 (6.4) servings/week in men and women, respectively. No significant associations were observed for any of the dairy foods and bone microarchitecture measures except for cheese intake, which was inversely associated with cortical BMD at the radius (p = 0.001) and tibia (p = 0.002) in women alone. In this cohort of primarily healthy older men and women, dairy intake was not associated with bone microarchitecture. The findings related to cheese intake and bone microarchitecture in women warrant further investigation.
- Published
- 2021
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