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Ma M, Liu X, Jia G, Geng B, Xia Y. The association between body fat distribution and bone mineral density: evidence from the US population. BMC Endocr Disord 2022; 22:170. [PMID: 35787696 PMCID: PMC9254427 DOI: 10.1186/s12902-022-01087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the association between different body fat distribution and different sites of BMD in male and female populations. METHODS Use the National Health and Nutrition Examination Survey (NHANES) datasets to select participants. The weighted linear regression model investigated the difference in body fat and Bone Mineral Density (BMD) in different gender. Multivariate adjusted smoothing curve-fitting and multiple linear regression models were used to explore whether an association existed between body fat distribution and BMD. Last, a subgroup analysis was performed according to age and gender group. RESULTS Overall, 2881 participants were included in this study. Compared to males, female participants had lower BMD (P < 0.05) and higher Gynoid fat mass (P < 0.00001), while there was no difference between Android fat mass (P = 0.91). Android fat mass was positively associated with Total femur BMD (Males, β = 0.044, 95% CI = 0.037, 0.051, P < 0.00001; Females, β = 0.044, 95% CI = 0.039, 0.049, P < 0.00001), Femoral neck BMD (Males, β = 0.034, 95% CI = 0.027, 0.041, P < 0.00001; Females, β = 0.032, 95% CI = 0.027, 0.037, P < 0.00001), and Total spine BMD (Males, β = 0.036, 95% CI = 0.029, 0.044, P < 0.00001; Females, β = 0.025, 95% CI = 0.019, 0.031, P < 0.00001). The Gynoid fat mass, subgroup analysis of age and ethnicity reached similar results. CONCLUSION Body fat in different regions was positively associated with BMD in different sites, and this association persisted in subgroup analyses across age and race in different gender.
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Affiliation(s)
- Ming Ma
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Xiaolong Liu
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Gengxin Jia
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Bin Geng
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Technology Center for Intelligent Orthopedic Industry, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
| | - Yayi Xia
- Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Second Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Orthopaedic Clinical Medical Research Center, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
- Technology Center for Intelligent Orthopedic Industry, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730000 Gansu Province China
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Lee DW, Cho MS, Choe EY, Park SW, Song YM, Lee SC, Sung J. Epicardial Fat Thickness and Bone Mineral Content: The Healthy Twin Study in Korea. J Epidemiol 2018; 28:253-259. [PMID: 29332861 PMCID: PMC5911676 DOI: 10.2188/jea.je20170027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The conventional concept of positive association between general obesity and bone health was challenged in recent studies reporting the different effects of specific fat deposition on bone health. In the present study, we investigated the association between epicardial fat and bone health. Methods We measured echocardiographic epicardial fat thickness (EFT) and bone mineral content (BMC) in a twin-family cohort of Koreans (n = 1,198; 525 men, 460 pre- and 213 post-menopausal women). A total 121 pairs of monozygotic twin (MZ) and 404 pairs of dizygotic twin and sibling pairs (DZ/Sib) were included. Results EFT was positively associated with BMC in total, as well as in three subgroups (β = 0.107, 0.076, and 0.058 for men, pre-, and post-menopausal women, respectively). The positive association between EFT and BMC remained for DZ/Sib difference analysis, but was absent for MZ comparisons. The positive association between BMI and BMC was consistent for DZ/Sib and MZ difference analysis. After adjusting for the effect of general obesity via BMI, the association between BMC and EFT was statistically non-significant (β = 0.020, 0.000, and −0.009 for men, pre-, and post-menopausal women, respectively). Conclusion Our findings do not support epicardial fat’s beneficial effects on bone health, whereas general adiposity has an osteotropic effect. The association between EFT and BMC is through common genetic component factors.
