1
|
Li L, Zhang C, Wang R, Zhang N, Huo M, Zhang M, Fan Q, Sun L. Relationship between abdominal fat volume and bone base material pairs from dual-energy spectral computed tomography in young and middle-aged patients with metabolic syndrome. Quant Imaging Med Surg 2024; 14:6635-6646. [PMID: 39281133 PMCID: PMC11400658 DOI: 10.21037/qims-24-573] [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] [Received: 03/20/2024] [Accepted: 07/23/2024] [Indexed: 09/18/2024]
Abstract
Background Metabolic syndrome (MetS) has complex effects on bone health, and dual-energy spectral computed tomography (CT) has become increasingly valuable for bone quantification. However, the relationship between bone base material pairs (BMPs) and abdominal fat volume in patients with MetS remains underexplored. This study thus aimed to analyze the relationship between abdominal fat volume and various bone BMPs using dual-energy spectral CT in young and middle-aged patients with MetS. Methods Patients with MetS who underwent sleeve gastrectomy at the Center of Obesity and Metabolic Diseases, Beijing Shijitan Hospital, Capital Medical University, from June to November 2021 were retrospectively collected. The abdominal fat measurements and BMPs were acquired using dual-energy spectral CT imaging. These included the volumes of total abdominal fat (TAF), abdominal visceral fat (AVF), and abdominal subcutaneous fat (ASF), as well as bone densities based on hydroxyapatite (water), i.e., HAP (water), and calcium (water), i.e., Ca (water), BMPs. After grouping the patients by sex, we analyzed the differences in clinical and imaging features. The correlation between the clinical and imaging parameters of patients with MetS was evaluated with Pearson correlation coefficients. Age- and sex-adjusted partial correlation analysis between fat volume and bone BMPs was conducted for patients of different sexes. Additionally, multiple linear regression analyses were performed with age, sex, and TAF volume as the independent variables and with Ca (water) and HAP (water) as dependent variables. Results A total of 112 young and middle-aged patients with MetS were included in this study, including 85 females and 27 males. Compared to male patients with MetS, the females with MetS exhibited higher lumbar Ca (water) and HAP (water) BMPs, with lower volumes of TAF and AVF and a smaller abdominal circumference (P<0.01). The volumes of TAF, AVF, and ASF were negatively correlated with the average Ca (water) and HAP (water) BMPs in the first to third lumbar vertebrae (L1-L3) (P<0.05). Ca (water) and HAP (water) BMPs decreased with age and increasing TAF volume (P<0.001). The fitted equations for the relationship between bone BMPs with age, sex, and TAF volume were as follows: (I) bone Ca (water) BMP = 76.469 - 0.500 age + 6.762 sex - 0.002 TAF volume; (II) bone HAP (water) BMP =171.704 - 1.138 age + 11.825 sex - 0.004 TAF volume. Conclusions In young and middle-aged patients with MetS, the abdominal fat volume was negatively correlated with lumbar bone Ca (water) and HAP (water) BMPs, implying that increased abdominal fat volume may play a crucial role in the pathogenesis of osteopenia among those with MetS. The reduction of bone Ca (water) and HAP (water) with high abdominal fat volume may hold clinical significance for fracture risk in individuals with MetS.
Collapse
Affiliation(s)
- Ling Li
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chunyan Zhang
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Rengui Wang
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Nengwei Zhang
- Center of Obesity and Metabolic Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Meng Huo
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Mingxia Zhang
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Qing Fan
- Center of Obesity and Metabolic Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lei Sun
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Xiao P, Wang Z, Lu Z, Liu S, Huang C, Xu Y, Tian Y. The association between remnant cholesterol and bone mineral density in US adults: the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Lipids Health Dis 2024; 23:148. [PMID: 38762471 PMCID: PMC11102129 DOI: 10.1186/s12944-024-02145-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Previous evidence showed a possible link of dyslipidemia with bone health. Nevertheless, the correlation of remnant cholesterol (RC) with bone mineral density (BMD) has yet to be well investigated. This study investigated the association of RC with total spine BMD in general Americans. METHODS This study explored the relationship of RC with total spine BMD in subjects aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. After adjusting for covariates, multivariate linear regression and stratified analyses were conducted to determine the correlation of serum RC with total spine BMD in adult Americans. Restricted cubic spline (RCS) was applied to examine the nonlinear association of serum RC with total spine BMD. RESULTS This study included 3815 individuals ≥ 20 years old, 1905 (49.93%) of whom were men and 1910 (50.07%) of whom were women. After adjusting for all covariates, the results showed a negative relationship of serum RC with total spine BMD (β= -0.024, 95% CI: -0.039, -0.010). The interaction tests of age, sex, race, and BMI showed no statistically significant effects on the association. The RCS also indicated a negative linear correlation of serum RC with total spine BMD (nonlinear P = 0.068, overall P < 0.001). Moreover, RC had a stronger effect on total spine BMD than total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). CONCLUSIONS This study found that serum RC was negatively related to total spine BMD in U.S. adults. These findings emphasized the important role of RC in bone health in American adults.
Collapse
Affiliation(s)
- Peilun Xiao
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhihang Wang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zeyao Lu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shijia Liu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chongjun Huang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Xu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Ye Tian
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China.
| |
Collapse
|
3
|
Sun Y, Qi X, Wang X, Lin X, Zhou Y, Du Y, Liu A, Lv X, Zhou J, Li Z, Wu X, Zou Z, Zhang M, Zhu J, Shang F, Li Y, Li H. Association between high-density lipoprotein cholesterol and lumbar bone mineral density in Chinese: a large cross-sectional study. Lipids Health Dis 2024; 23:27. [PMID: 38267987 PMCID: PMC10807139 DOI: 10.1186/s12944-024-02023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The association between lipid and bone metabolism, particularly the role of high-density lipoprotein cholesterol (HDL-C) in regulating bone mineral density (BMD), is of significant interest. Despite numerous studies, findings on this relationship remain inconclusive, especially since evidence from large, sexually diverse Chinese populations is sparse. This study, therefore, investigates the correlation between HDL-C and lumbar BMD in people of different genders using extensive population-based data from physical examinations conducted in China. METHODS Data from a cross-sectional survey involving 20,351 individuals aged > = 20 years drawn from medical records of health check-ups at the Health Management Centre of the Henan Provincial People's Hospital formed the basis of this study. The primary objective was to determine the correlation between HDL-C levels and lumbar BMD across genders. The analysis methodology included demographic data analysis, one-way ANOVA, subgroup analyses, multifactorial regression equations, smoothed curve fitting, and threshold and saturation effect analyses. RESULTS Multifactorial regression analysis revealed a significant inverse relationship between HDL-C levels and lumbar BMD in both sexes, controlling for potential confounders (Male: β = -8.77, 95% CI -11.65 to -5.88, P < 0.001; Female: β = -4.77, 95% CI -8.63 to -0.90, P = 0.015). Subgroup and threshold saturation effect analyses indicated a stronger association in males, showing that increased HDL-C correlates with reduced lumbar BMD irrespective of age and body mass index (BMI). The most significant effect was observed in males with BMI > 28 kg/m2 and HDL-C > 1.45 mmol/L and in females with a BMI between 24 and 28 kg/m2. CONCLUSION Elevated HDL-C is associated with decreased bone mass, particularly in obese males. These findings indicate that individuals with high HDL-C levels should receive careful clinical monitoring to mitigate osteoporosis risk. TRIAL REGISTRATION The research protocol received ethics approval from the Ethics Committee at Beijing Jishuitan Hospital, in conformity with the Declaration of Helsinki guidelines (No. 2015-12-02). These data are a contribution of the China Health Quantitative CT Big Data Research team, registered at clinicaltrials.gov (code: NCT03699228).
Collapse
Affiliation(s)
- Yongbing Sun
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Xin Qi
- Department of Medical Imaging, Henan Provincial People's Hospital, Xinxiang Medical College, Zhengzhou, Henan, 450003, China
| | - Xuan Wang
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, #7 Kungfu Street, Zhengzhou, Henan, 450052, China
| | - Xinbei Lin
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Yang Zhou
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Yawei Du
- Department of Medical Imaging, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, 450003, China
| | - Ao Liu
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Xue Lv
- Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Jing Zhou
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Zhonglin Li
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Xiaoling Wu
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Zhi Zou
- Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, Henan, 450003, China
| | - Michael Zhang
- Sevenoaks Health Management Center, Canada-Canada Institute of Health Engineering, University of Manitoba, Winnipeg, Canada
| | - Jiadong Zhu
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Feifei Shang
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Yongli Li
- Department of Health Management, Chronic Health Management Laboratory, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China.
| | - Hao Li
- Fuwaihua Central Vascular Disease Hospital, #1 Fuwai Avenue, Zhengzhou, Henan, 451464, China.
| |
Collapse
|
4
|
Chen R, Armamento-Villareal R. Obesity and Skeletal Fragility. J Clin Endocrinol Metab 2024; 109:e466-e477. [PMID: 37440585 PMCID: PMC10795939 DOI: 10.1210/clinem/dgad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/15/2023]
Abstract
Skeletal fracture has recently emerged as a complication of obesity. Given the normal or better than normal bone mineral density (BMD), the skeletal fragility of these patients appears to be a problem of bone quality rather than quantity. Type 2 diabetes mellitus (T2DM), the incidence of which increases with increasing body mass index, is also associated with an increased risk for fractures despite a normal or high BMD. With the additional bone pathology from diabetes itself, patients with both obesity and T2DM could have a worse skeletal profile. Clinically, however, there are no available methods for identifying those who are at higher risk for fractures or preventing fractures in this subgroup of patients. Weight loss, which is the cornerstone in the management of obesity (with or without T2DM), is also associated with an increased risk of bone loss. This review of the literature will focus on the skeletal manifestations associated with obesity, its interrelationship with the bone defects associated with T2DM, and the available approach to the bone health of patients suffering from obesity.
Collapse
Affiliation(s)
- Rui Chen
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| |
Collapse
|
5
|
Zhang Y, Wu H, Li C, Liu C, Liu M, Liu X, Yin Q, Li X, Xie R. Associations between weight-adjusted waist index and bone mineral density: results of a nationwide survey. BMC Endocr Disord 2023; 23:162. [PMID: 37537589 PMCID: PMC10399051 DOI: 10.1186/s12902-023-01418-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The weight-adjusted waist circumference index (WWI) is a novel obesity indicator that offers improved accuracy in assessing both muscle and fat mass compared to traditional measures. This study aimed to investigate the association between WWI and bone mineral density (BMD) in adults. METHODS Weighted multivariate logistic regression, subgroup analysis, interaction tests and restricted cubic spline (RCS) curves were used to explore the relationship between WWI and BMD based on data from the National Health and Nutrition Examination Survey (NHANES). RESULTS This study had 40,568 individuals in total. At all four measurement sites, we detected a negative linear correlation between WWI and BMD. Even when quartile factors for WWI were created, this unfavorable connection maintained. In comparison to those in the lowest quartile, those in the highest percentile of WWI showed declines in lumbar BMD of 0.08 g/cm2 and femoral neck BMD of 0.03 g/cm2, respectively. This adverse correlation, nevertheless, differed among several categories. CONCLUSIONS Our findings suggest an adverse correlation between WWI and BMD among US adults. Employing WWI as a tool for osteoporosis prevention in the general population may enhance interventions.
Collapse
Affiliation(s)
- Ya Zhang
- Department of Gland Surgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China
| | - Haiyang Wu
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, Durham, NC, USA
| | - Cheng Li
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Changxiong Liu
- Department of Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China
| | - Mingjiang Liu
- Department of Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiming Yin
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Xianzhe Li
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Ruijie Xie
- Department of Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| |
Collapse
|
6
|
Lin Y, Zhong X, Lu D, Yao W, Zhou J, Wu R, Feng F. Association of visceral and subcutaneous fat with bone mineral density in US adults: a cross-sectional study. Sci Rep 2023; 13:10682. [PMID: 37393338 PMCID: PMC10314932 DOI: 10.1038/s41598-023-37892-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/29/2023] [Indexed: 07/03/2023] Open
Abstract
The relationship between the accumulation of fat in visceral or subcutaneous tissue and bone mineral density (BMD) remains unclear. Our primary objective in this study was to illuminate this relationship by conducting an investigation on a vast scale, encompassing a nationally representative population in the United States. A weighted multiple linear regression model was established to evaluate the relationship between visceral fat, subcutaneous fat, and BMD. Additionally, the exploration of the potential nonlinear relationship was conducted employing the methodology of smooth curve fitting. In order to determine potential inflection points, a two-stage linear regression model was utilized. A total of 10,455 participants between the ages of 20 and 59 were included in this study. Various weighted multiple linear regression models revealed a negative correlation between lumbar BMD and visceral mass index (VMI) and subcutaneous mass index (SMI). However, the association between VMI and lumbar BMD displayed a U-shaped pattern upon employing the smooth curve fitting, and the inflection point of 0.304 kg/m2was determined using a two-stage linear regression model. Our findings indicated a negative association between subcutaneous fat and BMD. A U-shaped relationship was observed between visceral fat and BMD.
