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Wen Q, Zhang X, Yang Y, Chen H, Han X, Chen Q. Association between neck circumference and bone mineral loss: A cross-sectional study in Sichuan province in China. Am J Med Sci 2024; 368:214-223. [PMID: 38754779 DOI: 10.1016/j.amjms.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND The associations of fat distribution with bone health are debatable. We aimed to investigate the associations between neck circumference (NC) and bone mineral loss among the adult Chinese population in Sichuan province. METHODS We examined overall NC size and NC stratums (≤35 cm, 3538 cm) with bone mineral density (BMD) at the femoral neck, lumbar spine, total hip skeletal sites in 135 men and 479 women respectively, and assessed whether adiposity, lipids, and calcium and phosphorus levels, might have a biased role in the relationship of NC and bone mineral loss with linear regression, logistic regression, and restricted cubic spline models. RESULTS The overall NC size is not independently associated with BMD at all sites. However, stratification for NC revealed that the positive correlation between NC and BMD at all sites were significant in the NC stratum 1 (≤35 cm) in women (all p<0.05) and NC stratum 2 (3538 cm) compared with NC stratum 1 using logistic regression. However, in women, no statistically significant association was observed between NC stratum 1 and BMD values after adjustment for the same confounders. CONCLUSIONS Our findings suggest a NC stratum-specific association between NC size and bone mineral loss in men in Sichuan province in China, but not in women.
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Affiliation(s)
- Qing Wen
- Medical Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, No39 Shi-er-Qiao Road, Chengdu, China
| | - Xiaoran Zhang
- Medical Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, No39 Shi-er-Qiao Road, Chengdu, China
| | - Yunjiao Yang
- Medical Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, No39 Shi-er-Qiao Road, Chengdu, China
| | - Huizhen Chen
- Medical Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, No39 Shi-er-Qiao Road, Chengdu, China
| | - Xuke Han
- College of Acupuncture & Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Qiu Chen
- Medical Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, No39 Shi-er-Qiao Road, Chengdu, China.
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Yang G, Jiang H, Xie D, Yuan S, Wu J, Zhang J, Zhang L, Yuan J, Lin J, Chen J, Yin Y. Association of obesity with osteoporotic fracture risk in individuals with bone metabolism-related conditions: a cross sectional analysis. Front Nutr 2024; 11:1365587. [PMID: 39166135 PMCID: PMC11333327 DOI: 10.3389/fnut.2024.1365587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 07/17/2024] [Indexed: 08/22/2024] Open
Abstract
Introduction This study aimed to investigate the individual and composite associations of different indices of obesity on osteoporotic fractures at three different sites among individuals affected by conditions influencing bone metabolism. Methods Participants were included from the National Health and Nutrition Examination Survey (NHANES), a national cross-sectional survey. BMI and WC were used separately and in combination to evaluate the presence of obesity. Obesity was defined as BMI ≥ 30 kg/m2, WC ≥ 88 cm in females, and WC ≥ 102 cm in males. Associations between obesity and osteoporotic fractures were assessed using multivariable logistic regression and OR curves. Associations modified by age, sex, race, and alcohol consumption were also evaluated. Results A total of 5377 participants were included in this study. In multivariable logistic regression analyses, we found that BMI, WC, BMI defining obesity, and WC defining obesity were negatively associated with hip fracture (all p < 0.05). However, harmful associations between WC and BMI defining obesity and spine fracture were found (all p < 0.05). OR curves revealed that BMI and WC had a linear relationship with hip and spine fractures (all P for non-linearity >0.05). Further analyses showed that the highest WC quartile was harmfully associated with a higher risk of spine fractures (p < 0.05). Obese participants diagnosed by both BMI and WC were less likely to have hip fractures but more likely to have spine fractures (all P for trend <0.05). A significant interaction between age (Ref: age < 50 years) and BMI and WC was detected for hip fractures (all P for interaction <0.05). Discussion In people with conditions influencing bone metabolism, obesity diagnosed by BMI and WC was associated with a lower risk of hip fracture, while obesity diagnosed by BMI and the highest WC quartile were associated with a higher risk of spine fracture.
