1
|
Najafi S, Mohammadkhah F, Ebrahimi MM, Harsini PA, Khani Jeihooni A. Effect of educational intervention on preventing osteoporosis in postmenopausal women. Osteoporos Int 2024; 35:505-513. [PMID: 37938406 DOI: 10.1007/s00198-023-06962-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023]
Abstract
In the experimental group, the average scores of knowledge, constructs of theory of planned behavior, nutrition, and walking had a significant enhancement compared to the control group after the educational intervention. After the intervention, the value of the lumbar spine bone mineral density T-score in the experimental group increased, while in the control group, it decreased. INTRODUCTION Osteoporosis is a global public health problem currently affecting millions of people worldwide and in Iran. This study was conducted to assess the effect of an educational intervention based on the theory of planned behavior on the prevention of osteoporosis in postmenopausal women. METHODS This quasi-experimental study was performed on 160 women aging over 50 who were referred to health centers in Fasa City, Iran, in 2019. A simple random sampling method was applied to assign the participants into control and intervention groups (80 participants for each group). Data were gathered by questionnaires arranged based on the constructs of the theory of planned behavior, nutrition performance, and walking performance. The educational intervention included seven 50-minute educational sessions. The obtained data were analyzed using SPSS 22 software and Chi-square test, independent T-test, and paired T-test, and the significance level was considered 0.05. RESULTS The mean ages of the studied participants in the experimental and control groups were 59.18 ± 6.56 and 57.92 ± 5.70, respectively. In the experimental group, the average scores of knowledge, constructs of the theory of planned behavior, nutrition performance, and walking performance had a significant enhancement compared to the control group one year after the intervention (p < 0.001). At 12 months after the intervention, the value of the lumbar spine bone mineral density T-score in the experimental group increased, while in the control group, it reduced (p < 0.001). CONCLUSIONS The theory of planned behavior affected nutrition and walking performance in osteoporosis prevention of subjects. This theory can be used as a framework for designing and performing educational interventions for preventing osteoporosis and promoting women's health.
Collapse
Affiliation(s)
- S Najafi
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - F Mohammadkhah
- Department of Community Health, Child Nursing and Aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | - M M Ebrahimi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - P A Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - A Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
2
|
Vásquez E, Alam MT, Murillo R. Race and ethnic differences in physical activity, osteopenia, and osteoporosis: results from NHANES 2009-2010, 2013-2014, 2017-2018. Arch Osteoporos 2023; 19:7. [PMID: 38150070 DOI: 10.1007/s11657-023-01356-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023]
Abstract
This study aimed to determine current physical activity trends association with bone density in a racial and ethnically diverse sample of older adults. We found that those engaged in no and some physical activity had lower femoral BMD when compared to those that met the physical activity recommendation. PURPOSE Most older adults do not engage in the recommended levels of physical activity to improve health, and there are racial and ethnic differences in physical activity participation. This study aims to evaluate whether meeting the physical activity recommendation is related to osteopenia and osteoporosis in a racially and ethnically diverse sample of older adults. METHODS Femoral neck bone mineral density (BMD) data from the National Health and Nutrition Examination Survey (NHANES 2009-2010, 2013-2014, 2017-2018) was obtained from 5252adults 60-80 years old. Self-reported physical activity was categorized into met recommendation, some physical activity, and no physical activity. We used linear regression models to examine the association between physical activity and BMD for each race and ethnic group adjusting for sociodemographics and other selected variables. RESULTS Non-Latino Blacks (NLB) and Latinos reported the lowest prevalence of meeting the physical activity recommendation, compared with Non-Latino Whites (NLW) (40.0%, 44.0%, and 51.4%, respectively; p < 0.0001). Further, NLB and Latinos had a lower prevalence of osteoporosis when compared to NLW (5.4%, 7.3%, and 9.1% respectively; p < 0.0001). There was a 0.03 g/cm2 difference in BMD between those who met the physical activity recommendation when compared to the no physical activity group; however, this decreased after adjusting for selected covariates. CONCLUSION Considering the prevalence and burden of osteopenia and osteoporosis, and projected increases in the racial and ethnic diversity of the older population, more research is needed to further understand the association between meeting the physical activity recommendation and bone health among racial and ethnic diverse older adults.
Collapse
Affiliation(s)
- Elizabeth Vásquez
- School of Public Health, Department of Epidemiology and Biostatistics, University at Albany State University of New York, One University Place, Room 125, Rensselaer, NY, 12144, USA.
| | | | - Rosenda Murillo
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA
| |
Collapse
|
3
|
The effect of educational intervention based on theory of planned behavior on behavioral responses of premenopausal women in prevention of osteoporosis. BMC Womens Health 2022; 22:366. [PMID: 36068550 PMCID: PMC9446541 DOI: 10.1186/s12905-022-01953-1] [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: 12/29/2021] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Osteoporosis is one of the most prevalent bone diseases which is preventable. Implementing educational programs is an important step in prevention of chronic diseases in the community setting. One of the theories used for predicting behavior and performing educational intervention is theory of planned behavior (TPB) which predicts the intention of an individual toward doing a specific behavior. This study was conducted to assess the effect of educational intervention based on TPB on behavioral responses of premenopausal women in prevention from osteoporosis in Fasa city, Iran.
Methods
This study is a quasi-experimental study performed on 200 women aging from 35 and 55 years who referred to health centers in Fasa city; iran in 2019. Simple random sampling was applied to assign participants to control and intervention groups (100 participant for each group). Data were gathered by a "valid" and "reliable" questionnaire arranged based on the constructs of TPB, nutrition performance and physical activity. An educational program on osteoporosis prevention was conducted. educational intervention was performed in six sessions through group discussions and educational films and booklet for experimental group and then the changes in the scores of the two groups were evaluated and compared. Obtained data were analyzed by SPSS-22 software through Chi-square, independent t-test, paired t-test and ANOVA tests.
Results
The mean ages of studied participants in experimental and control groups were respectively 43.39 $$\pm$$
±
5.20 and 42.94 $$\pm$$
±
5.52. In experimental group, the average scores of knowledge [2 weeks (31.12 $$\pm$$
±
4.20) and 2 months (39.04 $$\pm$$
±
4.10) after educational intervention (p < 0.001)], constructs of theory of planned behavior [attitude construct: 2 weeks (89.32 $$\pm$$
±
9.22) and 2 months (98.57 $$\pm$$
±
9.13) after educational intervention (p < 0.001), Subjective norms construct: 2 weeks(88.39 $$\pm$$
±
8.84) and 2 months (122.57 $$\pm$$
±
8.58) after educational intervention (p < 0.001), Perceived behavioral control construct: 2 weeks (88.56 $$\pm$$
±
8.38) and 2 months (120.15 $$\pm$$
±
8.33) after educational intervention (p < 0.001), Behavioral intention construct: 2 weeks (54.44 ± 4.72) and 2 months (60.26 $$\pm$$
±
4.12) after educational intervention (p < 0.001)], nutrition performance [2 weeks (19.88 ± 2.56) and 2 months (24.14 $$\pm$$
±
2.36) after educational intervention (p < 0.001)] and physical activity [2 weeks (16.75 $$\pm$$
±
1.42) and 2 months (18.94 $$\pm$$
±
1.68) after educational intervention (p < 0.001)] had more significant enhancement than control group 2 weeks and 2 months after educational intervention.
Discussion
TPB was effected in nutrition performance and physical activity in osteoporosis prevention of subjects. This theory can be used as a framework for designing and performing educational intervention for preventing osteoporosis and promoting women’s health.
Collapse
|
4
|
Durdin R, Parsons C, Dennison EM, Williams S, Tillin T, Chaturvedi N, Cooper C, Harvey NC, Ward KA. Inflammatory status, body composition and ethnic differences in bone mineral density: The Southall and Brent Revisited Study. Bone 2022; 155:116286. [PMID: 34890861 PMCID: PMC8755916 DOI: 10.1016/j.bone.2021.116286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/19/2021] [Accepted: 12/02/2021] [Indexed: 11/25/2022]
Abstract
Ethnic differences in bone mineral density (BMD) and fracture risk are well-described; the aim of this study was to investigate whether central adiposity or inflammatory status contribute to these ethnic differences in BMD in later life. The Southall and Brent Revisited study (SABRE) is a UK-based tri-ethnic cohort of men and women of European, South Asian or African Caribbean origin. At the most recent SABRE follow-up (2014-2018), in addition to measures of cardiometabolic phenotype, participants had dual-energy X-ray absorptiometry (DXA) bone and body composition scans. Multiple linear regression was used to determine whether markers of body composition, central adiposity or inflammatory status contributed to ethnic differences in BMD. In men and women, age- and height-adjusted BMD at all sites was higher in African Caribbeans compared to Europeans (femoral neck: standardised β (95% confidence interval): men: 1.00SD (0.75, 1.25); women: 0.77SD (0.56, 0.99)). South Asian men had higher BMD than European men at the hip (femoral neck: 0.34SD (95%CI: 0.15, 0.54)). Although adjustment for body mass index (BMI) or lean mass index (LMI) at the lumbar spine reduced the size of the difference in BMD between African Caribbean and European men (age and height adjusted difference: 0.35SD (0.08, 0.62); age and BMI adjusted difference: 0.25SD (-0.02, 0.51)), in both men and women ethnic differences remained after adjustment for measures of central adiposity (estimated visceral adipose tissue mass (VAT mass) and android to gynoid ratio) and inflammation (interleukin-6 (logIL-6) and C-reactive protein (logCRP)). Furthermore, in women, we observed ethnic differences in the relationship between BMI (overall interaction: p = 0.04), LMI (p = 0.04) or VAT mass (p = 0.009) and standardised lumbar spine BMD. In this tri-ethnic cohort, ethnic differences in BMD at the femoral neck, total hip or lumbar spine were not explained by BMI, central adiposity or inflammatory status. Given ethnic differences in fracture incidence, it is important to further investigate why ethnic differences in BMD exist.
Collapse
Affiliation(s)
- Ruth Durdin
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Camille Parsons
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Suzanne Williams
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Therese Tillin
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; Institute of Musculoskeletal Science, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; Institute of Musculoskeletal Science, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| |
Collapse
|
5
|
An Z, Kim KH, Kim M, Kim YR. Biochemical, hematologic, and skeletal features associated with underweight, overweight, and eating disorders in young Korean women: A population-based study. Front Psychiatry 2022; 13:941043. [PMID: 36506441 PMCID: PMC9733672 DOI: 10.3389/fpsyt.2022.941043] [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: 05/11/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Extreme weight conditions in young women are associated with adverse health outcomes. Closely linked with extreme weight status, eating disorders (EDs) are associated with several medical complications and high mortality rates. OBJECTIVE The study aimed to investigate the biochemical, hematologic, and skeletal features of young Korean women with underweight (UW) and overweight/obesity (OW) conditions, and patients with anorexia nervosa (AN) and bulimia nervosa (BN) compared to women with normal-weight (NW). METHOD A total of 808 women (mean age 22.3 ± 3.4 years) were recruited for the study, including 144 with UW status [body mass index (BMI) < 18.5 kg/m2], 364 with NW, 137 with OW or obesity (27 with obesity; BMI ≥ 25 kg/m2), 63 patients with anorexia nervosa (AN), and 100 with bulimia nervosa (BN). We measured blood pressure and performed biochemical, hematologic and bone mineral density (BMD) evaluations at the lumbar and femoral neck. RESULTS Blood pressure and triiodothyronine levels were found to be lower in both ED groups and higher in the OW group, but no difference in the UW group, compared to the NW group. The aminotransferases and total cholesterol levels were higher in the ED and OW groups, compared to the NW group. Blood cell counts were decreased in the AN group, while increased in the OW group, compared to the NW group. Blood urea nitrogen was elevated in both ED groups. The UW and AN groups had lower BMD, whereas the OW group had higher BMD, compared to the NW group. CONCLUSION Our findings suggested that both ED groups were associated with decreases in the resting energy expenditure. OW status was associated with a risk of metabolic syndrome, and UW status with lower BMD in young women. Overall, the medical parameters in Korean patients with ED were similar to the patterns reported in Western samples in previous studies, with few exceptions such as potassium level in BN.
