Susan Birk

CHICAGO – Six months of growth hormone therapy significantly increased bone formation, vitamin D, and thigh muscle mass while decreasing abdominal fat in a study of women with abdominal obesity.

The randomized, double-blind, placebo-controlled trial was the first to explore the relationship between growth hormone levels and bone density in obese but otherwise healthy premenopausal women, Dr. Miriam A. Bredella of Massachusetts General Hospital and Harvard Medical School, Boston, said in at the meeting.

The study builds on work presented by Dr. Bredella at last year's Radiological Society of North America meeting showing an association between abdominal obesity and low bone mineral density in premenopausal women.

That study was the first to implicate abdominal fat as a risk factor for osteoporosis.

The study challenged previous research findings suggesting that increased weight protects against osteoporosis. Those previous studies focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat. Dr. Bredella's work zeroed in on visceral fat.

In the present study, 79 women with low growth hormone levels were randomized to receive low-dose growth hormone replacement therapy or placebo for 6 months. They had a mean age of 36 years and a mean body mass index of 35 kg/m

Subjects received MR spectroscopy to measure bone marrow fat and computed tomography to measure subcutaneous and visceral abdominal fat and thigh muscle mass at baseline and 6 months.

The participants were instructed not to change exercise regimens during the study and were monitored for changes in blood glucose.

One of the most surprising and important findings, according to Dr. Bredella, was that 32% of these obese but otherwise healthy young women were already osteopenic (T-score between −2.5 and −1) at baseline and that one had developed osteoporosis (T-score below −2.5).

“It's important that people become aware that obesity doesn't protect against bone loss,” she said.

Growth hormone was associated with increased P1NP (procollagen type 1 amino-terminal propeptide, a marker of bone formation) and CTX (carboxy-terminal collagen crosslinks, a marker of bone resorption), as well as increased vitamin D, thigh muscle mass, and decreased visceral and subcutaneous abdominal fat, compared with placebo, Dr. Bredella said.

Patients with the greatest abdominal fat loss had the greatest increases in bone formation.

Patients with the greatest increases in vitamin D also had the greatest increases in bone formation.

No statistically significant differences were found between the two groups in the more common side effects of growth hormone therapy, including edema of the hands and carpal tunnel syndrome.

“Overall, our patients didn't lose weight, but they had a redistribution of their body fat and muscle mass,” Dr. Bredella noted.

“They lost belly fat but increased their muscle mass, and because muscle is heavier than fat, their overall weight did not change,” she said.

Although the high cost of growth hormone replacement therapy would likely prohibit its widespread use as a treatment for obesity-related bone loss, the results of this study suggest new treatment possibilities.

“It's not going to be the magic therapy for obesity and bone loss, but it could help maybe someone who was unable to lose weight to lower their risk profile for diabetes and cardiovascular disease.”

However, growth hormone therapy “could be used in the aging population because we know as we get older, our growth hormone levels go down,” she added.

CHICAGO – Six months of growth hormone therapy significantly increased bone formation, vitamin D, and thigh muscle mass while decreasing abdominal fat in a study of women with abdominal obesity.

The randomized, double-blind, placebo-controlled trial was the first to explore the relationship between growth hormone levels and bone density in obese but otherwise healthy premenopausal women, Dr. Miriam A. Bredella of Massachusetts General Hospital and Harvard Medical School, Boston, said in at the meeting.

The study builds on work presented by Dr. Bredella at last year's Radiological Society of North America meeting showing an association between abdominal obesity and low bone mineral density in premenopausal women.

That study was the first to implicate abdominal fat as a risk factor for osteoporosis.

The study challenged previous research findings suggesting that increased weight protects against osteoporosis. Those previous studies focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat. Dr. Bredella's work zeroed in on visceral fat.

In the present study, 79 women with low growth hormone levels were randomized to receive low-dose growth hormone replacement therapy or placebo for 6 months. They had a mean age of 36 years and a mean body mass index of 35 kg/m

Subjects received MR spectroscopy to measure bone marrow fat and computed tomography to measure subcutaneous and visceral abdominal fat and thigh muscle mass at baseline and 6 months.

The participants were instructed not to change exercise regimens during the study and were monitored for changes in blood glucose.

One of the most surprising and important findings, according to Dr. Bredella, was that 32% of these obese but otherwise healthy young women were already osteopenic (T-score between −2.5 and −1) at baseline and that one had developed osteoporosis (T-score below −2.5).

“It's important that people become aware that obesity doesn't protect against bone loss,” she said.

Growth hormone was associated with increased P1NP (procollagen type 1 amino-terminal propeptide, a marker of bone formation) and CTX (carboxy-terminal collagen crosslinks, a marker of bone resorption), as well as increased vitamin D, thigh muscle mass, and decreased visceral and subcutaneous abdominal fat, compared with placebo, Dr. Bredella said.

Patients with the greatest abdominal fat loss had the greatest increases in bone formation.

Patients with the greatest increases in vitamin D also had the greatest increases in bone formation.

No statistically significant differences were found between the two groups in the more common side effects of growth hormone therapy, including edema of the hands and carpal tunnel syndrome.

“Overall, our patients didn't lose weight, but they had a redistribution of their body fat and muscle mass,” Dr. Bredella noted.

“They lost belly fat but increased their muscle mass, and because muscle is heavier than fat, their overall weight did not change,” she said.

Although the high cost of growth hormone replacement therapy would likely prohibit its widespread use as a treatment for obesity-related bone loss, the results of this study suggest new treatment possibilities.

“It's not going to be the magic therapy for obesity and bone loss, but it could help maybe someone who was unable to lose weight to lower their risk profile for diabetes and cardiovascular disease.”

However, growth hormone therapy “could be used in the aging population because we know as we get older, our growth hormone levels go down,” she added.

CHICAGO – Six months of growth hormone therapy significantly increased bone formation, vitamin D, and thigh muscle mass while decreasing abdominal fat in a study of women with abdominal obesity.

The randomized, double-blind, placebo-controlled trial was the first to explore the relationship between growth hormone levels and bone density in obese but otherwise healthy premenopausal women, Dr. Miriam A. Bredella of Massachusetts General Hospital and Harvard Medical School, Boston, said in at the meeting.

The study builds on work presented by Dr. Bredella at last year's Radiological Society of North America meeting showing an association between abdominal obesity and low bone mineral density in premenopausal women.

That study was the first to implicate abdominal fat as a risk factor for osteoporosis.

The study challenged previous research findings suggesting that increased weight protects against osteoporosis. Those previous studies focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat. Dr. Bredella's work zeroed in on visceral fat.

In the present study, 79 women with low growth hormone levels were randomized to receive low-dose growth hormone replacement therapy or placebo for 6 months. They had a mean age of 36 years and a mean body mass index of 35 kg/m

Subjects received MR spectroscopy to measure bone marrow fat and computed tomography to measure subcutaneous and visceral abdominal fat and thigh muscle mass at baseline and 6 months.

The participants were instructed not to change exercise regimens during the study and were monitored for changes in blood glucose.

One of the most surprising and important findings, according to Dr. Bredella, was that 32% of these obese but otherwise healthy young women were already osteopenic (T-score between −2.5 and −1) at baseline and that one had developed osteoporosis (T-score below −2.5).

“It's important that people become aware that obesity doesn't protect against bone loss,” she said.

Growth hormone was associated with increased P1NP (procollagen type 1 amino-terminal propeptide, a marker of bone formation) and CTX (carboxy-terminal collagen crosslinks, a marker of bone resorption), as well as increased vitamin D, thigh muscle mass, and decreased visceral and subcutaneous abdominal fat, compared with placebo, Dr. Bredella said.

Patients with the greatest abdominal fat loss had the greatest increases in bone formation.

Patients with the greatest increases in vitamin D also had the greatest increases in bone formation.

No statistically significant differences were found between the two groups in the more common side effects of growth hormone therapy, including edema of the hands and carpal tunnel syndrome.

“Overall, our patients didn't lose weight, but they had a redistribution of their body fat and muscle mass,” Dr. Bredella noted.

“They lost belly fat but increased their muscle mass, and because muscle is heavier than fat, their overall weight did not change,” she said.

Although the high cost of growth hormone replacement therapy would likely prohibit its widespread use as a treatment for obesity-related bone loss, the results of this study suggest new treatment possibilities.

“It's not going to be the magic therapy for obesity and bone loss, but it could help maybe someone who was unable to lose weight to lower their risk profile for diabetes and cardiovascular disease.”

However, growth hormone therapy “could be used in the aging population because we know as we get older, our growth hormone levels go down,” she added.

CHICAGO – Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.

The diet eliminated insulin dependence in all patients during treatment. After returning to a normal diet, approximately 75% of patients remained insulin free at 18 months, reported Dr. Sebastiaan [ammer ht Leiden (the Netherlands) University Medical Center.

The finding underscores the value of lifestyle interventions as a tool for diabetes management, Dr. Hammer said in a press briefing at the meeting.

The reductions in pericardial fat also persisted at 18 months from baseline – more than a year after patients had resumed their normal eating habits, Dr. Hammer said. These improvements were sustained even in patients who regained weight that had been lost during the 4-month period of caloric restriction.

Dr. Hammer and his colleagues analyzed changes in cardiac function, pericardial fat, and body mass index (BMI) using cardiac magnetic resonance imaging in eight men and seven women with obesity-related type 2 diabetes. At the beginning of the study, all patients had a BMI greater than 30 kg/m

Insulin treatment was stopped at baseline. Patients consumed a standardized, low-carbohydrate, 500-calorie/day diet for 4 months and were monitored weekly for blood glucose level and weight loss. At months 4 through 6, patients were gradually reintroduced to normal caloric intake. For the following 12 months, patients received treatment by their own physicians. Dr. Hammer and his colleagues performed cardiac MRI on all patients at baseline, 4 months, and 18 months.

Caloric restriction resulted in a decrease in mean BMI from 35.3 to 27.5 over a period of 4 months. Pericardial fat decreased from a mean of 39 mL to 31 mL.