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Affiliation(s)
- Guijun Yang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hejun Jiang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dan Xie
- Department of Respiratory Medicine, Sanya Women and Children’s Hospital Affiliated to Hainan Medical College, Hainan Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Sanya, Hainan, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajun Yuan
- Medical Department of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
| | - Jilei Lin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Respiratory Medicine, Sanya Women and Children’s Hospital Affiliated to Hainan Medical College, Hainan Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Sanya, Hainan, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
- Department of Respiratory Medicine, Linyi Maternal and Child Healthcare Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
- Shanghai Children’s Medical Center Pediatric Medical Complex (Pudong), Shanghai, China
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Lin YJ, Liang WM, Chiou JS, Chou CH, Liu TY, Yang JS, Li TM, Fong YC, Chou IC, Lin TH, Liao CC, Huang SM, Tsai FJ. Genetic predisposition to bone mineral density and their health conditions in East Asians. J Bone Miner Res 2024; 39:929-941. [PMID: 38753886 DOI: 10.1093/jbmr/zjae078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/17/2024] [Accepted: 05/15/2024] [Indexed: 05/18/2024]
Abstract
Osteoporosis, a condition defined by low BMD (typically < -2.5 SD), causes a higher fracture risk and leads to significant economic, social, and clinical impacts. Genome-wide studies mainly in Caucasians have found many genetic links to osteoporosis, fractures, and BMD, with limited research in East Asians (EAS). We investigated the genetic aspects of BMD in 86 716 individuals from the Taiwan Biobank and their causal links to health conditions within EAS. A genome-wide association study (GWAS) was conducted, followed by observational studies, polygenic risk score assessments, and genetic correlation analyses to identify associated health conditions linked to BMD. GWAS and gene-based GWAS studies identified 78 significant SNPs and 75 genes related to BMD, highlighting pathways like Hedgehog, WNT-mediated, and TGF-β. Our cross-trait linkage disequilibrium score regression analyses for BMD and osteoporosis consistently validated their genetic correlations with BMI and type 2 diabetes (T2D) in EAS. Higher BMD was linked to lower osteoporosis risk but increased BMI and T2D, whereas osteoporosis linked to lower BMI, waist circumference, hemoglobinA1c, and reduced T2D risk. Bidirectional Mendelian randomization analyses revealed that a higher BMI causally increases BMD in EAS. However, no direct causal relationships were found between BMD and T2D, or between osteoporosis and either BMI or T2D. This study identified key genetic factors for bone health in Taiwan, and revealed significant health conditions in EAS, particularly highlighting the genetic interplay between bone health and metabolic traits like T2D and BMI.
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Affiliation(s)
- Ying-Ju Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
| | - Jian-Shiun Chiou
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
- PhD Program for Health Science and Industry, College of Health Care, China Medical University, Taichung 406040, Taiwan
| | - Chen-Hsing Chou
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
- PhD Program for Health Science and Industry, College of Health Care, China Medical University, Taichung 406040, Taiwan
| | - Ting-Yuan Liu
- Million-person precision medicine initiative, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan
| | - Jai-Sing Yang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Te-Mao Li
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
| | - Yi-Chin Fong
- Department of Sports Medicine, College of Health Care, China Medical University, Taichung 406040, Taiwan
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung 404327, Taiwan
- Department of Orthopedic Surgery, China Medical University Beigang Hospital, Yunlin 65152, Taiwan
| | - I-Ching Chou
- Department of Pediatrics, China Medical University Children's Hospital, Taichung 404327, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404333, Taiwan
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan
| | - Fuu-Jen Tsai
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
- Division of Medical Genetics, China Medical University Children's Hospital, Taichung 404327, Taiwan
