1
|
Čermáková E, Forejt M. Metabolically healthy obesity and health risks - a review of meta-analyses. Cent Eur J Public Health 2024; 32:3-8. [PMID: 38669161 DOI: 10.21101/cejph.a7806] [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: 03/27/2023] [Accepted: 02/16/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE This article briefly summarizes the results of existing research on metabolically healthy obesity in the context of health risks. METHODS The PubMed database was searched for relevant meta-analyses addressing metabolically healthy obesity in the context of health risks. RESULTS We included a total of 17 relevant meta-analyses in this review. The results of the studied meta-analyses showed that metabolically healthy obesity may be only a transient condition associated with an increased risk of developing metabolic abnormalities in the future. People with obesity without metabolic abnormalities have an increased risk of type 2 diabetes, cardiovascular disease, cancer, chronic kidney disease, and depressive syndrome. In addition, all people with obesity are at risk of pathogenesis resulting from the mechanical stress caused by presence of abnormal adipose tissue, such as sleep apnoea syndrome or skin problems. CONCLUSION Based on the results of meta-analyses, we recommend motivating all obese patients to change their lifestyle regardless of the presence of metabolic defects.
Collapse
Affiliation(s)
- Erika Čermáková
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Forejt
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| |
Collapse
|
2
|
Kim J, Kang S, Kang H. Association between normal-weight obesity and bone mineral density in older Korean adults: A population-based cross-sectional study. Maturitas 2024; 180:107891. [PMID: 38006815 DOI: 10.1016/j.maturitas.2023.107891] [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: 07/05/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/27/2023]
Abstract
The effects of normal-weight obesity, which is defined as having a high level of body fat despite a normal body mass index, on the health of bones in older adults are poorly understood. This cross-sectional study examined the relationship between normal-weight obesity and bone mineral density in Korean adults aged 50 years or more (2815 men and 2744 women) from the 2008-2011 Korea National Health and Nutrition Examination Surveys. Between the ages of 50 and 69 years, individuals with normal-weight obesity had a higher risk of low bone mineral density (odds ratio = 1.596, 95 % confidence interval = 1.189-2.141, p = 0.002) compared with individuals with normal-weight non-obesity. However, no significant association between normal-weight obesity and bone mineral density was observed among people between the ages of 70 and 89 years. The study findings support the clinical significance of normal-weight obesity as a proxy biomarker to identify in primary care settings people who are at increased risk of developing osteoporosis at an early stage of aging.
Collapse
Affiliation(s)
- Jeonghyeon Kim
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Seamon Kang
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea.
| |
Collapse
|
3
|
Song C, Valeri A, Song F, Ji X, Liao X, Marmo T, Seeley R, Rutter J, Long F. Sexual dimorphism of osteoclast reliance on mitochondrial oxidation of energy substrates in the mouse. JCI Insight 2023; 8:e174293. [PMID: 37917194 PMCID: PMC10807709 DOI: 10.1172/jci.insight.174293] [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: 07/28/2023] [Accepted: 10/31/2023] [Indexed: 11/04/2023] Open
Abstract
Osteoclasts specialize in bone resorption and are critical for bone remodeling. Previous studies have shown that osteoclasts possess abundant mitochondria and derive most energy through oxidative phosphorylation (OXPHOS). However, the energy substrates fueling OXPHOS in osteoclasts remain to be fully defined. Here, we showed that osteoclast differentiation was coupled with increased oxidation of glucose, glutamine, and oleate. Transcriptomic analyses with RNA sequencing revealed marked upregulation of genes participating in OXPHOS and mitochondrial fatty acid oxidation, during osteoclast differentiation. Increased mitochondrial oxidation of long-chain fatty acids was required for osteoclast differentiation in vitro. However, blocking fatty acid oxidation in vivo, by deletion of carnitine palmitoyltransferase 1a (Cpt1a) in osteoclast progenitors, impaired osteoclast formation only in the female mice. The Cpt1a-deficient females were further protected from osteoclast activation by a high-fat diet. The males, on the contrary, exhibited normal bone resorption despite Cpt1a deletion, regardless of the dietary fat content. Moreover, concurrent deletion of mitochondrial pyruvate carrier 1 and Cpt1a, blocking mitochondrial oxidation of both glucose and fatty acids in the osteoclast lineage, failed to impede bone resorption in the males. The study therefore uncovers a female-specific dependence on mitochondrial oxidation of fatty acids and glucose in osteoclasts in vivo.