Collapse
Affiliation(s)
- Zhen An
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
| | - Kyung-Hee Kim
- Department of Food and Nutrition, Duksung Women's University, Seoul, South Korea
| | - Mirihae Kim
- Department of Psychology, College of Social Science, Duksung Women's University, Seoul, South Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea.,Department of Neuropsychiatry, Seoul Paik Hospital, Inje University, Seoul, South Korea
| |
Collapse
|
6
|
Obesity, Vascular Disease and Frailty in Aging Women with HIV. ACTA ACUST UNITED AC 2021; 3. [PMID: 34368807 PMCID: PMC8345026 DOI: 10.20900/agmr20210014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Women with chronic HIV infection (WWH) living in the United States,
experience a disproportionately high rate of obesity compared to uninfected
populations. Both overweight and obesity, particularly central obesity, are
major contributors to insulin resistance, hypertension, and
dyslipidemia—the major components of metabolic syndromes, including type
2 diabetes, and leading to increased cardiovascular risk, including coronary
heart disease, and cerebrovascular diseases. Notably, declining physical
performance and frailty co-occur with vascular morbidities as well as changes in
bone. These factors tend to exacerbate each other and accelerate the aging
trajectory, leading to poorer quality of life, cognitive impairments, dementia,
and eventually, death. In WWH, persistent HIV infection, sustained treatment for
HIV infection, and concomitant obesity, may accelerate aging-related morbidities
and poorer aging outcomes. Furthermore, health disparities factors common among
some WWH, are independently associated with obesity and higher vascular risk.
The purpose of this review is to describe the constellation of obesity, cardio-
and cerebrovascular diseases, bone health and frailty among aging WWH, a 21st
century emergence.
Collapse
|
7
|
Bredella MA, Singhal V, Hazhir Karzar N, Animashaun A, Bose A, Stanford FC, Carmine B, Misra M. Racial differences in lumbar marrow adipose tissue and volumetric bone mineral density in adolescents and young adults with obesity. Bone Rep 2020; 13:100726. [PMID: 33392365 PMCID: PMC7772680 DOI: 10.1016/j.bonr.2020.100726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Areal bone mineral density (BMD) of the lumbar spine by DXA is greater in Black compared to White adolescents. Bone strength is determined not only by BMD but also its microenvironment, and marrow adipose tissue (MAT) has been shown to be an important determinant of skeletal integrity, independent of BMD. Racial differences in volumetric BMD (vBMD) and MAT in adolescents and young adults with obesity are unknown. OBJECTIVE To assess racial differences in lumbar vBMD and MAT in Black and White adolescents and young adults with obesity and to assess body composition determinants of bone parameters. We hypothesized that Blacks will have higher vBMD and lower MAT of the lumbar spine compared to Whites. METHODS The study group comprised 77 adolescents/young adults, 25 Black and 52 White, (mean age 18.2 ± 2.5 years, range 13 to 24 years) with moderate to severe obesity (mean body mass index (BMI) 46.2 ± 7.3 kg/m2, range 35.5 to 69.7 kg/m2). Groups were similar in age, BMI, and sex distribution (p > 0.84). Subjects underwent QCT of the lumbar spine (L1-L2) for assessment of vBMD with the use of a calibration phantom and 1H-MRS/MRI for quantification of lumbar MAT content (L1-L2) and abdominal fat and thigh muscle mass. Groups were compared by Student's t-test or Wilcoxon test. Correlation analysis was performed to assess associations between bone parameters and body composition. RESULTS Black adolescents/young adults with obesity had higher vBMD compared to Whites (p < 0.0001), while there was no significant difference in lumbar MAT (p = 0.64). There were also no significant differences in body composition measures between groups (p ≥ 0.28). An inverse association between MAT and vBMD was observed in Whites (r = -0.47, P = 0.001) but not in Blacks (p = 0.6). There were no significant associations between body composition measures and bone parameters (p > 0.1). CONCLUSION There are racial differences in lumbar vBMD in adolescents and young adults with moderate to severe obesity, with Blacks having higher vBMD than Whites, while there were no differences in MAT content. The known inverse association between BMD and MAT was only observed in Whites but not in Blacks, suggesting possible racial differences in stem cell differentiation into the bone and fat lineages.
Collapse
Affiliation(s)
- Miriam A. Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Vibha Singhal
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- MGH Weight Center, Boston, MA, United States of America
| | - Nazanin Hazhir Karzar
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Abisayo Animashaun
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Amita Bose
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Fatima Cody Stanford
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- MGH Weight Center, Boston, MA, United States of America
| | - Brian Carmine
- Department of Surgery, Boston University Medical Center, Boston, MA, United States of America
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
8
|
Rochester E, Wickman BE, Bell A, Simecka C, Clayton ZS, Hakkak R, Hooshmand S. A diet containing high- versus low-daidzein does not affect bone density and osteogenic gene expression in the obese Zucker rat model. Food Funct 2020; 10:6851-6857. [PMID: 31580380 DOI: 10.1039/c9fo01292c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Phytoestrogens are nonsteroidal plant compounds with similar chemical structures to mammalian estrogen capable of mimicking the effect of estrogen in selective tissues. A diet rich in phytoestrogens is associated with a variety of health benefits including decreased risks for heart disease, breast cancer, and osteoporosis. Obesity has long thought to be associated with improved bone density due to increased mechanical loading, but recent literature suggests obesity may actually decrease bone health. Daidzein, a soy-derived phytoestrogen, has been shown to improve parameters of bone health in lean animal models of osteoporosis but has not been tested in obese animals. Following a one-week acclimation to a standard AIN-93G diet, 19 five-week-old female obese Zucker rats (OZR) were randomly assigned to a modified AIN-93G diet containing either high daidzein (HD, 0.121 g kg-1 feed) or low daidzein (LD, 0.01 g kg-1 feed). After 8 weeks, tibias and femurs were removed to assess true density (Archimedes principal), mechanical strength (three-point bending test), and femoral osteogenic gene expression. Serum was collected to assess osteocalcin and deoxypyridinoline. Our results indicated that there were no significant differences between the measures for tibial or femoral true density or mechanical strength for the rats in the HD and LD diet groups. Similarly, there were no significant differences in gene expressions related to osteogenic pathways, or serum biomarkers of bone formation and resorption. Overall, an increased dose of daidzein from soy protein supplementation does not elicit an improvement in markers of bone health in obese Zucker rats.
Collapse
Affiliation(s)
- Eric Rochester
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA.
| | | | | | | | | | | | | |
Collapse
|
9
|
Qiao D, Li Y, Liu X, Zhang X, Qian X, Zhang H, Zhang G, Wang C. Association of obesity with bone mineral density and osteoporosis in adults: a systematic review and meta-analysis. Public Health 2020; 180:22-28. [PMID: 31837611 DOI: 10.1016/j.puhe.2019.11.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/02/2019] [Accepted: 11/04/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Results from previous studies investigating the association of obesity with bone mineral density (BMD) and osteoporosis (OP) are inconsistent. The purpose of the present study was to examine whether obesity is associated with BMD and the risk of OP. STUDY DESIGN This is a meta-analysis. METHODS A computerised literature search was conducted using the PubMed, Web of Science, China National Knowledge Internet (CNKI) (Chinese) and Wanfang (Chinese) databases for relevant articles published in English or Chinese before the end of December 2017. Means with standard deviations and odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were computed to estimate the association between obesity and BMD and the risk of OP by using a random-effects model. In addition, a heterogeneity test and sensitivity analysis were conducted. RESULTS Adults with obesity had higher BMD than healthy-weight subjects in both the lumbar spine and femoral neck measurement sites. Obesity was positively related to BMD in the two sites, with merged weighted mean difference (WMD) of 0.07 g/cm2 in the lumbar spine (95% CI: 0.045, 0.095; P < 0.001; Pheterogeneity <0.001; I2 = 89.1%) and WMD of 0.087 g/cm2 in the femoral neck (95% CI: 0.063, 0.112; P < 0.001; Pheterogeneity <0.001; I2 = 92.8%). General obesity was negatively related to femoral neck OP, indicating that obesity is a protective factor for OP, with a merged OR of 0.169 (95% CI: 0.132, 0.216; P < 0.001; Pheterogeneity = 0.716; I2 = 0.0%). CONCLUSIONS Adults with obesity had significantly higher BMD than healthy-weight adults. Obesity was positively associated with BMD and negatively correlated with OP.
Collapse
Affiliation(s)
- D Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Y Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - X Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - X Qian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - H Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - G Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| |
Collapse
|
10
|
Bone-Loading Physical Activity and Alcohol Intake but not BMI Affect Areal Bone Mineral Density in Young College-Aged Korean Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245063. [PMID: 31842273 PMCID: PMC6950177 DOI: 10.3390/ijerph16245063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022]
Abstract
The purpose of this cross-sectional study was to determine the differences in areal bone mineral density (aBMD) based on alcohol consumption behaviors, bone-loading history as assessed by a bone-specific physical activity questionnaire (BPAQ), and the body mass index (BMI). College-aged female students (N = 112) were recruited from the universities in Seoul and Gyeonggi province, South Korea. The aBMD of the lumbar spine and non-dominant side of the proximal femur (total hip, TH; femoral neck, FN; femoral trochanter, FT) were measured using dual energy X-ray absorptiometry (DXA). Alcohol consumption was determined by the frequency and amount of alcohol intake during the past 12 months using a self-reported questionnaire. The X-scan plus II was used to measure height (cm), body mass (kg), fat-free mass (FFM, kg), and % body fat. Drinking two or more times alcohol per week was associated with greater aBMD of the TH (p = 0.04–0.002) and FN (p = 0.043) compared to a lower frequency of alcohol consumption and 2–4 times per month, respectively. Based on the drinking amount per occasion, there were no significant group differences (p > 0.05) in aBMD at any of the sites. The highest group of total BPAQ had greater aBMD of the TH, FN, and FT versus the lowest (p = 0.023–0.009) and mid of total BPAQ groups (p = 0.004–0.009). Additionally, the highest group had greater aBMD of the lumbar spine compared to the mid group (p = 0.001). No significant group differences in aBMD at any of the sites were noted based on the BMI (p > 0.05). Young college-aged women with greater bone-loading physical activity showed greater aBMD at the TH, FN, FT, and lumbar spine, while a moderate alcohol intake was associated with greater aBMD of the TH and FN. These findings have clinical implications for young women who may not participate in high-impact physical activity and are binge drinkers.
Collapse
|
11
|
Wu DY, Qiao D, Zhang X, Zhang HQ, Luo ZC, Wang Y, Pan J, Wang C. Lipid profiles as potential mediators linking body mass index to osteoporosis among Chinese adults: the Henan Rural Cohort Study. Osteoporos Int 2019; 30:1413-1422. [PMID: 30834945 DOI: 10.1007/s00198-019-04878-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/24/2019] [Indexed: 12/17/2022]
Abstract
UNLABELLED This study is to examine the relationship between body mass index (BMI) and osteoporosis in rural areas of China, and then explore whether this association was mediated by lipid profiles. Results showed that with the increasing of BMI, the risk of osteoporosis was reduced, and lipid profiles mediate this association. INTRODUCTION To examine the relationship between BMI and osteoporosis, and explore whether this association was mediated by lipid profiles. METHODS A total of 8272 participants (18-79 years) were enrolled from the Henan Rural Cohort Study. The bone mineral density of the calcaneus was measured using an ultrasonic bone density apparatus. Logistic regression and restricted cubic splines were used to evaluate the odds ratio (OR) and 95% confidence intervals (95% CI). Mediation analysis using bootstrap was performed to examine the contribution of lipid profiles to BMI-related osteoporosis. RESULTS The crude and age-standardized prevalence of osteoporosis were 15.93% and 11.77%, respectively. The mean BMIs were 24.12 kg/m2 for participants with osteoporosis and 25.06 kg/m2 for non-osteoporosis participants (P < 0.001). After adjusting for potential confounders, subjects with obesity had a lower OR of osteoporosis (0.493 [95% CI: 0.405-0.600], Ptrend < 0.001) compared with normal-weight individuals. Mediation analysis showed that lipid profile partly mediated the relationship between BMI and osteoporosis with indirect effect OR (95% CI) of 0.985 (0.978-0.992), and the proportion explained of BMI was 15.48% for lipid profile. CONCLUSION With the increasing of BMI, the risk of osteoporosis was reduced in the Chinese adult population, and lipid profiles may be a potential mediator linking reduced risk of osteoporosis. Elucidating the underlying mechanisms will facilitate developing feasible preventive and therapeutic measures for osteoporosis. Chinese clinical trial register: ChiCTR-OOC-15006699.