- Department of Medical Laboratory Science & Biotechnology, Asia University, Taichung 413005, Taiwan
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Martiniakova M, Biro R, Penzes N, Sarocka A, Kovacova V, Mondockova V, Omelka R. Links among Obesity, Type 2 Diabetes Mellitus, and Osteoporosis: Bone as a Target. Int J Mol Sci 2024; 25:4827. [PMID: 38732046 PMCID: PMC11084398 DOI: 10.3390/ijms25094827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Obesity, type 2 diabetes mellitus (T2DM) and osteoporosis are serious diseases with an ever-increasing incidence that quite often coexist, especially in the elderly. Individuals with obesity and T2DM have impaired bone quality and an elevated risk of fragility fractures, despite higher and/or unchanged bone mineral density (BMD). The effect of obesity on fracture risk is site-specific, with reduced risk for several fractures (e.g., hip, pelvis, and wrist) and increased risk for others (e.g., humerus, ankle, upper leg, elbow, vertebrae, and rib). Patients with T2DM have a greater risk of hip, upper leg, foot, humerus, and total fractures. A chronic pro-inflammatory state, increased risk of falls, secondary complications, and pharmacotherapy can contribute to the pathophysiology of aforementioned fractures. Bisphosphonates and denosumab significantly reduced the risk of vertebral fractures in patients with both obesity and T2DM. Teriparatide significantly lowered non-vertebral fracture risk in T2DM subjects. It is important to recognize elevated fracture risk and osteoporosis in obese and T2DM patients, as they are currently considered low risk and tend to be underdiagnosed and undertreated. The implementation of better diagnostic tools, including trabecular bone score, lumbar spine BMD/body mass index (BMI) ratio, and microRNAs to predict bone fragility, could improve fracture prevention in this patient group.
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Affiliation(s)
- Monika Martiniakova
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (R.B.); (V.K.)
| | - Roman Biro
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (R.B.); (V.K.)
| | - Noemi Penzes
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
| | - Anna Sarocka
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
| | - Veronika Kovacova
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (R.B.); (V.K.)
| | - Vladimira Mondockova
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
| | - Radoslav Omelka
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
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Greere D, Grigorescu F, Manda D, Voicu G, Lautier C, Nitu I, Poiana C. Relative Contribution of Metabolic Syndrome Components in Relation to Obesity and Insulin Resistance in Postmenopausal Osteoporosis. J Clin Med 2024; 13:2529. [PMID: 38731059 PMCID: PMC11084230 DOI: 10.3390/jcm13092529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Introduction. Osteoporosis (OP) affects 30% of postmenopausal women, often complicated by metabolic syndrome (MetS) with a still controversial role. We aimed to characterize MetS and its components in relation to bone mineral density (BMD), body mass index (BMI), and insulin resistance. Methods. Patients (n = 188) underwent DEXA scans, spine X-rays, and metabolic and hormonal investigations, including bone biomarkers, muscular strength, and physical performance tests, while insulin resistance was evaluated by the Homeostasis Model Assessment (HOMA-IR). Results. Patients with a normal BMD or osteopenia (n = 68) and with OP (n = 120) displayed 51.5% and 30.8% of MetS, but without differences in insulin resistance. When BMD was studied as a function of the cumulative MetS criteria and centiles of BMI, lower levels of BMD were observed beyond an inflection point of 27.2 kg/m2 for BMI, allowing for further stratification as lean and overweight/obese (OW/OB) subjects. In contrast with lean individuals (n = 74), in OW/OB patients (n = 46), MetS was associated with HbA1c (p < 0.0037, OR 9.6, 95% CI [1.64-55.6]) and insulin resistance (p < 0.0076, OR 6.7, 95% CI [1.49-30.8]) in the context where BMD values were lower than those predicted from BMI in non-OP subjects. In OP patients with fragility fractures (31% of MetS), glycemia also appeared to be the dominant factor for MetS (p < 0.0005, OR 4.1, 95% CI [1.63-10.39]). Conclusions. These data indicate a detrimental effect of insulin resistance in MetS on OP patients, while the prevalence of the syndrome depends on the proportion of obesity. These findings provide new insights into the pathogenic role of MetS and reveal the need to consider different strata of BMI and insulin resistance when studying postmenopausal OP.
