Relationships between obesity markers and bone parameters in community-dwelling older adults.
Aging
Bone architecture
Bone density
Fat mass
Obesity
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
29 Feb 2024
29 Feb 2024
Historique:
received:
03
07
2023
accepted:
21
11
2023
medline:
29
2
2024
pubmed:
29
2
2024
entrez:
29
2
2024
Statut:
epublish
Résumé
Osteoporosis is an age-related condition that can lead to fragility fractures and other serious consequences. The literature data on the impact of obesity on bone health are contradictory. The main reasons for this discrepancy could be the imperfect nature of the body mass index (BMI) as a marker of obesity, the metabolic status (inflammation and metabolically healthy obesity), and/or heterogeneity in bone variables and architecture or sex. To examine the relationship between bone variables and three validated obesity criteria. In this cross-sectional study, participants were classified as obese according to their BMI, waist circumference (WC), and fat mass (FM). Bone variables and architecture were assessed using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. One hundred sixty-eight adults aged 55 or over (men: 68%) were included. 48 (28%) participants were obese according to the BMI, with 108 (64%) according to the FM, and 146 (87%) according to the WC. Bone variables were positively correlated with WC and BMI (Pearson's r = 0.2-0.42). In men only, the obesity measures were negatively correlated with cortical bone density (Pearson's r = - 0.32 to - 0.19) and positively correlated with cortical bone area (Pearson's r = 0.22-0.39). Our findings indicate that independent of sex and obesity criteria, when significant, being obese seems to lead to higher bone parameters than being non-obese, except for cortical bone density. Thus, in the obese population, assessing cortical density might help the physician to identify bone alteration. Further researches are needed to confirm our findings.
Sections du résumé
BACKGROUND
BACKGROUND
Osteoporosis is an age-related condition that can lead to fragility fractures and other serious consequences. The literature data on the impact of obesity on bone health are contradictory. The main reasons for this discrepancy could be the imperfect nature of the body mass index (BMI) as a marker of obesity, the metabolic status (inflammation and metabolically healthy obesity), and/or heterogeneity in bone variables and architecture or sex.
AIMS
OBJECTIVE
To examine the relationship between bone variables and three validated obesity criteria.
METHODS
METHODS
In this cross-sectional study, participants were classified as obese according to their BMI, waist circumference (WC), and fat mass (FM). Bone variables and architecture were assessed using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively.
RESULTS
RESULTS
One hundred sixty-eight adults aged 55 or over (men: 68%) were included. 48 (28%) participants were obese according to the BMI, with 108 (64%) according to the FM, and 146 (87%) according to the WC. Bone variables were positively correlated with WC and BMI (Pearson's r = 0.2-0.42). In men only, the obesity measures were negatively correlated with cortical bone density (Pearson's r = - 0.32 to - 0.19) and positively correlated with cortical bone area (Pearson's r = 0.22-0.39).
CONCLUSION
CONCLUSIONS
Our findings indicate that independent of sex and obesity criteria, when significant, being obese seems to lead to higher bone parameters than being non-obese, except for cortical bone density. Thus, in the obese population, assessing cortical density might help the physician to identify bone alteration. Further researches are needed to confirm our findings.
Identifiants
pubmed: 38421551
doi: 10.1007/s40520-023-02673-8
pii: 10.1007/s40520-023-02673-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
49Informations de copyright
© 2024. The Author(s).