Collapse
Affiliation(s)
- D Y Wu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
- The Second Clinical Medical School, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - D Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - H Q Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Z C Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - J Pan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
- The Second Clinical Medical School, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| |
Collapse
|
12
|
Role of Calcium and Low-Fat Dairy Foods in Weight-Loss Outcomes Revisited: Results from the Randomized Trial of Effects on Bone and Body Composition in Overweight/Obese Postmenopausal Women. Nutrients 2019; 11:nu11051157. [PMID: 31126121 PMCID: PMC6566640 DOI: 10.3390/nu11051157] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/09/2019] [Accepted: 05/20/2019] [Indexed: 02/08/2023] Open
Abstract
Several studies have investigated the possibility of dairy foods and calcium (Ca) mediating weight and body composition, but a consensus has not been reached. We aimed to investigate weight-loss-related outcomes during intervention with low-fat dairy foods or Ca + vitamin D supplements, both as complements to hypocaloric diets. Overweight/obese Caucasian, early-postmenopausal women (n = 135) were recruited for a 6 month energy-restricted weight loss study complemented with either low-fat dairy foods (D; 4–5 servings/day), or Ca + vitamin D supplements (S); both to amount a total of ~1500 mg/day and 600 IU/day of Ca and vitamin D, respectively, or placebo pills (C). Bone mineral density (BMD) and lean and fat tissue were measured by Lunar iDXA. Serum and urinary markers of bone turnover were analyzed. Diet and physical activity were assessed with 3-day records. Participants on average lost ~4%, ~3%, and ~2% of body weight, fat, and lean tissue, respectively. The significantly better outcomes were noticed in participants in the D group regarding body composition (fat loss/lean tissue preservation) and in participants in the S group regarding the BMD outcomes, compared to those in the C group. Therefore, increasing low-fat dairy foods to 4–5 servings/day and/or increasing Ca & vitamin D intake by supplements (in those who are at the borderline dietary intake) may be beneficial for weight loss/maintenance and may lead to more favorable bone and body composition outcomes in postmenopausal women during moderate weight loss.
Collapse
|
13
|
Zadeh AF, Hanafi MG, Kiasat A, Mousavi M. Evaluation of the tibial cortical thickness accuracy in osteoporosis diagnosis in comparison with dual energy X-ray absorptiometry. J Family Med Prim Care 2019; 8:523-527. [PMID: 30984666 PMCID: PMC6436287 DOI: 10.4103/jfmpc.jfmpc_456_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Unlike public awareness around the world, osteoporosis is still underdiagnosed in most cases till bone fractures. Currently, the dual-energy X-ray absorptiometry (DEXA) is the gold standard diagnostic method of osteoporosis, but unfortunately this method is not available in all diagnostic centers, especially in developing countries. Aims: To evaluate the accuracy of tibial cortical thickness in the diagnosis of osteoporosis compared with DEXA. Materials and Methods: In this descriptive--analytic study, patients suspicious of osteoporosis who referred to Imam Khomeini Hospital, Ahvaz from 2016 --2017 were recruited. Data was collected for each patient including age, sex, radiography, and DEXA. The total thickness of the tibia cortex (sum of the two sides) was measured using knee anteroposterior radiography at 10 cm from the proximal tibial joint. The bone mineral density (BMD) was measured by DEXA method and reported as T-score. Results: In this study, 62 patients (90% female) were evaluated. The mean age of the patients was 57 years (range 45--80 years). T-score had a direct significant correlation with TCT level (r = 0.51, P < 0.0001). Also, T-score had a reverse and significant correlation with age of patients (r = −0.280, P = 0.028). The area under the curve (AUC) was 77%. Also, the sensitivity and specificity for the TCT level less than 4.37 mm (as cutoff point) was 100% and 39.1%, respectively. Conclusion: The findings of this study indicate that TCT has a direct significant correlation with the T-score obtained by the DEXA method. It has also been shown that TCT can be a relatively accurate diagnostic tool for predicting osteoporosis.
Collapse
Affiliation(s)
- Ahmad Fakhri Zadeh
- Department of Radiology, School of Medicine, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Ghasem Hanafi
- Department of Radiology, School of Medicine, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Ali Kiasat
- Department of Nuclear Medicine, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Marjan Mousavi
- Department of Radiology, School of Medicine, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
14
|
Souza Gomes TP, Veloso FLDM, Antunes Filho J, Mourão FC, Nascif NHT, Loures EDA, Labronici PJ, Mendes Júnior AF. Obesidade, Diabetes Mellitus tipo 2 e fragilidade óssea: uma revisão narrativa. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2018.v44.14058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Durante anos a obesidade foi vista como um fator protetor para fraturas e osteoporose. Diversos estudos, no entanto, contestam esta tese, descrevendo que a obesidade na verdade afeta negativamente o sistema esquelético, em especial a homeostase óssea, diminuindo a rigidez do tecido ósseo e aumentando o risco de fraturas. A obesidade e o diabetes estão frequentemente associados no mesmo paciente, e a compreensão da alteração do tecido ósseo nestas duas condições clínicas é fundamental para o melhor cuidado destes pacientes, principalmente devido ao risco aumentado de fraturas, que estão associadas a maior número de complicações no seu tratamento. O presente estudo, em revisão narrativa, descreve a relação entre obesidade e homeostase óssea, a fragilidade óssea nos pacientes obesos, diabéticos ou não, e a relação entre obesidade e fraturas.
Collapse
|
15
|
Liang M, Zhang B, Deng L, Xu R, Wu H, Chen J. Effects of Olanzapine on Bone Mineral Density, Glucose, and Lipid Metabolism in Schizophrenia Patients. Int J Endocrinol 2019; 2019:1312804. [PMID: 31019532 PMCID: PMC6451798 DOI: 10.1155/2019/1312804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/25/2019] [Accepted: 02/15/2019] [Indexed: 11/17/2022] Open
Abstract
AIM To explore whether olanzapine alters bone mineral density (BMD), glucose, and lipid metabolism in schizophrenia patients. METHODS This study enrolled 150 patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), including 101 patients who had over 6-month history of olanzapine use (olanzapine-treated group) and 49 patients who had no history of antipsychotic use (first episode drug-naïve group). 71 subjects with age- and gender-matched healthy volunteers (healthy control group) were also enrolled. All study subjects were from the Chinese Han population recruited in the Second Xiangya Hospital from January 2015 to January 2016. Demographic and physical examination data were collected from all subjects. BMD measurements of the radius+ulna, lumbar spine (L1-4), and left hip were performed via a dual-energy X-ray absorptiometry test. Serum lipid, glucose, and insulin levels were analyzed. Psychopathology profiles in all enrolled schizophrenia patients were assessed by the positive and negative syndrome scale (PANSS). RESULTS There was no significant difference in age, gender, activity intensity, smoking, or drinking among the three groups. In the majority of evaluated bone areas, the BMD values in olanzapine-treated or drug-naïve patients were lower than those in the control group. However, BMD values in the drug-naïve group showed no difference or even decreased as compared with those in the olanzapine-treated group. Among the olanzapine-treated group, although not observed in every tested region, a positive correlation was found of BMI or HOMA-IR with BMD. Stepwise multiple linear regression analysis revealed independent predictive factors associated with BMD in groups/subgroups of schizophrenia patients or healthy controls, including gender, TG, BMI, body weight, HOMA-IR, and FBG. CONCLUSIONS Schizophrenia, but not the long-term use of olanzapine, correlates with BMD loss in schizophrenia patients. Elevated BMI, TG, FBG, and insulin levels might protect these patients against bone degradation. Our work provides new information to improve the understanding, prevention, and treatment of osteoporosis in schizophrenia patients.
Collapse
Affiliation(s)
- Mining Liang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Chinese National Clinical Research Center for Mental Disorder (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Beibei Zhang
- Brain Hospital of Hunan Province, Changsha, Hunan Province, China
| | - Lu Deng
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Rong Xu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haishan Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Chinese National Clinical Research Center for Mental Disorder (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- Chinese National Clinical Research Center for Mental Disorder (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
16
|
Etehadnezhad S, Moradi Z, Kashfi M, Khani-jeihooni A, khiyali Z. Predictors of Osteoporosis Preventive Behaviors among Women: An Application of the Transtheoretical Model. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2018. [DOI: 10.21859/jech.5.3.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
17
|
Chen YY, Fang WH, Wang CC, Kao TW, Chang YW, Wu CJ, Zhou YC, Sun YS, Chen WL. Body fat has stronger associations with bone mass density than body mass index in metabolically healthy obesity. PLoS One 2018; 13:e0206812. [PMID: 30408060 PMCID: PMC6224061 DOI: 10.1371/journal.pone.0206812] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/21/2018] [Indexed: 11/19/2022] Open
Abstract
Objective The effect of obesity-induced metabolic abnormalities on bone mineral density (BMD) and osteoporosis are well established. However, the association between metabolically healthy obesity (MHO) and BMD remains unclear. Our aim was to investigate whether different obesity phenotypes in MHO were associated with BMD in a cross-sectional study. Methods All eligible adults receiving a health examination at the Tri-Service General Hospital from 2010 to 2016 were included. They were categorized based on body mass index (BMI) or percentage body fat (PBF). The associations between BMI or PBF and BMD were analyzed by adjusting for pertinent covariables. Results Males with normal weight and overweight and females with underweight and normal weight were associated with reduced BMD (β = 0.221, 95%CI = -0.354, -0.088; β = -0.155, 95%CI = -0.286, -0.023) (β = -0.736, 95%CI = -1.043, 0.429; β = -0.340, 95%CI = -0.567, -0.112), respectively. Females in Q1 had close to significant associations with reduced BMD (β = -0.253, 95%CI = -0.465, -0.041). Normal weight, overweight, Q2, and Q3 had stronger prediction of low BMD with ORs of 0.402 (95%CI = 0.204–0.791), 0.539 (95%CI = 0.321–0.905), 0.694 (95%CI = 0.490–0.982), and 0.466 (95%CI = 0.342–0.636), respectively. The relationship remained significant in male population that PBF was associated with reduced BMD with ORs of 0.435 (95%CI = 0.203, 0.935), 0.494 (95%CI = 0.247, 0.991), 0.268 (95%CI = 0.120, 0.597) in Q1, Q2, Q3 respectively. Conclusion Increased PBF had a significant association with low BMD in the MHO population. Obesity defined by PBF might be a useful indicator for low BMD. The association between body fat and bone health deserves further investigation regarding the potential pathophysiological mechanisms.