The researchers also quantified the elasticity of the left ventricle by quantifying blood flow across the valve between the left atrium and the left ventricle, using the ratio between the early filling phase (vessel filling phase) and the atrial filling phase as a measure of diastolic heart function. The mean E/A ratio improved from 0.96 to 1.2.

Dr. Hammer noted recent findings that “the fat around the heart is not an inert adipose tissue compartment, but it is metabolically active, it is associated with coronary plaque formation, and it may be associated with cardiac dysfunction in patients with diabetes.”

Pericardial fat shows promise as a marker for cardiac risk in patients with type 2 diabetes because it can be quantified using standard MRI, he said.

Although the patients in this study were obese and insulin dependent at baseline, none had cardiac disease, kidney disease, or other diabetic complications, he noted. “We are also testing if this strategy works in patients who do have some cardiac complaints,” Dr. Hammer said.

Dr. Hammer said he had no relevant financial disclosures.

Transverse abdominal MRI shows subcutaneous and intra-abdominal fat for a typical patient before (a) and after 4 months of caloric restriction (b).

Source Courtesy RSNA

CHICAGO – Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.

The diet eliminated insulin dependence in all patients during treatment. After returning to a normal diet, approximately 75% of patients remained insulin free at 18 months, reported Dr. Sebastiaan [ammer ht Leiden (the Netherlands) University Medical Center.

The finding underscores the value of lifestyle interventions as a tool for diabetes management, Dr. Hammer said in a press briefing at the meeting.

The reductions in pericardial fat also persisted at 18 months from baseline – more than a year after patients had resumed their normal eating habits, Dr. Hammer said. These improvements were sustained even in patients who regained weight that had been lost during the 4-month period of caloric restriction.

Dr. Hammer and his colleagues analyzed changes in cardiac function, pericardial fat, and body mass index (BMI) using cardiac magnetic resonance imaging in eight men and seven women with obesity-related type 2 diabetes. At the beginning of the study, all patients had a BMI greater than 30 kg/m

Insulin treatment was stopped at baseline. Patients consumed a standardized, low-carbohydrate, 500-calorie/day diet for 4 months and were monitored weekly for blood glucose level and weight loss. At months 4 through 6, patients were gradually reintroduced to normal caloric intake. For the following 12 months, patients received treatment by their own physicians. Dr. Hammer and his colleagues performed cardiac MRI on all patients at baseline, 4 months, and 18 months.

Caloric restriction resulted in a decrease in mean BMI from 35.3 to 27.5 over a period of 4 months. Pericardial fat decreased from a mean of 39 mL to 31 mL.

The researchers also quantified the elasticity of the left ventricle by quantifying blood flow across the valve between the left atrium and the left ventricle, using the ratio between the early filling phase (vessel filling phase) and the atrial filling phase as a measure of diastolic heart function. The mean E/A ratio improved from 0.96 to 1.2.

Dr. Hammer noted recent findings that “the fat around the heart is not an inert adipose tissue compartment, but it is metabolically active, it is associated with coronary plaque formation, and it may be associated with cardiac dysfunction in patients with diabetes.”

Pericardial fat shows promise as a marker for cardiac risk in patients with type 2 diabetes because it can be quantified using standard MRI, he said.

Although the patients in this study were obese and insulin dependent at baseline, none had cardiac disease, kidney disease, or other diabetic complications, he noted. “We are also testing if this strategy works in patients who do have some cardiac complaints,” Dr. Hammer said.

Dr. Hammer said he had no relevant financial disclosures.

Transverse abdominal MRI shows subcutaneous and intra-abdominal fat for a typical patient before (a) and after 4 months of caloric restriction (b).

Source Courtesy RSNA

CHICAGO – Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.

The diet eliminated insulin dependence in all patients during treatment. After returning to a normal diet, approximately 75% of patients remained insulin free at 18 months, reported Dr. Sebastiaan [ammer ht Leiden (the Netherlands) University Medical Center.

The finding underscores the value of lifestyle interventions as a tool for diabetes management, Dr. Hammer said in a press briefing at the meeting.

The reductions in pericardial fat also persisted at 18 months from baseline – more than a year after patients had resumed their normal eating habits, Dr. Hammer said. These improvements were sustained even in patients who regained weight that had been lost during the 4-month period of caloric restriction.

Dr. Hammer and his colleagues analyzed changes in cardiac function, pericardial fat, and body mass index (BMI) using cardiac magnetic resonance imaging in eight men and seven women with obesity-related type 2 diabetes. At the beginning of the study, all patients had a BMI greater than 30 kg/m

Insulin treatment was stopped at baseline. Patients consumed a standardized, low-carbohydrate, 500-calorie/day diet for 4 months and were monitored weekly for blood glucose level and weight loss. At months 4 through 6, patients were gradually reintroduced to normal caloric intake. For the following 12 months, patients received treatment by their own physicians. Dr. Hammer and his colleagues performed cardiac MRI on all patients at baseline, 4 months, and 18 months.

Caloric restriction resulted in a decrease in mean BMI from 35.3 to 27.5 over a period of 4 months. Pericardial fat decreased from a mean of 39 mL to 31 mL.

The researchers also quantified the elasticity of the left ventricle by quantifying blood flow across the valve between the left atrium and the left ventricle, using the ratio between the early filling phase (vessel filling phase) and the atrial filling phase as a measure of diastolic heart function. The mean E/A ratio improved from 0.96 to 1.2.

Dr. Hammer noted recent findings that “the fat around the heart is not an inert adipose tissue compartment, but it is metabolically active, it is associated with coronary plaque formation, and it may be associated with cardiac dysfunction in patients with diabetes.”

Pericardial fat shows promise as a marker for cardiac risk in patients with type 2 diabetes because it can be quantified using standard MRI, he said.

Although the patients in this study were obese and insulin dependent at baseline, none had cardiac disease, kidney disease, or other diabetic complications, he noted. “We are also testing if this strategy works in patients who do have some cardiac complaints,” Dr. Hammer said.

Dr. Hammer said he had no relevant financial disclosures.

Transverse abdominal MRI shows subcutaneous and intra-abdominal fat for a typical patient before (a) and after 4 months of caloric restriction (b).

Source Courtesy RSNA

CHICAGO – One week of violent video game play produced significant changes in brain function, a small study of men aged 18-28 shows.

Violent video games were associated with reduced activity in regions of the brain involved in attention, inhibition, and monitoring of emotions, Dr. Vincent P. Mathews, of Indiana University reported.

Courtesy Indiana University Center for Neuroimaging

The study is one of the first to document the effects of violent video games on brain activity, Dr. Mathews said in a press briefing at the annual meeting of the Radiological Society of North America.

Although numerous behavioral studies have shown a correlation between violent video games and increased aggression, few neuroimaging studies have been done, said Dr. Mathews, of the Northwest Radiology Network in Indianapolis. Gathering that neurophysiologic data is important, because researchers believe the active role-playing involved in violent video games might make them more harmful than violent television shows or movies, he said.

The detrimental effects of violent video games described in behavioral studies include desensitization to violence; observational learning, in which repeated exposure to violent behavior is rewarded and aggressive behavior becomes encoded as appropriate; an increasingly hostile view of the world; and behavioral and cognitive scripts that might counteract positive environmental influences and in which violence can come to be seen as acceptable or even necessary.

Recent work by Dr. Mathews and his colleagues demonstrated the short-term effects of violent video games on brain function in adolescents. Functional magnetic resonance imaging (fMRI) revealed decreased activity in areas of the brain involved in inhibition and attention after 30 minutes of game time.

"In this study we wanted to look at longer-term violent video game play and its potential to alter brain function," Dr. Mathews said.

For the study, 28 young men, none of whom were heavy video game players, were randomized to experimental and control groups. The groups did not differ significantly in age, IQ, or video game experience.

Subjects in the video game group were given a computer loaded with a first-person shooter video game (industry-rated for mature audiences) for home use and were asked to play the game 2 hours daily for 1 week, followed by 1 week of no game play. Subjects averaged a total of 10 hours of game time. The control group refrained from video games throughout the study period.

Functional MRI was performed on all subjects at baseline, 1 week, and 2 weeks. Subjects performed two Stroop psychological tests: an emotional task and a counting task. The emotional task required participants to name the color of words in a series, which included both neutral (run, walk) and emotional (hit, kill) words. Emotionally charged words have been shown to produce a subconscious interference effect that results in a delayed response.

The counting task required subjects to view number words (two, three) and respond with the number of visual stimuli presented, not the words themselves (for example, the correct response to the word "three" shown twice would be "two"). This task also is designed to produce an interference effect.

Dr. Mathews and his colleagues looked specifically at changes in the dorsolateral prefrontal cortex, the area of the brain known to be most highly activated by the interference effect and an area involved in emotional modulation and inhibition, and the anterior cingulate cortex, which is involved in attention.

Statistical maps showed that brain activation in these regions remained unchanged in the nongame group from baseline to week 1 and week 2. Brain activation in the video game group did not differ significantly from the nongame group at baseline.

However, activation decreased significantly in the video game group, compared with the nongame group, after 1 week of daily violent video game playing. Activation in this group returned almost to baseline at week 2 after 1 week of no game playing. Maps of brain activation also showed significant differences in the video game group between baseline and week 1 and between weeks 1 and 2.

"What we’re seeing is that there’s a decrease in normal blood flow to that area after a week of playing violent games," Dr. Mathews said.

"Because the groups were randomly assigned and didn’t have any significant differences in their demographics, the differences can be assumed to be a result of the violent video game playing," he said. "Our results may be an explanation for these behavioral studies that show increased aggressive behavior following violent video games. So this actually is a physiologic explanation for what others have previously measured in behavioral studies."

This study was supported by the Center for Successful Parenting, a group that seeks to help parents understand the consequences of "children watching video violence." Dr. Mathews had no disclosures.

CHICAGO – One week of violent video game play produced significant changes in brain function, a small study of men aged 18-28 shows.