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Affiliation(s)
- Dong-Won Lee
- Department of Internal Medicine, Division of Gastroenterology, Korea University Ansan Hospital
| | - Min Soo Cho
- Heart Institute, Asan Medical Center, University of Ulsan College of Medicine
| | - Eun Yeong Choe
- Department of Internal Medicine, Division of Endocrinology, Yonsei University College of Medicine
| | - Seung Woo Park
- Department of Cardiology and Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Sang-Chol Lee
- Department of Cardiology and Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Joohon Sung
- Department of Epidemiology, School of Public Health, Seoul National University.,Institute of Health and Environment, Seoul National University.,Bio-MAX Institute, Seoul National University
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Zareef TA, Jackson RT, Alkahtani AA. Vitamin D Intake among Premenopausal Women Living in Jeddah: Food Sources and Relationship to Demographic Factors and Bone Health. J Nutr Metab 2018; 2018:8570986. [PMID: 29750126 PMCID: PMC5884207 DOI: 10.1155/2018/8570986] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/12/2017] [Accepted: 12/28/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Saudi women depend on food sources to maintain their serum 25(OH) D concentrations because covering by traditional clothing and time spent indoors limit their sun exposure. Little is known about vitamin D intake and its main food sources in Saudi Arabia. In addition, the association between vitamin D and calcium intake and bone mineral density (BMD) in young women is not well researched. OBJECTIVES To assess the adequacy of vitamin D intake among Saudi women as compared to the estimated average requirements (EARs), to identify dietary vitamin D sources, to examine potential determinants of vitamin D intake, and to assess bone health and the association of calcium and vitamin D intake with BMD. METHODS This cross-sectional study was conducted in 257 premenopausal women aged 20-50 years in Jeddah, Saudi Arabia. Dietary vitamin D and calcium were assessed by the Semiquantitative Food Frequency Questionnaire. BMD was measured using dual-energy X-ray absorptiometry (DXA) in a subset of women (n=102) at the lumbar spine and femur neck. RESULTS Sixty-five percent of women were below the EAR for vitamin D, and 61% fell below the EAR for calcium. Dairy products, supplements, and fish contributed most to vitamin D intake. Increased age was an independent determinant of sufficient vitamin D intake (p < 0.001). The prevalence of osteopenia was 33% in the lumbar spine and 30% in the femur neck. There was a significant positive association between calcium intake and BMD at the lumbar spine (p=0.043) after controlling for body mass index and energy intake. Vitamin D intake was not significantly different between women with low and normal bone mass. CONCLUSION Premenopausal women in Jeddah have insufficient vitamin D and calcium intakes. Public health strategies to improve nutrition in young women are needed, and expanding fortification programs to include all dairy products would be useful.
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Affiliation(s)
- Tahani A. Zareef
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Robert T. Jackson
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Abdulkareem A. Alkahtani
- Department of Nuclear Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Gibbs JC, Giangregorio LM, Wong AKO, Josse RG, Cheung AM. Appendicular and whole body lean mass outcomes are associated with finite element analysis-derived bone strength at the distal radius and tibia in adults aged 40years and older. Bone 2017; 103:47-54. [PMID: 28614701 DOI: 10.1016/j.bone.2017.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 05/16/2017] [Accepted: 06/06/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of this cross-sectional study was to determine how appendicular lean mass index (ALMI), and whole body lean (LMI) and fat mass indices (FMI) associate with estimated bone strength outcomes at the distal radius and tibia in adults aged 40 years and older. METHODS Dual energy X-ray absorptiometry (DXA) scans were performed to determine body composition, including whole body lean and fat mass, and appendicular lean mass. ALMI (appendicular lean mass/height2), LMI (lean tissue mass/height2) and FMI (fat mass/height2) were calculated. High-resolution peripheral quantitative computed tomography (HRpQCT) scans were performed to assess bone structural properties at the distal radius and tibia. Using finite element analysis, failure load (N), stiffness (N/mm), ultimate stress (MPa), and cortical-to-trabecular load ratio were estimated from HRpQCT scans. The associations between body composition (ALMI, LMI, FMI) and estimated bone strength were examined using bivariate and multivariable linear regression analyses adjusting for age, sex, and other confounding variables. RESULTS In 197 participants (127 women; mean±SD, age: 69.5±10.3y, body mass index: 27.95±4.95kg/m2, ALMI: 7.31±1.31kg/m2), ALMI and LMI were significantly associated with failure load at the distal radius and tibia (explained 39%-48% of the variance) and remained significant after adjusting for confounding variables and multiple testing (R2=0.586-0.645, p<0.001). ALMI, LMI, and FMI did not have significant associations with ultimate stress in our multivariable models. FMI was significantly associated with cortical-to-trabecular load ratio at the distal radius and tibia (explained 6%-12% of the variance) and remained significant after adjusting for confounders and multiple testing (R2=0.208-0.243, p<0.001). FMI was no longer significantly associated with failure load after adjusting for confounders. CONCLUSION These findings suggest that ALMI and LMI are important determinants of estimated bone strength, particularly failure load, at the distal radius and tibia, and may contribute to preservation of bone strength in middle-to-late adulthood.