Références
Wright NC, Saag KG, Dawson-Hughes B et al (2017) The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 28:1225–1232. https://doi.org/10.1007/s00198-016-3865-3
doi: 10.1007/s00198-016-3865-3
Cooper C, Campion G, Melton LJ (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 2:285–289. https://doi.org/10.1007/BF01623184
doi: 10.1007/BF01623184
Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 7:407–413. https://doi.org/10.1007/pl00004148
doi: 10.1007/pl00004148
Bliuc D, Nguyen ND, Milch VE et al (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521. https://doi.org/10.1001/jama.2009.50
doi: 10.1001/jama.2009.50
pubmed: 19190316
Kanis JA, Cooper C, Rizzoli R et al (2017) Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 28:2023–2034. https://doi.org/10.1007/s00198-017-4009-0
doi: 10.1007/s00198-017-4009-0
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259. https://doi.org/10.1136/bmj.312.7041.1254
doi: 10.1136/bmj.312.7041.1254
pubmed: 8634613
pmcid: 2351094
Cummings SR, Nevitt MC (1989) A hypothesis: the causes of hip fractures. J Gerontol 44:M107–M111. https://doi.org/10.1093/geronj/44.5.M107
doi: 10.1093/geronj/44.5.M107
pubmed: 2738306
Kanis JA, Black D, Cooper C et al (2002) A new approach to the development of assessment guidelines for osteoporosis. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 13:527–536. https://doi.org/10.1007/s001980200069
doi: 10.1007/s001980200069
Qiao D, Li Y, Liu X et al (2020) Association of obesity with bone mineral density and osteoporosis in adults: a systematic review and meta-analysis. Public Health 180:22–28. https://doi.org/10.1016/j.puhe.2019.11.001
doi: 10.1016/j.puhe.2019.11.001
pubmed: 31837611
De Laet C, Kanis JA, Odén A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338. https://doi.org/10.1007/s00198-005-1863-y
doi: 10.1007/s00198-005-1863-y
pubmed: 15928804
Sornay-Rendu E, Boutroy S, Vilayphiou N et al (2013) In obese postmenopausal women, bone microarchitecture and strength are not commensurate to greater body weight: the Os des Femmes de Lyon (OFELY) study. J Bone Miner Res Off J Am Soc Bone Miner Res 28:1679–1687. https://doi.org/10.1002/jbmr.1880
doi: 10.1002/jbmr.1880
Ishii S, Cauley JA, Greendale GA et al (2014) Pleiotropic effects of obesity on fracture risk: the Study of Women’s Health Across the Nation. J Bone Miner Res Off J Am Soc Bone Miner Res 29:2561–2570. https://doi.org/10.1002/jbmr.2303
doi: 10.1002/jbmr.2303
Felson DT, Zhang Y, Hannan MT et al (1993) Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res Off J Am Soc Bone Miner Res 8:567–573. https://doi.org/10.1002/jbmr.5650080507
doi: 10.1002/jbmr.5650080507
Cao JJ (2011) Effects of obesity on bone metabolism. J Orthop Surg 6:30. https://doi.org/10.1186/1749-799X-6-30
doi: 10.1186/1749-799X-6-30
Kyle UG, Genton L, Hans D et al (2001) Age-related differences in fat-free mass, skeletal muscle, body cell mass and fat mass between 18 and 94 years. Eur J Clin Nutr 55:663–672. https://doi.org/10.1038/sj.ejcn.1601198
doi: 10.1038/sj.ejcn.1601198
pubmed: 11477465
The obesity paradox: an endocrine perspective - Cheung - 2017 - Internal Medicine Journal - Wiley Online Library. Accessed 1 Mar 2020. https://onlinelibrary.wiley.com/doi/abs/
Li X, Gong X, Jiang W (2017) Abdominal obesity and risk of hip fracture: a meta-analysis of prospective studies. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 28:2747–2757. https://doi.org/10.1007/s00198-017-4142-9
doi: 10.1007/s00198-017-4142-9
Baumgartner RN, Wayne SJ, Waters DL et al (2004) Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 12:1995–2004. https://doi.org/10.1038/oby.2004.250
doi: 10.1038/oby.2004.250
pubmed: 15687401
Hsu YH, Venners SA, Terwedow HA et al (2006) Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. Am J Clin Nutr 83:146–154. https://doi.org/10.1093/ajcn/83.1.146