Violent video games were associated with reduced activity in regions of the brain involved in attention, inhibition, and monitoring of emotions, Dr. Vincent P. Mathews, of Indiana University reported.

Courtesy Indiana University Center for Neuroimaging

The study is one of the first to document the effects of violent video games on brain activity, Dr. Mathews said in a press briefing at the annual meeting of the Radiological Society of North America.

Although numerous behavioral studies have shown a correlation between violent video games and increased aggression, few neuroimaging studies have been done, said Dr. Mathews, of the Northwest Radiology Network in Indianapolis. Gathering that neurophysiologic data is important, because researchers believe the active role-playing involved in violent video games might make them more harmful than violent television shows or movies, he said.

The detrimental effects of violent video games described in behavioral studies include desensitization to violence; observational learning, in which repeated exposure to violent behavior is rewarded and aggressive behavior becomes encoded as appropriate; an increasingly hostile view of the world; and behavioral and cognitive scripts that might counteract positive environmental influences and in which violence can come to be seen as acceptable or even necessary.

Recent work by Dr. Mathews and his colleagues demonstrated the short-term effects of violent video games on brain function in adolescents. Functional magnetic resonance imaging (fMRI) revealed decreased activity in areas of the brain involved in inhibition and attention after 30 minutes of game time.

"In this study we wanted to look at longer-term violent video game play and its potential to alter brain function," Dr. Mathews said.

For the study, 28 young men, none of whom were heavy video game players, were randomized to experimental and control groups. The groups did not differ significantly in age, IQ, or video game experience.

Subjects in the video game group were given a computer loaded with a first-person shooter video game (industry-rated for mature audiences) for home use and were asked to play the game 2 hours daily for 1 week, followed by 1 week of no game play. Subjects averaged a total of 10 hours of game time. The control group refrained from video games throughout the study period.

Functional MRI was performed on all subjects at baseline, 1 week, and 2 weeks. Subjects performed two Stroop psychological tests: an emotional task and a counting task. The emotional task required participants to name the color of words in a series, which included both neutral (run, walk) and emotional (hit, kill) words. Emotionally charged words have been shown to produce a subconscious interference effect that results in a delayed response.

The counting task required subjects to view number words (two, three) and respond with the number of visual stimuli presented, not the words themselves (for example, the correct response to the word "three" shown twice would be "two"). This task also is designed to produce an interference effect.

Dr. Mathews and his colleagues looked specifically at changes in the dorsolateral prefrontal cortex, the area of the brain known to be most highly activated by the interference effect and an area involved in emotional modulation and inhibition, and the anterior cingulate cortex, which is involved in attention.

Statistical maps showed that brain activation in these regions remained unchanged in the nongame group from baseline to week 1 and week 2. Brain activation in the video game group did not differ significantly from the nongame group at baseline.

However, activation decreased significantly in the video game group, compared with the nongame group, after 1 week of daily violent video game playing. Activation in this group returned almost to baseline at week 2 after 1 week of no game playing. Maps of brain activation also showed significant differences in the video game group between baseline and week 1 and between weeks 1 and 2.

"What we’re seeing is that there’s a decrease in normal blood flow to that area after a week of playing violent games," Dr. Mathews said.

"Because the groups were randomly assigned and didn’t have any significant differences in their demographics, the differences can be assumed to be a result of the violent video game playing," he said. "Our results may be an explanation for these behavioral studies that show increased aggressive behavior following violent video games. So this actually is a physiologic explanation for what others have previously measured in behavioral studies."

This study was supported by the Center for Successful Parenting, a group that seeks to help parents understand the consequences of "children watching video violence." Dr. Mathews had no disclosures.

CHICAGO – One week of violent video game play produced significant changes in brain function, a small study of men aged 18-28 shows.

Violent video games were associated with reduced activity in regions of the brain involved in attention, inhibition, and monitoring of emotions, Dr. Vincent P. Mathews, of Indiana University reported.

Courtesy Indiana University Center for Neuroimaging

The study is one of the first to document the effects of violent video games on brain activity, Dr. Mathews said in a press briefing at the annual meeting of the Radiological Society of North America.

Although numerous behavioral studies have shown a correlation between violent video games and increased aggression, few neuroimaging studies have been done, said Dr. Mathews, of the Northwest Radiology Network in Indianapolis. Gathering that neurophysiologic data is important, because researchers believe the active role-playing involved in violent video games might make them more harmful than violent television shows or movies, he said.

The detrimental effects of violent video games described in behavioral studies include desensitization to violence; observational learning, in which repeated exposure to violent behavior is rewarded and aggressive behavior becomes encoded as appropriate; an increasingly hostile view of the world; and behavioral and cognitive scripts that might counteract positive environmental influences and in which violence can come to be seen as acceptable or even necessary.

Recent work by Dr. Mathews and his colleagues demonstrated the short-term effects of violent video games on brain function in adolescents. Functional magnetic resonance imaging (fMRI) revealed decreased activity in areas of the brain involved in inhibition and attention after 30 minutes of game time.

"In this study we wanted to look at longer-term violent video game play and its potential to alter brain function," Dr. Mathews said.

For the study, 28 young men, none of whom were heavy video game players, were randomized to experimental and control groups. The groups did not differ significantly in age, IQ, or video game experience.

Subjects in the video game group were given a computer loaded with a first-person shooter video game (industry-rated for mature audiences) for home use and were asked to play the game 2 hours daily for 1 week, followed by 1 week of no game play. Subjects averaged a total of 10 hours of game time. The control group refrained from video games throughout the study period.

Functional MRI was performed on all subjects at baseline, 1 week, and 2 weeks. Subjects performed two Stroop psychological tests: an emotional task and a counting task. The emotional task required participants to name the color of words in a series, which included both neutral (run, walk) and emotional (hit, kill) words. Emotionally charged words have been shown to produce a subconscious interference effect that results in a delayed response.

The counting task required subjects to view number words (two, three) and respond with the number of visual stimuli presented, not the words themselves (for example, the correct response to the word "three" shown twice would be "two"). This task also is designed to produce an interference effect.

Dr. Mathews and his colleagues looked specifically at changes in the dorsolateral prefrontal cortex, the area of the brain known to be most highly activated by the interference effect and an area involved in emotional modulation and inhibition, and the anterior cingulate cortex, which is involved in attention.

Statistical maps showed that brain activation in these regions remained unchanged in the nongame group from baseline to week 1 and week 2. Brain activation in the video game group did not differ significantly from the nongame group at baseline.

However, activation decreased significantly in the video game group, compared with the nongame group, after 1 week of daily violent video game playing. Activation in this group returned almost to baseline at week 2 after 1 week of no game playing. Maps of brain activation also showed significant differences in the video game group between baseline and week 1 and between weeks 1 and 2.

"What we’re seeing is that there’s a decrease in normal blood flow to that area after a week of playing violent games," Dr. Mathews said.

"Because the groups were randomly assigned and didn’t have any significant differences in their demographics, the differences can be assumed to be a result of the violent video game playing," he said. "Our results may be an explanation for these behavioral studies that show increased aggressive behavior following violent video games. So this actually is a physiologic explanation for what others have previously measured in behavioral studies."

This study was supported by the Center for Successful Parenting, a group that seeks to help parents understand the consequences of "children watching video violence." Dr. Mathews had no disclosures.

Family history data support annual mammograms in 40s

Women aged 40–49 years with and without a family history of breast cancer had almost the same rates of invasive disease in a retrospective analysis of data on more than 1,000 patients diagnosed over a 10-year period at a single site.

The finding adds weight to the American Cancer Society’s recommendation in favor of annual screening mammograms for women beginning at age 40, said principal author Dr. Stamatia V. Destounis of Elizabeth Wende Breast Care LLC in Rochester, NY. Dr. Destounis presented the results of her study in a press briefing.

A study presented at last year’s meeting by researchers at the London Breast Institute of the Princess Grace Hospital indicated that annual mammograms could reduce by half the risk of mastectomy in women who were diagnosed with breast cancer between the ages of 40 and 50 years.

Both studies challenge the recommendation against routine annual mammography for women under the age of 50 made in 2009 by the US Preventive Services Task Force. ...

* For a PDF of the full article, click in the link to the left of this introduction.

Family history data support annual mammograms in 40s

Women aged 40–49 years with and without a family history of breast cancer had almost the same rates of invasive disease in a retrospective analysis of data on more than 1,000 patients diagnosed over a 10-year period at a single site.

The finding adds weight to the American Cancer Society’s recommendation in favor of annual screening mammograms for women beginning at age 40, said principal author Dr. Stamatia V. Destounis of Elizabeth Wende Breast Care LLC in Rochester, NY. Dr. Destounis presented the results of her study in a press briefing.

A study presented at last year’s meeting by researchers at the London Breast Institute of the Princess Grace Hospital indicated that annual mammograms could reduce by half the risk of mastectomy in women who were diagnosed with breast cancer between the ages of 40 and 50 years.

Both studies challenge the recommendation against routine annual mammography for women under the age of 50 made in 2009 by the US Preventive Services Task Force. ...

* For a PDF of the full article, click in the link to the left of this introduction.

Family history data support annual mammograms in 40s

Women aged 40–49 years with and without a family history of breast cancer had almost the same rates of invasive disease in a retrospective analysis of data on more than 1,000 patients diagnosed over a 10-year period at a single site.

The finding adds weight to the American Cancer Society’s recommendation in favor of annual screening mammograms for women beginning at age 40, said principal author Dr. Stamatia V. Destounis of Elizabeth Wende Breast Care LLC in Rochester, NY. Dr. Destounis presented the results of her study in a press briefing.

A study presented at last year’s meeting by researchers at the London Breast Institute of the Princess Grace Hospital indicated that annual mammograms could reduce by half the risk of mastectomy in women who were diagnosed with breast cancer between the ages of 40 and 50 years.

Both studies challenge the recommendation against routine annual mammography for women under the age of 50 made in 2009 by the US Preventive Services Task Force. ...