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Affiliation(s)
- Jenna C Gibbs
- University of Waterloo, Department of Kinesiology, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Lora M Giangregorio
- University of Waterloo, Department of Kinesiology, 200 University Ave W, Waterloo, ON N2L 3G1, Canada; University Health Network-Toronto Rehabilitation Institute, Brain and Spinal Cord Rehabilitation Program, 520 Sutherland Drive, Toronto, ON M4G 3V9, Canada; Schlegel Research Institute for Aging, University of Waterloo, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada.
| | - Andy K O Wong
- University Health Network Osteoporosis Program, University of Toronto Centre of Excellence in Skeletal Health Assessment, 200 Elizabeth Street, EN7-221, Toronto, ON M5G 2C4, Canada.
| | - Robert G Josse
- St. Michael's Hospital, Department of Medicine, Osteoporosis Centre, 61 Queen St E, Toronto, ON M5C 2T2, Canada.
| | - Angela M Cheung
- University Health Network Osteoporosis Program, University of Toronto Centre of Excellence in Skeletal Health Assessment, 200 Elizabeth Street, EN7-221, Toronto, ON M5G 2C4, Canada.
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He H, Liu Y, Tian Q, Papasian CJ, Hu T, Deng HW. Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int 2016; 27:473-82. [PMID: 26243357 DOI: 10.1007/s00198-015-3241-8] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 07/07/2015] [Indexed: 01/08/2023]
Abstract
UNLABELLED The purpose of the study is to investigate the relationship between sarcopenia and body composition and osteoporosis in cohorts of three different races with a total of 17,891 subjects. Lean mass and grip strength were positively associated with bone mineral densities (BMDs). Subjects with sarcopenia were two times more likely to have osteoporosis compared with normal subjects. INTRODUCTION The relationship between sarcopenia and osteoporosis is not totally clear. First, the present study assessed this relationship by using two different definitions for sarcopenia. Second, we examined the associations of body composition (including muscle mass as a major and important component) and muscle strength on regional and whole-body BMDs. METHODS In total, 17,891 subjects of African American, Caucasian, and Chinese ethnicities were analyzed. Sarcopenia was defined by relative appendicular skeletal muscle mass (RASM) cut points and also by the definition of the European Working Group on Sarcopenia in Older People (low RASM plus low muscle function). Multiple regression analyses were conducted to examine the association of fat mass, lean mass (including muscle mass), and grip strength with regional and whole-body BMDs. Multivariate logistic regression analysis was performed to explore the association between sarcopenia and osteopenia/osteoporosis. RESULTS BMDs were positively associated with lean mass and negatively associated with fat mass, after controlling for potential confounders. Grip strength was significantly associated with higher BMDs. Each standard deviation (SD) increase in RASM resulted in a ~37 % reduction in risk of osteopenia/osteoporosis (odds ratio (OR) = 0.63; 95 % confidence interval (CI) = 0.59, 0.66). Subjects with sarcopenia defined by RASM were two times more likely to have osteopenia/osteoporosis compared with the normal subjects (OR = 2.04; 95 % CI = 1.61, 2.60). Similarly, subjects with sarcopenia (low muscle mass and low grip strength) were ~1.8 times more likely to have osteopenia/osteoporosis than normal subjects (OR = 1.87; 95 % CI = 1.09, 3.20). CONCLUSIONS High lean mass and muscle strength were positively associated with BMDs. Sarcopenia is associated with low BMD and osteoporosis.
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Affiliation(s)
- H He
- Center of Genomics and Bioinformatics, Tulane University, New Orleans, LA, 70118, USA
- Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Suite 2001, New Orleans, LA, 70112, USA
| | - Y Liu
- Center of Genomics and Bioinformatics, Tulane University, New Orleans, LA, 70118, USA
- Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Suite 2001, New Orleans, LA, 70112, USA
| | - Q Tian
- Center of Genomics and Bioinformatics, Tulane University, New Orleans, LA, 70118, USA
- Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Suite 2001, New Orleans, LA, 70112, USA
| | - C J Papasian
- Department of Basic Medical Sciences, University of Missouri-Kansas City, Kansas City, MO, 64110, USA
| | - T Hu
- Department of Epidemiology, Tulane University, New Orleans, LA, 70112, USA
| | - H-W Deng
- Center of Genomics and Bioinformatics, Tulane University, New Orleans, LA, 70118, USA.
- Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Suite 2001, New Orleans, LA, 70112, USA.
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Evans AL, Paggiosi MA, Eastell R, Walsh JS. Bone density, microstructure and strength in obese and normal weight men and women in younger and older adulthood. J Bone Miner Res 2015; 30:920-8. [PMID: 25400253 DOI: 10.1002/jbmr.2407] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 11/07/2014] [Accepted: 11/15/2014] [Indexed: 12/14/2022]
Abstract
Obesity is associated with greater areal BMD (aBMD) and is considered protective against hip and vertebral fracture. Despite this, there is a higher prevalence of lower leg and proximal humerus fracture in obesity. We aimed to determine if there are site-specific differences in BMD, bone structure, or bone strength between obese and normal-weight adults. We studied 100 individually-matched pairs of normal (body mass index [BMI] 18.5 to 24.9 kg/m2) and obese (BMI >30 kg/m2) men and women, aged 25 to 40 years or 55 to 75 years. We assessed aBMD at the whole body (WB), hip (TH), and lumbar spine (LS) with dual-energy X-ray absorptiometry (DXA), LS trabecular volumetric BMD (Tb.vBMD) by quantitative computed tomography (QCT), and vBMD and microarchitecture and strength at the distal radius and tibia with high-resolution peripheral QCT (HR-pQCT) and micro-finite element analysis. Serum type 1 procollagen N-terminal peptide (P1NP) and collagen type 1 C-telopeptide (CTX) were measured by automated electrochemiluminescent immunoassay (ECLIA). Obese adults had greater WB, LS, and TH aBMD than normal adults. The effect of obesity on LS and WB aBMD was greater in older than younger adults (p < 0.01). Obese adults had greater vBMD than normal adults at the tibia (p < 0.001 both ages) and radius (p < 0.001 older group), thicker cortices, higher cortical BMD and tissue mineral density, lower cortical porosity, higher trabecular BMD, and higher trabecular number than normal adults. There was no difference in bone size between obese and normal adults. Obese adults had greater estimated failure load at the radius (p < 0.05) and tibia (p < 0.01). Differences in HR-pQCT measurements between obese and normal adults were seen more consistently in the older than the younger group. Bone turnover markers were lower in obese than in normal adults. Greater BMD in obesity is not an artifact of DXA measurement. Obese adults have higher BMD, thicker and denser cortices, and higher trabecular number than normal adults. Greater differences between obese and normal adults in the older group suggest that obesity may protect against age-related bone loss and may increase peak bone mass.
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Affiliation(s)
- Amy L Evans
- Academic Unit of Bone metabolism, University of Sheffield, Sheffield, UK
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Salimzadeh A, Abolhasani M, Sedaghattalab M, Moghadasi M. Relationship between bone density and abdominal visceral fat in premenopausal overweight and obese Iranian women aged 30-50 years. Int J Rheum Dis 2014; 20:555-560. [PMID: 24832545 DOI: 10.1111/1756-185x.12400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The presence of a direct relationship between body mass index (BMI) and bone mineral density (BMD) is frequently reported. However, data on the relationship between visceral fat and bone density varies, with positive, negative or no relationship having been reported. This study aims to examine the relationship between abdominal visceral fat and BMD. METHODS A cross sectional study was carried out on 95 premenopausal, overweight and obese women aged 30-50 years referred to Sina Hospital, Tehran, Iran in 2011-2012. Anthropometric indices and visceral fat levels were measured. RESULTS Multiple linear regression analysis showed that proximal femur BMD (P = 0.856) and lumbar spine BMD (P = 0.558) were not significantly related to visceral fat level. However, BMI had a direct and significant positive relationship with proximal femur BMD (P = 0.001) and lumbar spine BMD (P = 0.031). Menarche age was negatively related to lumbar spine BMD (P = 0.003). CONCLUSIONS In this study, after adjusting for fat-free mass, no significant relationship was found between MBD of the proximal femur and lumbar spine, and visceral fat level or visceral fat to total fat percentage ratio. Therefore, abdominal visceral fat may not affect BMD, independent of weight. It seems that the positive relationship between BMI and proximal femur and lumbar spine BMD is due to the mechanical effects of weight on bones.
