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Lee JH, Park J, Kim JH, Choi JY, Choi HJ, Ku EJ, Hong AR, Shin CS, Cho NH. Integrative analysis of genetic and clinical risk factors for bone loss in a Korean population. Bone 2021; 147:115910. [PMID: 33722773 DOI: 10.1016/j.bone.2021.115910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The relative contribution of genetic and clinical factors for bone loss is not well known. This study aimed to investigate the annualized percentage change in total hip bone mineral density (BMD) and the genetic and clinical risk factors for bone loss in a Korean prospective cohort study over a 6-year period. METHODS We included 645 men aged ≥50 years and 683 postmenopausal women who had repeated BMD testing between 2007 and 2014. The association between covariates and annualized percentage change in hip BMD was analyzed through the multivariate linear regression analysis. A total of 2614 single-nucleotide polymorphisms (SNPs) from 23 known BMD-related candidate genes and genome-wise association study were investigated. RESULTS Hip bone loss increased more rapidly in women than in men with advancing age. Hip bone loss in men increased with lean mass (LM) loss (%/year) (P < 0.001) and current smoking (P = 0.024) and decreased with increasing waist circumference (WC) (P < 0.001), alcohol consumption (P = 0.049), and increase in red blood cell counts (P = 0.031). Decreasing WC (P = 0.009), LM loss (%/year) (P < 0.001), and years since menopause ≤ 3 years (P = 0.003) significantly correlated with hip bone loss in women aged 45-59 years. Hip bone loss in women aged ≥60 years increased with advancing age (P = 0.012), alcohol consumption (P = 0.028), LM loss (%/year) (P = 0.031), and fat mass loss (%/year) (P < 0.001) and decreased with increasing WC (P = 0.025). LRP5 rs498830 (β = 0.127, P = 0.007) and TNFSF11 rs7325635 (β = 0.146, P = 0.001) were the top SNPs related to hip bone loss in men and postmenopausal women, respectively. However, none of the SNPs were associated with hip bone loss after Benjamini-Hochberg adjustment. CONCLUSION In this study, decreasing WC and LM were significant risk factors for hip bone loss in both men and women. Those factors were also identified that had sex-specific or age-specific effects on hip bone loss. None of the SNPs were associated with hip bone loss after multiple testing adjustments. The understanding of the modifiable factors contributing to bone loss has been broadened, and this may have implications such as in developing individualized preventive strategy. Further studies are needed to better predict the risk for bone loss in men and women.
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Affiliation(s)
- Ji Hyun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, VHS Medical Center, Seoul, Republic of Korea
| | - JooYong Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyung Jin Choi
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eu Jeong Ku
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Chungbuk National University hospital, Cheongju Si, Republic of Korea
| | - A Ram Hong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Chonnam National University Medical School, Chonnam, Republic of Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
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Mo D, Hsieh P, Yu H, Zhou L, Gong J, Xu L, Liu P, Chen G, Chen Z, Deng Q. The relationship between osteoporosis and body composition in pre- and postmenopausal women from different ethnic groups in China. ETHNICITY & HEALTH 2017; 22:295-310. [PMID: 27764963 DOI: 10.1080/13557858.2016.1244758] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the ethnic differences in osteoporosis (OP) and body composition (BC) and their relationship in the Maonan, Mulam, Hmong, and Yao minorities in China. DESIGN A total of 860 Maonan, Mulam, Hmong, and Yao women were included in this cross-sectional study. Demographic, health history, and lifestyle information was collected using questionnaires. BC was measured through bioelectrical impedance analysis, and bone mineral density (BMD) was assessed via calcaneal quantitative ultrasound. RESULTS Compared with premenopausal women, postmenopausal women exhibited a lower fat-free mass (FFM), muscle mass (MM), limb muscle mass, and T-score but a higher waist-to-hip ratio and prevalence of OP in each minority (p < .05). After adjustment for age, Hmong women displayed the highest body mass index, fat mass, percentage of body fat, visceral fat, and subcutaneous fat contents, while Yao women presented the highest T-scores and lowest prevalence of OP among the four minorities (p < .05). Having a greater number of children and an older age were significant risk factors for OP in all ethnic groups (p < .05, OR > 1). In addition, our results revealed that FFM and MM exhibited exactly the same weak positive relationship with the T-score (r = 0.081, p < .05) after adjusting for menopausal status and age in all of the participants. Furthermore, significant ethnic differences in the relationship between BC and the T-score existed in the four minorities studied here. CONCLUSIONS BC and OP prevalence varied by menopausal status and ethnic group, and ethnic-specific relationships between BC and BMD were present in the four minorities. More research is needed to further investigate the ethnic differences in BC, OP, and risk factors for lower BMD to develop targeted prevention strategies to reduce the burden of OP across different ethnic groups in China.