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Affiliation(s)
- Daniela Greere
- Department of Endocrinology, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Bd., 050474 Bucharest, Romania;
- Department of Clinical Endocrinology, C. I. Parhon Institute of Endocrinology, 34-38 Aviatorilor Bd., 011863 Bucharest, Romania
| | - Florin Grigorescu
- Institut Convergences Migrations, Collège de France, 1440 Ave des Orchidées, 34980 Saint Clément de Rivière, France;
| | - Dana Manda
- Molecular Cellular and Structural Endocrinology Laboratory, C. I. Parhon Institute of Endocrinology, 34-38 Aviatorilor Bd., 011863 Bucharest, Romania;
| | - Gabriela Voicu
- Nuclear Medicine Laboratory, C. I. Parhon Institute of Endocrinology, 34-38 Aviatorilor Bd., 011863 Bucharest, Romania;
| | - Corinne Lautier
- Qualisud, Univ Montpellier, Avignon Université, Centre de Coopération Internationale en Recherche Agronomique Pour le Développement, Institut Agro, Institut de Recherche Pour le Développement, Université de La Réunion, 15 Ave Charles Flahault, 97400 Montpellier, France;
| | - Ileana Nitu
- Department of Cardiology, C. I. Parhon Institute of Endocrinology, 34-38 Aviatorilor Bd., 011863 Bucharest, Romania;
| | - Catalina Poiana
- Department of Endocrinology, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Bd., 050474 Bucharest, Romania;
- Department of Clinical Endocrinology, C. I. Parhon Institute of Endocrinology, 34-38 Aviatorilor Bd., 011863 Bucharest, Romania
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Yu J, Zhuang C, Guo W, Zhou X, Chen Y, Wang L, Li W, Zhu Y, Zhuang R, Tian K. Causal relationship between breakfast skipping and bone mineral density: a two-sample Mendelian randomized study. Front Endocrinol (Lausanne) 2023; 14:1200892. [PMID: 38027166 PMCID: PMC10660815 DOI: 10.3389/fendo.2023.1200892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To explore the causal association between breakfast skipping and bone mineral density (BMD) through two-sample Mendelian randomisation (MR) analysis. Methods A two-sample MR approach was adopted to explore the causal relationship of breakfast skipping with BMDs (across three skeletal sites and five age groups). Publicly available genome-wide association study summary data were used for MR analysis. We used five methods to estimate the causal associations between breakfast skipping and BMDs: inverse-variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode. IVW was used for the main analysis and the remaining four methods were used as supplementary analyses. The heterogeneity of the MR results was determined using IVW and MR-Egger methods. The pleiotropy of the MR results was determined using MR-Egger intercept. Furthermore, a leave-one-out test was performed to determine whether the MR results were affected by a single nucleotide polymorphism. Results With the IVW method, we did not find any causal relationship between breakfast skipping and forearm, femoral neck, and lumbar spine BMD. Subsequently, when we included BMD data stratified by five different age groups in the analysis, the results showed that there was no apparent causal effect between breakfast skipping and age-stratified BMD. This finding was supported by all four supplementary methods (P > 0.05 for all methods). No heterogeneity or horizontal pleiotropy was detected in any of the analyses (P > 0.05). The leave-one-out tests conducted in the analyses did not identify any single nucleotide polymorphism that could have influenced the MR results, indicating the reliability of our findings. Conclusion No causal effect was found between breakfast skipping and BMD (across three skeletal sites and five age groups).
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Affiliation(s)
- Jinsheng Yu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chen Zhuang
- Alberta Institute, Wenzhou Medical University, Wenzhou, China
| | - Wenxuan Guo
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Xing Zhou
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yixuan Chen
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Likang Wang
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenkai Li
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yiwen Zhu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rujie Zhuang
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Kun Tian
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
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Sun A, Hu J, Wang S, Yin F, Liu Z. Association of the visceral adiposity index with femur bone mineral density and osteoporosis among the U.S. older adults from NHANES 2005-2020: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1231527. [PMID: 38027200 PMCID: PMC10653335 DOI: 10.3389/fendo.2023.1231527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background The visceral adiposity index (VAI) is a marker of abdominal fat distribution and adipose tissue function. However, the association between VAI and femur bone mineral density (BMD) and osteoporosis is unclear among the U.S. older adults. Methods Cross-sectional data for adults aged 60 years and older from the 2007-2020 National Health and Nutrition Examination Survey (NHANES) were included. Multivariable linear and logistic regression were used to evaluate the association between VAI and femur BMD and osteoporosis. We used the smooth curve fitting to address nonlinearity. Moreover, a two-piecewise linear regression model was used to explain the nonlinearity further. Results The findings of the multivariable logistic regression models showed that as the VAI value increased by one unit, the prevalence of osteoporosis decreased by 1.2% after adjusting for covariates associated with osteoporosis. The multivariable linear regression models demonstrated that VAI was positively correlated with femur BMD. Further analysis revealed an inverted L-shaped and inverted U-shaped relationship between VAI and femur BMD at different sites. Conclusions Our findings indicated that an increased VAI is independently linked to a higher prevalence of osteoporosis among the U.S. older adults. Further analysis reveals that once VAI reaches a certain threshold, femur BMD no longer increases and may even decrease. This suggests that a moderate accumulation of visceral fat may be beneficial for bone health, while excessive visceral fat could potentially have detrimental effects.