doi: 10.1093/ajcn/83.1.146
pubmed: 16400063
Blüher M (2020) Metabolically healthy obesity. Endocr Rev 41:bnaa004. https://doi.org/10.1210/endrev/bnaa004
doi: 10.1210/endrev/bnaa004
pubmed: 32128581
pmcid: 7098708
Karelis AD, Brochu M, Rabasa-Lhoret R (2004) Can we identify metabolically healthy but obese individuals (MHO)? Diabetes Metab 30:569. https://doi.org/10.1016/s1262-3636(07)70156-8
doi: 10.1016/s1262-3636(07)70156-8
pubmed: 15671927
Scott D, Seibel M, Cumming R et al (2017) Sarcopenic obesity and its temporal associations with changes in bone mineral density, incident falls, and fractures in older men: the concord health and ageing in men project. J Bone Miner Res Off J Am Soc Bone Miner Res 32:575–583. https://doi.org/10.1002/jbmr.3016
doi: 10.1002/jbmr.3016
Scott D, Chandrasekara S, Laslett L et al (2016) Associations of sarcopenic obesity and dynapenic obesity with bone mineral density and incident fractures over 5–10 years in community-dwelling older adults. Calcif Tissue Int 99:30. https://doi.org/10.1007/s00223-016-0123-9
doi: 10.1007/s00223-016-0123-9
pubmed: 26939775
Premaor MO, Pilbrow L, Tonkin C et al (2010) Obesity and fractures in postmenopausal women. J Bone Miner Res 25:292–297. https://doi.org/10.1359/jbmr.091004
doi: 10.1359/jbmr.091004
pubmed: 19821769
Sornay-Rendu E, Cabrera-Bravo JL, Boutroy S et al (2009) Severity of vertebral fractures is associated with alterations of cortical architecture in postmenopausal women. J Bone Miner Res Off J Am Soc Bone Miner Res 24:737–743. https://doi.org/10.1359/jbmr.081223
doi: 10.1359/jbmr.081223
Nguyen ND, Ahlborg HG, Center JR et al (2007) Residual lifetime risk of fractures in women and men. J Bone Miner Res Off J Am Soc Bone Miner Res 22:781–788. https://doi.org/10.1359/jbmr.070315
doi: 10.1359/jbmr.070315
Johnell O, Kanis JA, Oden A et al (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res Off J Am Soc Bone Miner Res 20:1185–1194. https://doi.org/10.1359/JBMR.050304
doi: 10.1359/JBMR.050304
Seeman E (1998) Growth in bone mass and size–are racial and gender differences in bone mineral density more apparent than real? J Clin Endocrinol Metab 83:1414–1419. https://doi.org/10.1210/jcem.83.5.4844
doi: 10.1210/jcem.83.5.4844
pubmed: 9589631
Nguyen ND, Pongchaiyakul C, Center JR et al (2005) Identification of high-risk individuals for hip fracture: a 14-year prospective study. J Bone Miner Res Off J Am Soc Bone Miner Res 20:1921–1928. https://doi.org/10.1359/JBMR.050520
doi: 10.1359/JBMR.050520
Riggs BL, Melton Iii LJ, Robb RA et al (2004) Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res Off J Am Soc Bone Miner Res 19:1945–1954. https://doi.org/10.1359/JBMR.040916
doi: 10.1359/JBMR.040916
Sigurdsson G, Aspelund T, Chang M et al (2006) Increasing sex difference in bone strength in old age: the age, gene/environment susceptibility-Reykjavik study (AGES-REYKJAVIK). Bone 39:644–651. https://doi.org/10.1016/j.bone.2006.03.020
doi: 10.1016/j.bone.2006.03.020
pubmed: 16790372
Solomon DH, Johnston SS, Boytsov NN et al (2014) Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J Bone Miner Res 29:1929–1937. https://doi.org/10.1002/jbmr.2202
doi: 10.1002/jbmr.2202
pubmed: 24535775
Pion CH, Barbat-Artigas S, St-Jean-Pelletier F et al (2017) Muscle strength and force development in high- and low-functioning elderly men: Influence of muscular and neural factors. Exp Gerontol 96:19–28. https://doi.org/10.1016/j.exger.2017.05.021
doi: 10.1016/j.exger.2017.05.021
pubmed: 28579089
Youssef L, Granet J, Marcangeli V et al (2022) Clinical and biological adaptations in obese older adults following 12-weeks of high-intensity interval training or moderate-intensity continuous training. Healthcare 10:1346. https://doi.org/10.3390/healthcare10071346