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Affiliation(s)
- Ahmad Salimzadeh
- Rheumatology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Abolhasani
- Endocrine and Metabolic Research Center, Obesity Group, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Moslem Sedaghattalab
- Department of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Moghadasi
- Rheumatology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Madeira E, Mafort TT, Madeira M, Guedes EP, Moreira RO, de Mendonça LMC, Lima ICB, de Pinho PRA, Lopes AJ, Farias MLF. Lean mass as a predictor of bone density and microarchitecture in adult obese individuals with metabolic syndrome. Bone 2014; 59:89-92. [PMID: 24220493 DOI: 10.1016/j.bone.2013.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 11/01/2013] [Accepted: 11/05/2013] [Indexed: 12/31/2022]
Abstract
The effects of obesity and metabolic syndrome (MS) on bone health are controversial. Furthermore, the relationship between body composition and bone quality has not yet been determined in this context. The aim of this study was to investigate the correlations between body composition and bone mineral density (BMD) and bone microstructure in obese individuals with MS. This cross-sectional study assessed 50 obese individuals with MS with respect to their body composition and BMD, both assessed using dual X-ray absorptiometry, and bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) of the distal tibia and radius. Several HR-pQCT measurements exhibited statistically significant correlations with lean mass. Lean mass was positively correlated with parameters of better bone quality (r: 0.316-0.470) and negatively correlated with parameters of greater bone fragility (r: -0.460 to -0.310). Positive correlations were also observed between lean mass and BMD of the total femur and radius 33%. Fat mass was not significantly correlated with BMD or any HR-pQCT measurements. Our data suggest that lean mass might be a predictor of bone health in obese individuals with MS.
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Affiliation(s)
- Eduardo Madeira
- Postgraduate Programme in Endocrinology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Thiago Thomaz Mafort
- Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Miguel Madeira
- Postgraduate Programme in Endocrinology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Erika Paniago Guedes
- Endocrinology Department, The Capriglione Luiz State Institute of Diabetes and Endocrinology, Rio de Janeiro, RJ, Brazil.
| | - Rodrigo Oliveira Moreira
- Endocrinology Department, The Capriglione Luiz State Institute of Diabetes and Endocrinology, Rio de Janeiro, RJ, Brazil.
| | | | - Inayá Correa Barbosa Lima
- PhD. COPPE, Nuclear Instrumentation Laboratory, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | | | - Agnaldo José Lopes
- Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Maria Lucia Fleiuss Farias
- Postgraduate Programme in Endocrinology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Shin D, Kim S, Kim KH, Park SM. Importance of fat mass and lean mass on bone health in men: the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Osteoporos Int 2014; 25:467-74. [PMID: 23779082 DOI: 10.1007/s00198-013-2412-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 06/03/2013] [Indexed: 12/28/2022]
Abstract
UNLABELLED This study was aimed to evaluate the association between body composition and bone health. High lean mass and low fat mass have protective effects on bone health in men representative of the national population. INTRODUCTION The aim of this study was to evaluate the association between body composition (fat mass and lean mass) and bone health in men. METHODS Totally, 3,945 men (age ≥ 20 years) from the fourth Korean National Health and Nutrition Examination Survey of 2008-2009 (KNHANES IV) were included in this study. Body composition and bone mineral densities (BMDs) were measured using dual energy X-ray absorptiometry. Osteopenia or osteoporosis was identified on the basis of the World Health Organization T-score criteria. RESULTS Multiple linear regression analyses showed that BMDs of the whole body, femoral neck, and lumbar spine were positively associated with lean mass and negatively associated with fat mass, after controlling for body weight and other potential confounders. Subjects with more fat mass or less lean mass, categorized according to quartiles of fat mass and lean mass, had higher odds of having osteopenia or osteoporosis, as shown by multivariable logistic regression (P for trend <0.001). CONCLUSIONS High lean mass and low fat mass have protective effects on bone health in a population of Korean adult men. Fat mass appears to exert a detrimental effect on BMD, in contrast with the positive weight-bearing effect. Body composition seems to be a more important determinant for bone health than simple body weight.