* For a PDF of the full article, click in the link to the left of this introduction.

CHICAGO – Consumption of baked or broiled fish on a weekly basis improved brain health and significantly reduced the risk of mild cognitive impairment and Alzheimer’s disease in a 20-year longitudinal study of older adults presented at the annual meeting of the Radiological Society of North America.

Fish consumption improved brain volume in the frontal lobes, temporal lobes (including the hippocampus) and posterior cingulate gyrus, as shown on high-resolution, three-dimensional volumetric magnetic resonance imaging (MRI). "That’s important because these are areas of the brain that are responsible for memory and learning and are severely affected by Alzheimer’s disease," reported Dr. Cyrus A. Raji of the University of Pittsburgh.

Dr. Raji and his colleagues analyzed data collected at three time points from the ongoing Cardiovascular Health Study-Cognition Study. In 1989-1990, 260 subjects (mean age 71 years) completed standardized diet questionnaires. In 1998-1999, these individuals (mean age 78 years) underwent volumetric MRI.

An analysis of clinical conversion to mild cognitive impairment (MCI) or Alzheimer’s disease (AD) in 2002 among study participants (mean age 82 years) found that individuals with larger brain volumes as a result of weekly baked or broiled fish consumption had a greatly reduced incidence of MCI or AD, compared with individuals who did not eat fish regularly.

Clinical conversion rates to MCI or AD were 30.8% for non–fish eaters, compared with 8% for individuals whose brains benefited partially from fish consumption (as shown on volumetric MRI), and 3.2% for individuals whose brains benefited fully from fish consumption.

These findings indicate "a large reduction in the risk for developing AD or MCI as a result of consuming baked or broiled fish," Dr. Raji said

The benefits of regular fish intake persisted even after accounting for such potential confounding variables as age, gender, head size, and cerebrovascular disease.

Study participants who were not fish eaters and who showed atrophy in the hippocampus – the region most frequently affected by AD – had a 47% incidence of MCI or AD, compared with only 28% of fish eaters with larger hippocampal volumes, he reported.

In addition, mean scores on cognitive tests of working memory were significantly higher (P less than .05) in individuals who ate fish weekly compared with those who did not. The improvement remained even after accounting for potential confounders such as age, gender, and education.

The researchers also looked at cognitive test scores and brain volumes and found a relationship between larger frontal lobe volumes in fish eaters and higher working memory test scores. "This makes a lot of sense, because the frontal lobes are responsible for working memory function," Dr. Raji said.

The reduced risk of MCI and AD among fish eaters in this study probably stems from the protective benefits of omega-3 fatty acids, he noted. Omega-3 fatty acids are believed to increase blood flow to the brain, act as antioxidants and anti-inflammatories, and prevent the accumulation of the amyloid plaques characteristic of AD. Consumption of fried fish, which is high in cholesterol and low in omega-3 fatty acids, did not confer any benefits.

Data presented by Dr. Raji at last year’s meeting of the Radiological Society of North America (Internal Medicine News, Dec. 20, 2010) showed the protective benefits of physical activity in preserving brain volume and reducing the risk of AD and MCI in the same cohort. "What we’re adding to the picture this year is specific information on diet," he said. "The long-term goal of this research is to incorporate our understanding of all the various lifestyle factors that could reduce risk and give us a unified picture of how to best prevent the disease."

Dr. Raji had no disclosures related to this study.

CHICAGO – Consumption of baked or broiled fish on a weekly basis improved brain health and significantly reduced the risk of mild cognitive impairment and Alzheimer’s disease in a 20-year longitudinal study of older adults presented at the annual meeting of the Radiological Society of North America.

Fish consumption improved brain volume in the frontal lobes, temporal lobes (including the hippocampus) and posterior cingulate gyrus, as shown on high-resolution, three-dimensional volumetric magnetic resonance imaging (MRI). "That’s important because these are areas of the brain that are responsible for memory and learning and are severely affected by Alzheimer’s disease," reported Dr. Cyrus A. Raji of the University of Pittsburgh.

Dr. Raji and his colleagues analyzed data collected at three time points from the ongoing Cardiovascular Health Study-Cognition Study. In 1989-1990, 260 subjects (mean age 71 years) completed standardized diet questionnaires. In 1998-1999, these individuals (mean age 78 years) underwent volumetric MRI.

An analysis of clinical conversion to mild cognitive impairment (MCI) or Alzheimer’s disease (AD) in 2002 among study participants (mean age 82 years) found that individuals with larger brain volumes as a result of weekly baked or broiled fish consumption had a greatly reduced incidence of MCI or AD, compared with individuals who did not eat fish regularly.

Clinical conversion rates to MCI or AD were 30.8% for non–fish eaters, compared with 8% for individuals whose brains benefited partially from fish consumption (as shown on volumetric MRI), and 3.2% for individuals whose brains benefited fully from fish consumption.

These findings indicate "a large reduction in the risk for developing AD or MCI as a result of consuming baked or broiled fish," Dr. Raji said

The benefits of regular fish intake persisted even after accounting for such potential confounding variables as age, gender, head size, and cerebrovascular disease.

Study participants who were not fish eaters and who showed atrophy in the hippocampus – the region most frequently affected by AD – had a 47% incidence of MCI or AD, compared with only 28% of fish eaters with larger hippocampal volumes, he reported.

In addition, mean scores on cognitive tests of working memory were significantly higher (P less than .05) in individuals who ate fish weekly compared with those who did not. The improvement remained even after accounting for potential confounders such as age, gender, and education.

The researchers also looked at cognitive test scores and brain volumes and found a relationship between larger frontal lobe volumes in fish eaters and higher working memory test scores. "This makes a lot of sense, because the frontal lobes are responsible for working memory function," Dr. Raji said.

The reduced risk of MCI and AD among fish eaters in this study probably stems from the protective benefits of omega-3 fatty acids, he noted. Omega-3 fatty acids are believed to increase blood flow to the brain, act as antioxidants and anti-inflammatories, and prevent the accumulation of the amyloid plaques characteristic of AD. Consumption of fried fish, which is high in cholesterol and low in omega-3 fatty acids, did not confer any benefits.

Data presented by Dr. Raji at last year’s meeting of the Radiological Society of North America (Internal Medicine News, Dec. 20, 2010) showed the protective benefits of physical activity in preserving brain volume and reducing the risk of AD and MCI in the same cohort. "What we’re adding to the picture this year is specific information on diet," he said. "The long-term goal of this research is to incorporate our understanding of all the various lifestyle factors that could reduce risk and give us a unified picture of how to best prevent the disease."

Dr. Raji had no disclosures related to this study.

CHICAGO – Consumption of baked or broiled fish on a weekly basis improved brain health and significantly reduced the risk of mild cognitive impairment and Alzheimer’s disease in a 20-year longitudinal study of older adults presented at the annual meeting of the Radiological Society of North America.

Fish consumption improved brain volume in the frontal lobes, temporal lobes (including the hippocampus) and posterior cingulate gyrus, as shown on high-resolution, three-dimensional volumetric magnetic resonance imaging (MRI). "That’s important because these are areas of the brain that are responsible for memory and learning and are severely affected by Alzheimer’s disease," reported Dr. Cyrus A. Raji of the University of Pittsburgh.

Dr. Raji and his colleagues analyzed data collected at three time points from the ongoing Cardiovascular Health Study-Cognition Study. In 1989-1990, 260 subjects (mean age 71 years) completed standardized diet questionnaires. In 1998-1999, these individuals (mean age 78 years) underwent volumetric MRI.

An analysis of clinical conversion to mild cognitive impairment (MCI) or Alzheimer’s disease (AD) in 2002 among study participants (mean age 82 years) found that individuals with larger brain volumes as a result of weekly baked or broiled fish consumption had a greatly reduced incidence of MCI or AD, compared with individuals who did not eat fish regularly.

Clinical conversion rates to MCI or AD were 30.8% for non–fish eaters, compared with 8% for individuals whose brains benefited partially from fish consumption (as shown on volumetric MRI), and 3.2% for individuals whose brains benefited fully from fish consumption.

These findings indicate "a large reduction in the risk for developing AD or MCI as a result of consuming baked or broiled fish," Dr. Raji said

The benefits of regular fish intake persisted even after accounting for such potential confounding variables as age, gender, head size, and cerebrovascular disease.

Study participants who were not fish eaters and who showed atrophy in the hippocampus – the region most frequently affected by AD – had a 47% incidence of MCI or AD, compared with only 28% of fish eaters with larger hippocampal volumes, he reported.

In addition, mean scores on cognitive tests of working memory were significantly higher (P less than .05) in individuals who ate fish weekly compared with those who did not. The improvement remained even after accounting for potential confounders such as age, gender, and education.

The researchers also looked at cognitive test scores and brain volumes and found a relationship between larger frontal lobe volumes in fish eaters and higher working memory test scores. "This makes a lot of sense, because the frontal lobes are responsible for working memory function," Dr. Raji said.

The reduced risk of MCI and AD among fish eaters in this study probably stems from the protective benefits of omega-3 fatty acids, he noted. Omega-3 fatty acids are believed to increase blood flow to the brain, act as antioxidants and anti-inflammatories, and prevent the accumulation of the amyloid plaques characteristic of AD. Consumption of fried fish, which is high in cholesterol and low in omega-3 fatty acids, did not confer any benefits.

Data presented by Dr. Raji at last year’s meeting of the Radiological Society of North America (Internal Medicine News, Dec. 20, 2010) showed the protective benefits of physical activity in preserving brain volume and reducing the risk of AD and MCI in the same cohort. "What we’re adding to the picture this year is specific information on diet," he said. "The long-term goal of this research is to incorporate our understanding of all the various lifestyle factors that could reduce risk and give us a unified picture of how to best prevent the disease."

Dr. Raji had no disclosures related to this study.

CHICAGO – Six months of growth hormone therapy significantly increased bone formation, vitamin D, and thigh muscle mass while decreasing abdominal fat in a study of women with abdominal obesity.