Collapse
Affiliation(s)
- Chao Song
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Orthopedic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Arianna Valeri
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Fangfang Song
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Xing Ji
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Xueyang Liao
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Tyler Marmo
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Rebecca Seeley
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jared Rutter
- Department of Biochemistry, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
| | - Fanxin Long
- Translational Research Program in Pediatric Orthopaedics, Department of Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
4
|
Wu X, Park S. A Prediction Model for Osteoporosis Risk Using a Machine-Learning Approach and Its Validation in a Large Cohort. J Korean Med Sci 2023; 38:e162. [PMID: 37270917 DOI: 10.3346/jkms.2023.38.e162] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/15/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Osteoporosis develops in the elderly due to decreased bone mineral density (BMD), potentially increasing bone fracture risk. However, the BMD is not regularly measured in a clinical setting. This study aimed to develop a good prediction model for the osteoporosis risk using a machine learning (ML) approach in adults over 40 years in the Ansan/Anseong cohort and the association of predicted osteoporosis risk with a fracture in the Health Examinees (HEXA) cohort. METHODS The 109 demographic, anthropometric, biochemical, genetic, nutrient, and lifestyle variables of 8,842 participants were manually selected in an Ansan/Anseong cohort and included in the ML algorithm. The polygenic risk score (PRS) of osteoporosis was generated with a genome-wide association study and added for the genetic impact of osteoporosis. Osteoporosis was defined with < -2.5 T scores of the tibia or radius compared to people in their 20s-30s. They were divided randomly into the training (n = 7,074) and test (n = 1,768) sets-Pearson's correlation between the predicted osteoporosis risk and fracture in the HEXA cohort. RESULTS XGBoost, deep neural network, and random forest generated the prediction model with a high area under the curve (AUC, 0.86) of the receiver operating characteristic (ROC) with 10, 15, and 20 features; the prediction model by XGBoost had the highest AUC of ROC, high accuracy and k-fold values (> 0.85) in 15 features among seven ML approaches. The model included the genetic factor, genders, number of children and breastfed children, age, residence area, education, seasons to measure, height, smoking status, hormone replacement therapy, serum albumin, hip circumferences, vitamin B6 intake, and body weight. The prediction models for women alone were similar to those for both genders, with lower accuracy. When the prediction model was applied to the HEXA study, the correlation between the fracture incidence and predicted osteoporosis risk was significant but weak (r = 0.173, P < 0.001). CONCLUSION The prediction model for osteoporosis risk generated by XGBoost can be applied to estimate osteoporosis risk. The biomarkers can be considered for enhancing the prevention, detection, and early therapy of osteoporosis risk in Asians.
Collapse
Affiliation(s)
- Xuangao Wu
- Department of Bioconvergence, Hoseo University, Asan, Korea
| | - Sunmin Park
- Department of Bioconvergence, Hoseo University, Asan, Korea
- Department of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, Korea.
| |
Collapse
|
5
|
Loureiro LM, Cordeiro A, Barboza L, Mendes R, Pereira S, Saboya CJ, Ramalho A. Evaluation of Liver Metabolism Biomarkers in Metabolic Associated Fatty Liver Disease According to Obesity Phenotype. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:140-147. [PMID: 35512760 DOI: 10.1080/07315724.2021.2007427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To analyze the relationship between the biochemical markers of liver metabolism in different stages of Metabolic Associated Fatty Liver Disease (MAFLD) according to the obesity phenotype. METHODOLOGY This is a cross-sectional study with individuals with class III obesity classified according to the obesity phenotypes proposed by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Biochemical and anthropometric variables were analyzed according to the staging of MAFLD and obesity phenotype. RESULTS A total of 50 subjects with MAFLD, 62% (n = 31) with steatosis and 38% (n = 19) with steatohepatitis without fibrosis; 36% were classified as metabolically healthy obesity (MHO) and 64% as metabolically unhealthy obesity (MUHO), respectively. Mean values of alkaline phosphatase were 85.44 ± 27.27 vs. 61.92 ± 17.57 (p = 0.006); gamma-glutamyl transpeptidase, 25.77 ± 15.36 vs. 30.63 ± 19.49 (p = 0.025); and albumin, 3.99 ± 0.34 vs. 4.24 ± 0.23 (p = 0.037), were lower and statistically significant in the MHO group with steatosis. The results show when considering individuals with IR, only AP is a predictor of unhealthy phenotype (B-0.934, 0.848- 1.029, p = 0.031). CONCLUSION MHO individuals with steatosis present lower severe changes related to markers of liver damage and function and AP is considered the predictor of MUHO phenotype.