Collapse
Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yaw-Wen Chang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Yi-Chao Zhou
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yu-Shan Sun
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- * E-mail:
| |
Collapse
|
18
|
Kriksciuniene R, Zilaitiene B, Lukosevicius S, Ereminiene E, Klimaite R, Verkauskiene R. The main predictors of the enlargement of ascending aorta in Turner syndrome: a cross-sectional contrast-enhanced magnetic resonance angiography study. MINERVA ENDOCRINOL 2018; 44:185-191. [PMID: 30290692 DOI: 10.23736/s0391-1977.18.02818-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The aim of this study was to identify the main predictors of the enlargement of ascending aorta and to assess the possible relation between reduced bone mineral density and a diameter of ascending aorta in the specific Turner syndrome (TS) population. METHODS Fifty adult females diagnosed with TS have been enrolled into the cross-sectional study. Dimensions of ascending aorta have been measured in four positions using thoracic magnetic resonance imaging, Aortic Size Index (ASI) has been calculated. BMD has been assessed on dual-energy-X ray absorptiometry (DXA) in 1-4 lumbar vertebrae and neck of the femur. According to Z Score on DXA two groups have been formed: a group of patients with normal BMD and a group with reduced BMD. Metabolic parameters and the measurements of ascending aorta have been compared between the two groups. RESULTS Extremely high rate of the dilatation of the root of aorta (up to 50%) was identified in this study. The larger ASI has been found in patients with reduced BMD, negative relation between BMD and ASI has been identified, although after the adjustment for SHRT this correlation remained insignificant. In the multivariate analysis, the main factors affecting ASI were age, body surface area and bicuspid aortic valve. CONCLUSIONS The main factors associated with the enlargement of ascending aorta in Turner syndrome were age, body surface area and bicuspid aortic valve, the relation between diameter of ascending aorta and bone mineral density was not identified.
Collapse
Affiliation(s)
- Ruta Kriksciuniene
- Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania - .,Kauno Klinikos, Department of Endocrinology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania -
| | - Birute Zilaitiene
- Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Kauno Klinikos, Department of Endocrinology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Saulius Lukosevicius
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Egle Ereminiene
- Department of Cardiology, Medical Academy, Lithuanian University Of Health Sciences, Kaunas, Lithuania
| | - Raimonda Klimaite
- Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Kauno Klinikos, Department of Endocrinology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Verkauskiene
- Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Kauno Klinikos, Department of Endocrinology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
19
|
Abstract
Osteoporosis and adipose tissue are closely related with many contradictions. Visfatin is an adipokine that is related to osteoporosis and adiposity. This nutrigenomics study examined the interaction between visfatin genotypes and dietary fat intake, with regard to bone mineral density (BMD) among an obese population. In this cross-sectional study, 336 subjects were enrolled; the mean age was 38·25 (sd 11·69) years and the mean BMI was 31·79 (sd 4·77) kg/m2. Laboratory measurements were lipid profile, insulin and fasting blood sugar. Bone density measurements were assessed by dual-energy X-ray absorptiometry. Dietary data were collected through a 3-d 24-h dietary recall. Genotyping for visfatin gene SNP (rs2110385) was performed by the PCR-restriction fragment length polymorphism method. The frequency of GG, GT and TT genotypes were 33·92 48·51 and 17·54 %, respectively, and 86·6 % of participants were women. The results showed that subjects with TT genotypes had significantly higher lumbar BMD, T score and z score (P<0·0001). After categorisation by percentage of fat intake (30 % of total energy content as a cut-off point), no interaction was found, but when categorised by fat types, we found an interaction between visfatin genotypes and dietary PUFA intake in terms of the hip T score and z score (P=0·043, B= -0·08; P=0·04, B= -0·078, respectively). There was a significant relationship between high PUFA intake and lower energy and protein intake. When participants were categorised by median PUFA intake (22·8 g), it was concluded that subjects with GG genotype who had high PUFA-intake diets had lower hip z scores and T scores, unlike the other genotypes.
Collapse
|
20
|
Shariati-Sarabi Z, Rezaie HE, Milani N, Rezaie FE, Rezaie AE. Evaluation of Bone Mineral Density in Perimenopausal Period. THE ARCHIVES OF BONE AND JOINT SURGERY 2018; 6:57-62. [PMID: 29430497 PMCID: PMC5799602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 08/27/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND The menopausal transition called perimenopause, happens after the reproductive years, and is specified with irregular menstrual cycles, perimenopause symptoms and hormonal changes. Women going through peri menopausal period are vulnerable to bone loss . Osteoporosis is one of the most common debilitating metabolic bone diseases, especially in the women almost around 50 years. This study was intended to evaluate the prevalence of osteopenia/osteoporosis amongst asymptomatic individuals during the menopause transition period. METHODS A total of 714 asymptomatic peri-menopausal female volunteers were recruited through a billboard invitation for participation in the study. The subjects were selected based on already defined inclusion and exclusion criteria. The project, which was conducted between 2010 and 2014 was affiliated to the Educational and Therapeutic Center, Imam Reza Hospital, Mashhad, Iran. Bone Mineral Densitometry (BMD) measured by DEXA (dual-energy X-ray absorptiometry) was carried out on two distinct sites, the proximal femur and the lumbar vertebrae from L1 to L4. Pertained data were analyzed. RESULTS The mean age of the subjects was 49.7±2.years. The overall prevalence of osteopenia and osteoporosis in these peri-menopausal individuals were 37.6 % and 10% respectively. Thirty five point two percent of 714 women presented with osteopenia and eight percent of them have osteoporosis in the femoral neck, respectively. Nonetheless, BMD values at the lumbar spine indicated 41.6% and 12% of individual participants being affected by osteopenia and osteoporosis. CONCLUSION In general osteopenia or osteoporosis, occurred in 48% of this study population, implying that special attention is required for the bone health status of Iranian women who undergo menopause.Level of evidence: II.
Collapse
Affiliation(s)
- Zhaleh Shariati-Sarabi
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Hamid Etemad Rezaie
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Nasrin Milani
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Farnaz Etemad Rezaie
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Ali Etemad Rezaie
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| |
Collapse
|
21
|
The emerging role of bone marrow adipose tissue in bone health and dysfunction. J Mol Med (Berl) 2017; 95:1291-1301. [PMID: 29101431 DOI: 10.1007/s00109-017-1604-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/17/2017] [Accepted: 10/20/2017] [Indexed: 01/27/2023]
Abstract
Replacement of red hematopoietic bone marrow with yellow adipocyte-rich marrow is a conserved physiological process among mammals. The extent of this conversion is influenced by a wide array of pathological and non-pathological conditions. Of particular interest is the observation that some marrow adipocyte-inducing factors seem to oppose each other, for instance obesity and caloric restriction. Intriguingly, several important molecular characteristics of bone marrow adipose tissue (BMAT) are distinct from the classical depots of white and brown fat tissue. This depot of fat has recently emerged as an active part of the bone marrow niche that exerts paracrine and endocrine functions thereby controlling osteogenesis and hematopoiesis. While some functions of BMAT may be beneficial for metabolic adaptation and bone homeostasis, respectively, most findings assign bone fat a detrimental role during regenerative processes, such as hematopoiesis and osteogenesis. Thus, an improved understanding of the biological mechanisms leading to formation of BMAT, its molecular characteristics, and its physiological role in the bone marrow niche is warranted. Here we review the current understanding of BMAT biology and its potential implications for health and the development of pathological conditions.
Collapse
|
22
|
JafariNasabian P, Inglis JE, Kelly OJ, Ilich JZ. Osteosarcopenic obesity in women: impact, prevalence, and management challenges. Int J Womens Health 2017; 9:33-42. [PMID: 28144165 PMCID: PMC5245917 DOI: 10.2147/ijwh.s106107] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Osteosarcopenic obesity syndrome (OSO) has recently been identified as a condition encompassing osteopenia/osteoporosis, sarcopenia and obesity. OSO is especially deleterious in older adults (even if they are not obese by conventional measures), due to age-related redistribution of fat and its infiltration into bone and muscle. Osteoporosis and bone fractures in elderly increase the risk of sarcopenia, which, through decreased mobility, increases the risk of more falls and fractures, creating a vicious cycle. Obesity plays a dual role: to a certain extent, it promotes bone and muscle gains through mechanical loading; in contrast, increased adiposity is also a source of pro-inflammatory cytokines and other endocrine factors that impair bone and muscle. As the elderly population increases, changes in lifestyle to delay the onset of OSO, or prevent OSO, are warranted. Among these changes, dietary patterns and physical activity modifications are the first ones to be implemented. The typical Western diet (and lifestyle) promotes several chronic diseases including OSO, by facilitating a pro-inflammatory state, largely via the imbalance in omega-6/omega-3 fatty acid ratio and low-fiber and high-processed food consumption. Nutritional modifications to prevent and/or alleviate the OSO syndrome include adequate intake of protein, calcium, magnesium and vitamin D and increasing consumptions of foods containing omega-3 polyunsaturated fatty acids and fiber. Certain types of physical activity, often decreased in overweight/obese women and in elderly, might preserve bone and muscle, as well as help in reducing body fat accrual and fat infiltration. Habitual daily activities and some alternative modes of exercise may be more appropriate for older adults and play a crucial role in preventing bone and muscle loss and maintaining optimal weight. In conclusion, older adults who suffer from OSO syndrome may benefit from combined efforts to improve diet and physical activity, and such recommendations should be fostered as part of public health programs.
Collapse
Affiliation(s)
- Pegah JafariNasabian
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL
| | - Julia E Inglis
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL
| | | | - Jasminka Z Ilich
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL
| |
Collapse
|
23
|
Heidari B, Muhammadi A, Javadian Y, Bijani A, Hosseini R, Babaei M. Associated Factors of Bone Mineral Density and Osteoporosis in Elderly Males. Int J Endocrinol Metab 2017; 15:e39662. [PMID: 28835759 PMCID: PMC5554609 DOI: 10.5812/ijem.39662] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/19/2016] [Accepted: 11/19/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Low bone mineral density and osteoporosis is prevalent in elderly subjects. This study aimed to determine the associated factors of bone mineral density and osteoporosis in elderly males. METHODS All participants of the Amirkola health and ageing project cohort aged 60 years and older entered the study. Bone mineral density at femoral neck and lumbar spine was assessed by the dual energy X-ray absorptiometry (DXA) method. Osteoporosis was diagnosed by the international society for clinical densitometry criteria and the association of bone mineral density and osteoporosis with several clinical, demographic and biochemical parameters. Multiple logistic regression analysis was used to determine independent associations. RESULTS A total of 553 patients were studied and 90 patients (16.2%) had osteoporosis at either femoral neck or lumbar spine. Diabetes, obesity, metabolic syndrome, overweight, and quadriceps muscle strength > 30 kg, metabolic syndrome, abdominal obesity and education level were associated with higher bone mineral density and lower prevalence of osteoporosis, whereas age, anemia, inhaled corticosteroids and fracture history were associated with lower bone mineral density and higher prevalence of osteoporosis (P = 0.001). After adjustment for all covariates, osteoporosis was negatively associated only with diabetes, obesity, overweight, and QMS > 30 kg and positively associated with anemia and fracture history. The association of osteoporosis with other parameters did not reach a statistical level. CONCLUSIONS The findings of the study indicate that in elderly males, diabetes, obesity and higher muscle strength was associated with lower prevalence of osteoporosis and anemia, and prior fracture with higher risk of osteoporosis. This issue needs further longitudinal studies.