The randomized, double-blind, placebo-controlled trial was the first to explore the relationship between growth hormone levels and bone density in obese but otherwise healthy premenopausal women, Dr. Miriam A. Bredella of Massachusetts General Hospital and Harvard Medical School, Boston, said in a press briefing at the annual meeting of the Radiological Society of North America.

The study builds on work presented by Dr. Bredella at last year’s RSNA meeting showing an association between abdominal obesity and low bone mineral density in women. That study was the first to implicate abdominal fat as a risk factor for osteoporosis.

The study challenged previous research findings suggesting that increased weight protects against osteoporosis. Those previous studies focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat. Dr. Bredella’s work zeroed in on visceral fat.

In the present study, 79 women (mean age, 36 years; mean BMI, 35 kg/m²) with low growth hormone levels were randomized to receive low-dose growth hormone replacement therapy or placebo for 6 months. Subjects received MR spectroscopy to measure bone marrow fat and computed tomography to measure subcutaneous and visceral abdominal fat and thigh muscle mass at baseline and 6 months. Subjects were instructed not to change exercise regimens during the study and were monitored for changes in blood glucose.

One of the most surprising and important findings, according to Dr. Bredella, was that 32% of these obese but otherwise healthy young women were already osteopenic (T-score between –2.5 and –1) at baseline and that one had developed osteoporosis (T-score below –2.5). "It’s important that people become aware that obesity doesn’t protect against bone loss," she said.

Growth hormone was associated with increased P1NP (procollagen type 1 amino-terminal propeptide, a marker of bone formation) and CTX (carboxy-terminal collagen crosslinks, a marker of bone resorption), as well as increased vitamin D, thigh muscle mass, and decreased visceral and subcutaneous abdominal fat, compared with placebo, Dr. Bredella said.

Patients with the greatest abdominal fat loss had the greatest increases in bone formation. Patients with the greatest increases in vitamin D also had the greatest increases in bone formation.

No significant differences were found between the two groups in the more common side effects of growth hormone therapy, including edema of the hands and carpal tunnel syndrome.

"Overall, our patients didn’t lose weight, but they had a redistribution of their body fat and muscle mass," Dr. Bredella noted. "They lost belly fat but increased their muscle mass, and because muscle is heavier than fat, their overall weight didn’t change."

Although the high cost of growth hormone replacement therapy would likely prohibit its widespread use as a treatment for obesity-related bone loss, the results of this study suggest new treatment possibilities. "It’s not going to be the magic therapy for obesity and bone loss, but it could help maybe someone who was unable to lose weight to lower their risk profile for diabetes and cardiovascular disease, and it could be used in the aging population because we know as we get older our growth hormone levels go down," she said.

Dr. Bredella had no disclosures related to this study.

CHICAGO – Six months of growth hormone therapy significantly increased bone formation, vitamin D, and thigh muscle mass while decreasing abdominal fat in a study of women with abdominal obesity.

The randomized, double-blind, placebo-controlled trial was the first to explore the relationship between growth hormone levels and bone density in obese but otherwise healthy premenopausal women, Dr. Miriam A. Bredella of Massachusetts General Hospital and Harvard Medical School, Boston, said in a press briefing at the annual meeting of the Radiological Society of North America.

The study builds on work presented by Dr. Bredella at last year’s RSNA meeting showing an association between abdominal obesity and low bone mineral density in women. That study was the first to implicate abdominal fat as a risk factor for osteoporosis.

The study challenged previous research findings suggesting that increased weight protects against osteoporosis. Those previous studies focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat. Dr. Bredella’s work zeroed in on visceral fat.

In the present study, 79 women (mean age, 36 years; mean BMI, 35 kg/m²) with low growth hormone levels were randomized to receive low-dose growth hormone replacement therapy or placebo for 6 months. Subjects received MR spectroscopy to measure bone marrow fat and computed tomography to measure subcutaneous and visceral abdominal fat and thigh muscle mass at baseline and 6 months. Subjects were instructed not to change exercise regimens during the study and were monitored for changes in blood glucose.

One of the most surprising and important findings, according to Dr. Bredella, was that 32% of these obese but otherwise healthy young women were already osteopenic (T-score between –2.5 and –1) at baseline and that one had developed osteoporosis (T-score below –2.5). "It’s important that people become aware that obesity doesn’t protect against bone loss," she said.

Growth hormone was associated with increased P1NP (procollagen type 1 amino-terminal propeptide, a marker of bone formation) and CTX (carboxy-terminal collagen crosslinks, a marker of bone resorption), as well as increased vitamin D, thigh muscle mass, and decreased visceral and subcutaneous abdominal fat, compared with placebo, Dr. Bredella said.

Patients with the greatest abdominal fat loss had the greatest increases in bone formation. Patients with the greatest increases in vitamin D also had the greatest increases in bone formation.

No significant differences were found between the two groups in the more common side effects of growth hormone therapy, including edema of the hands and carpal tunnel syndrome.

"Overall, our patients didn’t lose weight, but they had a redistribution of their body fat and muscle mass," Dr. Bredella noted. "They lost belly fat but increased their muscle mass, and because muscle is heavier than fat, their overall weight didn’t change."

Although the high cost of growth hormone replacement therapy would likely prohibit its widespread use as a treatment for obesity-related bone loss, the results of this study suggest new treatment possibilities. "It’s not going to be the magic therapy for obesity and bone loss, but it could help maybe someone who was unable to lose weight to lower their risk profile for diabetes and cardiovascular disease, and it could be used in the aging population because we know as we get older our growth hormone levels go down," she said.

Dr. Bredella had no disclosures related to this study.

CHICAGO – Six months of growth hormone therapy significantly increased bone formation, vitamin D, and thigh muscle mass while decreasing abdominal fat in a study of women with abdominal obesity.

The randomized, double-blind, placebo-controlled trial was the first to explore the relationship between growth hormone levels and bone density in obese but otherwise healthy premenopausal women, Dr. Miriam A. Bredella of Massachusetts General Hospital and Harvard Medical School, Boston, said in a press briefing at the annual meeting of the Radiological Society of North America.

The study builds on work presented by Dr. Bredella at last year’s RSNA meeting showing an association between abdominal obesity and low bone mineral density in women. That study was the first to implicate abdominal fat as a risk factor for osteoporosis.

The study challenged previous research findings suggesting that increased weight protects against osteoporosis. Those previous studies focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat. Dr. Bredella’s work zeroed in on visceral fat.

In the present study, 79 women (mean age, 36 years; mean BMI, 35 kg/m²) with low growth hormone levels were randomized to receive low-dose growth hormone replacement therapy or placebo for 6 months. Subjects received MR spectroscopy to measure bone marrow fat and computed tomography to measure subcutaneous and visceral abdominal fat and thigh muscle mass at baseline and 6 months. Subjects were instructed not to change exercise regimens during the study and were monitored for changes in blood glucose.

One of the most surprising and important findings, according to Dr. Bredella, was that 32% of these obese but otherwise healthy young women were already osteopenic (T-score between –2.5 and –1) at baseline and that one had developed osteoporosis (T-score below –2.5). "It’s important that people become aware that obesity doesn’t protect against bone loss," she said.

Growth hormone was associated with increased P1NP (procollagen type 1 amino-terminal propeptide, a marker of bone formation) and CTX (carboxy-terminal collagen crosslinks, a marker of bone resorption), as well as increased vitamin D, thigh muscle mass, and decreased visceral and subcutaneous abdominal fat, compared with placebo, Dr. Bredella said.

Patients with the greatest abdominal fat loss had the greatest increases in bone formation. Patients with the greatest increases in vitamin D also had the greatest increases in bone formation.

No significant differences were found between the two groups in the more common side effects of growth hormone therapy, including edema of the hands and carpal tunnel syndrome.

"Overall, our patients didn’t lose weight, but they had a redistribution of their body fat and muscle mass," Dr. Bredella noted. "They lost belly fat but increased their muscle mass, and because muscle is heavier than fat, their overall weight didn’t change."

Although the high cost of growth hormone replacement therapy would likely prohibit its widespread use as a treatment for obesity-related bone loss, the results of this study suggest new treatment possibilities. "It’s not going to be the magic therapy for obesity and bone loss, but it could help maybe someone who was unable to lose weight to lower their risk profile for diabetes and cardiovascular disease, and it could be used in the aging population because we know as we get older our growth hormone levels go down," she said.

Dr. Bredella had no disclosures related to this study.

CHICAGO – Women aged 40-49 years with and without a family history of breast cancer had virtually the same rates of invasive disease in a retrospective analysis of data on more than 1,000 patients diagnosed over a 10-year period at a single site.

The finding adds weight to the American Cancer Society’s recommendation in favor of annual screening mammograms for women beginning at age 40, said principal author Dr. Stamatia V. Destounis of Elizabeth Wende Breast Care LLC in Rochester, N.Y. Dr. Destounis presented the results of her study in a press briefing at the annual meeting of the Radiological Society of North America.

A study presented at last year’s meeting by researchers at the London Breast Institute of the Princess Grace Hospital indicated that annual mammograms could reduce by half the risk of mastectomy in women who were diagnosed with breast cancer between the ages of 40 and 50 years.

Both studies challenge the recommendation against routine annual mammography for women under the age of 50 made in 2009 by the United States Preventive Services Task Force.

"These conflicting recommendations have led to confusion among patients and physicians," Dr. Destounis said.

In the present study, Dr. Destounis and her colleagues analyzed data on women between the ages of 40 and 49 years who underwent screening mammography at the center between 2000 and 2010.

In all, 1,116 cancers were found in 1,071 patients aged 40-49 years. Of these patients, 373 were diagnosed by screening mammography. Of these 373 women, 144 (39%) had a family history of breast cancer, 228 (61%) did not, and 1 patient did not know her family history. (A total of 7 patients with and 16 patients without a family history of breast cancer also had a personal history of breast cancer.)