Collapse
Affiliation(s)
- Ligiane M Loureiro
- Postgraduate Program, Doctorate in Nutritional Sciences, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Health Sciences Institute, Faculty of Nutrition, Federal University of Pará (UFPA), Belém, Brazil.,Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| | - Adryana Cordeiro
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil.,Biomedicine Department, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Letícia Barboza
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| | - Rodrigo Mendes
- Postgraduate Program, Master in Applied Mathematics, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sílvia Pereira
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil.,Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, Brazil
| | - Carlos J Saboya
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil.,Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, Brazil
| | - Andrea Ramalho
- Department of Social and Applied Nutrition of the Institute of Nutrition, UFRJ, Rio de Janeiro, Brazil
| |
Collapse
|
6
|
Pana TA, Kioh SH, Neal SR, Tan MP, Mat S, Moayyeri A, Luben RN, Wareham NJ, Khaw KT, Myint PK. Body Fat Percentage and the Long-term Risk of Fractures. The EPIC-Norfolk Prospective Population Cohort Study. Maturitas 2023; 168:71-77. [PMID: 36502648 DOI: 10.1016/j.maturitas.2022.11.005] [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: 04/03/2022] [Revised: 10/27/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND This cohort study aimed to determine the association between body fat percentage (BF%), incident fractures and calcaneal broadband ultrasound attenuation (BUA). METHODS Participants were drawn from the EPIC-Norfolk Prospective Population Cohort Study (median follow-up = 16.4 years). Cox models analysed the relationship between BF% and incident fractures (all and hip). Linear and restricted cubic spline (RCS) regressions modelled the relationship between BF% and BUA. RESULTS 14,129 participants (56.2 % women) were included. There were 1283 and 537 incident all and hip fractures respectively. The participants had a mean (standard deviation) age of 61.5 (9.0) years for women and 62.9 (9.0) years for men. Amongst men, BF% was not associated with incident all fractures. While BF% < 23 % (median) was not associated with hip fractures, BF% > 23 % was associated with increased risk of hip fractures by up to 50 % (hazard ratio (95 % confidence interval) = 1.49 (1.06-2.12)). In women, BF% < 39 % (median) was associated with up to 32 % higher risk of all fractures (1.32 (1.13-1.44)), while BF% > 35 % was not associated with this outcome. Higher BF% was associated with lower risk of incident hip fractures in women. Higher BF% was associated with higher BUA amongst women. Higher BF% up to ~23 % was associated with higher BUA amongst men. CONCLUSIONS Higher BF% is associated with lower risk of fractures in women. While there was no association between BF% and all fractures in men, increasing BF% >23 % was associated with higher risk of hip fractures in men. This appears to be independent of estimated bone mineral density. Fracture prevention efforts need to consider wider physical, clinical, and environmental factors.
Collapse
Affiliation(s)
- Tiberiu A Pana
- Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom.