doi: 10.3390/healthcare10071346
pubmed: 35885872
pmcid: 9315493
Weir CB, Jan A. BMI Classification percentile and cut off points. In: StatPearls. StatPearls Publishing; 2021. Accessed 30 Aug 2021. http://www.ncbi.nlm.nih.gov/books/NBK541070/
Alberti KGMM, Zimmet P, Shaw J (2006) Metabolic syndrome–a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med J Br Diabet Assoc 23:469–480. https://doi.org/10.1111/j.1464-5491.2006.01858.x
doi: 10.1111/j.1464-5491.2006.01858.x
Expert Panel On Detection, Evaluation, And Treatment Of High Blood Cholesterol In Adults (2001) Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA J Am Med Assoc. 285:2486–2497. https://doi.org/10.1001/jama.285.19.2486
Studenski SA, Peters KW, Alley DE et al (2014) The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 69:547–558. https://doi.org/10.1093/gerona/glu010
doi: 10.1093/gerona/glu010
pubmed: 24737557
pmcid: 3991146
Doube M, Kłosowski MM, Arganda-Carreras I et al (2010) BoneJ: Free and extensible bone image analysis in ImageJ. Bone 47:1076–1079. https://doi.org/10.1016/j.bone.2010.08.023
doi: 10.1016/j.bone.2010.08.023
pubmed: 20817052
pmcid: 3193171
Mukaka MM (2012) Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J Med Assoc Malawi 24:69–71
Lenhard W, Lenhard A (2014) Hypothesis tests for comparing correlations. Published online 2014. https://www.psychometrica.de/correlation.html
JafariNasabian P, Inglis JE, Reilly W et al (2017) Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. J Endocrinol 234:R37–R51. https://doi.org/10.1530/JOE-16-0603
doi: 10.1530/JOE-16-0603
pubmed: 28442508
Dufour AB, Hannan MT, Murabito JM et al (2013) Sarcopenia definitions considering body size and fat mass are associated with mobility limitations: the Framingham study. J Gerontol A Biol Sci Med Sci 68:168–174. https://doi.org/10.1093/gerona/gls109
doi: 10.1093/gerona/gls109
pubmed: 22503991
Scott D, Johansson J, Ebeling PR et al (2020) Adiposity without obesity: associations with osteoporosis, sarcopenia, and falls in the healthy ageing initiative cohort study. Obes Silver Spring Md 28:2232–2241. https://doi.org/10.1002/oby.22984
doi: 10.1002/oby.22984
Sharma DK, Anderson PH, Morris HA et al (2020) Visceral fat is a negative determinant of bone health in obese postmenopausal women. Int J Environ Res Public Health 17:3996. https://doi.org/10.3390/ijerph17113996
doi: 10.3390/ijerph17113996
pubmed: 32512872
pmcid: 7312497
Xue P, Gao P, Li Y (2012) The association between metabolic syndrome and bone mineral density: a meta-analysis. Endocrine 42:546–554. https://doi.org/10.1007/s12020-012-9684-1
doi: 10.1007/s12020-012-9684-1
pubmed: 22547367
Chin KY, Chan CY, Subramaniam S et al (2020) Positive association between metabolic syndrome and bone mineral density among Malaysians. Int J Med Sci 17:2585–2593. https://doi.org/10.7150/ijms.49030
doi: 10.7150/ijms.49030
pubmed: 33029101
pmcid: 7532478
Sukumar D, Schlussel Y, Riedt CS et al (2011) Obesity alters cortical and trabecular bone density and geometry in women. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 22:635–645. https://doi.org/10.1007/s00198-010-1305-3
doi: 10.1007/s00198-010-1305-3
Jiang H, Robinson DL, Yates CJ et al (2020) Peripheral quantitative computed tomography (pQCT)-based finite element analysis provides enhanced diagnostic performance in identifying non-vertebral fracture patients compared with dual-energy X-ray absorptiometry. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 31:141–151. https://doi.org/10.1007/s00198-019-05213-1
doi: 10.1007/s00198-019-05213-1
Turcotte A, Jean S, Morin SN et al (2023) Relationships between obesity and incidence of fractures in a middle-aged population: a study from the Cartagene cohort. JBMR Plus 7:e10730. https://doi.org/10.1002/jbm4.10730