Among women with a family history, 32% (46) had a first-degree relative with a premenopausal history, 38% (54) had a first-degree relative with a postmenopausal history, and 31% (44) had a second- or third-degree relative with a pre- or postmenopausal history of the disease.

The incidence of invasive breast cancer was virtually the same – 63% (91) and 64% (146), respectively – in women with and without a family history. The incidence of noninvasive disease in the two groups was also similar, at 37% and 36%, respectively. Those with and without a family history shared similar rates of lymph node metastatic disease (31% and 29%) as well.

"Family history does not seem to [affect] the rate of invasive disease in our patient cohort," Dr. Destounis said.

The following types of lesions were found in women with and without a family history, respectively: mass (42, 86), microcalcification (69, 97), mass with calcification (21, 18), architectural distortion (11, 18), and asymmetry (1, 9).

All 144 patients with a family history and 227 of 228 patients in the no family history group proceeded to surgery. One patient had metastatic disease and opted for no surgery or treatment.

Among women with and without a family history, 63% and 68%, respectively, underwent a lumpectomy. Some of these patients did not have clear margins after surgery and went on to mastectomy. In all, 38% (54) of women with a family history and 31% (71) women without a family history went on to mastectomy.

Since no difference in the rate of invasive breast cancer between women with and without a family history was found in this population, "the recommendation should be that women in their 40s have a screening mammogram yearly," she said.

Dr. Destounis and her colleagues are currently collecting additional data on breast density, demographics, and survival rates for this patient group.

Dr. Destounis disclosed that she has been an investigator for Siemens AG, Fujifilm Holdings, Hologic Inc., and Koning Corp. She has also served as an advisory board member for Philips Electronics and Matakina International Ltd.

CHICAGO – Women aged 40-49 years with and without a family history of breast cancer had virtually the same rates of invasive disease in a retrospective analysis of data on more than 1,000 patients diagnosed over a 10-year period at a single site.

The finding adds weight to the American Cancer Society’s recommendation in favor of annual screening mammograms for women beginning at age 40, said principal author Dr. Stamatia V. Destounis of Elizabeth Wende Breast Care LLC in Rochester, N.Y. Dr. Destounis presented the results of her study in a press briefing at the annual meeting of the Radiological Society of North America.

A study presented at last year’s meeting by researchers at the London Breast Institute of the Princess Grace Hospital indicated that annual mammograms could reduce by half the risk of mastectomy in women who were diagnosed with breast cancer between the ages of 40 and 50 years.

Both studies challenge the recommendation against routine annual mammography for women under the age of 50 made in 2009 by the United States Preventive Services Task Force.

"These conflicting recommendations have led to confusion among patients and physicians," Dr. Destounis said.

In the present study, Dr. Destounis and her colleagues analyzed data on women between the ages of 40 and 49 years who underwent screening mammography at the center between 2000 and 2010.

In all, 1,116 cancers were found in 1,071 patients aged 40-49 years. Of these patients, 373 were diagnosed by screening mammography. Of these 373 women, 144 (39%) had a family history of breast cancer, 228 (61%) did not, and 1 patient did not know her family history. (A total of 7 patients with and 16 patients without a family history of breast cancer also had a personal history of breast cancer.)

Among women with a family history, 32% (46) had a first-degree relative with a premenopausal history, 38% (54) had a first-degree relative with a postmenopausal history, and 31% (44) had a second- or third-degree relative with a pre- or postmenopausal history of the disease.

The incidence of invasive breast cancer was virtually the same – 63% (91) and 64% (146), respectively – in women with and without a family history. The incidence of noninvasive disease in the two groups was also similar, at 37% and 36%, respectively. Those with and without a family history shared similar rates of lymph node metastatic disease (31% and 29%) as well.

"Family history does not seem to [affect] the rate of invasive disease in our patient cohort," Dr. Destounis said.

The following types of lesions were found in women with and without a family history, respectively: mass (42, 86), microcalcification (69, 97), mass with calcification (21, 18), architectural distortion (11, 18), and asymmetry (1, 9).

All 144 patients with a family history and 227 of 228 patients in the no family history group proceeded to surgery. One patient had metastatic disease and opted for no surgery or treatment.

Among women with and without a family history, 63% and 68%, respectively, underwent a lumpectomy. Some of these patients did not have clear margins after surgery and went on to mastectomy. In all, 38% (54) of women with a family history and 31% (71) women without a family history went on to mastectomy.

Since no difference in the rate of invasive breast cancer between women with and without a family history was found in this population, "the recommendation should be that women in their 40s have a screening mammogram yearly," she said.

Dr. Destounis and her colleagues are currently collecting additional data on breast density, demographics, and survival rates for this patient group.

Dr. Destounis disclosed that she has been an investigator for Siemens AG, Fujifilm Holdings, Hologic Inc., and Koning Corp. She has also served as an advisory board member for Philips Electronics and Matakina International Ltd.

CHICAGO – Women aged 40-49 years with and without a family history of breast cancer had virtually the same rates of invasive disease in a retrospective analysis of data on more than 1,000 patients diagnosed over a 10-year period at a single site.

The finding adds weight to the American Cancer Society’s recommendation in favor of annual screening mammograms for women beginning at age 40, said principal author Dr. Stamatia V. Destounis of Elizabeth Wende Breast Care LLC in Rochester, N.Y. Dr. Destounis presented the results of her study in a press briefing at the annual meeting of the Radiological Society of North America.

A study presented at last year’s meeting by researchers at the London Breast Institute of the Princess Grace Hospital indicated that annual mammograms could reduce by half the risk of mastectomy in women who were diagnosed with breast cancer between the ages of 40 and 50 years.

Both studies challenge the recommendation against routine annual mammography for women under the age of 50 made in 2009 by the United States Preventive Services Task Force.

"These conflicting recommendations have led to confusion among patients and physicians," Dr. Destounis said.

In the present study, Dr. Destounis and her colleagues analyzed data on women between the ages of 40 and 49 years who underwent screening mammography at the center between 2000 and 2010.

In all, 1,116 cancers were found in 1,071 patients aged 40-49 years. Of these patients, 373 were diagnosed by screening mammography. Of these 373 women, 144 (39%) had a family history of breast cancer, 228 (61%) did not, and 1 patient did not know her family history. (A total of 7 patients with and 16 patients without a family history of breast cancer also had a personal history of breast cancer.)

Among women with a family history, 32% (46) had a first-degree relative with a premenopausal history, 38% (54) had a first-degree relative with a postmenopausal history, and 31% (44) had a second- or third-degree relative with a pre- or postmenopausal history of the disease.

The incidence of invasive breast cancer was virtually the same – 63% (91) and 64% (146), respectively – in women with and without a family history. The incidence of noninvasive disease in the two groups was also similar, at 37% and 36%, respectively. Those with and without a family history shared similar rates of lymph node metastatic disease (31% and 29%) as well.

"Family history does not seem to [affect] the rate of invasive disease in our patient cohort," Dr. Destounis said.

The following types of lesions were found in women with and without a family history, respectively: mass (42, 86), microcalcification (69, 97), mass with calcification (21, 18), architectural distortion (11, 18), and asymmetry (1, 9).

All 144 patients with a family history and 227 of 228 patients in the no family history group proceeded to surgery. One patient had metastatic disease and opted for no surgery or treatment.

Among women with and without a family history, 63% and 68%, respectively, underwent a lumpectomy. Some of these patients did not have clear margins after surgery and went on to mastectomy. In all, 38% (54) of women with a family history and 31% (71) women without a family history went on to mastectomy.

Since no difference in the rate of invasive breast cancer between women with and without a family history was found in this population, "the recommendation should be that women in their 40s have a screening mammogram yearly," she said.

Dr. Destounis and her colleagues are currently collecting additional data on breast density, demographics, and survival rates for this patient group.

Dr. Destounis disclosed that she has been an investigator for Siemens AG, Fujifilm Holdings, Hologic Inc., and Koning Corp. She has also served as an advisory board member for Philips Electronics and Matakina International Ltd.

CHICAGO – Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.

The diet eliminated insulin dependence in all patients during treatment. After returning to a normal diet, approximately 75% of patients remained insulin-free at 18 months, reported Dr. Sebastiaan Hammer of Leiden (the Netherlands) University Medical Center.

The finding underscores the value of lifestyle interventions as a tool for diabetes management, Dr. Hammer said in a press briefing at the annual meeting of the Radiological Society of North America.

The reductions in pericardial fat also persisted at 18 months from baseline – more than a year after patients had resumed their normal eating habits, Dr. Hammer said. These improvements were sustained even in patients who regained weight that had been lost during the 4-month period of caloric restriction.

Dr. Hammer and his colleagues analyzed changes in cardiac function, pericardial fat, and body mass index (BMI) using cardiac magnetic resonance imaging (MRI) in eight men and seven women with obesity-related type 2 diabetes. At the beginning of the study, all patients had a BMI greater than 30 kg/m², were being treated with insulin, and had no cardiac complaints.

Insulin treatment was stopped at baseline. Patients consumed a standardized, low-carbohydrate, 500 calorie/day diet for 4 months and were monitored weekly for blood glucose and weight loss. At months 4 through 6, patients were gradually reintroduced to normal caloric intake. For the following 12 months, patients received treatment by their own physicians. Dr. Hammer and his colleagues performed cardiac MRI on all patients at baseline, 4 months, and 18 months.

Caloric restriction resulted in a decrease in mean BMI from 35.3 to 27.5 over 4 months. Pericardial fat decreased from a mean of 39 mL to 31 mL. The researchers also quantified the elasticity of the left ventricle by quantifying blood flow across the valve between the left atrium and the left ventricle, using the ratio between the early filling phase (vessel filling phase) and the atrial filling phase as a measure of diastolic heart function. The mean E/A ratio improved from 0.96 to 1.2.

At 14 months of follow-up on a regular diet (18 months from baseline), mean BMI increased to 31.7 (P less than .05). However, despite this weight gain, improvements in pericardial fat levels (32 mL, P less than .05) and E/A ratios (mean 1.06, P less than .05) persisted.