| | - Sheng Hui Kioh
- Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom; Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Samuel R Neal
- Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Malaysia
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; Center of Healthy Ageing and Wellness, Faculty of Health Sciences, National University of Malaysia, Malaysia
| | | | - Robert N Luben
- Gonville and Caius College, University of Cambridge, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, United Kingdom
| | - Kay-Tee Khaw
- Gonville and Caius College, University of Cambridge, United Kingdom
| | - Phyo K Myint
- Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| |
Collapse
|
7
|
Vachliotis ID, Anastasilakis AD, Goulas A, Goulis DG, Polyzos SA. Nonalcoholic fatty liver disease and osteoporosis: A potential association with therapeutic implications. Diabetes Obes Metab 2022; 24:1702-1720. [PMID: 35589613 DOI: 10.1111/dom.14774] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/01/2022] [Accepted: 05/17/2022] [Indexed: 11/11/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) and osteoporosis are two highly prevalent metabolic diseases. Increasing experimental evidence supports a pathophysiological link between NAFLD and osteoporosis. A key feature could be chronic, low-grade inflammation, which characterizes NAFLD and possibly affects bone metabolism. In this context, several factors, including but not limited to receptor activator of nuclear factor kappa-B ligand, osteoprotegerin, osteopontin and osteocalcin, may serve as mediators. In the clinical setting, most but not all epidemiological evidence indicates that NAFLD is associated with lower bone mineral density or osteoporosis in adults. Although an association between NAFLD and osteoporosis has not yet been established, and thus remains speculative, pharmacological considerations already exist. Some of the current and emerging pharmacological options for NAFLD have shown possible anti-osteoporotic properties (eg, vitamin E, obeticholic acid, semaglutide), while others (eg, pioglitazone, canagliflozin) have been associated with increased risk of fractures and may be avoided in patients with NAFLD and concomitant osteoporosis, especially those at high fracture risk. Conversely, some anti-osteoporotic medications (denosumab) might benefit NAFLD, while others (raloxifene) might adversely affect it and, consequently, may be avoided in patients with osteoporosis and NAFLD. If an association between NAFLD and osteoporosis is established, a medication that could target both diseases would be a great advancement. This review summarizes the main experimental and clinical evidence on the potential association between NAFLD and osteoporosis and focuses on treatment considerations derived from this potential association.
Collapse
Affiliation(s)
- Ilias D Vachliotis
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece
| | | | - Antonis Goulas
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
8
|
Kerkadi A, Lathief S, Khial Y, Teleb T, Attieh G, Rahman MM, Shi Z, Agouni A. The Relationship Between Bone Mineral Density and Body Composition Among Qatari Women With High Rate of Obesity: Qatar Biobank Data. Front Nutr 2022; 9:834007. [PMID: 35479749 PMCID: PMC9037149 DOI: 10.3389/fnut.2022.834007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/15/2022] [Indexed: 12/19/2022] Open
Abstract
Studies have reported inconsistent results for the relationship between body composition and bone mineral density (BMD) among women, especially those with a high rate of obesity. This study aims to examine the association between BMD and body composition among Qatari women. A cross-sectional study, using data from the Qatar Biobank (QBB), was conducted on 2,000 Qatari women aged 18 and over. Measurements were taken by dual-energy X-ray absorptiometry (DEXA) for body composition [visceral fat and android fat (AF)], gynoid fat (GF), trunk fat, total fat mass (TFM), total lean mass (LM) and bone mineral density (BMD), including the lumber spine, neck, femur and total body. The participants were divided into groups of normal and low BMD, based on their T-score. Non-linear regression analysis using the restricted cubic spline method was performed according to the T-score of the total BMD for the fat mass variables. Women with a low BMD (T-score <-1) had significantly lower body composition indicators. LM was positively correlated with BMD at the spine (r = 0.29, p < 0.001), neck (r = 0.32, p < 0.001), and femur (r = 0.28, p < 0.001), as well as total BMD (r = 0.29, p < 0.001) and T-score (r = 0.31, p < 0.001), while the correlatio between TFM and BMD was negative and weak (r = -0.05, <0.017). Results of the non-linear regression indicated that components of fat distribution (TFM, AF, GF and trunk fat) were positively associated with total body T-score. In the adjusted non-liner regression, only a slight increase in T-score was recorded with an increase in FM. The association between FM and BMD was non-linear, suggesting that FM may not be a strong protector of bones among women with high rate of obesity.