Collapse
Affiliation(s)
- Yanze Lin
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xugang Zhong
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Qingdao University, Qingdao, China
| | - Dongning Lu
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenchao Yao
- Department of Orthopaedics, The First People's Hospital of Chun'an County, Hangzhou, Zhejiang, China
| | - Jinlei Zhou
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ruiji Wu
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fabo Feng
- Center for Plastic and Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
| |
Collapse
|
7
|
Tao J, Zhang Y, Tan C, Tan W. Associations between weight-adjusted waist index and fractures: a population-based study. J Orthop Surg Res 2023; 18:290. [PMID: 37038167 PMCID: PMC10088134 DOI: 10.1186/s13018-023-03776-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/02/2023] [Indexed: 04/12/2023] Open
Abstract
INTRODUCTION The weight-adjusted waist circumference index (WWI) is a novel obesity evaluation indicator that appears to be superior to body mass index (BMI) and waist circumference (WC) in evaluating muscle and fat mass. The purpose of this study was to investigate the association between WWI and fractures among adults. METHODS In this cross-sectional study, multivariate logistic regression and smoothed curve fitting were used to investigate linear and nonlinear associations between WWI and fractures, based on data from 28,679 adult participants in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. RESULTS After adjusting for all covariates, the prevalence of hip/wrist/spine fractures among all participants was 1.09%, 8.87%, and 1.97%, respectively. A 1-unit increase in WWI was associated with a 5% increase in the odds of hip fractures [1.05 (1.01, 1.10)], and a 9% increase in the odds of spine fractures [1.09 (1.06, 1.13)], but not with the prevalence of wrist fractures [0.97 (0.94, 1.06)]. CONCLUSIONS Higher WWI was associated with an increased prevalence of hip fracture and spine fracture, but not wrist fracture.
Collapse
Affiliation(s)
- Jianchun Tao
- Department of Traumatic and Pediatric Orthopedics, The Affiliated Second Hospital, Hengyang Medical School, University of South China, No. 30 Jiefang Road, Shigu District, Hengyang City, 421009, Hunan Province, People's Republic of China
| | - Yun Zhang
- Department of Traumatic and Pediatric Orthopedics, The Affiliated Second Hospital, Hengyang Medical School, University of South China, No. 30 Jiefang Road, Shigu District, Hengyang City, 421009, Hunan Province, People's Republic of China
| | - Caixia Tan
- Department of Traumatic and Pediatric Orthopedics, The Affiliated Second Hospital, Hengyang Medical School, University of South China, No. 30 Jiefang Road, Shigu District, Hengyang City, 421009, Hunan Province, People's Republic of China
| | - Wenfu Tan
- Department of Traumatic and Pediatric Orthopedics, The Affiliated Second Hospital, Hengyang Medical School, University of South China, No. 30 Jiefang Road, Shigu District, Hengyang City, 421009, Hunan Province, People's Republic of China.
| |
Collapse
|
8
|
Walowski CO, Herpich C, Enderle J, Braun W, Both M, Hasler M, Müller MJ, Norman K, Bosy-Westphal A. Determinants of bone mass in older adults with normal- and overweight derived from the crosstalk with muscle and adipose tissue. Sci Rep 2023; 13:5030. [PMID: 36977715 PMCID: PMC10050471 DOI: 10.1038/s41598-023-31642-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Lower bone mass in older adults may be mediated by the endocrine crosstalk between muscle, adipose tissue and bone. In 150 community-dwelling adults (59-86 years, BMI 17-37 kg/m2; 58.7% female), skeletal muscle mass index, adipose tissue and fat mass index (FMI) were determined. Levels of myokines, adipokines, osteokines, inflammation markers and insulin were measured as potential determinants of bone mineral content (BMC) and density (BMD). FMI was negatively associated with BMC and BMD after adjustment for mechanical loading effects of body weight (r-values between -0.37 and -0.71, all p < 0.05). Higher FMI was associated with higher leptin levels in both sexes, with higher hsCRP in women and with lower adiponectin levels in men. In addition to weight and FMI, sclerostin, osteocalcin, leptin × sex and adiponectin were independent predictors of BMC in a stepwise multiple regression analysis. Muscle mass, but not myokines, showed positive correlations with bone parameters that were weakened after adjusting for body weight (r-values between 0.27 and 0.58, all p < 0.01). Whereas the anabolic effect of muscle mass on bone in older adults may be partly explained by mechanical loading, the adverse effect of obesity on bone is possibly mediated by low-grade inflammation, higher leptin and lower adiponectin levels.
Collapse
Affiliation(s)
- Carina O Walowski
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Catrin Herpich
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Janna Enderle
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University, Kiel, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Kristina Norman
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany.
| |
Collapse
|
9
|
Alekos NS, Kushwaha P, Kim SP, Li Z, Abood A, Dirckx N, Aja S, Kodama J, Garcia-Diaz JG, Otsuru S, Rendina-Ruedy E, Wolfgang MJ, Riddle RC. Mitochondrial β-oxidation of adipose-derived fatty acids by osteoblasts fuels parathyroid hormone-induced bone formation. JCI Insight 2023; 8:e165604. [PMID: 36729662 PMCID: PMC10070112 DOI: 10.1172/jci.insight.165604] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/01/2023] [Indexed: 02/03/2023] Open
Abstract
The energetic costs of bone formation require osteoblasts to coordinate their activities with tissues, like adipose, that can supply energy-dense macronutrients. In the case of intermittent parathyroid hormone (PTH) treatment, a strategy used to reduce fracture risk, bone formation is preceded by a change in systemic lipid homeostasis. To investigate the requirement for fatty acid oxidation by osteoblasts during PTH-induced bone formation, we subjected mice with osteoblast-specific deficiency of mitochondrial long-chain β-oxidation as well as mice with adipocyte-specific deficiency for the PTH receptor or adipose triglyceride lipase to an anabolic treatment regimen. PTH increased the release of fatty acids from adipocytes and β-oxidation by osteoblasts, while the genetic mouse models were resistant to the hormone's anabolic effect. Collectively, these data suggest that PTH's anabolic actions require coordinated signaling between bone and adipose, wherein a lipolytic response liberates fatty acids that are oxidized by osteoblasts to fuel bone formation.
Collapse
Affiliation(s)
- Nathalie S. Alekos
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Graduate Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Priyanka Kushwaha
- Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Soohyun P. Kim
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zhu Li
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Abdullah Abood
- Center for Public Health Genomics, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Naomi Dirckx
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Susan Aja
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joe Kodama
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jean G. Garcia-Diaz
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Graduate Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Satoru Otsuru
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth Rendina-Ruedy
- Department of Medicine and Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael J. Wolfgang
- Department of Biological Chemistry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ryan C. Riddle
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Research & Development Service, Baltimore Veterans Administration Medical Center, Baltimore, Maryland, USA
| |
Collapse
|
10
|
Kutleša Z, Ordulj I, Perić I, Jerković K, Poljak D, Gavrilović V, Čapkun V, Devčić Š, Budimir Mršić D. Opportunistic measures of bone mineral density at multiple skeletal sites during whole-body CT in polytrauma patients. Osteoporos Int 2023; 34:775-782. [PMID: 36799980 DOI: 10.1007/s00198-023-06699-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
UNLABELLED Whole-body CT in polytrauma patients revealed bone mineral density variations throughout the skeleton. Bone density was the highest in cranial bones and the lowest in proximal extremities and pelvis. Skeletal age-related changes were generally more pronounced than sex-related changes. Cranial bones did not follow the same aging pattern compared to other bones. INTRODUCTION Whole-body CT (WBCT) in polytrauma patients enables the detection of numerous incidental findings, such as estimates of bone mineral density (BMD) at multiple skeletal sites. This could help in better understanding of age- and sex-related changes in BMD through skeleton. METHODS Data were retrospectively retrieved from the WBCTs requested during a 2-year period. BMD, expressed in CT Hounsfield units (HU), was measured at frontal and occipital bone, four vertebrae (C4, Th7, L4, and S2), iliac bone, and proximal humerus and femur. Measurements were done on native and postcontrast scans. The population sample was age-, sex-, and visceral fat volume adjusted for analysis. RESULTS A total of 296 patients were included, with a median age of 51 years. BMD varied from the highest HU in cranial bones (629 HU) to the lowest HU in the pelvic bones (114 HU), P < 0.001. Sex differences were independent predictors of BMD in cranial bones and proximal humerus. The age-related decline in BMD was significant in all other bones, but the association with age differed among the measurement's sites. Visceral fat showed the strongest correlation with the lumbar spine and iliac wing, although multivariate analysis revealed it was not an independent predictor of bone density, such as age and sex. CONCLUSIONS BMD varies through skeleton, being the highest in the proximal axial skeleton. Age-related changes in BMD are significant and more pronounced than sex-related changes in almost all bones. Cranial bones do not follow the same pattern compared to other bones.
Collapse
Affiliation(s)
- Zvonimir Kutleša
- Department of Orthopaedics and Traumatology, Split-Dalmatia County Health Center, Kavanjinova 2, 21000, Split, Croatia
| | - Ivan Ordulj
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčičeva 1, Šoltanska 2, 21000, Split, Croatia
| | - Iva Perić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčičeva 1, Šoltanska 2, 21000, Split, Croatia
| | - Kristian Jerković
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčičeva 1, Šoltanska 2, 21000, Split, Croatia
| | - Dino Poljak
- Department of Orthopaedics and Traumatology, University Hospital Split, Šoltanska 2, 21000, Split, Croatia
| | - Vlado Gavrilović
- Department of Orthopaedics and Traumatology, University Hospital Split, Šoltanska 2, 21000, Split, Croatia
| | - Vesna Čapkun
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia
| | - Šime Devčić
- Department of Orthopaedics and Traumatology, University Hospital Split, Šoltanska 2, 21000, Split, Croatia
| | - Danijela Budimir Mršić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčičeva 1, Šoltanska 2, 21000, Split, Croatia.
- School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia.
- University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000, Split, Croatia.
| |
Collapse
|
11
|
Riddle RC. Endocrine Functions of Sclerostin. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2023; 28:10.1016/j.coemr.2022.100433. [PMID: 36713826 PMCID: PMC9881182 DOI: 10.1016/j.coemr.2022.100433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Sclerostin, the product of the SOST gene has primarily been studied for its profound impact on bone mass. By interacting with LRP5 and LRP6, the glycoprotein suppresses the propagation of Wnt signals to β-catenin and thereby suppresses new bone formation. In this review, we discuss emerging data which suggest that sclerostin also acts outside the skeleton to influence metabolism. In humans, serum sclerostin levels are associated with body mass index and indices of metabolic function. Likewise, genetic mouse models of Sost gene deficiency indicate sclerostin influences adipocyte development and insulin signaling. These data raise the possibility that sclerostin neutralization may be effective at treating two epidemic conditions: osteoporosis and obesity.
Collapse
Affiliation(s)
- Ryan C. Riddle
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Research and Development Service, Baltimore Veterans Administration Medical Center, Baltimore, Maryland, USA.,Address Correspondence to: Ryan C. Riddle, Ph.D., Department of Orthopaedics, University of Maryland School of Medicine, 660 W. Redwood Street, Room 592, Baltimore, MD 21201, USA, , Ph: 410-706-0422
| |
Collapse
|
12
|
Bland VL, Bea JW, Going SB, Yaghootkar H, Arora A, Ramadan F, Funk JL, Chen Z, Klimentidis YC. Metabolically favorable adiposity and bone mineral density: a Mendelian randomization analysis. Obesity (Silver Spring) 2023; 31:267-278. [PMID: 36502291 DOI: 10.1002/oby.23604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This analysis assessed the putative causal association between genetically predicted percent body fat and areal bone mineral density (aBMD) and, more specifically, the association between genetically predicted metabolically "favorable adiposity" (MFA) and aBMD at clinically relevant bone sites. METHODS Mendelian randomization was used to assess the relationship of MFA and percent body fat with whole-body, lumbar spine, femoral neck, and forearm aBMD. Sex-stratified and age-stratified exploratory analyses were conducted. RESULTS In all MR analyses, genetically predicted MFA was inversely associated with aBMD for the whole body (β = -0.053, p = 0.0002), lumbar spine (β = -0.075; p = 0.0001), femoral neck (β = -0.045; p = 0.008), and forearm (β = -0.115; p = 0.001). This negative relationship was strongest in older individuals and did not differ by sex. The relationship between genetically predicted percent body fat and aBMD was nonsignificant across all Mendelian randomization analyses. Several loci that were associated at a genome-wide significance level (p < 5 × 10-8 ) in opposite directions with body fat and aBMD measures were also identified. CONCLUSIONS This study did not support the hypothesis that MFA protects against low aBMD. Instead, it showed that MFA may result in lower aBMD. Further research is needed to understand how MFA affects aBMD and other components of bone health such as bone turnover, bone architecture, and osteoporotic fractures.