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Affiliation(s)
- D Shin
- Jangseong Public Health Center, Jangseong, South Korea
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Bijlsma AY, Meskers MCG, Molendijk M, Westendorp RGJ, Sipilä S, Stenroth L, Sillanpää E, McPhee JS, Jones DA, Narici M, Gapeyeva H, Pääsuke M, Seppet E, Voit T, Barnouin Y, Hogrel JY, Butler-Browne G, Maier AB. Diagnostic measures for sarcopenia and bone mineral density. Osteoporos Int 2013; 24:2681-91. [PMID: 23649802 DOI: 10.1007/s00198-013-2376-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 04/19/2013] [Indexed: 12/17/2022]
Abstract
SUMMARY Currently used diagnostic measures for sarcopenia utilize different measures of muscle mass, muscle strength, and physical performance. These diagnostic measures associate differently to bone mineral density (BMD), as an example of muscle-related clinical outcome. These differences should be taken into account when studying sarcopenia. INTRODUCTION Diagnostic measures for sarcopenia utilize different measures of muscle mass, muscle strength, and physical performance. To understand differences between these measures, we determined the association with respect to whole body BMD, as an example of muscle-related clinical outcome. METHODS In the European cross-sectional study MYOAGE, 178 young (18-30 years) and 274 healthy old participants (69-81 years) were recruited. Body composition and BMD were evaluated using dual-energy X-ray densitometry. Diagnostic measures for sarcopenia were composed of lean mass as percentage of body mass, appendicular lean mass (ALM) as percentage of body mass, ALM divided by height squared (ALM/height(2)), knee extension torque, grip strength, walking speed, and Timed Up and Go test (TUG). Linear regression models were stratified for sex and age and adjusted for age and country, and body composition in separate models. RESULTS Lean mass and ALM/height(2) were positively associated with BMD (P < 0.001). Significance remained in all sex and age subgroups after further adjustment for fat mass, except in old women. Lean mass percentage and ALM percentage were inversely associated with BMD in old women (P < 0.001). These inverse associations disappeared after adjustment for body mass. Knee extension torque and handgrip strength were positively associated with BMD in all subgroups (P < 0.01), except in old women. Walking speed and TUG were not related to BMD. CONCLUSIONS The associations between diagnostic measures of sarcopenia and BMD as an example of muscle-related outcome vary widely. Differences between diagnostic measures should be taken into account when studying sarcopenia.
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Affiliation(s)
- A Y Bijlsma
- Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Postbus 7057, 1007, Amsterdam, The Netherlands
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11
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Tao B, Li Z, Zhao HY, Sun LH, Zhao L, Li XY, Wang WQ, Ning G, Liu JM. A lower value for quantitative ultrasound at radius is an additional indicator of metabolic syndrome and cardiovascular disease risk. Clin Endocrinol (Oxf) 2013; 79:348-55. [PMID: 23009709 DOI: 10.1111/cen.12058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 05/02/2012] [Accepted: 09/19/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND The relationships between quantitative ultrasound (QUS) values, metabolic syndrome (MetS) and cardiovascular disease (CVD) risk are unclear. Objective The objective was to determine the relationships between QUS and MetS as well as CVD risk. DESIGN This was a cross-sectional study conducted in Shanghai, China. PATIENTS One-thousand four hundred and thirty-nine Chinese women and men with or without MetS were studied. MEASUREMENTS Speed of sound (SOS) at radius, phalanx and tibia and their relationships with MetS and Framingham's 10-year cardiovascular disease risk scores were investigated. RESULTS Premenopausal women with MetS had significant lower SOS at radius than those without MetS after adjusting for age, BMI and fat mass percentage (P = 0·02). The radius SOS was negatively associated with waist circumference (r = -0·109, P = 0·025), waist-to-hip ratio (r = -0·124, P = 0·01) and 2 h postprandial glucose level (r = -0·125, P = 0·012) in premenopausal women. Waist circumference, waist-to-hip ratio and 2 h postprandial glucose level increased with the decreasing tertiles of radius SOS after adjustment of age (P = 0·003, 0·002 and 0·008, respectively). The CVD risk increased with decreasing tertiles of radius SOS in postmenopausal women even after the adjustment of age, years since menopause, MetS components, smoking and alcohol habits (P < 0·001), but not in premenopausal women and men. CONCLUSIONS Lower radius SOS is associated with greater risks of MetS and CVD in premenopausal and postmenopausal women, respectively. The QUS value derived from non-weight-bearing site, such as radius, may represent an additional indicator of MetS and CVD risk in women.