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Affiliation(s)
- Aochuan Sun
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiayu Hu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shushangzhi Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fen Yin
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhengtang Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Li L, Zhong H, Shao Y, Zhou X, Hua Y, Chen M. Association between lean body mass to visceral fat mass ratio and bone mineral density in United States population: a cross-sectional study. Arch Public Health 2023; 81:180. [PMID: 37803458 PMCID: PMC10559600 DOI: 10.1186/s13690-023-01190-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/18/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Studies have explored the correlation between body composition and bone mineral density (BMD), but there has yet to be a consensus. Thus, the present study aims to comprehensively investigate the association between lean body mass, adipose tissue, and BMD. METHODS We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) (2011-2018) with 11,227 subjects. Multiple linear regression, smoothed curve fitting, threshold, and saturation effect analysis were used to explore the association between lean body mass, visceral fat mass, and BMD. Also, we used the lean body mass to visceral fat mass ratio (Log LM/VFM) as a proxy variable to analyze its association with BMD alone. RESULTS After adjusting for potential confounding factors, the results showed a positive correlation between lean mass and total BMD (for continuous: β = 0.078, P < 0.001; for quartile: β = 0.138, P < 0.001), while visceral fat mass was negatively correlated (for continuous: β = -0.027, P < 0.001; for quartile: β = -0.065, P < 0.001). A positive correlation was observed when the alternative variable Log LM/VFM was analyzed separately for its association with BMD (for continuous: β = 0.034, P < 0.001; for quartile: β = 0.084, P < 0.001). In addition, subgroup analyses for gender, age, body mass index, hypertension, and diabetes showed that all subgroups except the diabetes subgroup showed a substantial degree of robustness (P < 0.05). The smoothed curve fitting showed a nonlinear relationship between Log LM/VFM and BMD, and there was a threshold effect with a critical value of 2.60. CONCLUSION Maintaining a proper ratio of lean body mass and visceral fat mass is beneficial for increasing BMD.
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Affiliation(s)
- Longti Li
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Huiqin Zhong
- Department of Gastroenterology, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ya Shao
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China.
| | - Xu Zhou
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu Hua
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Maoqian Chen
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
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Rył A, Szylińska A, Skonieczna-Żydecka K, Miazgowski T, Rotter I. The Impact of Metabolic Syndrome on Bone Mass in Men: Systematic Review and Meta-Analysis. Biomedicines 2023; 11:1915. [PMID: 37509553 PMCID: PMC10377465 DOI: 10.3390/biomedicines11071915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
Studies to date have yielded conflicting results on associations between components of metabolic syndrome (MetS) and bone mineral density (BMD), particularly in men. This current systematic review and meta-analysis addresses the existing gap in the literature and aims to evaluate bone mineral density (BMD) at the femoral neck (FN) and lumbar spine (LS) in men diagnosed with MetS. The two study authors independently searched PubMed, Cinahl, Embase, and Web of Science up to 8 February 2022 for studies in English. The inclusion criteria were (i) diagnosis of MetS according to the NCEP-ATP III 2001 criteria; (ii) adult male demographic; (iii) analyzable data on BMD in at least two sites using dual-energy X-ray absorptiometry (DXA), and (iv) original observational studies. Case reports and non-English articles were excluded. We analyzed the results of seven studies providing data on bone density in men with MetS. Results: Based on random effect weights, the mean BMD of the femoral neck and lumbar spine were 0.84 and 1.02, respectively. The mean lumbar spine T-score was -0.92. In meta-regression analysis, the variances in mean BMD in the lumbar spine and femoral neck could not be significantly explained by BMI (lumbar BMD: Q = 1.10, df = 1, p = 0.29; femoral neck BMD: Q = 0.91, df = 1, p = 0.34). Our meta-analysis suggests normal bone mass in adult males with MetS. Due to the high heterogeneity in the seven analyzed studies and the lack of control groups in these studies, further research is needed to fully elucidate the associations between MetS and its components and BMD in men.