Collapse
Affiliation(s)
- Abdelhamid Kerkadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Shalima Lathief
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Yasmen Khial
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Toka Teleb
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Grace Attieh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Md Mizanur Rahman
- Biological Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Abdelali Agouni
- Department of Pharmaceutical Sciences, College of Pharmacy, QU-Health, Qatar University, Doha, Qatar
| |
Collapse
|
9
|
Regular Exercise and Weight-Control Behavior Are Protective Factors against Osteoporosis for General Population: A Propensity Score-Matched Analysis from Taiwan Biobank Participants. Nutrients 2022; 14:nu14030641. [PMID: 35277000 PMCID: PMC8838409 DOI: 10.3390/nu14030641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/22/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
The rising prevalence of osteoporosis, which can lead to osteoporotic fractures, increases morbidity, mortality, and socioeconomic burden. Multiple factors influencing bone mass have already been identified. The aim of this study was to investigate whether exercise habits and weight-control behaviors can lower the incidence of osteoporosis in the general population. This retrospective study recruited all participants aged 35–70 years who underwent dual-energy X-ray absorptiometry (DXA) from Taiwan Biobank (TWB). The final analysis consisted of 3320 eligible participants divided into two groups; demographic characteristics, prevalence of clinical symptoms, comorbidities, and daily behavior were collected using a self-reported questionnaire. After propensity score matching with a 1:1 ratio, 1107 out of 2214 individuals were classified into the osteoporosis group. Age, body fat rate, body shape, diabetes mellitus, and social status were found to affect the incidence of osteoporosis. Subjects with a habit of regular exercise and weight-control behavior showed decreased odds of osteoporosis. (odds ratio: 0.709 and 0.753, 95% confidence interval: 0.599–0.839 and 0.636–0.890). In the general population, regular exercise or weight-control behavior lowers the incidence of osteoporosis.
Collapse
|
10
|
Chen YC, Hsu BG, Lin WC, Lee MC. Inverse association of serum osteocalcin and bone mineral density in renal transplant recipients. Tzu Chi Med J 2022. [DOI: 10.4103/tcmj.tcmj_55_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Balogun SA, Aitken D, Wu F, Scott D, Jones G, Winzenberg T. Linear and non-linear associations between physical activity, body composition and multimorbidity over 10 years among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2021; 76:2015-2020. [PMID: 33780541 DOI: 10.1093/gerona/glab086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND This study aims to describe the relationships between physical activity (PA), body composition and multimorbidity over 10 years. METHODS Participants (N=373; 49% women; average age 61.3±6.7 years) were followed for 10 years. Multimorbidity was defined by self-report as the presence of two or more of 12 listed chronic conditions. PA (steps-per-day) at baseline was assessed by pedometer, handgrip strength (HGS) by dynamometer and appendicular lean mass (ALM) and total body fat mass by dual x-ray absorptiometry . Relative HGS and ALM were calculated by dividing each body mass index (BMI). Regression cubic splines were used to assess evidence for a non-linear relationship. RESULTS After 10 years, 45% participants had multimorbidity. There was a non-linear relationship between PA and multimorbidity - PA was associated with lower multimorbidity risk among individuals who engaged in <10,000 steps-per-day (RR=0.91, 95% CI: 0.85, 0.97, per 1000 steps-per-day), but not among those who participated in ≥10,000 steps-per-day (RR=1.04, 95% CI: 0.93, 1.09, per 1000 steps-per-day). Higher BMI (RR=1.05, 95% CI: 1.02, 1.08, per kg/m 2) and fat mass (RR=1.03, 95% CI: 1.01, 1.04, per kg), and lower relative HGS (RR=0.85, 95% CI: 0.77, 0.94, per 0.1 psi/kg/m 2) and ALM (RR=0.93, 95% CI: 0.88, 0.98, per 0.1 kg/kg/m 2) were linearly associated with a higher risk of multimorbidity. Absolute HGS and ALM were not significantly associated with multimorbidity. DISCUSSION These findings highlight the potential clinical importance of maintaining adequate levels of PA and of reducing adiposity and maintaining muscle function for minimising the risk of multimorbidity in older adults.