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Affiliation(s)
- Dan Mo
- a Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Peishan Hsieh
- b Department of Systems and Industrial Engineering , University of Arizona , Tucson , AZ , USA
| | - Hongrong Yu
- c Department of Human Anatomy , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Lining Zhou
- c Department of Human Anatomy , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Jichun Gong
- c Department of Human Anatomy , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Lin Xu
- c Department of Human Anatomy , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Peng Liu
- c Department of Human Anatomy , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Gang Chen
- d Department of Pathology , First Affiliated Hospital of Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Zhao Chen
- e Division of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health , University of Arizona , Tucson , AZ , USA
| | - Qiongying Deng
- a Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
- c Department of Human Anatomy , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
- f Guangxi Colleges and Universities Key Laboratory of Human Development and Disease Research , Guangxi Medical University , Nanning , Guangxi Zhuang Autonomous Region, People's Republic of China
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Bazzocchi A, Ponti F, Diano D, Amadori M, Albisinni U, Battista G, Guglielmi G. Trabecular bone score in healthy ageing. Br J Radiol 2015; 88:20140865. [PMID: 26148778 DOI: 10.1259/bjr.20140865] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The main aim of this work was to report on trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) of healthy Italian subjects to be used as a reference standard for future study in clinical and research settings. The secondary aim was to investigate the link between TBS and conventional parameters of bone and body composition by DXA. METHODS 250 individuals of 5 age bands (spanning from 18 to 70 years of age, equally distributed for both age and sex) were prospectively recruited. A lumbar spine (LS) DXA scan (Lunar iDXA™; GE Healthcare, Madison, WI) was acquired for each subject and then analysed with the latest version of TBS iNsight v. 2.1 (Med-Imaps, Pessac, France) software. LS bone mineral density (LS BMD), Z-score, T-score and TBS values were collected. Pearson's test was used to investigate the correlations between TBS and LS BMD and the influence of age, body mass index (BMI) and body composition on these parameters. RESULTS A significant decrease of TBS and LS BMD was observed with ageing in both males (TBS mean values from 1.486 to 1.374; LS BMD mean values from 1.219 to 1.187) and females (TBS mean values from 1.464 to 1.306; LS BMD mean values from 1.154 to 1.116). No statistically significant difference was achieved among males and females of the same age group for both TBS and LS BMD, with the exception of the fifth age group. A significant correlation was found between LS BMD and TBS values in both sexes (r = 0.555-0.655, p < 0.0001). BMI influenced LS BMD but not TBS. TBS values were inversely correlated with some fat mass parameters, in particular with visceral adipose tissue (in males: r = -0.332, p < 0.001; in females: r = -0.348, p < 0.0001). No significant correlation was found between TBS and total lean mass, opposite to LS BMD (in males: r = 0.418; p < 0.0001; in females: r = -0.235; p < 0.001). CONCLUSION This report is an attempt to start building a database for healthy Italian people providing age- and sex-specific reference curves for TBS. This could help clinicians to improve patient management in the detection of impaired bone mineral status and to monitor bone changes. ADVANCES IN KNOWLEDGE The study reports TBS values of a selectively enrolled Italian healthy population, ranging from younger to older ages and including males as a reference standard. Moreover, links between body composition and TBS are explored.