Collapse
Affiliation(s)
- Behzad Heidari
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Abdollah Muhammadi
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Yahya Javadian
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Reza Hosseini
- Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mansour Babaei
- Department of Internal Medicine, Clinical Research Development Unit, Rouhani Hospital, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
- Corresponding author: Mansour Babaei, Department of Internal Medicine, Clinical Research Development Unit, Rouhani Hospital, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran. Tel: +098-1132238301-5; +98-9113134249, Fax: +98-1132238284, E-mail:
| |
Collapse
|
24
|
Sarwar G, Bisquera A, Peel R, Hancock S, Grainge C, Attia J. The effect of inhaled corticosteroids on bone mineral density measured by quantitative ultrasonography in an older population. CLINICAL RESPIRATORY JOURNAL 2016; 12:659-665. [PMID: 27805313 DOI: 10.1111/crj.12576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 09/26/2016] [Accepted: 10/25/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Prolonged use of systemic corticosteroids leads to reduced bone mineral density and osteoporosis, in turn increasing the risk of minimal trauma fractures with their associated morbidity and mortality in elderly populations. However, the effect of inhaled corticosteroids on bone mineral density has been debated in the medical literature. OBJECTIVES We aimed to determine the effect of inhaled corticosteroids on bone mineral density measured using calcaneal quantitative ultrasonography in a cohort of older Australians. METHODS Data was collected from the Hunter Community Study, a longitudinal cohort of Australians aged 55-85. Simple and multiple linear regression methods were used to test the cross-sectional association between inhaled corticosteroids and calcaneal bone mineral density measured with quantitative ultrasound at baseline. A causal diagram was used to determine the minimally sufficient number of co-variates necessary to determine the unconfounded effect of inhaled corticosteroids on bone mineral density; these included gender, body mass index, smoking, asthma, alcohol use, age, physical activity, and diet. RESULTS There were 152 (6.8%) patients on inhaled corticosteroids and 2098 (93%) controls. Simple and multiple linear regression methods showed a non-significant effect of inhaled steroids on BMD with slight decrease of BMD -0.010 g/cm2 (95% CI -0.042 to 0.022, P = .55) and -0.013 g/cm2 (95% CI -0.062 to 0.036, P = .61) respectively. Age, gender, body mass index, and smoking were stronger predictors of BMD. CONCLUSIONS No statistically significant relationship was detected between the use of inhaled corticosteroids and reduced bone mineral density in this observational study of a cohort of older Australians.
Collapse
Affiliation(s)
- Ghulam Sarwar
- John Hunter Hospital, New Lambton, New South Wales, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, 2308, Australia
| | - Alessandra Bisquera
- Hunter Research Medical Institute, New Lambton, New South Wales, 2305, Australia
| | - Roseanne Peel
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, 2308, Australia.,Hunter Research Medical Institute, New Lambton, New South Wales, 2305, Australia
| | - Stephen Hancock
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, 2308, Australia.,Hunter Research Medical Institute, New Lambton, New South Wales, 2305, Australia
| | - Christopher Grainge
- John Hunter Hospital, New Lambton, New South Wales, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, 2308, Australia.,Hunter Research Medical Institute, New Lambton, New South Wales, 2305, Australia
| | - John Attia
- John Hunter Hospital, New Lambton, New South Wales, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, 2308, Australia.,Hunter Research Medical Institute, New Lambton, New South Wales, 2305, Australia
| |
Collapse
|
25
|
Neglia C, Argentiero A, Chitano G, Agnello N, Ciccarese R, Vigilanza A, Pantile V, Argentiero D, Quarta R, Rivezzi M, Di Tanna GL, Di Somma C, Migliore A, Iolascon G, Gimigliano F, Distante A, Piscitelli P. Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111067. [PMID: 27809297 PMCID: PMC5129277 DOI: 10.3390/ijerph13111067] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/19/2016] [Accepted: 10/24/2016] [Indexed: 11/16/2022]
Abstract
Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m². Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis.
Collapse
Affiliation(s)
- Cosimo Neglia
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Alberto Argentiero
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Giovanna Chitano
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Nadia Agnello
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Roberta Ciccarese
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Antonella Vigilanza
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Valerio Pantile
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Domenico Argentiero
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Raffaele Quarta
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Matteo Rivezzi
- IOS, Southern Italy Hospital Institute, Medicina Futura Research, Naples 80100, Italy.
| | - Gian Luca Di Tanna
- Centre for Primary Care and Public Health, Queen Mary University of London, London E1 4NS, UK.
| | - Carolina Di Somma
- IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare, Naples 80133, Italy.
| | | | - Giovanni Iolascon
- Department of Orthopaedic Surgery and Rehabilitation, Second University of Naples, Naples 81100, Italy.
| | - Francesca Gimigliano
- Department of Orthopaedic Surgery and Rehabilitation, Second University of Naples, Naples 81100, Italy.
| | - Alessandro Distante
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Prisco Piscitelli
- IOS, Southern Italy Hospital Institute, Medicina Futura Research, Naples 80100, Italy.
| |
Collapse
|
26
|
Kumar A, Sharma AK, Mittal S, Kumar G. The Relationship Between Body Mass Index and Bone Mineral Density in Premenopausal and Postmenopausal North Indian Women. J Obstet Gynaecol India 2016; 66:52-6. [PMID: 26924908 PMCID: PMC4755946 DOI: 10.1007/s13224-014-0629-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 09/22/2014] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Present study aims to examine the relationship of the bone mineral density (BMD) with body mass index (BMI) in an apparently healthy premenopausal and postmenopausal north Indian female population. METHODS Two hundred and fifty-five apparently healthy women were evaluated by a detailed questionnaire including all possible factors that could affect the BMD. The height and weight of all the subjects were recorded and BMI was calculated. Bone mineral density was measured by DXA (Dual Electron X-ray Absorptiometry) at L1-L4 Lumbar spine (LS) and femur neck (FN) by using the Prodigy DXA system (software version:8.50) manufactured by GE medical systems LUNAR. RESULTS The population was divided into pre and postmenopausal groups. The BMD at all sites increased with BMI in both groups. In a multiple regression model, the attributability of BMI and age to variation in LSBMD and FNBMD was 10.3 and 13.9 %, respectively. In postmenopausal women, age, BMI, and a previous history of fracture together attributed to a variance in BMI of 40.1 and 27.6 % at lumbar spine and femur neck, respectively. BMI was found to be significantly associated with low BMD at both sites in premenopausal women, while the association was lost in postmenopausal females. CONCLUSION BMI is an important determinant of BMD in Indian females. However, the association is not present in postmenopausal women with osteopenia. In addition, the effect of increase in BMI on BMD has a ceiling effect, and moderate to morbid obesity might not actually be a preventive factor for osteopenia.
Collapse
Affiliation(s)
- Ashok Kumar
- />Department of Obstetrics & Gynaecology, Maulana Azad Medical College, Associated Lok Nayak Hospital, New Delhi, 110002 India
| | - Aparna K. Sharma
- />Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
- />D-11/1, DLF Exclusive Floors, DLF Phase V, Gurgaon, 122009 Haryana India
| | - Soniya Mittal
- />Department of Obstetrics & Gynaecology, Maulana Azad Medical College, Associated Lok Nayak Hospital, New Delhi, 110002 India
| | - Guresh Kumar
- />Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
27
|
Luo Y. A biomechanical sorting of clinical risk factors affecting osteoporotic hip fracture. Osteoporos Int 2016; 27:423-39. [PMID: 26361947 DOI: 10.1007/s00198-015-3316-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 09/03/2015] [Indexed: 02/07/2023]
Abstract
Osteoporotic fracture has been found associated with many clinical risk factors, and the associations have been explored dominantly by evidence-based and case-control approaches. The major challenges emerging from the studies are the large number of the risk factors, the difficulty in quantification, the incomplete list, and the interdependence of the risk factors. A biomechanical sorting of the risk factors may shed lights on resolving the above issues. Based on the definition of load-strength ratio (LSR), we first identified the four biomechanical variables determining fracture risk, i.e., the risk of fall, impact force, bone quality, and bone geometry. Then, we explored the links between the FRAX clinical risk factors and the biomechanical variables by looking for evidences in the literature. To accurately assess fracture risk, none of the four biomechanical variables can be ignored and their values must be subject-specific. A clinical risk factor contributes to osteoporotic fracture by affecting one or more of the biomechanical variables. A biomechanical variable represents the integral effect from all the clinical risk factors linked to the variable. The clinical risk factors in FRAX mostly stand for bone quality. The other three biomechanical variables are not adequately represented by the clinical risk factors. From the biomechanical viewpoint, most clinical risk factors are interdependent to each other as they affect the same biomechanical variable(s). As biomechanical variables must be expressed in numbers before their use in calculating LSR, the numerical value of a biomechanical variable can be used as a gauge of the linked clinical risk factors to measure their integral effect on fracture risk, which may be more efficient than to study each individual risk factor.
Collapse
Affiliation(s)
- Y Luo
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB, Canada.
- Department of Biomedical Engineering, University of Manitoba, Winnipeg, MB, Canada.
- Department of Anatomy, South Medical University, Guangzhou, China.
| |
Collapse
|
28
|
Abstract
Os métodos de avaliação da composição corporal em obesos têm sido amplamente discutidos, uma vez que nesses indivíduos a avaliação é dificultada devido às limitações dos equipamentos e características dos métodos utilizados. Esta sessão temática tem o objetivo de esclarecer as características, vantagens e limitações dos métodos de avaliação da composição corporal em adultos obesos. A quantificação de gordura corporal e mas-sa livre de gordura, assim como a avaliação da perda de massa muscular e de massa óssea em obesos são temas de grande interesse científico, uma vez que são utilizados para diagnosticar a obesidade osteosarcopênica. A avaliação da composição corporal de obesos pelo modelo de múltiplos compartimentos é padrão-ouro na prática científica. Por outro lado, o método de absorciometria radiológica de feixe duplo é considerado o padrão de referência em pesquisas e na prática clínica. Estudos indicam que a ressonância magnética e a tomografia computadorizada, em alguns casos, são fortemente correlacionadas com a absorciometria radiológica de feixe duplo. Os demais métodos apresentam limitações em avaliar a composição corporal, bem como suas modificações durante a redução ponderal em indivíduos obesos.
Collapse
|
29
|
Neglia C, Argentiero A, Chitano G, Agnello N, Giolli L, Di Tanna G, Paladini D, Amati A, Marsico A, Caiaffa V, Conte P, La Selva G, Crafa S, Colì G, Ciccarese R, Vigilanza A, Distante C, Argentiero D, Pantile V, Benvenuto M, Di Renzo T, Reale A, Coppola R, Distante A, Colao A, Di Somma C, Migliore A, Auriemma R, Piscitelli P. Diabetes and Obesity as Independent Risk Factors for Osteoporosis in Postmenopausal Women: A Population Study. EUR J INFLAMM 2014. [DOI: 10.1177/1721727x1401200309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. We studied 2,756 postmenopausal subjects out of ≥10,000 records from the ROIS registry in the frame of the PROF Project, a population study carried out in Salento (Taranto, Brindisi, Lecce) from 2009 to 2012. All subjects were assessed by phalangeal Quantitative Ultrasound (QUS) to evaluate their bone mineralization (assessed by Amplitude Dependent Speed of Sound, AD-SoS) and the association between demineralization and the presence of other conditions or risk factors. Mean age was 64±9.5 years and mean BMI was 28.7±3.5 Kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (P<0.001). By using multivariate logistic regression analysis, we observed significant values of Odds Ratios of osteoporosis (adjusted for age, physical activity and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (CI: 1,05–1,83) and 1.46 (CI: 1.20–1.78), respectively. A statistically significant linear trend of higher Odds Ratios of osteoporosis was found for increasing values of BMI. The percent change in the odds of vertebral fractures per single SD decrease of AD-SoS was 47% (P<0.001). Diabetes and obesity in postmenopausal women are likely to represent independent risk factors for osteoporosis. Phalangeal QUS showed a good power of predictivity in identifying subjects with vertebral fractures.