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Affiliation(s)
- Bei Tao
- Department of Endocrine and Metabolic Disease, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Endocrine and Metabolic Division of E-Institutes of Shanghai Universities (EISU), Shanghai, China
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12
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Namwongprom S, Rojanasthien S, Mangklabruks A, Soontrapa S, Wongboontan C, Ongphiphadhanakul B. Effect of fat mass and lean mass on bone mineral density in postmenopausal and perimenopausal Thai women. Int J Womens Health 2013; 5:87-92. [PMID: 23467695 PMCID: PMC3589079 DOI: 10.2147/ijwh.s41884] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the association between fat mass, lean mass, and bone mineral density (BMD) in postmenopausal and perimenopausal Thai women. METHODS A cross-sectional study was conducted in 1579 healthy Thai women aged 40-90 years. Total body, lumbar spine, total femur, and femoral neck BMD and body composition were measured by dual x-ray absorptiometry. To evaluate the associations between fat mass and lean mass and various measures of BMD, multivariable linear regression models were used to estimate the regression coefficients for fat mass and lean mass, first in separate equations and then with both fat mass and lean mass in the same equation. RESULTS Among the study population, 1448 subjects (91.7%) were postmenopausal and 131 (8.3%) were perimenopausal. In postmenopausal women, after controlling for age, height, and duration of menopause, both fat mass and lean mass were positively correlated with BMD when they were analyzed independently of each other. When included in the same equation, both fat mass and lean mass continued to show a positive effect, but lean mass had a significantly greater impact on BMD than fat mass at all regions except for total body. Lean mass but not fat mass had a positive effect on BMD at all skeletal sites except the lumbar spine, after controlling for age and height in perimenopausal women. CONCLUSION Lean mass had a significant beneficial effect on BMD in both postmenopausal and perimenopausal women and can be considered as one of the determinants of bone mass. The effect of the fat mass was related to menopausal status, but only demonstrated a positive impact in perimenopausal women.
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Affiliation(s)
- Sirianong Namwongprom
- Clinical Epidemiology Program and Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai
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13
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Yuan JCC, Lee DJ, Afshari FS, Galang MTS, Sukotjo C. Dentistry and Obesity: A Review and Current Status in U.S. Predoctoral Dental Education. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2012.76.9.tb05367.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Judy Chia-Chun Yuan
- Department of Restorative Dentistry; College of DentistryUniversity of Illinois; Chicago
| | - Damian J. Lee
- Department of Restorative Dentistry; College of DentistryUniversity of Illinois; Chicago
| | - Fatemeh S. Afshari
- Department of Restorative Dentistry; College of DentistryUniversity of Illinois; Chicago
| | | | - Cortino Sukotjo
- Department of Restorative Dentistry; College of DentistryUniversity of Illinois; Chicago
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14
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Site-specific effects of trunk fat mass on bone mineral density in a group of adolescent girls. Sci Sports 2012. [DOI: 10.1016/j.scispo.2011.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Park JH, Song YM, Sung J, Lee K, Kim YS, Kim T, Cho SI. The association between fat and lean mass and bone mineral density: the Healthy Twin Study. Bone 2012; 50:1006-11. [PMID: 22306928 DOI: 10.1016/j.bone.2012.01.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 01/19/2012] [Accepted: 01/20/2012] [Indexed: 01/29/2023]
Abstract
The potential beneficial effects of increased body weight on bone mineral density (BMD) conflict with the adverse effects of obesity on various health outcomes, necessitating more specific evaluations of the association between each body component and BMD. In the present study, we evaluated associations of lean mass (LM) and fat mass (FM) with BMD in a Korean sample consisting of a total of 1782 men and women whose mean (standard deviation) age was 43.2 (12.6) years. They were selected from the Healthy Twin Study, a nationwide Korean twin and family study. BMD, FM and LM were measured using dual-energy X-ray absorptiometry. Quantitative genetic analysis and linear mixed analysis were performed with respect to familial relationships and a wide range of probable covariates. Linear mixed analysis revealed that BMD was positively associated with both FM and LM at each region of BMD measurement (whole body, spine, arms, and legs) in men, premenopausal women, and postmenopausal women. However, the association with BMD was stronger for LM than FM. Both LM and FM had positive genetic correlations with BMD at each region, although the correlation with BMD tended to be stronger for LM than FM. Together, these findings suggest that increased LM, rather than FM, is more beneficial for BMD in the Korean population and warrants further study of the common genetic determinants of BMD and body composition.