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Affiliation(s)
- A Bazzocchi
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - F Ponti
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - D Diano
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - M Amadori
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - U Albisinni
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - G Battista
- 2 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - G Guglielmi
- 3 Department of Radiology, University of Foggia, Foggia, Italy.,4 Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
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Gonnelli S, Caffarelli C, Tanzilli L, Alessi C, Tomai Pitinca MD, Rossi S, Campagna MS, Nuti R. The associations of body composition and fat distribution with bone mineral density in elderly Italian men and women. J Clin Densitom 2013; 16:168-77. [PMID: 22575590 DOI: 10.1016/j.jocd.2012.02.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 02/22/2012] [Accepted: 02/23/2012] [Indexed: 10/28/2022]
Abstract
This study aimed to investigate the associations of body composition and fat distribution with bone mineral density (BMD) in elderly Italian subjects. In 866 women (age 64.2±6.5yr) and 168 men (age 65.1±6.1yr), we measured BMD at lumbar spine, at femur, at the total body, and at the right hand. In all subjects, we also measured sex hormones, 25-hydroxyvitamin D, bone markers, and calcium intake. In both men and women, all body composition parameters had significant positive correlations with BMD at all sites after adjusting for age only; after adjusting also for body weight only lean mass (LM) remained positively associated with BMD at all sites except BMD at lumbar spine. In males, LM was associated with BMD at all sites, whereas android fat was associated with BMD at lumbar spine, at femur, and at whole body. In females, fat mass (FM) was positively and age inversely associated with BMD at all sites, whereas gynoid fat and alkaline phosphatase were inversely associated with BMD at lumbar spine and at femur. In conclusion, the role of LM seems more important in males, whereas in women the role of FM prevails with negative associations between gynoid fat and BMD.
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Affiliation(s)
- Stefano Gonnelli
- Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Siena, Italy.
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Lee K. Soft tissue composition and the risk of low bone mineral density: the Fourth Korea National Health And Nutrition Examination Survey (KNHANES IV-3), 2009. Calcif Tissue Int 2012; 90:186-92. [PMID: 22298125 DOI: 10.1007/s00223-012-9573-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 01/13/2012] [Indexed: 12/01/2022]
Abstract
The effects of total fat mass (FM) and total lean mass (LM) on total bone mineral density (BMD) were examined using the Fourth Korea National Health and Nutrition Examination Survey, 2009. FM, LM, and BMD were measured by DXA in a population-based sample of 6,762 Koreans, aged 19-93 (1,613 men < 50 years, 1,400 men ≥ 50 years, 2,120 premenopausal women, and 1,629 postmenopausal women). After adjusting for confounders (age, height, education, economic status, physical activity, smoking, alcohol use, serum vitamin D, medical history [diabetes, dyslipidemia, rheumatoid arthritis, and osteoporosis], family history of osteoporosis, multivitamin use, dietary intake [energy, calcium, and sodium], age at menarche, age at menopause, and hormone replacement therapy) and FM, higher LM was associated with a lower odds ratio for being in the group-specific lowest quintile of BMD (low BMD) in all groups. The odds for low BMD increased with higher FM in multivariate-adjusted analyses in men < 50 years, but this was not significant in other groups. Total BMD decreased with a decrease in the LM quintile across all FM subgroups in men of all ages, in the lower two subgroups of FM quintile in premenopausal women, and in the middle subgroup of FM quintile in postmenopausal women. In conclusion, higher LM was associated with a lower risk of low BMD in both genders, while higher FM was associated with a higher risk of low BMD for men < 50 years but not for women and men ≥ 50 years. The combined effects of LM and FM on BMD were gender- and menopause status-specific.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, 633-165 Kaegum-dong, Busan Jin-Gu, Busan 614-735, South Korea.
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