Collapse
Affiliation(s)
- C. Neglia
- Department of Biological and Environmental Science and Technology (Di.S.T.E.B.A), University of Salento, Lecce, Italy
| | - A. Argentiero
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G. Chitano
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - N. Agnello
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - L. Giolli
- E-Campus University, Novedrate, Italy
| | | | - D. Paladini
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - A. Amati
- Local Health Authority, ASL Taranto Taranto, Italy
| | - A. Marsico
- Local Health Authority, ASL Taranto Taranto, Italy
| | - V. Caiaffa
- Local Health Authority, ASL Taranto Taranto, Italy
| | - P. Conte
- Local Health Authority, ASL Taranto Taranto, Italy
| | - G. La Selva
- Local Health Authority, ASL Brindisi, Brindisi, Italy
| | - S. Crafa
- Local Health Authority, ASL Taranto Taranto, Italy
| | - G. Colì
- Local Health Authority, ASL Lecce, Gallipoli Hospital, Gallipoli, Italy
| | - R. Ciccarese
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - A. Vigilanza
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - C. Distante
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - D. Argentiero
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - V. Pantile
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - M. Benvenuto
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | | | | | | | - A. Distante
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi, Italy
| | - A. Colao
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - A. Migliore
- Fatebenefratelli St. Peter's Hospital- Department of Rheumatology, Rome, Italy
| | - R. Auriemma
- IOS, Southern Italy Hospital Institute, Naples, Italy
- Coleman Ltd, Naples, Italy
| | - P. Piscitelli
- IOS, Southern Italy Hospital Institute, Naples, Italy
- Coleman Ltd, Naples, Italy
| |
Collapse
|
30
|
Okita K, Kanahara N, Nishimura M, Yoshida T, Yasui-Furukori N, Niitsu T, Yoshida T, Ishikawa M, Kimura H, Nomura F, Iyo M. Second-generation antipsychotics and bone turnover in schizophrenia. Schizophr Res 2014; 157:137-41. [PMID: 24888527 DOI: 10.1016/j.schres.2014.05.009] [Citation(s) in RCA: 15] [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: 11/19/2013] [Revised: 04/25/2014] [Accepted: 05/12/2014] [Indexed: 11/18/2022]
Abstract
Accumulating evidence suggests that patients with schizophrenia are exposed to a high risk of osteoporosis/osteopenia caused by long-term antipsychotic treatment. The degree of bone mineral density (BMD) loss that a given antipsychotic may cause is not known. Examinations using a bone turnover marker may more accurately predict the ongoing bone states in psychiatric patients. We measured prolactin, estradiol, testosterone, and bone resorption marker (TRACP-5b) levels in 167 patients with schizophrenia and 60 normal controls. The patients showed significantly higher levels of prolactin and lower levels of TRACP-5b compared to the controls. Moreover, prolactin was negatively correlated with estradiol and testosterone in the group of all male subjects and the male patients. TRACP-5b was positively correlated with prolactin in the female patients and negatively correlated with estradiol in the group of all female subjects. The results show that the bone resorption rate was rather attenuated in the patients compared to the normal controls, suggesting a complicated etiology of BMD loss in schizophrenia patients. Several meaningful correlations between key factors in this study confirmed that hyperprolactinemia induced the suppression of sex hormones, and possibly led to the higher bone turnover. These results indicate that measurement of the resorption marker TRACP-5b might be useful to clarify the pathology of BMD loss.
Collapse
Affiliation(s)
- Kyoji Okita
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan; Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan.
| | - Motoi Nishimura
- Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan; Clinical Proteomics Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan; Division of Laboratory Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Toshihiko Yoshida
- Division of Laboratory Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, 1 Bunkyo-cho, Hirosaki, Aomori 036-8562, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Taisuke Yoshida
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Fumio Nomura
- Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan; Clinical Proteomics Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan; Division of Laboratory Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, Chiba 260-8670, Japan
| |
Collapse
|
31
|
El Hage R, Khairallah W, Bachour F, Issa M, Bedran F, Zakhem E, Nasser-Eddine F, Eid R, Fayad F, Maalouf G. Is obesity protective against vertebral deformities in Lebanese women? J Clin Densitom 2014; 17:433-4. [PMID: 23615620 DOI: 10.1016/j.jocd.2013.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 03/27/2013] [Indexed: 11/16/2022]
Affiliation(s)
- Rawad El Hage
- Department of Physical Education, University of Balamand, Tripoli, Lebanon
| | - Walid Khairallah
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Lebanon
| | - Falah Bachour
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Lebanon
| | - Majed Issa
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Lebanon
| | - Farid Bedran
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Lebanon
| | - Eddy Zakhem
- Department of Physical Education, University of Balamand, Tripoli, Lebanon
| | | | - Roy Eid
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Lebanon
| | - Fouad Fayad
- Hôtel-Dieu Hospital, University of Saint-Joseph, Beirut, Lebanon
| | - Ghassan Maalouf
- Bellevue Medical Center, Faculty of Medicine of St. Joseph University, Lebanon
| |
Collapse
|
32
|
Chen JH, Chen YC, Mao CL, Chiou JM, Tsao CK, Tsai KS. Association between secreted phosphoprotein-1 (SPP1) polymorphisms and low bone mineral density in women. PLoS One 2014; 9:e97428. [PMID: 24831687 PMCID: PMC4022728 DOI: 10.1371/journal.pone.0097428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/21/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A recent meta-analysis found that secreted phosphoprotein-1 (SPP1) can predict the risk of both osteoporosis and fracture. No study has explored the association of SPP1 haplotype-tagging single nucleotide polymorphisms (htSNPs) and haplotypes with bone mineral density (BMD). METHODS This is a cross-sectional study. A total of 1,313 healthy Taiwanese women aged 40 to 55 years were recruited from MJ Health Management Institute from 2009 to 2010. BMD was dichotomized into high and low BMD groups. Three common (allele frequency ≥5%) htSNPs were selected to examine the association between sequence variants of SPP1 and BMD. RESULTS Homozygosity for the T allele of rs4754 were protective from low BMD [TT vs. CC: adjusted OR (AOR) = 0.58, 95% confidence interval (CI) = 0.83-0.89]. A protective effect was also found for women carrying 2 copies of Hap3 TCT (AOR = 0.57, 95% CI = 0.34-0.95). Menopausal status marginally interacted with SPP1 rs6839524 on BMD (p = 0.049). Postmenopausal women carrying variant rs6839524 (GG+GC vs. CC: AOR = 2.35, 95% CI = 1.06-5.20) or Hap1 TGC (AOR = 2.36, 95% CI = 1.06-5.24) were associated with 2.4-fold risk of low BMD. For women with low BMI (<18.5 kg/m2), variant rs6839524 (AOR = 7.64) and Hap1 (AOR = 6.42) were associated with increased risk of low BMD. These findings did not reach statistical significance after correction for multiple tests. CONCLUSIONS SPP1 htSNP protected against low BMD in middle-aged women. SPP1 genetic markers may be important for the prediction of osteoporosis at an early age.
Collapse
Affiliation(s)
- Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 1, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chien-Lin Mao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Nankang, Taipei, Taiwan
| | - Chwen Keng Tsao
- MJ Health Management Institution, 12F., No. 413, Section 4, Taipei, Taiwan
| | - Keh-Sung Tsai
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 1, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Taipei, Taiwan
- Department of Laboratory Medicine, National Taiwan University Hospital, No. 7, Taipei, Taiwan,
| |
Collapse
|
33
|
Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR, Orwig DL. Body mass index is positively associated with bone mineral density in US older adults. Arch Osteoporos 2014; 9:175. [PMID: 24664472 DOI: 10.1007/s11657-014-0175-2] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/19/2013] [Indexed: 02/03/2023]
Abstract
UNLABELLED Literature has been conflicting as to whether obesity is protective against osteoporosis. Understanding the relationship is particularly important in light of the increasing prevalence of obesity among older adults. Study results confirm a protective association between obesity and osteoporosis in a recent, nationally representative sample of US older adults. PURPOSE Currently, the majority of US older adults are either overweight or obese. Evidence regarding the relationship between body composition measures and bone mass is conflicting, possibly because different measures of obesity reflect multiple mechanisms. Additionally, there are important age, gender, and racial differences in a risk of osteoporosis and fat mass composition. The objective of this study was to examine the association between body mass index (BMI) and bone mineral density (BMD) in a recent, nationally representative sample of US older adults as well as to see if this relationship differs by age, sex, and race. METHODS Data for this study were obtained from the National Health and Nutrition Examination Survey (2005-2008) for adults ages 50 and older (n = 3,296). Linear regression models were used to predict BMD of the femoral neck (measured by dual-energy X-ray absorptiometry (DXA)) as a function of BMI (measured height and weight) and a range of study covariates. RESULTS Every unit increase in BMI was associated with an increase of 0.0082 g/cm(2) in BMD (p < 0.001). Interaction terms for BMI and age (p = 0.345), BMI and sex (p = 0.413), and BMI and race (p = 0.725) were not statistically significant. CONCLUSIONS Study results confirm the positive association between BMI and BMD, and this relationship does not differ by age, sex, or race. A 10-unit increase in BMI (e.g., from normal BMI to obese) would result in moving an individual from an osteoporotic BMD level to a normal BMD level. Results demonstrate a protective, cross-sectional association between obesity and osteoporosis in a recent sample of US older adults.
Collapse
Affiliation(s)
- Jennifer T Lloyd
- Doctoral Program in Gerontology, University of Maryland, Baltimore and Baltimore County, USA,
| | | | | | | | | | | |
Collapse
|
34
|
Feresin RG, Johnson SA, Elam ML, Jo E, Arjmandi BH, Hakkak R. Effects of obesity on bone mass and quality in ovariectomized female Zucker rats. J Obes 2014; 2014:690123. [PMID: 25309751 PMCID: PMC4189520 DOI: 10.1155/2014/690123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 12/27/2022] Open
Abstract
Obesity and osteoporosis are two chronic conditions that have been increasing in prevalence. Despite prior data supporting the positive relationship between body weight and bone mineral density (BMD), recent findings show excess body weight to be detrimental to bone mass, strength, and quality. To evaluate whether obesity would further exacerbate the effects of ovariectomy on bone, we examined the tibiae and fourth lumbar (L4) vertebrae from leptin receptor-deficient female (Lepr(fa/fa)) Zucker rats and their heterozygous lean controls (Lepr(fa/+)) that were either sham-operated or ovariectomized (Ovx). BMD of L4 vertebra was measured using dual-energy X-ray absorptiometry, and microcomputed tomography was used to assess the microstructural properties of the tibiae. Ovariectomy significantly (P < 0.001) decreased the BMD of L4 vertebrae in lean and obese Zucker rats. Lower trabecular number and greater trabecular separation (P < 0.001) were also observed in the tibiae of lean- and obese-Ovx rats when compared to sham rats. However, only the obese-Ovx rats had lower trabecular thickness (Tb.Th) (P < 0.005) than the other groups. These findings demonstrated that ovarian hormone deficiency adversely affected bone mass and quality in lean and obese rats while obesity only affected Tb.Th in Ovx-female Zucker rats.
Collapse
Affiliation(s)
- Rafaela G. Feresin
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
- The Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL 32306, USA
| | - Sarah A. Johnson
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
- The Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL 32306, USA
| | - Marcus L. Elam
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
- The Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL 32306, USA
| | - Edward Jo
- The Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL 32306, USA
- Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA 91768, USA
| | - Bahram H. Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
- The Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL 32306, USA
- *Bahram H. Arjmandi: and
| | - Reza Hakkak
- Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA
- Arkansas Children's Hospital Research Institute, Little Rock, AR 72202, USA
- Arkansas Cancer Research Center, Little Rock, AR 72205, USA
- *Reza Hakkak:
| |
Collapse
|
35
|
Bhupathiraju SN, Lichtenstein AH, Dawson-Hughes B, Hannan MT, Tucker KL. Adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone health in older Puerto Ricans. Am J Clin Nutr 2013; 98:1309-16. [PMID: 24047918 PMCID: PMC3798082 DOI: 10.3945/ajcn.112.056267] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) and osteoporosis are 2 major public health problems that share common pathophysiological mechanisms. It is possible that strategies to reduce CVD risk may also benefit bone health. OBJECTIVE We tested the hypothesis that adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations (AHA-DLR) is associated with bone health. DESIGN We previously developed a unique diet and lifestyle score (American Heart Association Diet and Lifestyle Score; AHA-DLS) to assess adherence to the AHA-DLR. In a cross-sectional study of 933 Puerto Ricans aged 47-79 y, we modified the AHA-DLS to test associations with bone health. Bone mineral density (BMD) at the femoral neck, trochanter, total hip, and lumbar spine (L2-L4) was measured by using dual-energy X-ray absorptiometry. RESULTS For every 5-unit increase in the modified AHA-DLS, BMD at the femoral neck, trochanter, total hip, and lumbar spine (L2-L4) was associated with a 0.005-0.008-g/cm(2) (P < 0.05) higher value. No component of the AHA-DLR alone was responsible for the observed positive associations. For every 5-unit increase in the modified AHA-DLS, the odds for osteoporosis or osteopenia at the trochanter, total hip, and lumbar spine (L2-L4) were lower by 14% (OR: 0.86; 95% CI: 0.79, 0.92), 17% (OR: 0.83; 95% CI: 0.76, 0.92), and 9% (OR: 0.91; 95% CI: 0.84, 0.99), respectively. CONCLUSIONS Dietary guidelines for CVD risk reduction may also benefit bone health in this Hispanic cohort. Synchronizing dietary guidelines for these 2 common diseases may provide a simplified public health message. This trial was registered at clinicaltrials.gov as NCT01231958.