Collapse
Affiliation(s)
- Saliu A Balogun
- Menzies Institute for Medical Research, University of Tasmania, Australia.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - David Scott
- Menzies Institute for Medical Research, University of Tasmania, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Victoria, Australia.,School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Australia.,Faculty of Health, University of Tasmania, Australia
| |
Collapse
|
12
|
Gandham A, Zengin A, Bonham MP, Winzenberg T, Balogun S, Wu F, Aitken D, Cicuttini F, Ebeling PR, Jones G, Scott D. Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage. Bone 2020; 140:115546. [PMID: 32730938 DOI: 10.1016/j.bone.2020.115546] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this study was to determine and compare risk factors associated with incident fractures in older adults with and without obesity, defined by both body mass index (BMI) and body fat percentage. METHODS 1,099 older adults (mean ± standard deviation age = 63.0 ± 7.5) years, participated in this prospective cohort study. Obesity status at baseline was defined by BMI (≥30 kg/m2) obtained by anthropometry and body fat percentage (≥30% for men and ≥40% for women) assessed by dual-energy X-ray absorptiometry (DXA). Total hip and lumbar spine areal bone mineral density (aBMD) were assessed by DXA up to five years. Incident fractures were self-reported up to 10 years. RESULTS Prevalence of obesity was 28% according to BMI and 43% according to body fat percentage. Obese older adults by BMI, but not body fat percentage, had significantly higher aBMD at the total hip and spine compared with non-obese (both p-value<0.05). Obese older adults by body fat percentage had significantly higher likelihood of all incident fractures (OR: 1.71; CI:1.08, 2.71) and non-vertebral fractures (OR: 1.88; CI:1.16, 3.04) compared with non-obese after adjusting for confounders. Conversely, obese older adults by BMI had a significantly lower likelihood (OR: 0.54; CI:0.31, 0.94) of non-vertebral fractures although this was no longer significant after adjustment for total hip aBMD (all p-value > 0.05). Mediation analysis confirmed that aBMD meditated the effects of BMI, but not body fat percentage, on all incident fractures. Higher baseline falls risk score was the only consistent predictor of increased likelihood of incident fracture in obese individuals only, according to both BMI and body fat percentage (both p-value<0.05). CONCLUSIONS Obesity defined by body fat percentage is associated with increased likelihood of incident fractures in community-dwelling older adults, whereas those who are obese according to BMI have reduced likelihood of incident fracture which appears to be explained by higher aBMD. Falls risk assessment may improve identification of obese older adults at increased risk of incident fractures.
Collapse
Affiliation(s)
- Anoohya Gandham
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
13
|
Campoverde Reyes KJ, Stanford FC, Singhal V, Animashaun AO, Bose A, Gleeson EL, Bredella MA, Misra M. Bone density, microarchitecture and strength estimates in white versus African American youth with obesity. Bone 2020; 138:115514. [PMID: 32622072 PMCID: PMC7423738 DOI: 10.1016/j.bone.2020.115514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND African Americans (AA) have more favorable bone density and microarchitecture compared to Whites (W), which may explain their observed lower fracture rates. Obesity has deleterious effects on bone microarchitecture and strength estimates and is associated with an increase in fracture risk. Adolescence and young adulthood are periods of active bone accrual and also periods characterized by an increasing prevalence of obesity. The effect of obesity on the relationship between race and bone parameters remains unclear, particularly in youth. OBJECTIVE To assess differences in BMD, bone microarchitecture and strength estimates in AA and W adolescents and young adults with moderate to severe obesity. We hypothesized that racial differences in bone endpoints in lean youth would also be noted in youth with moderate to severe obesity. METHODS We evaluated 24 AA and 48 W adolescent and young adults with a mean age of 18.2 ± 2.4 years and a median body mass index (BMI) of 44.8 (40.5-49.4) kg/m2 who underwent dual energy X-ray absorptiometry (DXA), high resolution peripheral quantitative computed tomography (HRpQCT), extended cortical analysis (ECA) and micro-finite element analysis (FEA) to obtain measures of volumetric bone mineral density (vBMD), bone geometry, microarchitecture, and strength estimates at the distal radius and tibia. RESULTS We found no differences between AA and W for total fat and lean mass, and areal BMD Z-scores (p > 0.05 for all). At the distal radius, no significant differences were detected in vBMD, bone geometry or microarchitecture (p > 0.05 for all); however, stiffness and failure load were higher in the AA group (p = 0.031 and 0.047 respectively). At the distal tibia, cortical vBMD was higher in AA vs. W (p = 0.012), while trabecular number was higher and trabecular separation lower in W vs. AA (p ≤ 0.028). Stiffness and failure load trended higher in AA vs. W (p = 0.052 and p = 0.048, respectively). Groups did not differ for any other bone parameter (p > 0.05). CONCLUSION Racial differences in bone endpoints appear to be less marked in those with moderate to severe obesity, suggesting that effects of obesity may blunt the effect of race on bone endpoints.