Collapse
Affiliation(s)
- Victoria L Bland
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona, USA
| | - Jennifer W Bea
- Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona, USA
- The University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Scott B Going
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona, USA
| | - Hanieh Yaghootkar
- Centre for Inflammation Research and Translational Medicine, Department of Life Sciences, Brunel University London, Uxbridge, UK
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London, UK
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Royal Devon & Exeter Hospital, Exeter, UK
| | - Amit Arora
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Ferris Ramadan
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Janet L Funk
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona, USA
- Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Yann C Klimentidis
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
13
|
Body Composition as a Modulator of Bone Health Changes in Patients with Inflammatory Bowel Disease. Life (Basel) 2022; 12:life12020272. [PMID: 35207559 PMCID: PMC8875340 DOI: 10.3390/life12020272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Bone impairment of multifactorial etiology is a common feature in inflammatory bowel disease (IBD). Body composition parameters, which might be selectively modified in these patients, are important determinants of bone strength. Our aim was to investigate the relationship between components of body composition and bone parameters in IBD patients. Methods: This is a cross-sectional, retrospective study including 80 IBD patients (43 women, 37 men). Lumbar spine (LS), femoral neck (FN) and whole body DXA scans were performed to analyze regional bone mineral density (BMD), as well as body composition, including appendicular skeletal muscle mass index (ASMI), total and visceral fat mass (VAT). Trabecular bone score (TBS) was assessed using iNsight Software. Results: Twenty (25%) IBD patients had inadequate LS-BMD z scores (<=−2DS). Lean mass (LM) was a significant determinant of LS-BMD, after adjusting for age, gender, BMI and fat mass (p < 0.01), while fat mass% remained associated with FN-BMD (p < 0.01). TBS correlated positively with BMI (r = 0.24, p < 0.05), LS-BMD (r = 0.56, p < 0.001), ASMI (r = 0.34, p < 0.001) and negatively with VAT/total fat% (r = −0.27, p < 0.05). Multivariate analysis showed that ASMI, LS-BMD (positively) and VAT/total fat% (negatively) were independently associated with TBS. Conclusions: In IBD patients, skeletal muscle mass and fat percentage and distribution are important factors associated with bone health.
Collapse
|
14
|
Bland VL, Klimentidis YC, Bea JW, Roe DJ, Funk JL, Going SB. Cross-sectional associations between adipose tissue depots and areal bone mineral density in the UK Biobank imaging study. Osteoporos Int 2022; 33:391-402. [PMID: 34490505 DOI: 10.1007/s00198-021-06140-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022]
Abstract
UNLABELLED The relationship between obesity and osteoporosis is poorly understood. In this study, we assessed the association between adiposity and bone. The fat-bone relationship was dependent on sex, body mass index classification, and menopausal status. Results highlight the importance of accounting for direct measures of adiposity (beyond BMI) and menopause status. INTRODUCTION Assess the relationship between direct measures of adiposity (total body fat mass, visceral adipose tissue, and abdominal subcutaneous adipose tissue) with the whole body and clinically relevant bone sites of the lumbar spine, and femoral neck areal bone mineral density (aBMD) in men and women. METHODS This cross-sectional analysis was conducted utilizing de-identified data from the UK Biobank on participants (n = 3674) with available dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) data. Sex-stratified multiple linear regression was used to assess the relationship between adiposity measures and aBMD outcomes, controlling for age, race, total body lean mass (DXA), height, BMI class, physical activity, smoking, menopausal status (women), and hormone use (women). RESULTS In men, significant interactions were observed between measures of adiposity and BMI on aBMD for the whole body and lumbar spine. Interactions indicated a positive relationship between adiposity and aBMD in men classified as normal weight, but an inverse relationship in men with elevated BMI. In women, significant interactions between adiposity measures and menopausal status were observed primarily for the whole body and femoral neck aBMD bone outcomes which indicated a negative relationship between adiposity and aBMD in premenopausal women, but a positive relationship in postmenopausal women. CONCLUSION Total body adiposity, abdominal subcutaneous adipose tissue, and visceral adipose tissue were all significantly associated with aBMD in both men and women. The strength and direction of association were dependent on sex, BMI classification, and menopausal status (women).
Collapse
Affiliation(s)
- V L Bland
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E 17th Ave Rm 368, Aurora, CO, 80045-2589, USA.
| | - Y C Klimentidis
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, 85724, USA
| | - J W Bea
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, 85724, USA
- The University of Arizona Cancer Center, Tucson, AZ, 85724, USA
| | - D J Roe
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, 85724, USA
- The University of Arizona Cancer Center, Tucson, AZ, 85724, USA
| | - J L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA
- Department of Medicine, University of Arizona, Tucson, AZ, 85724, USA
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA
| |
Collapse
|
15
|
Hilton C, Vasan SK, Neville MJ, Christodoulides C, Karpe F. The associations between body fat distribution and bone mineral density in the Oxford Biobank: a cross sectional study. Expert Rev Endocrinol Metab 2022; 17:75-81. [PMID: 34859739 PMCID: PMC8944227 DOI: 10.1080/17446651.2022.2008238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Body composition is associated with bone mineral density (BMD), but the precise associations between body fat distribution and BMD remain unclear. The regional adipose tissue depots have different metabolic profiles. We hypothesized that they would have independent associations with BMD. RESEARCH DESIGN AND METHODS We used data from 4,900 healthy individuals aged 30-50 years old from the Oxford Biobank to analyze associations between regional fat mass, lean mass and total BMD. RESULTS Total lean mass was strongly positively associated with BMD. An increase in total BMD was observed with increasing mass of all the fat depots, as measured either by anthropometry or DXA, when accounting for lean mass. However, on adjustment for both total fat mass and lean mass, fat depot specific associations emerged. Increased android and visceral adipose tissue mass in men, and increased visceral adipose tissue mass in women, were associated with lower BMD. CONCLUSIONS Fat distribution alters the association between adiposity and BMD.
Collapse
Affiliation(s)
- Catriona Hilton
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - Matt J Neville
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Trust, Oxford, UK
| | - Constantinos Christodoulides
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Trust, Oxford, UK
| |
Collapse
|
16
|
Serum Metabolite Profile Associated with Sex-Dependent Visceral Adiposity Index and Low Bone Mineral Density in a Mexican Population. Metabolites 2021; 11:metabo11090604. [PMID: 34564420 PMCID: PMC8472083 DOI: 10.3390/metabo11090604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 01/03/2023] Open
Abstract
Recent evidence shows that obesity correlates negatively with bone mass. However, traditional anthropometric measures such as body mass index could not discriminate visceral adipose tissue from subcutaneous adipose tissue. The visceral adiposity index (VAI) is a reliable sex-specified indicator of visceral adipose distribution and function. Thus, we aimed to identify metabolomic profiles associated with VAI and low bone mineral density (BMD). A total of 602 individuals from the Health Workers Cohort Study were included. Forty serum metabolites were measured using the targeted metabolomics approach, and multivariate regression models were used to test associations of metabolomic profiles with anthropometric, clinical, and biochemical parameters. The analysis showed a serum amino acid signature composed of glycine, leucine, arginine, valine, and acylcarnitines associated with high VAI and low BMD. In addition, we found a sex-dependent VAI in pathways related to primary bile acid biosynthesis, branched-chain amino acids, and the biosynthesis of pantothenate and coenzyme A (CoA). In conclusion, a metabolic profile differs by VAI and BMD status, and these changes are gender-dependent.
Collapse
|
17
|
Balat K, Pazarlı AC, İnönü Köseoğlu H, Yaşayancan N, Demir O. Importance of Anthropometric Measurements to Determine Cardiometabolic Diseases in Obstructive Sleep Apnea Syndrome. Turk Thorac J 2021; 22:11-17. [PMID: 33646098 DOI: 10.5152/turkthoracj.2020.19105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/09/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Obesity is considered a major risk factor for obstructive sleep apnea syndrome (OSAS). This study aimed to examine the correlation between anthropometric measurements, which have been recently defined and are indicative of abdominal obesity and cardiometabolic diseases, OSAS severity, and polysomnography (PSG) parameters in patients with OSAS. MATERIAL AND METHODS This retrospective cohort study included patients who underwent all-night polysomnography with a prediagnosis of OSAS. These patients were categorized as having mild (5-15), moderate (15-30), and severe (>30) OSAS according to the apnea-hypopnea index (AHI). The anthropometric measurements used in the study consisted of waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), (waist/hip)-to-height ratio (WHHR), a body shape index (ABSI), body adiposity index (BAI), abdominal volume index (AVI), and conicity index (CI). RESULTS A total of 410 individuals were enrolled in the study (31 control subjects and 129 with mild, 101 with moderate, and 149 with severe OSAS). A significant difference was observed between groups in terms of all anthropometric measurements (p<0.05). The difference between the groups was significant in terms of diabetes mellitus, hypertension, and cardiovascular disease (p<0.05). There was a significant correlation between each of the anthropometric measurements and the PSG parameters. In the receiver operating characteristic analysis, cutoff values that predicted severe OSAS were ABSI>0.08, BAI>28.29, AVI>25.54, and CI>1.37. Multiple regression analyses demonstrated that age, sex, and AVI were independent predictors that determine OSAS presence. CONCLUSION Anthropometric parameters that are indicators of abdominal obesity were found to be robustly correlated with cardiometabolic diseases and the severity of OSAS.
Collapse
Affiliation(s)
- Kenan Balat
- Department of Pulmonary Diseases, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Ahmet Cemal Pazarlı
- Department of Pulmonary Diseases, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Handan İnönü Köseoğlu
- Department of Pulmonary Diseases, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Nurşen Yaşayancan
- Department of Pulmonary Diseases, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Osman Demir
- Department of Biostatistics and Medical Informatics, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| |
Collapse
|
18
|
Deng G, Yin L, Li K, Hu B, Cheng X, Wang L, Zhang Y, Xu L, Xu S, Zhu L, Shao J, Hao X, Zhou J, Tang J, Li W, Jiang Y, Cheng X. Relationships between anthropometric adiposity indexes and bone mineral density in a cross-sectional Chinese study. Spine J 2021; 21:332-342. [PMID: 33091612 DOI: 10.1016/j.spinee.2020.10.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/18/2020] [Accepted: 10/14/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Previous studies have reported conflicting results for the relationships between anthropometric adiposity indexes and bone mineral density, based on dual-energy X-ray absorptiometry (DXA). However, few studies were published based on quantitative computed tomography (QCT), especially for Chinese population. PURPOSE To evaluate the associations of spine bone mineral density (BMD) with body mass index (BMI), waist circumstance (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and a body shape index (ABSI) using QCT. STUDY DESIGN/SETTING A Cross-sectional study. PATIENT SAMPLE Around 3,457 participants in multiple communities across 7 administrative regions of China. OUTCOME MEASURES Spine BMD was measured using QCT, and the classification of osteoporosis was defined as follows: 1) osteoporosis if BMD <80mg/cm3, 2) osteopenia if BMD 80-119 mg/cm3, and 3) normal bone mass if BMD≥120 mg/cm3. METHODS This study was conducted using convenient sampling between 2013 and 2017. Multivariable linear regression model and logistic regression models were used for the associations of continuous and categorical BMD, respectively. RESULTS Around 3,405 participants were included in the final analyses, including 1,272 males and 2,133 females, with spine BMD of 111.00±35.47 mg/cm3 and 99.38±40.60 mg/cm3, respectively. Spine BMD decreased significantly with the increase of ABSI in females (adjusted β, -5.74; 95% confidence interval [CI], -8.50 to -2.98), and this trend also was kept in females aged at less than 60 years (adjusted β, -14.54; 95% CI, -20.40 to -8.68), and females with age ≥60 years (adjusted β, -7.59; 95% CI, -10.91 to -4.28). However, this inverse association was observed only in males with age ≥ 60 years (adjusted β, -5.19; 95% CI, -10.08 to -0.29). Except ABSI, negative associations of Spine BMD with WC (adjusted β, -0.46; 95% CI, -0.77 to -0.15), WHR (adjusted β, -6.25; 95% CI, -10.63 to -1.86), WHtR (adjusted β, -6.80; 95% CI, -11.63 to -1.97) were shown in females aged at <60 years, and positive association with BMI in males with age ≥60 years (adjusted β, 0.92; 95% CI, 0.29-1.55). CONCLUSIONS ABSI had more remarkable association with spine BMD, compared with the other four indexes.