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Affiliation(s)
- Joo-Hyun Park
- Health Care Center, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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16
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Fu X, Ma X, Lu H, He W, Wang Z, Zhu S. Associations of fat mass and fat distribution with bone mineral density in pre- and postmenopausal Chinese women. Osteoporos Int 2011; 22:113-9. [PMID: 20306018 DOI: 10.1007/s00198-010-1210-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED Fat mass (FM) is closely related to bone mineral density (BMD). However, the associations of FM and fat distribution with BMD in pre- and postmenopausal women are still poorly understood. The present study showed android fat mass accumulation after menopause had a negative association with BMD. INTRODUCTION FM is closely related to BMD. However, it is unknown whether FM and central fat distribution have different associations with BMD in pre- and postmenopausal women. The study aims to investigate the associations of FM and fat distribution with BMD in pre- and postmenopausal Chinese women. METHODS Two hundred sixty premenopausal and 267 postmenopausal women aged 18 to 79 years were analyzed. Lean mass (LM), FM, percent body fat (%BF), android FM, gynoid FM, and total and regional BMD were measured using dual-energy X-ray absorptiometry. Fat distribution was assessed by android to gynoid FM ratio (AOI). Multiple regression analysis was performed to examine the associations of BMD with FM, LM, and AOI. RESULTS FM, %BF, android FM, and AOI were significantly higher, whereas total and regional BMD were significantly lower in postmenopausal women (all р < 0.01). In premenopausal women, FM was positively associated with total and regional BMD (all р < 0.05). AOI had no significant association with BMD. In postmenopausal women, FM was significantly associated with total and regional BMD even additionally adjusting for LM (all р < 0.01). AOI had significantly negative association with total, head, arm, and leg BMD (all р < 0.05). The results remained unchanged when replacing FM with %BF. CONCLUSIONS There were different associations of FM and fat distribution with BMD in pre- and postmenopausal Chinese women. Increased central body fat had a negative association with BMD. Our findings may have significant implications in the prevention of menopause-related osteoporosis through reducing centralized fat deposition.
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Affiliation(s)
- X Fu
- Obesity and Body Composition Research Center, School of Public Health, Zhejiang University, 388 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China
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Xu L, Nicholson P, Wang QJ, Wang Q, Alén M, Cheng S. Fat mass accumulation compromises bone adaptation to load in Finnish women: a cross-sectional study spanning three generations. J Bone Miner Res 2010; 25:2341-9. [PMID: 20499343 DOI: 10.1002/jbmr.136] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Body weight and lean mass correlate with bone mass, but the relationship between fat mass and bone remains elusive. The study population consisted of 396 girls and 138 premenopausal mothers and 114 postmenopausal grandmothers of these girls. Body composition and tibial length were assessed using dual-energy X-ray absorptiometry (DXA), and bone traits were determined at the tibia using peripheral quantitative computed tomography (pQCT) in the girls at the ages of 11.2 ± 0.8, 13.2 ± 0.9, and 18.3 ± 1.0 years and in the mothers (44.7 ± 4.1 years) and grandmothers (70.7 ± 6.3 years). The values of relative bone strength index (RBSI), an index reflecting the ratio of bone strength to the load applied on the tibia, were correlated among family members (all p < .05). The mean values of RBSI were similar among 11- and 18-year-old girls and premenopausal women but significantly lower in 13-year-old girls and postmenopausal women. However, in each age group, subjects in the highest BMI tertiles had the lowest RBSI values (all p < .01). RBSI was inversely associated with body weight (all p < .01), indicating a deficit in bone strength relative to the applied load from greater body weight. RBSI was inversely associated with fat mass (all p < .001) across age groups and generations but remained relatively constant with increasing lean mass in girls and premenopausal women (all p > .05), indicating that the bone-strength deficit was attributable to increased fat mass, not lean mass. Moreover, the adverse effect of fat mass was age-dependent, with every unit increase in fat mass associated with a greater decrease in RBSI in pre- and postmenopausal women than in girls (all p < .001). This is largely due to the different capacity of young and adult bones to increase diaphyseal width by periosteal apposition in response to increased load. In summary, increasing body weight with fat accumulation is accompanied by an age-dependent relative bone-strength deficit in women because the beneficial effects of increased fat mass on bone, if any, do not compensate for the mechanical burden that it imposes.
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Affiliation(s)
- Leiting Xu
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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