Collapse
Affiliation(s)
- Karen J Campoverde Reyes
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Liver Research Center, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Fatima Cody Stanford
- 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, Massachusetts General Hospital, 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, Massachusetts General Hospital, Boston, MA, United States of America
| | - Abisayo O 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
| | - Elizabeth L Gleeson
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 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
|
14
|
Ali K, El Said SMS, Adly NN, Abdul-Rahman SA. The Relation Between Calcaneus Stiffness Index as a Measure of Bone Density and Body Mass Index in an Egyptian Cohort. J Multidiscip Healthc 2019; 12:1085-1090. [PMID: 32099376 PMCID: PMC6997196 DOI: 10.2147/jmdh.s230730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/25/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Obesity and osteoporosis are two conditions that are associated with morbidity and mortality; there is contradictory evidence regarding this association. PURPOSE The aim of the current study was to explore further the association between obesity and calcaneus stiffness index (CSI), as a measure of bone density, in a community-based cross-sectional study in an Egyptian population. METHODS A cross-sectional study was conducted among active subjects, aged ≥20 years old, over one year. CSI was measured by Quantitative ultrasound (QUS), in addition; QUS T-score and Z-score of the non-dominant heel scan were recorded. RESULTS Two hundred and eighty participants were recruited; 7 subjects were excluded because of Z score more than -2, mean age was 61 (± 11.9) years, and mean BMI was 29.7 (±5.6). Female participants were 77.7%, with mean of age 60.3 (± 11.6); and age range 20-82 years. Male participants were 22.3%, with mean of age 63.6 (± 12.7); and age range 30-80 years. Older subjects (>55 years) had significantly lower CSI and worse T-score than the younger subjects (P < 0.001 for both). In the younger age group, BMI was not significantly associated with CSI, even after adjustment for gender (P= 0.52). However, in the older age group, BMI was significantly associated with stiffness index (P= 0.049, O.R.= 1.73), even after adjustment for gender (P= 0.041, O.R.= 1.7). CONCLUSION Compared to young subjects, older subjects (≥55 years) had significantly lower bone strength as measured by CSI, and their BMI was significantly positively associated with bone density. In younger people (<55 years), BMI was not associated with bone strength.
Collapse
Affiliation(s)
- Khalid Ali
- Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, UK
| | - Salma MS El Said
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nermien N Adly
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samia A Abdul-Rahman
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
15
|
Loureiro LM, Cordeiro A, Mendes R, Luna M, Pereira S, Saboya CJ, Ramalho A. Clinic, Anthropometric And Metabolic Changes In Adults With Class III Obesity Classified As Metabolically Healthy And Metabolically Unhealthy. Diabetes Metab Syndr Obes 2019; 12:2419-2431. [PMID: 31819568 PMCID: PMC6885561 DOI: 10.2147/dmso.s210616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 08/30/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To describe clinical, biochemical and anthropometric profiles in adults with class III obesity classified as metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). PATIENTS AND METHODS This is a cross-sectional study with patients classified as MHO and MUHO according to the NCEP-ATP III. Anthropometric, biochemical and clinical variables were analyzed. RESULTS A total of 223 subjects were evaluated and 32.73% were classified as MHO and 67.26% as MUHO, respectively. The insulin resistance homeostasis model (HOMA-IR) showed elevation in the MUHO group (p=0.003) and anthropometric variables were correlated with bone markers [body index mass (BMI) vs phosphorus: r=0.31, p<0.001; BMI vs 25(OH)D: r=-0.31, p=0.041]. Visceral adiposity index was lower in MHO (p=0.001). Negative correlations between inflammatory markers and bone markers were observed in the MHO group (calcium vs C-reactive protein: -0.30, p=0.017; parathyroid hormone vs HOMA-IR: r=-0.28, p=0.017. CONCLUSION MHO individuals showed important metabolic changes, such as those observed in MUHO, despite lower prevalence and severity. Continuous monitoring of these individuals is suggested, given the transient nature of the MHO phenotype.
Collapse
Affiliation(s)
- Ligiane M Loureiro
- Postgraduate Program, Doctorate in Nutritional Sciences, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Health Sciences Institute, Faculty of Nutrition, Federal University of Pará (UFPA), Belém, Brazil
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| | - Adryana Cordeiro
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Biomedicine Department, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rodrigo Mendes
- Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Luna
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| | - Sílvia Pereira
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, Brazil
| | - Carlos J Saboya
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, Brazil
| | - Andrea Ramalho
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
- Department of Social and Applied Nutrition of the Institute of Nutrition, UFRJ, Rio de Janeiro, Brazil
| |
Collapse
|
16
|
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
|