Collapse
Affiliation(s)
- Guijuan Deng
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing, China; School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Yin
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing, China
| | - Kai Li
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Bo Hu
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing, China
| | - Xiaoru Cheng
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing, China
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Yong Zhang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Li Xu
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Shaoqi Xu
- Department of Radiology, Nanjing University of Chinese Medicine Affiliated Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, China
| | - Lei Zhu
- Department of Radiology, The People's Hospital of Dayi County, Chengdu, China
| | - Jiman Shao
- Department of Radiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xiaoguang Hao
- Department of Radiology, Taiyuan Central Hospital, Taiyuan, China
| | - Jun Zhou
- Department of Radiology, The Fourth People's Hospital of Shenyang, Shenyang, China
| | | | - Wei Li
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing, China.
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.
| |
Collapse
|
19
|
Hou J, He C, He W, Yang M, Luo X, Li C. Obesity and Bone Health: A Complex Link. Front Cell Dev Biol 2020; 8:600181. [PMID: 33409277 PMCID: PMC7779553 DOI: 10.3389/fcell.2020.600181] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022] Open
Abstract
So far, the connections between obesity and skeleton have been extensively explored, but the results are inconsistent. Obesity is thought to affect bone health through a variety of mechanisms, including body weight, fat volume, bone formation/resorption, proinflammatory cytokines together with bone marrow microenvironment. In this review, we will mainly describe the effects of adipokines secreted by white adipose tissue on bone cells, as well as the interaction between brown adipose tissue, bone marrow adipose tissue, and bone metabolism. Meanwhile, this review also reviews the evidence for the effects of adipose tissue and its distribution on bone mass and bone-related diseases, along with the correlation between different populations with obesity and bone health. And we describe changes in bone metabolism in patients with anorexia nervosa or type 2 diabetes. In summary, all of these findings show that the response of skeleton to obesity is complex and depends on diversified factors, such as mechanical loading, obesity type, the location of adipose tissue, gender, age, bone sites, and secreted cytokines, and that these factors may exert a primary function in bone health.
Collapse
Affiliation(s)
- Jing Hou
- Department of Endocrinology, Endocrinology Research Center, The Xiangya Hospital of Central South University, Changsha, China
| | - Chen He
- Department of Endocrinology, Endocrinology Research Center, The Xiangya Hospital of Central South University, Changsha, China
| | - Wenzhen He
- Department of Endocrinology, Endocrinology Research Center, The Xiangya Hospital of Central South University, Changsha, China
| | - Mi Yang
- Department of Endocrinology, Endocrinology Research Center, The Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Xianghang Luo
- Department of Endocrinology, Endocrinology Research Center, The Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| | - Changjun Li
- Department of Endocrinology, Endocrinology Research Center, The Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
| |
Collapse
|
20
|
Zhu K, Hunter M, James A, Lim EM, Cooke BR, Walsh JP. Relationship between visceral adipose tissue and bone mineral density in Australian baby boomers. Osteoporos Int 2020; 31:2439-2448. [PMID: 32719992 DOI: 10.1007/s00198-020-05556-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/21/2020] [Indexed: 02/01/2023]
Abstract
UNLABELLED Adiposity has a complex relationship with bone health. In 4865 Australian baby boomers (2642 females) aged 45-70 years, we found that higher visceral adipose tissue mass is associated with reduced bone density adjusting for body mass and lifestyle factors, suggesting that excess visceral fat may be deleterious to bone. INTRODUCTION Increased body mass is associated with higher bone mineral density (BMD), but higher visceral adipose tissue (VAT) may have a negative impact on bone health. In the Busselton Healthy Ageing Study, we examined associations between VAT mass and BMD in 4865 participants (2642 females) aged 45-70 years. METHODS VAT mass and BMD of whole body, total hip, femoral neck and lumbar spine were measured using DXA. VAT mass was examined as a continuous variable and in quartiles using sex-specific cut-offs. RESULTS The mean age was 58.0 ± 5.8 years. Males had significantly higher BMI (28.3 ± 3.7 vs 27.5 ± 4.9 kg/m2) and VAT mass (1675 ± 878 vs 882 ± 600 g) than females (both P < 0.001). In males, after adjustment for age, body mass, height and lifestyle factors, VAT mass negatively associated with total body, total hip and femoral neck BMD (β = - 0.153 to - 0.293, all P < 0.001). Males in the highest quartile of VAT mass (> 2200 g) had significantly lower BMD at all three sites than those in lower quartiles, with estimated BMD differences of 2.3-5.7% (all P < 0.05). In females, VAT mass negatively associated with total body, femoral neck and lumbar spine BMD (β = - 0.067 to - 0.178, all P < 0.05) and those in the highest quartile (> 1250 g) had significantly lower total body BMD than other quartiles (by 1.7-3.7%, all P < 0.05). CONCLUSION In middle-aged Australians, after covariate adjustment, higher DXA-derived VAT mass is associated with reduced bone density, suggesting that excess visceral fat may be deleterious to bone, especially in males.
Collapse
Affiliation(s)
- K Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia.
- Medical School, University of Western Australia, Crawley, Western Australia, Australia.
| | - M Hunter
- Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - A James
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - E M Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - B R Cooke
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, 6009, Australia
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
| |
Collapse
|
21
|
Kellen de Souza Cardoso C, Gondim Peixoto MDR, dos Santos Rodrigues AP, Rodrigues Mendonça C, de Oliveira C, Aparecida Silveira E. Bone Mineral Density in Severely Obese Women: Health Risk and Health Protective Risk Factors in Three Different Bone Sites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7017. [PMID: 32992832 PMCID: PMC7579229 DOI: 10.3390/ijerph17197017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/21/2022]
Abstract
Factors associated with bone mineral density (BMD) are poorly known in severely obese individuals i.e., a body mass index (BMI) > 35 kg/m2. The objectives of this study were to describe the bone health profile of severely obese Brazilian women, to identify the health risk and health protective factors for BMD in this group and to assess whether these factors vary according to three different bone sites. BMD was assessed using dual-energy X-ray absorptiometry (DXA). This study analyzed baseline data from 104 women who had an average BMI of 43.7 ± 4.5 kg/m2 and presented the following BMD status: 1.283 ± 0.094 g/cm2 for total body, 1.062 ± 0.159 g/cm2 for vertebral column and 1.195 ± 0.134 g/cm2 for hip. They took part in the "Effect of nutritional intervention and olive oil in severe obesity" randomized clinical trial (DieTBra Trial). The risk factors negatively associated with lower BMD were age ≥50 years for the three bone sites i.e., total body, vertebral column and hip. Smoking for total body BMD (p = 0.045); BMI ≥ 50kg/m2 for vertebral column and hip; menopause for hip; high C-reactive protein (CRP) levels (p = 0.049), insufficient zinc (p = 0.010) and previous fracture for vertebral column (p = 0.007). The protective factors positively associated with BMD were physical activity (≥150 min/week (p = 0.001)) for hip; type 2 diabetes mellitus (DM2) (p < 0.0001) total body and adequate vitamin D levels from food consumption (p = 0.039) for vertebral column. A BMI ≥ 50 kg/m2 was a risk factor for lower BMD. The findings showed that protective and risk factors varied by bone site. The original study is registered with ClinicalTrials.gov. (protocol number: NCT02463435).
Collapse
Affiliation(s)
| | - Maria do Rosário Gondim Peixoto
- Postgraduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil;
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| |
Collapse
|
22
|
Pahk K, Kwon Y, Kim MK, Park S, Kim S. Visceral fat metabolic activity evaluated by 18F-FDG PET/CT is associated with osteoporosis in healthy postmenopausal Korean women. Obes Res Clin Pract 2020; 14:339-344. [PMID: 32561167 DOI: 10.1016/j.orcp.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/12/2020] [Accepted: 05/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Traditionally, obesity has been regarded as protective against osteoporosis. However, recent accumulating evidences suggest that visceral obesity can increase the risk of osteoporosis and obesity-driven dysfunctional metabolic activity in visceral adipose tissue (VAT) is considered as a key underlying mechanism. Visceral obesity is known to increase during menopausal transition.18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to assess the degree of VAT metabolic activity. We aimed to investigate the association between VAT metabolic activity evaluated by 18F-FDG PET/CT and osteoporosis in healthy postmenopausal Korean women. METHODS A total of 115 postmenopausal women who underwent routine health check-up were enrolled in this study, retrospectively. They all underwent dual-energy X-ray absorptiometry and 18F-FDG PET/CT. Osteoporosis was defined as bone mineral density (BMD) T-score ≤ -2.5 at either lumbar spine or femoral neck. VAT metabolic activity was defined as the maximum standardized uptake value (SUVmax) of VAT divided by the SUVmax of subcutaneous adipose tissue (V/S ratio). RESULTS The participants with osteoporosis showed significantly higher V/S ratio, age, body mass index, waist circumference, and postmenopausal period than the participants without osteoporosis. V/S ratio of 1.33 was proposed as an optimal cut-off value for identifying osteoporosis. Furthermore, V/S ratio was the most significant predictive factor for osteoporosis in postmenopausal woman by uni-and multivariate analyses. Interestingly, V/S ratio showed significant positive correlation with high sensitivity C-reactive protein, a surrogate marker for systemic inflammation. CONCLUSION VAT metabolic activity assessed by 18F-FDG PET/CT is associated with osteoporosis in healthy postmenopausal Korean women.
Collapse
Affiliation(s)
- Kisoo Pahk
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Yeongkeun Kwon
- Center for Obesity and Metabolic Disease, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Meyoung-Kon Kim
- Department of Medical Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sungsoo Park
- Center for Obesity and Metabolic Disease, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Sungeun Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.
| |
Collapse
|
23
|
Gender-Specific Body Composition Relationships between Adipose Tissue Distribution and Peak Bone Mineral Density in Young Chinese Adults. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6724749. [PMID: 32337266 PMCID: PMC7152964 DOI: 10.1155/2020/6724749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/14/2020] [Indexed: 02/08/2023]
Abstract
Background The relationships between adipose tissue distribution and peak bone mineral density (BMD) in young adults are still unclear. The aim of this study was to investigate the body composition associations between fat mass (FM), lean mass (LM), regional adipose tissue distribution, and peak BMD across a cohort of young Chinese adults. Methods Dual-energy X-ray absorptiometry (DXA) scans were performed on 786 men and 825 women aged from 20 to 40 years old to measure the markers for whole-body LM, FM, and BMD in the lumbar spine (LS), femoral neck (FN), and total hip (TH) areas. The android/gynoid FM ratio (A/G FMR) based on the DXA scans was calculated as an indicator of adipose tissue distribution. Pearson's correlation and multivariable linear regression analyses were conducted to determine the body composition relationships between adipose tissue distribution and BMD of each skeletal site. Results The body composition characteristics were different in young males and females: a higher body FM percentage was found in females, while males had higher LM and A/G FMR. The markers for WBLM and WBFM had significant positive correlations with BMD among the linear regression analyses in both genders, while the relationships between A/G FMR and BMD were different in males and females; significant inverse associations were showed in all skeletal sites for women (standard β ranged from -0.266 to -0.170, P < 0.001 for all), but no significant relationships were found in men except for an inverse association in the LS skeletal site (standard β with -0.115, P = 0.016). Conclusions In this sample of young Chinese adults, both whole-body lean mass and fat mass had significant positive relationships with BMD in both genders. The A/G FMR, as an indicator of central adipose tissue distribution, was inversely associated with BMD, especially in females.