Collapse
Affiliation(s)
- Shilpa N Bhupathiraju
- Gerald J and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (SNB and AHL); the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA (SNB, BD-H, AHL, and KLT); the School of Medicine, Tufts University, Boston, MA (BD-H); the Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA (MTH); and the Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA (KLT)
| | | | | | | | | |
Collapse
|
36
|
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
|
37
|
Chang CS, Chang YF, Wang MW, Chen CY, Chao YJ, Chang HJ, Kuo PH, Yang YC, Wu CH. Inverse relationship between central obesity and osteoporosis in osteoporotic drug naive elderly females: The Tianliao Old People (TOP) Study. J Clin Densitom 2013; 16:204-11. [PMID: 22717906 DOI: 10.1016/j.jocd.2012.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 03/20/2012] [Accepted: 03/21/2012] [Indexed: 11/28/2022]
Abstract
To examine the relationship between central obesity and osteoporosis in elderly females in a rural community, a total of 368 ambulatory elderly women were recruited by random sampling during July 2009. Structured questionnaires were completed to survey possible osteoporosis-related risk factors. Subjects were dichotomized into either noncentral obese (waist circumference [WC]<80cm) or central obese subgroups (WC≥80cm) for further analysis. Bone mineral densities were scanned by dual-energy X-ray absorptiometry installed in a mobile bus. Thoracolumbar spine X-ray examination was interpreted by the same radiologist. Of the 365 subjects with completed data, 275 (75.3%) aged women were classified as having osteoporosis based on diagnostic Model III. Compared with the nonosteoporosis subjects, the subjects with osteoporosis had relatively higher mean age, lower body mass index, and a lower percentage of central obesity. Using the binary logistic regression method, central obesity was negatively associated with osteoporosis in all 3 models (odds ratios in the 3 models were 0.348, 95% confidence interval [CI]: 0.130-0.927; 0.444, 95% CI: 0.218-0.905; and 0.415, 95% CI: 0.184-0.936, respectively; p<0.05). Our study suggests that the paradox between central obesity and osteoporosis in elderly women should be of concern and warrants further study.
Collapse
Affiliation(s)
- Chin-Sung Chang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
CONTEXT Differences in bone mineral density (BMD) as assessed with dual-energy x-ray absorptiometry are observed between geographic and ethnic groups, with important implications in clinical practice. EVIDENCE ACQUISITION PubMed was employed to identify relevant studies. A review of the literature was conducted, and data were summarized and integrated. EVIDENCE SYNTHESIS The available data highlight the complex ethnic variations in BMD, which only partially account for observed variations in fracture rates. Factors contributing to ethnic differences include genetics, skeletal size, body size and composition, lifestyle, and social determinants. Despite BMD differences, the gradient of risk for fracture from BMD and other clinical risk factors appears to be similar across ethnic groups. Furthermore, BMD variation is greater within an ethnic population than between ethnic populations. New imaging technologies have identified ethnic differences in bone geometry, volumetric density, microarchitecture, and estimated bone strength that may contribute to a better understanding of ethnic differences in fracture risk. CONCLUSIONS Factors associated with ethnicity affect BMD and fracture risk through direct and indirect mechanisms.
Collapse
Affiliation(s)
- William D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Canada R2H 2A6.
| |
Collapse
|
39
|
Migliaccio S, Greco EA, Fornari R, Donini LM, Lenzi A. Is obesity in women protective against osteoporosis? Diabetes Metab Syndr Obes 2011; 4:273-82. [PMID: 21792326 PMCID: PMC3139535 DOI: 10.2147/dmso.s11920] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Indexed: 12/11/2022] Open
Abstract
The belief that obesity is protective against osteoporosis has recently come into question. The latest epidemiologic and clinical studies have shown that a high level of fat mass might be a risk factor for osteoporosis and fragility fractures. Further, increasing evidence seems to indicate that different components of the metabolic syndrome, ie, hypertension, increased triglycerides, reduced high-density lipoprotein cholesterol, are also potential risk factors for the development of low bone mineral density and osteoporosis. This review considers both the older and more recent data in the literature in order to evaluate further the relationship between fat tissue and bone tissue.
Collapse
Affiliation(s)
- Silvia Migliaccio
- Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma
- Dipartimento di Scienze della Salute, Università Foro Italico di Roma, Italia
| | - Emanuela A Greco
- Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma
| | - Rachele Fornari
- Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma
| | - Lorenzo M Donini
- Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma
| | - Andrea Lenzi
- Dipartimento di Medicina Sperimentale, Sezione di Fisiopatologia, Endocrinologia e Nutrizione, Università Sapienza di Roma
| |
Collapse
|
40
|
Saarelainen J, Honkanen R, Kröger H, Tuppurainen M, Jurvelin JS, Niskanen L. Body fat distribution is associated with lumbar spine bone density independently of body weight in postmenopausal women. Maturitas 2011; 69:86-90. [PMID: 21388758 DOI: 10.1016/j.maturitas.2011.02.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 02/08/2011] [Accepted: 02/08/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the association between the body fat distribution and axial bone mineral density (BMD) in postmenopausal women with or without hormone replacement therapy (HRT). DESIGN Cross-sectional population-based study. SETTING University of Eastern Finland, Bone and Cartilage Research Unit, Kuopio, Finland. POPULATION 198 postmenopausal women, mean age 67.5 (1.9 SD), mean BMI 27.1 (3.9 SD). METHODS Regional body composition and BMD assessed by dual X-ray absorptiometry (DXA, Prodigy). MAIN OUTCOME MEASURES Spinal and Femoral BMD. RESULTS Out of the body composition parameters, FM was the main determinant of postmenopausal bone mass. Only the lumbar spine (L2-L4) BMD, not the femoral neck BMD, was positively associated with the trunk FM. Positive trends for association were revealed between the spinal BMD and the trunk FM regardless of the use of HRT. Adjustments did not change the results. CONCLUSIONS Higher trunk fat mass was associated with the spinal BMD, but not with the hip BMD in postmenopausal women, irrespective of the HRT use. In addition to biological factors, uncertainties related to DXA measurements in patients with varying body mass may contribute to this phenomenon.
Collapse
Affiliation(s)
- J Saarelainen
- Bone and Cartilage Research Unit, Clinical Research Center, University of Eastern Finland, Kuopio, Finland.
| | | | | | | | | | | |
Collapse
|
41
|
Pollock NK, Laing EM, Hamrick MW, Baile CA, Hall DB, Lewis RD. Bone and fat relationships in postadolescent black females: a pQCT study. Osteoporos Int 2011; 22:655-65. [PMID: 20449571 DOI: 10.1007/s00198-010-1266-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 03/30/2010] [Indexed: 11/29/2022]
Abstract
UNLABELLED Despite adolescent black females experiencing the highest rates of obesity, the effect of excess fat mass on bone structure and strength in this population is unknown. Our findings in postadolescent black females suggest that excess weight in the form of fat mass may adversely influence cortical bone structure and strength. INTRODUCTION Although adolescent obesity has been associated with reduced bone structure and strength in white females, this relationship has not been studied in adolescent black females, a population experiencing the highest rates of obesity. Our objective was to compare bone structure and strength between postadolescent black females with normal and high levels of adiposity. METHODS Black females with ≤ 32% body fat were classified as normal body fat (NF; n = 33, aged 19.3 ± 1.3 years); females exceeding this cutoff were classified as high body fat (HF; n = 15, aged 19.0 ± 1.1 years). Using peripheral quantitative computed tomography, tibial and radial bones were scanned at the 4% (trabecular) and 20% (cortical) sites from the distal metaphyses. Fat-free soft-tissue mass (FFST) and %body fat were assessed by dual-energy X-ray absorptiometry. RESULTS After controlling for either FFST or body weight, the HF vs. NF group had lower total cross-sectional area (CSA; 9-17%), cortical CSA (6-15%), and strength-strain index (SSI; 13-24%) at the cortical site of the tibia (all p < 0.05). At the cortical site of the radius, the HF vs. NF group had lower total CSA (14%, p = 0.03), cortical CSA (9%, p = 0.04), and SSI (15%, p = 0.07) after control for body weight. There were no group differences in either the FFST-adjusted cortical bone values at the radius or in the trabecular bone parameters (body weight- or FFST-adjusted) at the tibia and radius. CONCLUSIONS Consistent with our adiposity and bone data in late-adolescent white females, our findings in black females entering adulthood also suggest that obesity may adversely influence cortical bone strength.
Collapse
Affiliation(s)
- N K Pollock
- Department of Pediatrics, Medical College of Georgia, Augusta, GA, USA.
| | | | | | | | | | | |
Collapse
|
42
|
Berenson AB, Rahman M, Wilkinson G. Racial difference in the correlates of bone mineral content/density and age at peak among reproductive-aged women. Osteoporos Int 2009; 20:1439-49. [PMID: 19139800 PMCID: PMC2708327 DOI: 10.1007/s00198-008-0817-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Accepted: 11/17/2008] [Indexed: 11/15/2022]
Abstract
SUMMARY Racial/ethnic differences were observed in age at peak bone density and their correlates, with whites peaking at least 5 years earlier at the femoral neck than black and Hispanic women. Race-specific standards generated in this study could be useful when interpreting bone densitometry data in young women. INTRODUCTION The influence of race/ethnicity on bone measurements has not been widely examined. This study identifies age and amount of bone accumulated at peak density and their correlates by race/ethnicity. METHODS Bone mineral content (BMC) and bone mineral density (BMD) of the spine and femoral neck were measured by dual X-ray absorptiometry in 708 white, black, and Hispanic reproductive-aged women. Race-specific nonlinear models were used to describe the relationship between age and bone measurements, after adjusting for body weight and height. Log-transformed bone measurements were used to determine predictors based on multiple linear regression. RESULTS Predictors, which were race and site specific, included age, age at menarche, body weight, height, months of depot medroxyprogesterone acetate use, weight-bearing exercise, and alcohol use. Women of all races gained BMC and BMD at the spine up to 30-33 years of age. BMC and BMD of the femoral neck peaked among white women earlier (<or=16 years) than among blacks (BMC 22 years; BMD 21 years) and Hispanics (BMC 29 years; BMD 20 years). CONCLUSION Age at peak bone mass and its correlates differ by race/ethnicity. Race-specific standards generated in this study could be useful when interpreting bone densitometry data in young women.