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Affiliation(s)
- Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Żołnierska 54, 71-210 Szczecin, Poland
| | - Aleksandra Szylińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Żołnierska 54, 71-210 Szczecin, Poland
| | - Karolina Skonieczna-Żydecka
- Department of Biochemical Sciences, Pomeranian Medical University, Władysława Broniewskiego 24, 71-460 Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propaedeutics of Internal Diseases and Arterial Hypertension, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Żołnierska 54, 71-210 Szczecin, Poland
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Tao J, Yan Z, Huang W, Feng T. Seropositive for hepatitis B and C viruses is associated with the risk of decreased bone mineral density in adults: An analysis of studies from the NHANES database. Front Med (Lausanne) 2023; 10:1120083. [PMID: 37035336 PMCID: PMC10073499 DOI: 10.3389/fmed.2023.1120083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
Background Some studies had reported that patients with viral hepatitis are at increased risk of reduced bone mineral density and even osteoporosis. However, the interaction between reduced bone mineral density (BMD) and viral hepatitis remains inconclusive. Therefore, our study collected hepatitis test results and bone mineral density from respondents in the NHANES database. The aim of this study was to investigate whether there is an association between hepatitis and a decrease in bone mineral density. Methods The respondents with both hepatitis- and BMD-related indicators from the NHANES database in the United States from 2005-2010, 2013-2014, to 2017-2020 were collected for this study. BMD were compared between respondents who were positive and negative for respondents related to hepatitis B and C. BMD was measured using dual-energy X-ray absorptiometry of the femur and lumbar spine. Finally, multiple regression analysis was performed between hepatitis B surface antigen (HBsAg) and hepatitis C RNA (HCV-RNA) and BMD in the respondents. Results A total of 15,642 respondents were included in the hepatitis B surface antigen-related survey. Of these, 1,217 respondents were positive for hepatitis B surface antigen. A total of 5111 hepatitis C RNA-related responders were included. Hepatitis C RNA-positive had 268 respondents. According to the results of the multiple regression analysis, the femoral BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.018 (-0.026, -0.009) (P < 0.01). Moreover, spinal BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.020 (-0.030, -0.010) (P < 0.01). According to the results of multiple regression analysis for hepatitis C RNA, HCV-RNA (+) respondents had significantly lower BMD compared to HCV-RNA (-) respondents: -0.043 (-0.059, -0.026) (P < 0.01). Conclusion During the analysis of respondents in the NHANES database in the United States, positive tests for hepatitis B surface antigen and hepatitis C RNA were found to be associated with a reduction in BMD. Positive serology for these hepatitis indicators may increase the risk of reduced BMD. Of course, this conclusion still needs to be further confirmed by more large clinical trials.