Collapse
|
24
|
Xiao Z, Tan Z, Shang J, Cheng Y, Tang Y, Guo B, Gong J, Xu H. Sex-specific and age-specific characteristics of body composition and its effect on bone mineral density in adults in southern China: a cross-sectional study. BMJ Open 2020; 10:e032268. [PMID: 32312724 PMCID: PMC7245416 DOI: 10.1136/bmjopen-2019-032268] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study was an attempt to investigate the variation trend of body composition with ageing and explore the association between regional body composition and bone mineral density (BMD). DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 5749 healthy adults aged 20-95 years was recruited from 2004 to 2017. PRIMARY OUTCOME MEASURES Whole-body lean mass (LM), fat mass (FM), android FM, gynoid FM, appendicular lean mass (ALM) and BMD in the lumbar spine, femoral neck and total hip were obtained by dual-energy X-ray absorptiometry (DXA). The android/gynoid fat mass ratio (A/G FMR) based on DXA scan was calculated as an indicator of adipose distribution. Pearson correlation and multiple linear regression analyses were used to determine the associations between body composition, adipose distribution, and BMD of each skeletal site. RESULTS Whole-body FM, percentage of whole-body FM, Android FM and A/G FMR consistently increased with age in both genders, especially in women, and ALM began to decrease in the fifth decade for both men and women. In multivariable linear regression models with age, body mass index, A/G FMR and ALM as predictor variables, ALM was associated with the most BMD variance of all skeletal sites in men (standard β ranged from 0.207 to 0.405, p<0.001), although not the largest but still a positive predictor of BMD in women (standard β ranged from 0.074 to 0.186, p<0.05). A/G FMR was an inverse predictor of BMD at all skeletal sites for women (standard β ranged from -249 to -0.052, p<0.01) but not in men. CONCLUSIONS In this large cohort of Chinese adults, ALM had a strong positive association with BMD in both genders. A/G FMR as an indicator of central adipose accumulation was inversely associated with BMD in women but not in men.
Collapse
Affiliation(s)
- Zeyu Xiao
- Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhiqiang Tan
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jingjie Shang
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yong Cheng
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yongjin Tang
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Bin Guo
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jian Gong
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hao Xu
- Molecular Imaging Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| |
Collapse
|
25
|
Cardoso CKDS, Santos ASEADC, Rosa LPDS, Mendonça CR, Vitorino PVDO, Peixoto MDRG, Silveira ÉA. Effect of Extra Virgin Olive Oil and Traditional Brazilian Diet on the Bone Health Parameters of Severely Obese Adults: A Randomized Controlled Trial. Nutrients 2020; 12:E403. [PMID: 32032997 PMCID: PMC7071276 DOI: 10.3390/nu12020403] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 12/11/2022] Open
Abstract
Dietary interventions can stabilize and/or reverse bone mass loss. However, there are no reports on its effects on bone mineral density (BMD) in severely obese people, despite the vulnerability of this group to bone loss. We examine the effect of extra virgin olive oil supplementation and the traditional Brazilian diet (DieTBra) on BMD and levels of calcium, vitamin D, and parathyroid hormone (PTH) in severely obese adults. A randomized controlled trial followed-up with severely obese adults (n = 111, with mean body mass index 43.6 kg/m2 ± 4.5 kg/m2) for 12 weeks. Study participants received either olive oil (52 mL/day), DieTBra, or olive oil + DieTBra (52 mL/day + DieTBra). BMD was assessed by total spine and hip dual-energy X-ray absorptiometry. After interventions, BMD means for total spine (p = 0.016) and total hip (p = 0.029) were higher in the DieTBra group than in the olive oil + DieTBra group. Final mean calcium levels were higher in the olive oil group compared to the olive oil + DieTBra group (p = 0.026). Findings suggest that DieTBra and extra virgin olive oil have positive effects on bone health in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).
Collapse
Affiliation(s)
- Camila Kellen de Souza Cardoso
- The Postgraduate Program in Health Sciences, School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goiás, Goiânia, 74605-020 Goiás, Brazil;
| | - Annelisa Silva e Alves de Carvalho Santos
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Lorena Pereira de Souza Rosa
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Priscila Valverde de Oliveira Vitorino
- The Postgraduate Program in Health Sciences, Professor of the School of Social Sciences and Health, Pontifical Catholic University of Goiás, Goiânia, 74605-020 Goiás, Brazil;
| | - Maria do Rosário Gondim Peixoto
- The Postgraduate Program Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil;
| | - Érika Aparecida Silveira
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| |
Collapse
|
26
|
E Hassan N, A El-Masry S, A El Banna R, Al-Tohamy M, El-Lebedy D, Adel Abdelhalim D, Amin D, Megahed S, Khalil A. Bone Health and its Relation to Energy Intake, Fat Mass and its Distribution. Pak J Biol Sci 2020; 23:1075-1085. [PMID: 32700859 DOI: 10.3923/pjbs.2020.1075.1085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Osteoporosis and obesity are two of the most important inter-related diseases worldwide. This study aimed to investigate impact of fat mass and its distribution on bone health in relation to energy intake among sample of Egyptian women. MATERIALS AND METHODS A cross-sectional study included 116 Egyptian women with age range 25-65 years old. They were classified according to the menopause into 2 groups: Pre-menopausal (n = 51) and post menopausal (n = 65). All participants have undergone anthropometric measurements, body composition, DEXA and laboratory investigations. RESULTS Among overweight/obese women, pre-menopausal women had significant higher values of BMR and BMD at both lumbar spines, neck of femur and significant lower values of central obesity (waist/hip ratio, waist/height ratio, visceral fat) and C-terminal peptides than postmenopausal ones. Among pre and post-menopausal women, BMD at both sites had significant positive correlations with obesity markers (BMI, waist and hip circumferences), fat mass, BMR, in addition to fat distribution, visceral fat, leptin among pre-menopausal women and C-terminal peptide among postmenopausal women. Among pre-menopausal women, BMR significantly explained 56% of the variations in BMD at neck of femur, while at lumbar spines the best model was BMI, BMR and waist circumference, which significantly explain 33% of the variations in BMD. CONCLUSION Bone health positively correlated with BMI, fat mass and its distribution and BMR, particularly at femur neck, among pre and post-menopausal Egyptian women. Overweight/obesity can be considered as a protective factor for bone health.
Collapse
|
27
|
Passeri E, Sansone VA, Sconfienza LM, Messina C, Meola G, Corbetta S. Fragility fractures and bone mineral density in male patients affected by type 1 and type 2 myotonic dystrophy. Neuromuscul Disord 2019; 30:28-34. [PMID: 31902642 DOI: 10.1016/j.nmd.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 12/18/2022]
Abstract
Myotonic dystrophy is a multisystemic disorder affecting skeletal muscle. Male patients have an increased risk of fractures and develop a number of endocrine/metabolic impairments known to adversely affect bone health. The aim of this study was primarily to determine the occurrence of fragility fractures and the bone mineralization status (lumbar spine, hip and total body by dual X-ray absorptiometry) in 36 male patients affected with type 1 myotonic dystrophy and 13 male patients affected with type 2 myotonic dystrophy. Fragility fractures occurred in 15 type 1 and 7 type 2 myotonic dystrophy in non-classical osteoporotic sites, such as metatarses. Hip osteopenia was the most frequent finding, particularly in type 2 (n = 6) than type 1 myotonic dystrophy patients (n = 1), while osteoporosis was rare. Patients with type 1 myotonic dystrophy presented higher total body bone mass density than patients with type 2 myotonic dystrophy and healthy controls and lumbar spine was associated positively with the severity of the disease. Gonadic failure, with low testosterone and reduced INSL3 levels, visceral adiposity and insulin resistance correlated with reduced body mass index in both type 1 and type 2 myotonic dystrophic patients. The independent determinant of fragility fractures were low total body mass index, low blood testosterone and low global muscle mass.
Collapse
MESH Headings
- Absorptiometry, Photon
- Adult
- Body Mass Index
- Bone Density
- Bone Diseases, Metabolic/diagnostic imaging
- Bone Diseases, Metabolic/etiology
- Bone Diseases, Metabolic/metabolism
- Bone Diseases, Metabolic/pathology
- Fractures, Bone/diagnostic imaging
- Fractures, Bone/etiology
- Fractures, Bone/metabolism
- Fractures, Bone/pathology
- Humans
- Male
- Middle Aged
- Muscle, Skeletal/pathology
- Myotonic Dystrophy/complications
- Myotonic Dystrophy/metabolism
- Myotonic Dystrophy/pathology
- Osteoporosis/diagnostic imaging
- Osteoporosis/etiology
- Osteoporosis/metabolism
- Osteoporosis/pathology
- Pelvic Bones/diagnostic imaging
- Pelvic Bones/pathology
- Testosterone/blood
Collapse
Affiliation(s)
- E Passeri
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan 20161, Italy
| | - V A Sansone
- Neurorehabilitation Unit, University of Milan, The NEMO (NEuroMuscular Omniservice) Clinical Center, Milan 20162, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - L M Sconfienza
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy; Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
| | - C Messina
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy; Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
| | - G Meola
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy; Neurology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - S Corbetta
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan 20161, Italy; Department of Biomedical, Surgical and Odontoiatric Sciences, University of Milan, Milan 20122, Italy.
| |
Collapse
|
28
|
Chen L, Liang J, Wen J, Huang H, Li L, Lin W, Zong L, Wang N, Cai L, Tang K, Chen H, Li M, Lin L, Lu J, Bi Y, Wang W, Chen G. Is waist circumference a negative predictor of calcaneal bone mineral density in adult Chinese men with normal weight? ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:201. [PMID: 31205919 DOI: 10.21037/atm.2019.04.71] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Our study aimed to evaluate the association between waist circumference (WC) and calcaneal bone mineral density (BMD) in adult Chinese men with normal weight. Methods This was a cross-sectional study. A total of 4,663 male participants aged 40 years or older residing in Ningde and Wuyishan, two cities locating in Fujian province of China, were randomly recruited between 2011 and 2012. Each participant should complete a standard questionnaire, undergo anthropometric and calcaneus quantitative ultrasound (QUS) measurements and have blood sample taken. Anthropometric, biochemical and calcaneal QUS parameters of 1,583 male participants with BMI ranging from 18.5 to 22.9 were included in the analysis. WC was divided into quartiles (Q1-Q4: <71, 71-75, 75-78, >78 cm). The relationship between WC (quartiles) and BMD was analyzed by multiple linear regression models. Results Mean age of the whole population was 54.6±9.8 years. Anthropometric and biochemical parameters were almost normal. Multiple linear regression analysis showed that BMD was negatively associated with increasing WC quartiles except for Q2 after adjusting for age and BMI, and this relationship remained negative except for Q2 when further adjustment was made for other covariates. Multiple logistic regression model also showed that the risks of osteopenia and osteoporosis increased across WC quartiles. Conclusions The present study indicated that WC was a negative predictor of calcaneal BMD in adult Chinese men with normal weight. It suggests that, even for the normal-weight Asian males, monitoring accrual of abdominal adipose is still helpful for the purpose of preventing bone loss.
Collapse
Affiliation(s)
- Ling Chen
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Jixing Liang
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Junping Wen
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Huibin Huang
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Liantao Li
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Wei Lin
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Liyao Zong
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Nengying Wang
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Liangchun Cai
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Kaka Tang
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Hongjie Chen
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Meizhi Li
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Lixiang Lin
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Jieli Lu
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yufang Bi
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Weiqing Wang
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Gang Chen
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China.,Department of Scientific Research, Fujian Academy of Medical Sciences, Fuzhou 350000, China
| |
Collapse
|
29
|
Mihai G, Gasparik AI, Pascanu IM, Cevei M, Hutanu A, Pop RM. The influence of Visfatin, RBP-4 and insulin resistance on bone mineral density in women with treated primary osteoporosis. Aging Clin Exp Res 2019; 31:889-895. [PMID: 31054116 DOI: 10.1007/s40520-019-01206-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/12/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The impact of the two adipokines, visfatin and retinol-binding protein 4 (RBP-4) on bone mineral density (BMD) has been analysed in various studies with conflicting results. Visfatin is highly expressed in visceral fat with stimulatory effect on osteoblast proliferation and inhibition on osteoclast formation, while RBP-4 acts as a transporter protein for retinol, associated with changes in insulin sensitivity, independent of obesity, with no consensus on its effect on bone metabolism. We evaluated the relationship between serum concentrations of visfatin, RBP-4, markers of insulin resistance and current BMD in treated postmenopausal osteoporosis (PO). METHODS Demographics, previous treatment, metabolic status, anthropometry, serum Alkaline phosphatise (ALP), visfatin, RBP-4, the HOMA IR (homeostatic model assessment of insulin resistance) index and BMD were evaluated in 61 subjects with PO. Statistical analysis used SPSS v. 25.0, with a level of significance α = 0.05. Regression models were constructed to evaluate the relationship between adipokines and BMD, adjusting for covariates. RESULTS In multilinear regression analysis, the strongest predictor for current BMD was a previous BMD, followed by ALP and age. RBP4 and HOMA IR were significant predictors, while visfatin had no significant effect. A significant correlation between body mass index (BMI) and BMD at the femoral neck was observed. ALP was negatively correlated with BMD and visfatin positively with RBP4. CONCLUSIONS Data indicate a positive relationship between BMD and RBP-4, an inverse relationship between markers of insulin resistance, bone turn-over and current BMD. No significant effect of visfatin on BMD was observed.