Collapse
Affiliation(s)
- A B Berenson
- Department of Obstetrics and Gynecology and the Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX, USA.
| | | | | |
Collapse
|
43
|
Genetic relationships between obesity and osteoporosis in LGXSM recombinant inbred mice. Genet Res (Camb) 2009; 90:433-44. [PMID: 19061533 DOI: 10.1017/s0016672308009798] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Obesity and osteoporosis affect millions of Americans. While phenotypically, obesity is negatively correlated with fracture risk, research on a genetic basis for this relationship is lacking. We used males and females from 16 LGXSM recombinant inbred (RI) mouse strains to investigate the genetically mediated relationship between obesity and osteoporosis-related traits. First, heritabilities were estimated for (1) bone morphology properties determined by microCT (femoral and radial diaphyseal bone cross-sectional area and moments of inertia, as well as proximal tibial trabecular bone volume, connectivity density, structure model index, trabecular number, trabecular thickness and trabecular separation), (2) mechanical properties determined by bending tests (femoral and radial rigidity, yield moment, ultimate moment, fracture displacement and post-yield displacement), and (3) effective material properties (femoral and radial modulus of elasticity and ultimate tensile strength). All femoral (H2=43-74%) and tibial traits (H2=31-56%) were heritable; as were 8 of 10 radial traits (H2=21-33%). Eighteen significant genetic correlations were discovered between obesity- and osteoporosis-related phenotypes. Genetic correlations indicate that gene effects associated with increased fat mass and leptin levels are also associated with larger, stronger femora. Gene effects associated with larger, stronger radii and with denser tibiae were also associated with increased fat mass but not with leptin levels. Furthermore, quantitative trait loci (QTLs) previously reported for obesity and leptin levels also had effects on bone morphology, mechanical and material properties. Our results support the use of the LG/J-by-SM/J mouse intercross populations as models for normal, complex genetic variation in obesity, bone properties and their interrelationship.
Collapse
|
44
|
Filip R, Raszewski G. Bone mineral density and bone turnover in relation to serum leptin, alpha-ketoglutarate and sex steroids in overweight and obese postmenopausal women. Clin Endocrinol (Oxf) 2009; 70:214-20. [PMID: 18547340 DOI: 10.1111/j.1365-2265.2008.03313.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Recent studies have shown that parallel changes in body weight and bone mass can be partially mediated via circulating leptin. Therefore, among the hormones involved in bone and mineral metabolism, such as oestrogens, testosterone and parathormone, leptin has recently become a subject of considerable interest. The aim of this study was to assess associations between leptin, E(2), testosterone, dehydroepiandrosterone sulphate (DHEA-S), SHBG, alpha-ketoglutaric acid (AKG) and bone mineral density (BMD) and bone turnover markers in overweight and obese postmenopausal women. DESIGN Eighty healthy, postmenopausal Caucasian women were studied. BMD of the lumbar spine (L(2)-L(4)) and femoral neck regions were examined using the dual X-ray absorptiometry (DXA) method. Associations were evaluated in stepwise multiple regression analysis, including information on the possible confounders and effect modifiers, for example, age, years since menopause, height and weight. RESULTS Femoral neck BMD was positively correlated with weight (r = 0.52, P < 0.000001), body mass index (BMI) (r = 0.48, P < 0.000006), hipline (r = 0.48, P < 0.00006), waistline (r = 0.45, P < 0.00002) and DHEA-S (r = 0.36, P < 0.0008). Correlations of E(2), SHBG, testosterone and leptin, as well as biochemical markers of bone turnover with L(2)-L(4) and femoral neck BMD were not found. In the whole study group, significant predictors of L(2)-L(4 )BMD were BMI (beta = 0.35, P < 0.01) testosterone (beta = 0.27, P < 0.05) and osteocalcin (OC) (beta = 0.22, P < 0.05) (R(2) = 0.23), while predictors of femoral neck BMD were BMI (beta = 0.42, P < 0.001), testosterone (beta = 0.24, P < 0.05), E(2) (beta = 0.19, P < 0.05), as well as osteocalcin (beta = 0.20, P < 0.05) (R(2) = 0.41). In the subgroup with BMI 30-39.9, the significant predictors of both L(2)-L(4 )and femoral neck BMD were testosterone (beta = 0.32, P < 0.05, R(2) = 0.19; beta = 0.33, P < 0.05, R(2) = 0.29) and osteocalcin (beta = 0.34, P < 0.05, R(2) = 0.19; beta = 0.45, P < 0.01, R(2) = 0.29). In the subgroup with waist : hip ratio (WHR > or = 0.85, the predictor of L(2)-L(4 )BMD was E(2) (beta = 0.38, P < 0.05) (R(2) = 0.21), whereas the predictors of femoral neck BMD were BMI (beta = 0.29, P < 0.05) and testosterone (beta = 0.35, P < 0.01) (R(2) = 0.36). CONCLUSION The main endocrine variable predicting lumbar spine BMD in overweight and obese postmenopausal females was testosterone, while the main determinants of femoral neck BMD were both testosterone and E(2). No effect was found of serum leptin on examined indicators of bone status.
Collapse
Affiliation(s)
- Rafal Filip
- Department of Bone Metabolic Diseases, and Department of Internal and Occupational Diseases, Institute of Agricultural Medicine, Lublin, Poland.
| | | |
Collapse
|
45
|
Aubertin-Leheudre M, Lord C, Labonté M, Khalil A, Dionne IJ. Relationship Between Sarcopenia and Fracture Risks in Obese Postmenopausal Women. J Women Aging 2008; 20:297-308. [DOI: 10.1080/08952840801984964] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
46
|
Luis Hernández Hernández J, Riancho Moral JA, González Macías J. Síndrome metabólico, ¿también del hueso? Med Clin (Barc) 2008; 130:745-50. [DOI: 10.1157/13121079] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
47
|
Leslie WD, Weiler HA, Lix LM, Nyomba BLG. Body composition and bone density in Canadian White and Aboriginal women: the First Nations Bone Health Study. Bone 2008; 42:990-5. [PMID: 18329354 DOI: 10.1016/j.bone.2008.01.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Revised: 11/26/2007] [Accepted: 01/20/2008] [Indexed: 11/22/2022]
Abstract
Ethnic variation in soft tissue composition may contribute to observed ethnic differences in bone mineral density (BMD). This analysis was performed to determine whether ethnic differences in body composition affect differences in BMD between Canadian White and Aboriginal women. An age-stratified population-based sample of 206 Aboriginal women and 177 White women underwent multisite bone density measurements and total body soft tissue composition analysis. In univariate analyses, each kg of additional lean mass was associated with a greater increase in BMD than an equal amount of fat mass (p<.01). When models simultaneously evaluated both soft tissue measurements, lean mass (but not fat mass) was positively correlated with BMD at all measurement sites (p<.001). Aboriginal women had significantly lower weight-adjusted BMD than White women for two sites (calcaneus, p = .019; total body, p = .026) and lower BMI-adjusted for BMD three sites (calcaneus, p = .0076; distal forearm, p = .047; total body, p = .022). The ratio of lean mass to fat mass was lower in Aboriginal than White women (p<.001). When BMD was adjusted for body composition variables no significant difference was seen between Aboriginal and White women. Apparent ethnic differences in weight- and BMI-adjusted BMD between Canadian White and Aboriginal women were explained by a lower ratio of lean mass to fat mass in Aboriginal women, combined with a smaller increment in BMD from fat mass versus lean mass in both populations.
Collapse
|
48
|
Abstract
A recent case series from Australia suggested that children with hemophilia may be more likely to have low bone density or osteopenia than healthy controls. This finding has led to uncertainty among patients and their physicians as to whether treatment with bisphosphonates is indicated to treat osteopenia and prevent osteoporosis in children or young adults with hemophilia. In fact, several studies confirmed that selected patients with hemophilia were shorter, weighed less, had reduced physical activity, and had other factors (hepatitis C and HIV seropositivity) which predict lower peak bone mass. Some of these factors may accelerate loss of bone mass between ages 20 and 50 when bone mass should otherwise be stable, but no study has yet confirmed if this is the case for patients with hemophilia. Treatment with weight-bearing physical activity, physiotherapy and surgery to remobilize diseased joints, and calcium and vitamin D supplementation, can be recommended for anyone at any age. Treatment with an antiresorptive medication (usually a bisphosphonate) is not indicated for low peak bone mass that will otherwise be maintained by the patient between ages 20 and 50. On the other hand, on an individualized basis, treatment with an antiresorptive may be indicated for patients in whom rapid loss of bone mass has been confirmed by sequential BMD measurements, or who have already suffered fragility fractures, or who have reached an age and BMD value that places them into a high-risk category for estimated 10-year fracture risk.
Collapse
Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine - Endocrinology, Health Sciences Centre, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, Newfoundland, Canada A1B 3V6.
| |
Collapse
|
49
|
Zhao LJ, Jiang H, Papasian CJ, Maulik D, Drees B, Hamilton J, Deng HW. Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis. J Bone Miner Res 2008; 23:17-29. [PMID: 17784844 PMCID: PMC2663586 DOI: 10.1359/jbmr.070813] [Citation(s) in RCA: 359] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
It was previously believed that obesity and osteoporosis were two unrelated diseases, but recent studies have shown that both diseases share several common genetic and environmental factors. Body fat mass, a component of body weight, is one of the most important indices of obesity, and a substantial body of evidence indicates that fat mass may have beneficial effects on bone. Contrasting studies, however, suggest that excessive fat mass may not protect against osteoporosis or osteoporotic fracture. Differences in experimental design, sample structure, and even the selection of covariates may account for some of these inconsistent or contradictory results. Despite the lack of a clear consensus regarding the impact of effects of fat on bone, a number of mechanistic explanations have been proposed to support the observed epidemiologic and physiologic associations between fat and bone. The common precursor stem cell that leads to the differentiation of both adipocytes and osteoblasts, as well the secretion of adipocyte-derived hormones that affect bone development, may partially explain these associations. Based on our current state of knowledge, it is unclear whether fat has beneficial effects on bone. We anticipate that this will be an active and fruitful focus of research in the coming years.
Collapse
Affiliation(s)
- Lan-Juan Zhao
- Departments of Orthopedic Surgery and Basic Medical Sciences, School of Medicine, University of Missouri–Kansas City, Kansas City, Missouri, USA
- These authors contributed equally to this paper
| | - Hui Jiang
- These authors contributed equally to this paper
- Laboratory of Molecular and Statistical Genetics, College of Life Science, Hunan Normal University, Changsha, Hunan, China
| | - Christopher J Papasian
- Departments of Orthopedic Surgery and Basic Medical Sciences, School of Medicine, University of Missouri–Kansas City, Kansas City, Missouri, USA
| | - Dev Maulik
- Department of Obstetrics and Gynecology, University of Missouri–Kansas City, Kansas City, Missouri, USA
| | - Betty Drees
- Departments of Orthopedic Surgery and Basic Medical Sciences, School of Medicine, University of Missouri–Kansas City, Kansas City, Missouri, USA
| | - James Hamilton
- Departments of Orthopedic Surgery and Basic Medical Sciences, School of Medicine, University of Missouri–Kansas City, Kansas City, Missouri, USA
| | - Hong-Wen Deng
- Departments of Orthopedic Surgery and Basic Medical Sciences, School of Medicine, University of Missouri–Kansas City, Kansas City, Missouri, USA
- Laboratory of Molecular and Statistical Genetics, College of Life Science, Hunan Normal University, Changsha, Hunan, China
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education and Institute of Molecular Genetics, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
50
|
Abstract
Accumulating evidence indicates that the several components of the cardiometabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Furthermore, some of the underlying risk factors for atherosclerosis in the cardiometabolic syndrome, such as inflammation, also play a major role in the pathogenesis of osteoporosis, the most common metabolic bone disease. In this article for the premiere issue of the Journal of the CardioMetabolic Syndrome, the author presents the current evidence of the interaction of bone metabolism and the cardiometabolic syndrome, highlighting the major research in this area and discussing the potential of therapeutic agents that will be useful in the treatment of osteoporosis as well as atherosclerosis.
Collapse
Affiliation(s)
- Samy I McFarlane
- Division of Endocrinology, Diabetes and Hypertension, SUNY-Downstate and Kings County Hospital Center, Brooklyn, NY 11203, USA.
| |
Collapse
|