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Affiliation(s)
- Jiasheng Tao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zijian Yan
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wenmian Huang
- Affiliated Stomatological Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Tao Feng
- Department of Orthopedics, Nantong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, China
- *Correspondence: Tao Feng
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De Silva K, Demmer RT, Jönsson D, Mousa A, Teede H, Forbes A, Enticott J. Causality of anthropometric markers associated with polycystic ovarian syndrome: Findings of a Mendelian randomization study. PLoS One 2022; 17:e0269191. [PMID: 35679284 PMCID: PMC9182303 DOI: 10.1371/journal.pone.0269191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Using body mass index (BMI) as a proxy, previous Mendelian randomization (MR) studies found total causal effects of general obesity on polycystic ovarian syndrome (PCOS). Hitherto, total and direct causal effects of general- and central obesity on PCOS have not been comprehensively analyzed. Objectives To investigate the causality of central- and general obesity on PCOS using surrogate anthropometric markers. Methods Summary GWAS data of female-only, large-sample cohorts of European ancestry were retrieved for anthropometric markers of central obesity (waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR)) and general obesity (BMI and its constituent variables–weight and height), from the IEU Open GWAS Project. As the outcome, we acquired summary data from a large-sample GWAS (118870 samples; 642 cases and 118228 controls) within the FinnGen cohort. Total causal effects were assessed via univariable two-sample Mendelian randomization (2SMR). Genetic architectures underlying causal associations were explored. Direct causal effects were analyzed by multivariable MR modelling. Results Instrumental variables demonstrated no weak instrument bias (F > 10). Four anthropometric exposures, namely, weight (2.69–77.05), BMI (OR: 2.90–4.06), WC (OR: 6.22–20.27), and HC (OR: 6.22–20.27) demonstrated total causal effects as per univariable 2SMR models. We uncovered shared and non-shared genetic architectures underlying causal associations. Direct causal effects of WC and HC on PCOS were revealed by two multivariable MR models containing exclusively the anthropometric markers of central obesity. Other multivariable MR models containing anthropometric markers of both central- and general obesity showed no direct causal effects on PCOS. Conclusions Both and general- and central obesity yield total causal effects on PCOS. Findings also indicated potential direct causal effects of normal weight-central obesity and more complex causal mechanisms when both central- and general obesity are present. Results underscore the importance of addressing both central- and general obesity for optimizing PCOS care.
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Affiliation(s)
- Kushan De Silva
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
- * E-mail:
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Daniel Jönsson
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden
- Public Dental Service of Skane, Lund, Sweden
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
| | - Andrew Forbes
- Biostatistics Unit, Division of Research Methodology, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
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Song J, Liu T, Zhao J, Wang S, Dang X, Wang W. Causal associations of hand grip strength with bone mineral density and fracture risk: A mendelian randomization study. Front Endocrinol (Lausanne) 2022; 13:1020750. [PMID: 36578964 PMCID: PMC9792153 DOI: 10.3389/fendo.2022.1020750] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Muscle strength has been shown to exert positive effects on bone health. The causal relationship between hand grip strength and osteoporosis is an important public health issue but is not fully revealed. The goal of this study was to investigate whether and to what extent hand grip strength affects bone mineral density (BMD) and fracture risk. METHODS We conducted a state-of-the-art two-sample Mendelian randomization analysis. Genomewide significant (P<5×10-8) single nucleotide polymorphisms associated with hand grip strength were obtained. Summary level data of BMD and fractures at different body sites (lumbar spine, heel, forearm and femoral neck) was obtained from a large-scale osteoporosis database. The inverse variance weighted method was the primary method used for analysis, and the weighted-median, MR-Egger were utilized for sensitivity analyses. RESULTS The results provided strong evidence that hand grip strength trait was causally and positively associated with lumbar spine BMD (β: 0.288, 95% CI: 0.079 to 0.497; P=0.007), while no causal relationship was found between hand grip strength and BMD at heel (β: -0.081, 95% CI: -0.232 to 0.070; P=0.295), forearm (β: 0.-0.101, 95% CI: -0.451 to 0.248; P=0.571) or femoral neck (β: 0.054, 95% CI: -0.171 to 0.278; P=0.639). In addition, no statistically significant effects were observed for hand grip strength on fracture risks (β: -0.004, 95% CI: -0.019 to 0.012; P=0.662). CONCLUSIONS This study showed a positive causal relationship between hand grip strength and lumbar BMD, which is the most common site of osteoporotic fracture, but did not find a causal relationship between hand grip strength and BMD of heel, forearm, or femoral neck. No statistically significant effect of hand grip strength on fracture risk was observed. This study indicates variations in the abilities of hand grip strength trait to causally influence BMD at different skeleton sites. These results should be considered in further studies and public health measures on osteoporosis prevention strategies.
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Affiliation(s)
| | | | | | | | | | - Wei Wang
- *Correspondence: Xiaoqian Dang, ; Wei Wang,
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