Dr. Hammer noted recent findings that "the fat around the heart is not an inert adipose tissue compartment, but it is metabolically active, it is associated with coronary plaque formation, and it may be associated with cardiac dysfunction in patients with diabetes." Pericardial fat shows promise as a marker for cardiac risk in patients with type 2 diabetes because it can be quantified using standard MRI, he said.

Although the patients in this study were obese and insulin dependent at baseline, none had cardiac disease, kidney disease, or other diabetic complications. "We are also testing if this strategy works in patients who do have some cardiac complaints," Dr. Hammer said. "It would also be good to know if this strategy is safe to use in those patients."

Dr. Hammer had no financial disclosures related to this study.

CHICAGO – Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.

The diet eliminated insulin dependence in all patients during treatment. After returning to a normal diet, approximately 75% of patients remained insulin-free at 18 months, reported Dr. Sebastiaan Hammer of Leiden (the Netherlands) University Medical Center.

The finding underscores the value of lifestyle interventions as a tool for diabetes management, Dr. Hammer said in a press briefing at the annual meeting of the Radiological Society of North America.

The reductions in pericardial fat also persisted at 18 months from baseline – more than a year after patients had resumed their normal eating habits, Dr. Hammer said. These improvements were sustained even in patients who regained weight that had been lost during the 4-month period of caloric restriction.

Dr. Hammer and his colleagues analyzed changes in cardiac function, pericardial fat, and body mass index (BMI) using cardiac magnetic resonance imaging (MRI) in eight men and seven women with obesity-related type 2 diabetes. At the beginning of the study, all patients had a BMI greater than 30 kg/m², were being treated with insulin, and had no cardiac complaints.

Insulin treatment was stopped at baseline. Patients consumed a standardized, low-carbohydrate, 500 calorie/day diet for 4 months and were monitored weekly for blood glucose and weight loss. At months 4 through 6, patients were gradually reintroduced to normal caloric intake. For the following 12 months, patients received treatment by their own physicians. Dr. Hammer and his colleagues performed cardiac MRI on all patients at baseline, 4 months, and 18 months.

Caloric restriction resulted in a decrease in mean BMI from 35.3 to 27.5 over 4 months. Pericardial fat decreased from a mean of 39 mL to 31 mL. The researchers also quantified the elasticity of the left ventricle by quantifying blood flow across the valve between the left atrium and the left ventricle, using the ratio between the early filling phase (vessel filling phase) and the atrial filling phase as a measure of diastolic heart function. The mean E/A ratio improved from 0.96 to 1.2.

At 14 months of follow-up on a regular diet (18 months from baseline), mean BMI increased to 31.7 (P less than .05). However, despite this weight gain, improvements in pericardial fat levels (32 mL, P less than .05) and E/A ratios (mean 1.06, P less than .05) persisted.

Dr. Hammer noted recent findings that "the fat around the heart is not an inert adipose tissue compartment, but it is metabolically active, it is associated with coronary plaque formation, and it may be associated with cardiac dysfunction in patients with diabetes." Pericardial fat shows promise as a marker for cardiac risk in patients with type 2 diabetes because it can be quantified using standard MRI, he said.

Although the patients in this study were obese and insulin dependent at baseline, none had cardiac disease, kidney disease, or other diabetic complications. "We are also testing if this strategy works in patients who do have some cardiac complaints," Dr. Hammer said. "It would also be good to know if this strategy is safe to use in those patients."

Dr. Hammer had no financial disclosures related to this study.

CHICAGO – Four months of a restricted-calorie diet produced lasting reductions in pericardial fat and improvements in left ventricular diastolic function in a study of obese adults with type 2 diabetes.

The diet eliminated insulin dependence in all patients during treatment. After returning to a normal diet, approximately 75% of patients remained insulin-free at 18 months, reported Dr. Sebastiaan Hammer of Leiden (the Netherlands) University Medical Center.

The finding underscores the value of lifestyle interventions as a tool for diabetes management, Dr. Hammer said in a press briefing at the annual meeting of the Radiological Society of North America.

The reductions in pericardial fat also persisted at 18 months from baseline – more than a year after patients had resumed their normal eating habits, Dr. Hammer said. These improvements were sustained even in patients who regained weight that had been lost during the 4-month period of caloric restriction.

Dr. Hammer and his colleagues analyzed changes in cardiac function, pericardial fat, and body mass index (BMI) using cardiac magnetic resonance imaging (MRI) in eight men and seven women with obesity-related type 2 diabetes. At the beginning of the study, all patients had a BMI greater than 30 kg/m², were being treated with insulin, and had no cardiac complaints.

Insulin treatment was stopped at baseline. Patients consumed a standardized, low-carbohydrate, 500 calorie/day diet for 4 months and were monitored weekly for blood glucose and weight loss. At months 4 through 6, patients were gradually reintroduced to normal caloric intake. For the following 12 months, patients received treatment by their own physicians. Dr. Hammer and his colleagues performed cardiac MRI on all patients at baseline, 4 months, and 18 months.

Caloric restriction resulted in a decrease in mean BMI from 35.3 to 27.5 over 4 months. Pericardial fat decreased from a mean of 39 mL to 31 mL. The researchers also quantified the elasticity of the left ventricle by quantifying blood flow across the valve between the left atrium and the left ventricle, using the ratio between the early filling phase (vessel filling phase) and the atrial filling phase as a measure of diastolic heart function. The mean E/A ratio improved from 0.96 to 1.2.

At 14 months of follow-up on a regular diet (18 months from baseline), mean BMI increased to 31.7 (P less than .05). However, despite this weight gain, improvements in pericardial fat levels (32 mL, P less than .05) and E/A ratios (mean 1.06, P less than .05) persisted.

Dr. Hammer noted recent findings that "the fat around the heart is not an inert adipose tissue compartment, but it is metabolically active, it is associated with coronary plaque formation, and it may be associated with cardiac dysfunction in patients with diabetes." Pericardial fat shows promise as a marker for cardiac risk in patients with type 2 diabetes because it can be quantified using standard MRI, he said.

Although the patients in this study were obese and insulin dependent at baseline, none had cardiac disease, kidney disease, or other diabetic complications. "We are also testing if this strategy works in patients who do have some cardiac complaints," Dr. Hammer said. "It would also be good to know if this strategy is safe to use in those patients."

Dr. Hammer had no financial disclosures related to this study.

CHICAGO – Children with attention-deficit/hyperactivity disorder use different neural pathways for visual working memory than do children without the disorder, according to one of the first neuroimaging studies of the inattention component of the disorder.

The findings reveal a disruption of normal functional connectivity in visual attention-related tasks in children with attention-deficit/hyperactivity disorder (ADHD), reported Xiaobo Li, Ph.D., of the Albert Einstein College of Medicine in New York.

The study points to the potential future use of functional magnetic resonance imaging (fMRI) as a diagnostic tool for the brain disorder, which affects an estimated 5%-8% of school-age children, she said.

Current diagnostic techniques for ADHD rely primarily on behavioral assessments of hyperactivity and impulsivity, and neuroimaging studies to date also have tended to focus on these behavioral components, Dr. Li said in a press briefing at the annual meeting of the Radiological Society of North America. The neurobiological foundation of inattention has not been well studied, but it deserves attention because it is an equally important component of the condition, she said.

Most of the neuroimaging studies of impulsivity and hyperactivity in ADHD have indicated a disruption in the connection between the frontal and striatal cortices, "but this is not enough for a conclusion of ADHD," Dr. Li said.

In the current study, 18 nonmedicated children with combined-type ADHD and 18 healthy children matched for age (range, 9-14 years), IQ, and other variables completed two 5-minute visual attention tasks. Subjects were shown a set of numbers, followed by a series of additional number sets. They were asked to indicate with a handheld device whether each set did or did not match the original digit sequence.

Brain activation and post-hoc functional connectivity were assessed with fMRI scans during the task. Researchers analyzed 16 brain regions showing the most significant levels of activity. They looked at the averages for each group and generated a between-group comparison.

Compared with the control group, children with ADHD showed abnormal activity in several regions of the brain involved in the processing of visual working memory information, Dr. Li reported.

Specifically, the investigators found increased involvement of the anterior cingulate cortex and decreased and disrupted functional connectivity between the frontal lobe and the parietal lobe in children with ADHD.

The findings also suggest that functional differences in the bilateral middle temporal gyri may be associated with the psychopathology of ADHD.

These functional differences may stem from impairments in the white matter pathways involved in visual attention information processing, Dr. Li said.

ADHD "is a brain disorder, so we should use brain markers as more accurate diagnostic criteria," she stated. "Before we truly understand the foundations of each component, we can’t develop very reliable diagnostic criteria. But with this study, we are working on that."

Dr. Li had no financial disclosures related to this study.

CHICAGO – Children with attention-deficit/hyperactivity disorder use different neural pathways for visual working memory than do children without the disorder, according to one of the first neuroimaging studies of the inattention component of the disorder.

The findings reveal a disruption of normal functional connectivity in visual attention-related tasks in children with attention-deficit/hyperactivity disorder (ADHD), reported Xiaobo Li, Ph.D., of the Albert Einstein College of Medicine in New York.

The study points to the potential future use of functional magnetic resonance imaging (fMRI) as a diagnostic tool for the brain disorder, which affects an estimated 5%-8% of school-age children, she said.

Current diagnostic techniques for ADHD rely primarily on behavioral assessments of hyperactivity and impulsivity, and neuroimaging studies to date also have tended to focus on these behavioral components, Dr. Li said in a press briefing at the annual meeting of the Radiological Society of North America. The neurobiological foundation of inattention has not been well studied, but it deserves attention because it is an equally important component of the condition, she said.

Most of the neuroimaging studies of impulsivity and hyperactivity in ADHD have indicated a disruption in the connection between the frontal and striatal cortices, "but this is not enough for a conclusion of ADHD," Dr. Li said.