doi: 10.1002/jbm4.10730
pubmed: 37197317
pmcid: 10184011
Salamat MR, Salamat AH, Janghorbani M (2016) Association between obesity and bone mineral density by gender and menopausal status. Endocrinol Metab Seoul Korea 31:547–558. https://doi.org/10.3803/EnM.2016.31.4.547
doi: 10.3803/EnM.2016.31.4.547
Reid IR, Plank LD, Evans MC (1992) Fat mass is an important determinant of whole body bone density in premenopausal women but not in men. J Clin Endocrinol Metab 75:779–782. https://doi.org/10.1210/jcem.75.3.1517366
doi: 10.1210/jcem.75.3.1517366
pubmed: 1517366
Taaffe DR, Cauley JA, Danielson M et al (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the health, aging, and body composition study. J Bone Miner Res 16:1343–1352. https://doi.org/10.1359/jbmr.2001.16.7.1343
doi: 10.1359/jbmr.2001.16.7.1343
pubmed: 11450711
Gandham A, Scott D, Bonham MP et al (2022) Sex differences in bone health among Indian older adults with obesity, sarcopenia, and sarcopenic obesity. Calcif Tissue Int 111:152–161. https://doi.org/10.1007/s00223-022-00981-1
doi: 10.1007/s00223-022-00981-1
pubmed: 35507092
pmcid: 9300534
Cipriani C, Colangelo L, Santori R et al (2020) The interplay between bone and glucose metabolism. Front Endocrinol 11:122. https://doi.org/10.3389/fendo.2020.00122
doi: 10.3389/fendo.2020.00122
Karimi F, Ranjbar Omrani G, Dabbaghmanesh MH (2021) Insulin resistance and bone health in adolescents. Arch Osteoporos 16:66. https://doi.org/10.1007/s11657-021-00917-6
doi: 10.1007/s11657-021-00917-6
pubmed: 33837854
Monteiro R, Azevedo I (2010) Chronic inflammation in obesity and the metabolic syndrome. Mediators Inflamm 2010:289645. https://doi.org/10.1155/2010/289645
doi: 10.1155/2010/289645
pubmed: 20706689
pmcid: 2913796
Goossens GH (2017) The metabolic phenotype in obesity: fat mass, body fat distribution, and adipose tissue function. Obes Facts 10:207. https://doi.org/10.1159/000471488
doi: 10.1159/000471488
pubmed: 28564650
pmcid: 5644968
Shin MJ, Hyun YJ, Kim OY et al (2006) Weight loss effect on inflammation and LDL oxidation in metabolically healthy but obese (MHO) individuals: low inflammation and LDL oxidation in MHO women. Int J Obes 2005 30:1529–1534. https://doi.org/10.1038/sj.ijo.0803304
doi: 10.1038/sj.ijo.0803304
Fischer J, Hans D, Lamy O et al (2020) “Inflammaging” and bone in the OsteoLaus cohort. Immun Ageing A 17:5. https://doi.org/10.1186/s12979-020-00177-x
doi: 10.1186/s12979-020-00177-x
Yi-zhen N, Zhao-qi Y, Hui Y et al (2022) Osteosarcopenic obesity and its components-osteoporosis, sarcopenia, and obesity-are associated with blood cell count-derived inflammation indices in older Chinese people. BMC Geriatr. https://doi.org/10.1186/s12877-022-03225-x
doi: 10.1186/s12877-022-03225-x
Bano G, Trevisan C, Carraro S et al (2017) Inflammation and sarcopenia: a systematic review and meta-analysis. Maturitas 96:10–15. https://doi.org/10.1016/j.maturitas.2016.11.006
doi: 10.1016/j.maturitas.2016.11.006
pubmed: 28041587
Compston JE, Watts NB, Chapurlat R et al (2011) Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med 124:1043–1050. https://doi.org/10.1016/j.amjmed.2011.06.013
doi: 10.1016/j.amjmed.2011.06.013
pubmed: 22017783
pmcid: 4897773
Ho-Pham LT, Campbell LV, Nguyen TV (2011) More on body fat cutoff points. Mayo Clin Proc 86:584. https://doi.org/10.4065/mcp.2011.0097
doi: 10.4065/mcp.2011.0097
pubmed: 21628621
pmcid: 3104919
Turcotte AF, O’Connor S, Morin SN et al (2021) Association between obesity and risk of fracture, bone mineral density and bone quality in adults: a systematic review and meta-analysis. PLoS ONE 16:e0252487. https://doi.org/10.1371/journal.pone.0252487
doi: 10.1371/journal.pone.0252487
pubmed: 34101735
pmcid: 8186797