Collapse
Affiliation(s)
- Gabriela Mihai
- Department of Endocrinology, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| | - Andrea Ildiko Gasparik
- Department of Public Health and Health Management, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania.
| | - Ionela Maria Pascanu
- Department of Endocrinology, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| | - Mariana Cevei
- Medical Rehabilitation Hospital Băile Felix, Comuna Sinmartin, Romania
| | - Adina Hutanu
- Department of Laboratory Medicine, Centre for Advanced Medical and Pharmaceutical Research, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| | - Raluca-Monica Pop
- Research Methodology Department, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| |
Collapse
|
30
|
Kim DH, Lim H, Chang S, Kim JN, Roh YK, Choi MK. Association between Body Fat and Bone Mineral Density in Normal-Weight Middle-Aged Koreans. Korean J Fam Med 2018; 40:100-105. [PMID: 30441887 PMCID: PMC6444091 DOI: 10.4082/kjfm.17.0082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/12/2017] [Indexed: 11/05/2022] Open
Abstract
Background Osteoporosis and osteopenia are characterized by reduced bone mineral density (BMD) and increased fracture risk. Although the risk of fractures is higher in underweight people than in overweight people, the accumulation of body fat (especially abdominal fat) can increase the risk of bone loss. This study aimed to evaluate the association between body fat percentage and BMD in normal-weight middle-aged Koreans. Methods This study included 1,992 adults (mean age, 48.7 years; 52.9% women). BMD and body fat were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses and analysis of covariance were used to assess the association between BMD and body fat. Body fat percentage was grouped by cut-off values. The cut-off values were 20.6% and 25.7% for men with a body mass index of 18.5–22.9 kg/m2, while the cut-off values were 33.4% and 36% for women. Results Body fat percentage tended to be negatively associated with BMD. Increased body fat percentage was associated with reduced BMD in normal-weight middle-aged adults. The effects of body fat percentage on BMD in normal-weight individuals were more pronounced in men than in women. Conclusion There was a negative correlation between BMD and body fat percentage in middle-aged Korean men and women with normal body weight. This association was stronger in men than in women.
Collapse
Affiliation(s)
- Dong-Hyun Kim
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Heekyung Lim
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Seungbin Chang
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Ju-No Kim
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Yong-Kyun Roh
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Min-Kyu Choi
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| |
Collapse
|
31
|
Rasaei N, Mirzababaei A, Arghavani H, Tajik S, Keshavarz SA, Yekaninejad MS, Imani H, Mirzaei K. A comparison of the sensitivity and specificity of anthropometric measurements to predict unhealthy metabolic phenotype in overweight and obese women. Diabetes Metab Syndr 2018; 12:1147-1153. [PMID: 30017504 DOI: 10.1016/j.dsx.2018.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/29/2018] [Indexed: 01/22/2023]
Abstract
AIM Metabolically Healthy Obese (MHO) is called to obese people that their insulin sensitivity, lipid profiles and inflammatory profiles are favorable, and there are no signs of hypertension and cardio-metabolic diseases. The metabolically unhealthy obese (MUHO) is the opposite. A Body Shape Index (ABSI) is a marker to identifying abdominal obesity that is derived from weight, height and waist circumference (WC). Several studies have reported ABSI is associated with diabetes, metabolic syndrome, hypertension and higher mortality rate. MATERIALS AND METHODS A total of 305 overweight and obese women were included in the current comparative cross-sectional study. Body composition was measured using body composition analyzer. Blood samples were obtained. The usual food intake of evaluated through the use of a semi-quantitative food frequency questionnaire. RESULTS The results of this study revealed that there is a significant relationship between ABSI and MHO and MUHO (p = 0.04) and area under the ROC curve was 0.60. Also there is a significant relationship between BMI, fat mass index (FMI), free fat mass index (FFMI), neck circumference (NC), WC, fat mass (FM) and metabolic healthy status (MHS). The largest area under the ROC curve belonged to NC, WC, FM and BMI (0.66). CONCLUSION The findings of this study suggest that there is a significant relationship between ABSI, BMI, FMI, FFMI, NC, WC, FM and MHS. The largest area under the ROC curve was related to the NC, WC, FM and BMI not ABSI, that means NC, WC, FM and BMI have maximum sensitivity and specificity.
Collapse
Affiliation(s)
- Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hana Arghavani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Somayeh Tajik
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyed Ali Keshavarz
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| |
Collapse
|
32
|
Staiano AE, Beyl RA, Guan W, Hendrick CA, Hsia DS, Newton RL. Home-based exergaming among children with overweight and obesity: a randomized clinical trial. Pediatr Obes 2018; 13:724-733. [PMID: 30027607 PMCID: PMC6203598 DOI: 10.1111/ijpo.12438] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/30/2018] [Accepted: 05/26/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Given children's low levels of physical activity and high prevalence of obesity, there is an urgent need to identify innovative physical activity options. OBJECTIVE This study aims to test the effectiveness of exergaming (video gaming that involves physical activity) to reduce children's adiposity and improve cardiometabolic health. METHODS This randomized controlled trial assigned 46 children with overweight/obesity to a 24-week exergaming or control condition. Intervention participants were provided a gaming console with exergames, a gameplay curriculum (1 h per session, three times a week) and video chat sessions with a fitness coach (telehealth coaching). Control participants were provided the exergames following final clinic visit. The primary outcome was body mass index (BMI) z-score. Secondary outcomes were fat mass by dual energy X-ray absorptiometry and cardiometabolic health metrics. RESULTS Half of the participants were girls, and 57% were African-American. Intervention adherence was 94.4%, and children's ratings of acceptability and enjoyment were high. The intervention group significantly reduced BMI z-score excluding one control outlier (intervention [standard error] vs. control [standard error]: -0.06 [0.03] vs. 0.03 [0.03], p = 0.016) with a marginal difference in intent-to-treat analysis (-0.06 [0.03] vs. 0.02 [0.03], p = 0.065). Compared with control, the intervention group improved systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein-cholesterol and moderate-to-vigorous physical activity (all p values <0.05). CONCLUSIONS Exergaming at home elicited high adherence and improved children's BMI z-score, cardiometabolic health and physical activity levels. Exergaming with social support may be promoted as an exercise option for children.
Collapse
Affiliation(s)
| | - Robbie A. Beyl
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Win Guan
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Daniel S. Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Robert L. Newton
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| |
Collapse
|
33
|
Baker JF, Long J, Mostoufi-Moab S, Denburg M, Jorgenson E, Sharma P, Zemel BS, Taratuta E, Ibrahim S, Leonard MB. Muscle Deficits in Rheumatoid Arthritis Contribute to Inferior Cortical Bone Structure and Trabecular Bone Mineral Density. J Rheumatol 2017; 44:1777-1785. [PMID: 28916544 DOI: 10.3899/jrheum.170513] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is associated with muscle loss, osteoporosis, and fracture. We examined associations between skeletal muscle mass, strength, and quality and trabecular and cortical bone deficits in patients with RA and healthy controls. METHODS Participants, ages 18-75 years, completed whole-body dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT) of the tibia to quantify appendicular lean mass and fat mass indices (ALMI, FMI), muscle density at the lower leg, trabecular bone density, and cortical bone thickness. Age-, sex-, and race-specific Z scores were calculated based on distributions in controls. Associations between body composition and pQCT bone outcomes were assessed in patients with RA and controls. Linear regression analyses assessed differences in bone outcomes after considering differences in body mass index (BMI) and body composition. RESULTS The sample consisted of 112 patients with RA (55 men) and 412 controls (194 men). Compared to controls, patients with RA had greater BMI Z score (p < 0.001), lower ALMI Z score after adjustment for FMI (p = 0.02), lower muscle strength Z score (p = 0.01), and lower muscle density Z score (p < 0.001). Among RA, ALMI Z scores were positively associated with trabecular density [β: 0.29 (0.062-0.52); p = 0.01] and cortical thickness [β: 0.33 (0.13-0.53; p = 0.002]. Associations were similar in controls. Bone outcomes were inferior in patients with RA after adjusting for BMI, but similar to controls when adjusting for body composition. Radiographic damage and higher adiponectin levels were independently associated with inferior bone outcomes. CONCLUSION Patients with RA exhibit deficits in cortical bone structure and trabecular density at the tibia and a preserved functional muscle-bone unit. A loss of mechanical loading may contribute to bone deficits.
Collapse
Affiliation(s)
- Joshua F Baker
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA. .,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University.
| | - Jin Long
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Sogol Mostoufi-Moab
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Michele Denburg
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Erik Jorgenson
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Prerna Sharma
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Babette S Zemel
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Elena Taratuta
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Said Ibrahim
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| | - Mary B Leonard
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA.,J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University
| |
Collapse
|
34
|
Hardy DS, Stallings DT, Garvin JT, Gachupin FC, Xu H, Racette SB. Anthropometric discriminators of type 2 diabetes among White and Black American adults. J Diabetes 2017; 9:296-307. [PMID: 27106521 PMCID: PMC5079832 DOI: 10.1111/1753-0407.12416] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/30/2016] [Accepted: 04/15/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample. METHODS We used Atherosclerosis Risk in Communities study baseline data (1987-89) from 15 242 participants (1827 with T2DM) aged 45-65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist: height ratio (WHtR), and waist: hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models. RESULTS Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race-gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults. CONCLUSIONS Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race-gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females.