In the current study, 18 nonmedicated children with combined-type ADHD and 18 healthy children matched for age (range, 9-14 years), IQ, and other variables completed two 5-minute visual attention tasks. Subjects were shown a set of numbers, followed by a series of additional number sets. They were asked to indicate with a handheld device whether each set did or did not match the original digit sequence.

Brain activation and post-hoc functional connectivity were assessed with fMRI scans during the task. Researchers analyzed 16 brain regions showing the most significant levels of activity. They looked at the averages for each group and generated a between-group comparison.

Compared with the control group, children with ADHD showed abnormal activity in several regions of the brain involved in the processing of visual working memory information, Dr. Li reported.

Specifically, the investigators found increased involvement of the anterior cingulate cortex and decreased and disrupted functional connectivity between the frontal lobe and the parietal lobe in children with ADHD.

The findings also suggest that functional differences in the bilateral middle temporal gyri may be associated with the psychopathology of ADHD.

These functional differences may stem from impairments in the white matter pathways involved in visual attention information processing, Dr. Li said.

ADHD "is a brain disorder, so we should use brain markers as more accurate diagnostic criteria," she stated. "Before we truly understand the foundations of each component, we can’t develop very reliable diagnostic criteria. But with this study, we are working on that."

Dr. Li had no financial disclosures related to this study.

CHICAGO – Children with attention-deficit/hyperactivity disorder use different neural pathways for visual working memory than do children without the disorder, according to one of the first neuroimaging studies of the inattention component of the disorder.

The findings reveal a disruption of normal functional connectivity in visual attention-related tasks in children with attention-deficit/hyperactivity disorder (ADHD), reported Xiaobo Li, Ph.D., of the Albert Einstein College of Medicine in New York.

The study points to the potential future use of functional magnetic resonance imaging (fMRI) as a diagnostic tool for the brain disorder, which affects an estimated 5%-8% of school-age children, she said.

Current diagnostic techniques for ADHD rely primarily on behavioral assessments of hyperactivity and impulsivity, and neuroimaging studies to date also have tended to focus on these behavioral components, Dr. Li said in a press briefing at the annual meeting of the Radiological Society of North America. The neurobiological foundation of inattention has not been well studied, but it deserves attention because it is an equally important component of the condition, she said.

Most of the neuroimaging studies of impulsivity and hyperactivity in ADHD have indicated a disruption in the connection between the frontal and striatal cortices, "but this is not enough for a conclusion of ADHD," Dr. Li said.

In the current study, 18 nonmedicated children with combined-type ADHD and 18 healthy children matched for age (range, 9-14 years), IQ, and other variables completed two 5-minute visual attention tasks. Subjects were shown a set of numbers, followed by a series of additional number sets. They were asked to indicate with a handheld device whether each set did or did not match the original digit sequence.

Brain activation and post-hoc functional connectivity were assessed with fMRI scans during the task. Researchers analyzed 16 brain regions showing the most significant levels of activity. They looked at the averages for each group and generated a between-group comparison.

Compared with the control group, children with ADHD showed abnormal activity in several regions of the brain involved in the processing of visual working memory information, Dr. Li reported.

Specifically, the investigators found increased involvement of the anterior cingulate cortex and decreased and disrupted functional connectivity between the frontal lobe and the parietal lobe in children with ADHD.

The findings also suggest that functional differences in the bilateral middle temporal gyri may be associated with the psychopathology of ADHD.

These functional differences may stem from impairments in the white matter pathways involved in visual attention information processing, Dr. Li said.

ADHD "is a brain disorder, so we should use brain markers as more accurate diagnostic criteria," she stated. "Before we truly understand the foundations of each component, we can’t develop very reliable diagnostic criteria. But with this study, we are working on that."

Dr. Li had no financial disclosures related to this study.

CHICAGO – Visceral obesity was associated with low bone mineral density in a study of premenopausal women, indicating that abdominal fat is a risk factor for osteoporosis.

The finding indicates that "obesity does not always protect against osteoporosis," study investigator Dr. Miriam A. Bredella said in a press briefing at the annual meeting of the Radiological Society of North America. "Excessive visceral fat is not only a risk factor for heart disease and diabetes, but also for bone loss."

The study flies in the face of current thinking that obesity actually protects against osteoporosis. Previous studies suggesting a link between fat and bone health focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat, she said. The present study zeroed in specifically on visceral fat.

Dr. Bredella noted "disturbing pictures emerging from the obesity epidemic, because the number of forearm fractures among young patients has increased dramatically over the last year, and the strongest risk factor in that group ... was actually increased body weight." This finding prompted the investigators to see whether there was a connection between osteoporosis and fat, said Dr. Bredella of Massachusetts General Hospital and Harvard Medical School, both in Boston

In the present study, 50 premenopausal women with a BMI of 19-46 kg/m² (mean 30) underwent a magnetic resonance spectroscopy exam to assess L4 bone marrow (BM) fat, followed by quantitative computed tomography to assess trabecular bone mineral density (BMD).

The results showed a positive correlation between visceral fat and BM fat (r = 0.28) and an inverse association between visceral fat and BMD (r = –0.31) and between vertebral BM fat and BMD (r = –0.45). These results were statistically significant. There was no correlation between either subcutaneous fat (fat concentrated around the hips and thighs) or total body fat and either BM fat or BMD.

These results reveal the distinctly detrimental effect of abdominal obesity on bone health, Dr. Bredella said.

The study is among the first to explore the relationship between body fat and bone marrow fat, and the dynamic appears to be complex, she said in an interview. According to recent research, "the amount of fat within your bones could predict if you will develop a fracture independent of bone mineral density," she noted. A recent study by Dr. Bredella and her colleagues found that women with anorexia nervosa had three times the amount of bone marrow fat as did normal-weight women.

Dr. Bredella had no financial disclosures.

CHICAGO – Visceral obesity was associated with low bone mineral density in a study of premenopausal women, indicating that abdominal fat is a risk factor for osteoporosis.

The finding indicates that "obesity does not always protect against osteoporosis," study investigator Dr. Miriam A. Bredella said in a press briefing at the annual meeting of the Radiological Society of North America. "Excessive visceral fat is not only a risk factor for heart disease and diabetes, but also for bone loss."

The study flies in the face of current thinking that obesity actually protects against osteoporosis. Previous studies suggesting a link between fat and bone health focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat, she said. The present study zeroed in specifically on visceral fat.

Dr. Bredella noted "disturbing pictures emerging from the obesity epidemic, because the number of forearm fractures among young patients has increased dramatically over the last year, and the strongest risk factor in that group ... was actually increased body weight." This finding prompted the investigators to see whether there was a connection between osteoporosis and fat, said Dr. Bredella of Massachusetts General Hospital and Harvard Medical School, both in Boston

In the present study, 50 premenopausal women with a BMI of 19-46 kg/m² (mean 30) underwent a magnetic resonance spectroscopy exam to assess L4 bone marrow (BM) fat, followed by quantitative computed tomography to assess trabecular bone mineral density (BMD).

The results showed a positive correlation between visceral fat and BM fat (r = 0.28) and an inverse association between visceral fat and BMD (r = –0.31) and between vertebral BM fat and BMD (r = –0.45). These results were statistically significant. There was no correlation between either subcutaneous fat (fat concentrated around the hips and thighs) or total body fat and either BM fat or BMD.

These results reveal the distinctly detrimental effect of abdominal obesity on bone health, Dr. Bredella said.

The study is among the first to explore the relationship between body fat and bone marrow fat, and the dynamic appears to be complex, she said in an interview. According to recent research, "the amount of fat within your bones could predict if you will develop a fracture independent of bone mineral density," she noted. A recent study by Dr. Bredella and her colleagues found that women with anorexia nervosa had three times the amount of bone marrow fat as did normal-weight women.

Dr. Bredella had no financial disclosures.

CHICAGO – Visceral obesity was associated with low bone mineral density in a study of premenopausal women, indicating that abdominal fat is a risk factor for osteoporosis.

The finding indicates that "obesity does not always protect against osteoporosis," study investigator Dr. Miriam A. Bredella said in a press briefing at the annual meeting of the Radiological Society of North America. "Excessive visceral fat is not only a risk factor for heart disease and diabetes, but also for bone loss."

The study flies in the face of current thinking that obesity actually protects against osteoporosis. Previous studies suggesting a link between fat and bone health focused primarily on body mass index (BMI), which incorporates measures of muscle and bone mass and subcutaneous fat as well as visceral fat, she said. The present study zeroed in specifically on visceral fat.

Dr. Bredella noted "disturbing pictures emerging from the obesity epidemic, because the number of forearm fractures among young patients has increased dramatically over the last year, and the strongest risk factor in that group ... was actually increased body weight." This finding prompted the investigators to see whether there was a connection between osteoporosis and fat, said Dr. Bredella of Massachusetts General Hospital and Harvard Medical School, both in Boston

In the present study, 50 premenopausal women with a BMI of 19-46 kg/m² (mean 30) underwent a magnetic resonance spectroscopy exam to assess L4 bone marrow (BM) fat, followed by quantitative computed tomography to assess trabecular bone mineral density (BMD).

The results showed a positive correlation between visceral fat and BM fat (r = 0.28) and an inverse association between visceral fat and BMD (r = –0.31) and between vertebral BM fat and BMD (r = –0.45). These results were statistically significant. There was no correlation between either subcutaneous fat (fat concentrated around the hips and thighs) or total body fat and either BM fat or BMD.

These results reveal the distinctly detrimental effect of abdominal obesity on bone health, Dr. Bredella said.

The study is among the first to explore the relationship between body fat and bone marrow fat, and the dynamic appears to be complex, she said in an interview. According to recent research, "the amount of fat within your bones could predict if you will develop a fracture independent of bone mineral density," she noted. A recent study by Dr. Bredella and her colleagues found that women with anorexia nervosa had three times the amount of bone marrow fat as did normal-weight women.

Dr. Bredella had no financial disclosures.