Collapse
Affiliation(s)
- Dale S. Hardy
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia
- Correspondence, Dale S. Hardy, Institute of Public and Preventive Health, CJ-2325, Augusta University, 1120 15th Street, Augusta, GA 30912-0850, Phone: (706) 721-8794,
| | | | - Jane T. Garvin
- College of Nursing, Augusta University, Augusta, Georgia
| | - Francine C. Gachupin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Hongyan Xu
- Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia
| | - Susan B. Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
35
|
Liu CT, Broe KE, Zhou Y, Boyd SK, Cupples LA, Hannan MT, Lim E, McLean RR, Samelson EJ, Bouxsein ML, Kiel DP. Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study. J Bone Miner Res 2017; 32:143-150. [PMID: 27487454 PMCID: PMC5316419 DOI: 10.1002/jbmr.2931] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/19/2016] [Accepted: 07/30/2016] [Indexed: 12/14/2022]
Abstract
Obesity has been traditionally considered to protect the skeleton against osteoporosis and fracture. Recently, body fat, specifically visceral adipose tissue (VAT), has been associated with lower bone mineral density (BMD) and increased risk for some types of fractures. We studied VAT and bone microarchitecture in 710 participants (58% women, age 61.3 ± 7.7 years) from the Framingham Offspring cohort to determine whether cortical and trabecular BMD and microarchitecture differ according to the amount of VAT. VAT was measured from CT imaging of the abdomen. Cortical and trabecular BMD and microarchitecture were measured at the distal tibia and radius using high-resolution peripheral quantitative computed tomography (HR-pQCT). We focused on 10 bone parameters: cortical BMD (Ct.BMD), cortical tissue mineral density (Ct.TMD), cortical porosity (Ct.Po), cortical thickness (Ct.Th), cortical bone area fraction (Ct.A/Tt.A), trabecular density (Tb.BMD), trabecular number (Tb.N), trabecular thickness (Tb.Th), total area (Tt.Ar), and failure load (FL) from micro-finite element analysis. We assessed the association between sex-specific quartiles of VAT and BMD, microarchitecture, and strength in all participants and stratified by sex. All analyses were adjusted for age, sex, and in women, menopausal status, then repeated adjusting for body mass index (BMI) or weight. At the radius and tibia, Ct.Th, Ct.A/Tt.A, Tb.BMD, Tb.N, and FL were positively associated with VAT (all p-trend <0.05), but no other associations were statistically significant except for higher levels of cortical porosity with higher VAT in the radius. Most of these associations were only observed in women, and were no longer significant when adjusting for BMI or weight. Higher amounts of VAT are associated with greater BMD and better microstructure of the peripheral skeleton despite some suggestions of significant deleterious changes in cortical measures in the non-weight bearing radius. Associations were no longer significant after adjustment for BMI or weight, suggesting that the effects of VAT may not have a substantial effect on the skeleton independent of BMI or weight. © 2016 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Ching-Ti Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Kerry E Broe
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Yanhua Zhou
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine and Schulich School of Engineering, University of Calgary, Alberta, Canada
| | - L Adrienne Cupples
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA.,Framingham Heart Study, Framingham, MA, USA
| | - Marian T Hannan
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Elise Lim
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| | - Robert R McLean
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mary L Bouxsein
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
36
|
Turi BC, Codogno JS, Lynch KR, Araújo LGMD, Locci B, Monteiro HL. Physical activity during the early years of life and osteoporosis in adulthood: study among users of the Brazilian National Health System. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600040021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Bruna Camilo Turi
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil; Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil
| | - Jamile Sanches Codogno
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil; Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil
| | - Kyle Robinson Lynch
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil; Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil
| | | | - Bruna Locci
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil
| | - Henrique Luiz Monteiro
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil; Universidade Estadual Paulista "Júlio de Mesquita Filho", Brasil
| |
Collapse
|
37
|
Salamat MR, Salamat AH, Janghorbani M. Association between Obesity and Bone Mineral Density by Gender and Menopausal Status. Endocrinol Metab (Seoul) 2016; 31:547-558. [PMID: 27834082 PMCID: PMC5195832 DOI: 10.3803/enm.2016.31.4.547] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/13/2016] [Accepted: 08/17/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We investigated whether there were gender differences in the effect of obesity on bone mineral density (BMD) based on menopausal status. METHODS We assessed 5,892 consecutive patients 20 to 91 years old who were referred for dual-energy X-ray absorptiometry (DXA) scans. All subjects underwent a standard BMD scan of the hip (total hip and femoral neck) and lumbar spine (L1 to L4) using a DXA scan and body size assessment. Body mass index was used to categorize the subjects as normal weight, overweight, and obese. RESULTS BMD was higher in obese and overweight versus normal weight men, premenopausal women, and postmenopausal women. Compared to men ≥50 years and postmenopausal women with normal weight, the age-adjusted odds ratio of osteopenia was 0.19 (95% confidence interval [CI], 0.07 to 0.56) and 0.38 (95% CI, 0.29 to 0.51) for obese men ≥50 years and postmenopausal women. Corresponding summaries for osteoporosis were 0.26 (95% CI, 0.11 to 0.64) and 0.15 (95% CI, 0.11 to 0.20), respectively. Compared to men <50 years and premenopausal women with normal weight, the age-adjusted odds ratio of low bone mass was 0.22 (95% CI, 0.11 to 0.45) and 0.16 (95% CI, 0.10 to 0.26) for obese men <50 years and premenopausal women, respectively. CONCLUSION Obesity is associated with BMD of the hip and lumbar spine and overweight and obese individuals have similar degrees of osteoporosis. This result was not significantly different based on gender and menopausal status, which could be an important issue for further investigation.
Collapse
Affiliation(s)
- Mohammad Reza Salamat
- Department of Medical Physics and Medical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mohsen Janghorbani
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
38
|
Liu PJ, Ma F, Lou HP, Zhu YN. Body roundness index and body adiposity index: two new anthropometric indices to identify metabolic syndrome among Chinese postmenopausal women. Climacteric 2016; 19:433-9. [PMID: 27410775 DOI: 10.1080/13697137.2016.1202229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Body roundness index (BRI) and body adiposity index (BAI) have been recently proposed to assess obesity. The objectives of this cross-sectional study were to compare their potential for identifying metabolic syndrome (MetS) with traditional obesity indices in Chinese postmenopausal women. METHODS A total of 817 participants were involved in this study. Odds ratio and corresponding 95% confidence intervals (CI) between MetS and all indices were evaluated by binary logistic regression analysis. Receiver operating characteristic curve and area under curve (AUC) were employed to evaluate the abilities to identify MetS among all the indices. The differences in the AUC values between traditional indices and BAI as well as BRI were also evaluated. RESULTS The upper values of all indices were significantly associated with the presence of MetS after adjusting for potential confounders, except for BAI. There were no significant differences in the AUC values between BRI and the traditional indices; however, the AUC values of all the traditional indices were significantly larger than that of BAI. CONCLUSIONS Neither BAI nor BRI was superior to traditional obesity indices for predicting MetS. BAI showed the weakest predictive ability, while BRI showed potential for use as an alternative obesity measure in assessment of MetS.
Collapse
Affiliation(s)
- P J Liu
- a Department of Clinical Nutrition
| | - F Ma
- a Department of Clinical Nutrition
| | - H P Lou
- b Department of Medical Examination Center
| | - Y N Zhu
- c Department of Obstetrics and Gynecology , Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College , Beijing , PR China
| |
Collapse
|
39
|
Cao JJ, Picklo MJ. Involuntary wheel running improves but does not fully reverse the deterioration of bone structure of obese rats despite decreasing adiposity. Calcif Tissue Int 2015; 97:145-55. [PMID: 25903229 DOI: 10.1007/s00223-015-9992-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
Abstract
This study investigated whether exercise or antioxidant supplementation with vitamin C and E during exercise affects bone structure and markers of bone metabolism in obese rat. Sprague-Dawley rats, 6-week old, were fed a normal-fat diet (NF, 10 % kcal as fat) and a high-fat diet (HF, 45 % with extra fat from lard) ad libitum for 14 weeks. Then, rats on the high-fat diet were assigned randomly to three treatment groups for additional 12 weeks with forced exercise: HF; HF + exercise (HF + Ex); and HF with vitamin C (0.5 g ascorbate/kg diet) and vitamin E (0.4 g α-tocopherol acetate/kg diet) supplementation + exercise (HF + Ex + VCE). At the end of the study, body weight and fat (%) were similar among NF, HF + Ex, and HF + Ex + VCE, whereas HF had greater body weight and fat (%) than other groups. Compared to NF, HF had elevated serum leptin, tartrate-resistant acid phosphatase (TRAP), and IGF-1; increased trabecular separation and structural model index; and lowered bone mineral density, trabecular connectivity density, and trabecular number in distal femur, while HF + Ex and HF + Ex + VCE had elevated serum TRAP and decreased bone volume/total volume and trabecular number of distal femurs. Compared to HF, HF + Ex and HF + Ex + VCE had decreased serum TRAP and osteocalcin and improved bone structural properties of the distal femur. These findings suggest that exercise, while decreasing body fat, does not fully protect against the negative skeletal effects of existing obesity induced by a high-fat diet. Furthermore, vitamin C and E supplementation has no additional benefits on bone structural properties during exercise.
Collapse
Affiliation(s)
- Jay J Cao
- Grand Forks Human Nutrition Research Center, USDA, Agricultural Research Service, 2420 2nd Ave N, Grand Forks, ND, 58202-9034, USA,
| | | |
Collapse
|
40
|
Berg RM, Wallaschofski H, Nauck M, Rettig R, Markus MRP, Laqua R, Friedrich N, Hannemann A. Positive Association Between Adipose Tissue and Bone Stiffness. Calcif Tissue Int 2015; 97:40-9. [PMID: 25929703 DOI: 10.1007/s00223-015-0008-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/22/2015] [Indexed: 12/13/2022]
Abstract
Obesity is often considered to have a protective effect against osteoporosis. On the other hand, several recent studies suggest that adipose tissue may have detrimental effects on bone quality. We therefore aimed to investigate the associations between body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT) or abdominal subcutaneous adipose tissue (SAT), and bone stiffness. The study involved 2685 German adults aged 20-79 years, who participated in either the second follow-up of the population-based Study of Health in Pomerania (SHIP-2) or the baseline examination of the SHIP-Trend cohort. VAT and abdominal SAT were quantified by magnetic resonance imaging. Bone stiffness was assessed by quantitative ultrasound (QUS) at the heel (Achilles InSight, GE Healthcare). The individual risk for osteoporotic fractures was determined based on the QUS-derived stiffness index and classified in low, medium, and high risk. Linear regression models, adjusted for sex, age, physical activity, smoking status, risky alcohol consumption, diabetes, and height (in models with VAT or abdominal SAT as exposure), revealed positive associations between BMI, WC, VAT or abdominal SAT, and the QUS variables broadband-ultrasound attenuation or stiffness index. Moreover, BMI was positively associated with speed of sound. Our study shows that all anthropometric measures including BMI and, WC as well as abdominal fat volume are positively associated with bone stiffness in the general population. As potential predictors of bone stiffness, VAT and abdominal SAT are not superior to easily available measures like BMI or WC.
Collapse
Affiliation(s)
- R M Berg
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | | | | | | | | | | | | | | |
Collapse
|
41
|
El-Masry SA, Hassan NE, El-Banna RA, El Hussieny MS. The Relation between Visceral and Subcutaneous Fat to Bone Mass among Egyptian Children and Adolescents. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The relation between fat distribution and bone mass is still being debated in children and adolescents.AIM: To verify the influence of both visceral and subcutaneous fat on bone mass among Egyptian children and adolescents.SUBJECTS AND METHODS: The study involved 78 (38 boys and 40 girls) individuals from children (42) and adolescents (36), aged 8-17 years. They were divided into 2 age groups: children group (20 boys and 22 girls) aged 8-12 years and adolescent group (18 boys and 18 girls) aged 13-17 years. Anthropometric measurements, visceral and subcutaneous fat (measured by ultrasound), body composition, BMD and BMC (Measured by DXA), were attempted.RESULTS: Among children, significant positive correlations between visceral fat; in males; and subcutaneous fat; in females; with total BMC, BMD and its Z-score were revealed. After exclusion of age effect, the association between visceral fat in females with total BMD and its Z-score and lumbar BMD-Z-score became significant. For adolescents, no correlation was observed between either visceral or subcutaneous fat with any parameter of bone mass.CONCLUSIONS: Visceral and subcutaneous fat had significant positive association with bone mass in children; males and females respectively. On the contrary such association disappeared during adolescence.
Collapse
|
42
|
Zhang W, Ma X, Xue P, Gao Y, Wu X, Zhao J, Wang Y, Li S. Associations between fat distribution and volumetric bone mineral density in Chinese adults. Endocrine 2014; 47:862-8. [PMID: 24705911 DOI: 10.1007/s12020-014-0252-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 03/24/2014] [Indexed: 12/13/2022]
Abstract
The aim of this study was to explore the association between fat distribution and volumetric bone mineral density (vBMD) in Chinese Adults. Using a cross-sectional investigation of 867 participants including 521 women and 346 men from China, vBMD and subcutaneous adipose tissue (SCAT) or visceral adipose tissue (VAT) were measured accordingly by quantitative computed tomography. The peak vBMD values of the spine were observed at ages 30-39 years in women and at ages 20-29 years in men. In women, the peak values of VAT and SCAT were observed, respectively, at ages ≥ 70 years and at the age range of 60-69 years. In men, the peak values of VAT and SCAT were observed, respectively, at ages ≥ 70 years and at ages 30-39 years. Using the correlation tests, there was no correlation between SCAT and vBMD in both genders. Most relationships between VAT and BMD were negative (r = -0.204, P < 0.01, in premenopausal women; r = -0.150, P < 0.05, in postmenopausal women; and r = -0.181, P < 0.05, in middle-aged men). After multiple linear regression analysis, no correlations were observed. There appears to be no correlation between fat distribution and vBMD in Chinese adults, and further studies are needed to explore associations between fat distribution and vBMD.
Collapse
Affiliation(s)
- Wei Zhang
- Department of Radiology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050000, Hebei, China,
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Sex-related differences in the association between waist circumference and bone mineral density in a Korean population. BMC Musculoskelet Disord 2014; 15:326. [PMID: 25274071 PMCID: PMC4193133 DOI: 10.1186/1471-2474-15-326] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 09/26/2014] [Indexed: 12/11/2022] Open
Abstract
Background Large waist circumference is linked to poor health. Investigations of the relationship between waist circumference, as an index of abdominal fat, and bone mineral density (BMD) have yielded inconsistent results. We investigated the association between abdominal obesity measured using waist circumference and BMD in a large-scale population-based study. Methods We enrolled 8981 Korean (3592 males and 5389 females) community-dwelling individuals aged ≥50 years from 2007 to 2010. BMD was measured using dual-energy X-ray absorptiometry at lumbar spine and femoral neck skeletal sites. A multiple linear regression analysis was used to evaluate the relationship between waist circumference quartiles and BMD after adjusting for age, height, weight, and regular exercise. Results The adjustment for age, height, weight, and regular exercise revealed a negative linear association between quartile of waist circumference and BMD at the femoral neck and lumbar spine sites in males and females. Waist circumference was more strongly correlated with BMD in males than in females. Although the correlations were slightly attenuated following further adjustment for percent body fat, they remained statistically significant. Conclusions Our results revealed that waist circumference is independently and inversely associated with BMD after adjusting for age, weight, height, regular exercise and percent body fat, suggesting that waist circumference is a potential predictor of osteoporosis in middle-aged and older Korean males and females. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-326) contains supplementary material, which is available to authorized users.
Collapse
|
44
|
Abstract
PURPOSE OF REVIEW Despite evidence that energy deficit produces multiple physiological and metabolic benefits, clinicians are often reluctant to prescribe weight loss in older individuals or those with low bone mineral density (BMD), fearing BMD will be decreased. Confusion exists concerning the effects that weight loss has on bone health. RECENT FINDINGS Bone density is more closely associated with lean mass than total body mass and fat mass. Although rapid or large weight loss is often associated with loss of bone density, slower or smaller weight loss is much less apt to adversely affect BMD, especially when it is accompanied with high intensity resistance and/or impact loading training. Maintenance of calcium and vitamin D intake seems to positively affect BMD during weight loss. Although dual energy X-ray absorptiometry is normally used to evaluate bone density, it may overestimate BMD loss following massive weight loss. Volumetric quantitative computed tomography may be more accurate for tracking bone density changes following large weight loss. SUMMARY Moderate weight loss does not necessarily compromise bone health, especially when exercise training is involved. Training strategies that include heavy resistance training and high impact loading that occur with jump training may be especially productive in maintaining, or even increasing bone density with weight loss.
Collapse
Affiliation(s)
- Gary R Hunter
- Division of Kinesiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | |
Collapse
|
45
|
Park S, Park CY, Ham JO, Lee BK. Familial interactions and physical, lifestyle, and dietary factors to affect bone mineral density of children in the KNHANES 2009-2010. J Bone Miner Metab 2014; 32:455-67. [PMID: 24052208 DOI: 10.1007/s00774-013-0515-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/11/2013] [Indexed: 10/26/2022]
Abstract
We examined familial bone mineral density (BMD) interactions between parents and children and lifestyle factors affecting BMD in the Korean general population of children under 20 and parents under 50 years of age. This cross-sectional study included 2,453 participants (667 daughters, 705 sons, 719 mothers, and 362 fathers) in the 2009-2010 Korean National Health and Nutrition Examination Survey. We calculated prevalence ratios and 95 % confidence intervals for BMD values of whole femur, femur neck, lumbar spine, and whole body excluding the head being in the low tertile in adolescents according to parental BMD tertile after adjusting for physical, lifestyle, and dietary factors. For daughters and sons, there were significant differences in BMD at the four bone sites according to age group, body fat percentage, regular walking and exercise, and milk consumption compared to the reference value for each classification category. Surprisingly, there were no differences in BMD according to serum 25-OH-D levels. Birth order affected BMD of only whole body except head, but its impact was less than that of lifestyle factors. The mean differences in BMD between daughters and sons in the first and third parental BMD tertiles were statistically significant. Notably, the prevalence ratio of whole body without head BMD being in the low tertile increased eight and ten-folds in adolescent daughters and sons, respectively, when parents were in the low BMD tertile. In specific bone regions, parental BMD had a greater effect on total femur in daughters but in the lumbar spine in sons. In conclusion, parental BMD positively influences BMD in daughters and sons after adjustment for environmental parameters. This suggests that the children from parents with low BMD need to make an extra effort to increase BMD through dietary and lifestyle changes.
Collapse
Affiliation(s)
- Sunmin Park
- Department of Food and Nutrition, Hoseo University, 165 Sechul-Ri Baebang-Myun, Asan-Si, Chungnam-Do, 336-795, South Korea
| | | | | | | |
Collapse
|
46
|
George JA, Micklesfield LK, Norris SA, Crowther NJ. The association between body composition, 25(OH)D, and PTH and bone mineral density in black African and Asian Indian population groups. J Clin Endocrinol Metab 2014; 99:2146-54. [PMID: 24617710 DOI: 10.1210/jc.2013-3968] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT AND OBJECTIVE There are few data on the contribution of body composition to bone mineral density (BMD) in non-Caucasian populations. We therefore studied the contribution of body composition, and possible confounding of 25-hydroxyvitamin D and PTH, to BMD at various skeletal sites in black African (BA) and Asian Indian (AI) subjects. DESIGN AND SETTING This was a cross-sectional study in Johannesburg, South Africa. PARTICIPANTS BMD, body fat, and lean mass were measured using dual x-ray absorptiometry and abdominal fat distribution by ultrasound in 714 healthy subjects, aged 18-65 years. RESULTS Whole-body (subtotal), hip, femoral neck, and lumbar spine (lumbar) BMD were significantly higher in BA than AI subjects (P < .001 for all). Whole-body lean mass positively associated with BMD at all sites in both ethnic groups (P < .001 for all) and partially explained the higher BMD in BA females compared with AI females. Whole-body fat mass correlated positively with lumbar BMD in BA (P = .001) and inversely with subtotal BMD in AI subjects (P < .0001). Visceral adiposity correlated inversely with subtotal BMD in the BA (P = .037) and with lumbar BMD in the AI group (P = .005). No association was found between serum 25-hydroxyvitamin D and BMD. PTH was inversely associated with hip BMD in the BA group (P = .01) and with subtotal (P = .002), hip (P = .001), and femoral BMD (P < .0001) in the AI group. CONCLUSIONS Significant differences in whole-body and site-specific BMD between the BA and AI groups were observed, with lean mass the major contributor to BMD at all sites in both groups. The contribution of other components of body composition differed by site and ethnic group.
Collapse
Affiliation(s)
- Jaya A George
- Department of Chemical Pathology (J.G., N.J.C.), National Health Laboratory Service and University of the Witwatersrand, and Medical Research Council/Wits Developmental Pathways for Health Research Unit (L.K.M., S.A.N.), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa
| | | | | | | |
Collapse
|
47
|
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.
Collapse
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
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Choi HJ, Ki KH, Yang JY, Jang BY, Song JA, Baek WY, Kim JH, An JH, Kim SW, Kim SY, Kim JE, Shin CS. Chronic central administration of Ghrelin increases bone mass through a mechanism independent of appetite regulation. PLoS One 2013; 8:e65505. [PMID: 23843943 PMCID: PMC3699588 DOI: 10.1371/journal.pone.0065505] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/25/2013] [Indexed: 12/19/2022] Open
Abstract
Leptin plays a critical role in the central regulation of bone mass. Ghrelin counteracts leptin. In this study, we investigated the effect of chronic intracerebroventricular administration of ghrelin on bone mass in Sprague-Dawley rats (1.5 μg/day for 21 days). Rats were divided into control, ghrelin ad libitum-fed (ghrelin ad lib-fed), and ghrelin pair-fed groups. Ghrelin intracerebroventricular infusion significantly increased body weight in ghrelin ad lib-fed rats but not in ghrelin pair-fed rats, as compared with control rats. Chronic intracerebroventricular ghrelin infusion significantly increased bone mass in the ghrelin pair-fed group compared with control as indicated by increased bone volume percentage, trabecular thickness, trabecular number and volumetric bone mineral density in tibia trabecular bone. There was no significant difference in trabecular bone mass between the control group and the ghrelin ad-lib fed group. Chronic intracerebroventricular ghrelin infusion significantly increased the mineral apposition rate in the ghrelin pair-fed group as compared with control. In conclusion, chronic central administration of ghrelin increases bone mass through a mechanism that is independent of body weight, suggesting that ghrelin may have a bone anabolic effect through the central nervous system.
Collapse
Affiliation(s)
- Hyung Jin Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Ho Ki
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Yeon Yang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bo Young Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ah Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Wook-Young Baek
- Department of Molecular Medicine, Cell and Matrix Research Institute, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jee Hyun An
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Wan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Yeon Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Eun Kim
- Department of Molecular Medicine, Cell and Matrix Research Institute, Kyungpook National University School of Medicine, Daegu, Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
| |
Collapse
|
49
|
Sadie-Van Gijsen H, Crowther NJ, Hough FS, Ferris WF. The interrelationship between bone and fat: from cellular see-saw to endocrine reciprocity. Cell Mol Life Sci 2013; 70:2331-49. [PMID: 23178849 PMCID: PMC11113730 DOI: 10.1007/s00018-012-1211-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 10/05/2012] [Accepted: 11/07/2012] [Indexed: 01/03/2023]
Abstract
The number of mature osteoblasts and marrow adipocytes in bone is influenced by the differentiation of the common mesenchymal progenitor cell towards one phenotype and away from the other. Consequently, factors which promote adipogenesis not only lead to fatty marrow but also inhibit osteoblastogenesis, resulting in decreased osteoblast numbers, diminished bone formation and, potentially, inadequate bone mass and osteoporosis. In addition to osteoblast and bone adipocyte numbers being influenced by this skewing of progenitor cell differentiation towards one phenotype, mature osteoblasts and adipocytes secrete factors which may evoke changes in the cell fate and function of each other. This review examines the endogenous factors, such as PPAR-γ2, Wnt, IGF-1, GH, FGF-2, oestrogen, the GP130 signalling cytokines, vitamin D and glucocorticoids, which regulate the selection between osteoblastogenesis and adipogenesis and the interrelationship between fat and bone. The role of adipokines on bone, such as adiponectin and leptin, as well as adipose-derived oestrogen, is reviewed and the role of bone as an energy regulating endocrine organ is discussed.
Collapse
Affiliation(s)
- H. Sadie-Van Gijsen
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, University of Stellenbosch, Francie van Zijl Drive, Tygerberg, 7505 South Africa
| | - N. J. Crowther
- Department of Chemical Pathology, National Health Laboratory Services, University of Witwatersrand Medical School, 7 York Road, Parktown, 2193 South Africa
| | - F. S. Hough
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, University of Stellenbosch, Francie van Zijl Drive, Tygerberg, 7505 South Africa
| | - W. F. Ferris
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, University of Stellenbosch, Francie van Zijl Drive, Tygerberg, 7505 South Africa
| |
Collapse
|
50
|
Liu YH, Xu Y, Wen YB, Guan K, Ling WH, He LP, Su YX, Chen YM. Association of weight-adjusted body fat and fat distribution with bone mineral density in middle-aged chinese adults: a cross-sectional study. PLoS One 2013; 8:e63339. [PMID: 23700417 PMCID: PMC3658980 DOI: 10.1371/journal.pone.0063339] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 03/30/2013] [Indexed: 11/29/2022] Open
Abstract
Background Although it is well established that a higher body weight is protective against osteoporosis, the effects of body fat and fat distribution on bone mineral density (BMD) after adjustment for body weight remains uncertain. Objective To examine the relationship between body fat and fat distribution and BMD beyond its weight-bearing effect in middle-aged Chinese adults. Method The study had a community-based cross-sectional design and involved 1,767 women and 698 men aged 50–75 years. The BMD of the lumbar spine, total hip, and whole body, and the fat mass (FM) and percentage fat mass (%FM) of the total body and segments of the body were measured by dual-energy X-ray absorptiometry. General information on the participants was collected using structured questionnaire interviews. Result After adjusting for potential confounders, an analysis of covariance showed the weight-adjusted (WA-) total FM (or %FM) to be negatively associated with BMD in all of the studied sites (P<0.05) in both women and men. The unfavorable effects of WA-total FM were generally more substantial in men than in women, and the whole body was the most sensitive site related to FM, followed by the total hip and the lumbar spine, in both genders. The mean BMD of the lumbar spine, total hip, and whole body was 3.93%, 3.01%, and 3.65% (in women) and 5.02%, 5.57%, 6.03% (in men) lower in the highest quartile (vs. lowest quartile) according to the WA-total FM (all p<0.05). Similar results were noted among the groups for WA-total FM%. In women, abdominal fat had the most unfavorable association with BMD, whereas in men it was limb fat. Conclusion FM (or %FM) is inversely associated with BMD beyond its weight-bearing effect. Abdominal fat in women and limb fat in men seems to have the greatest effect on BMD.
Collapse
Affiliation(s)
- Yan-hua Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Ying Xu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Ya-bin Wen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Ke Guan
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Wen-hua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Li-ping He
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yi-xiang Su
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
- * E-mail: (YXS); (YMC)
| | - Yu-ming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
- * E-mail: (YXS); (YMC)
| |
Collapse
|