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Kamari N, Fateh HL, Pasdar Y, Rezaeian S, Shakiba E, Najafi F. Bone mineral density and muscle mass associated with healthy eating index in postmenopausal women; results from RaNCD cohort study. BMC Womens Health 2023; 23:615. [PMID: 37978520 PMCID: PMC10657131 DOI: 10.1186/s12905-023-02774-6] [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: 08/04/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The Healthy Eating Index 2015 (HEI-2015) is a tool for checking the quality of diet. This index is used to examine how well people's dietary behavior fits certain criteria for achieving a healthy diet in Dietary Guidelines for Americans 2015-2020. We look at the possible association between the HEI-2015 and bone mineral density (BMD) and muscle strength in postmenopausal women. METHODS This research included 1012 postmenopausal women from the recruitment phase of the Ravansar Noncommunicable Diseases (RaNCD) cohort study in Kermanshah-Iran. A standardized and repeatable food-frequency questionnaire (FFQ) that contains 118 items was used to quantify dietary consumption. Anthropometric indices measured via Bio-Impedance Analyzer BIA (Inbody 770, Inbody Co, Seoul, Korea). RESULT The mean age of postmenopausal women was (56.41 ± 5.31) years. Participants in the highest quartile had a more daily energy intake compared to the lowest quartile (2329.89 ± 837.59), (P < 0.001). Women in the upper quartiles had greater Skeletal Muscle Mass (SMM) than those in the lower quartiles (21.61 ± 2.80 vs 20.52 ± 3.13; p = 0.0002). The linear model didn't show a significant relationship between HEI score and greater BMD (β = 0.0014, P = 0.169). CONCLUSION A diet of high quality followed by a high HEL-2015 score was shown to be strongly connected to increased BMD and muscle mass in Kurdish postmenopausal women.
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Affiliation(s)
- Negin Kamari
- School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hawal Lateef Fateh
- Nursing Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Kurdistan region, Iraq
| | - Yahya Pasdar
- School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebrahim Shakiba
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Rinonapoli G, Pace V, Ruggiero C, Ceccarini P, Bisaccia M, Meccariello L, Caraffa A. Obesity and Bone: A Complex Relationship. Int J Mol Sci 2021; 22:ijms222413662. [PMID: 34948466 PMCID: PMC8706946 DOI: 10.3390/ijms222413662] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/29/2022] Open
Abstract
There is a large literature on the relationship between obesity and bone. What we can conclude from this review is that the increase in body weight causes an increase in BMD, both for a mechanical effect and for the greater amount of estrogens present in the adipose tissue. Nevertheless, despite an apparent strengthening of the bone witnessed by the increased BMD, the risk of fracture is higher. The greater risk of fracture in the obese subject is due to various factors, which are carefully analyzed by the Authors. These factors can be divided into metabolic factors and increased risk of falls. Fractures have an atypical distribution in the obese, with a lower incidence of typical osteoporotic fractures, such as those of hip, spine and wrist, and an increase in fractures of the ankle, upper leg, and humerus. In children, the distribution is different, but it is not the same in obese and normal-weight children. Specifically, the fractures of the lower limb are much more frequent in obese children. Sarcopenic obesity plays an important role. The authors also review the available literature regarding the effects of high-fat diet, weight loss and bariatric surgery.
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Affiliation(s)
- Giuseppe Rinonapoli
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
- Correspondence:
| | - Valerio Pace
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
| | - Carmelinda Ruggiero
- Orthogeriatric Service, Geriatric Unit, Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06156 Perugia, Italy;
| | - Paolo Ceccarini
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
| | - Michele Bisaccia
- Department of Orthopaedics and Traumatology, AORN San Pio “Gaetano Rummo Hospital”, Via R.Delcogliano, 82100 Benevento, Italy; (M.B.); (L.M.)
| | - Luigi Meccariello
- Department of Orthopaedics and Traumatology, AORN San Pio “Gaetano Rummo Hospital”, Via R.Delcogliano, 82100 Benevento, Italy; (M.B.); (L.M.)
| | - Auro Caraffa
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
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Maïmoun L, Renard E, Humbert L, Aouinti S, Mura T, Boudousq V, Lefebvre P, Mahadea K, Philibert P, de Santa-Barbara P, Avignon A, Guillaume S, Sultan A, Nocca D, Mariano-Goulart D. Modification of bone mineral density, bone geometry and volumetric BMD in young women with obesity. Bone 2021; 150:116005. [PMID: 33992821 DOI: 10.1016/j.bone.2021.116005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/15/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Most obese women with low-trauma fractures present normal areal bone mineral density (aBMD), suggesting that other bone parameters are more determinant for fracture risk in these patients. OBJECTIVES (i) Determine the effects of obesity in young women on areal bone mineral density (aBMD), bone geometry, strength, and volumetric BMD determined by advanced DXA-based methods; (ii) model the profiles of bone parameters for each population with age; and (iii) determine the factors related to body composition (i.e. lean tissue mass and fat mass) potentially implicated in the "bone adaptation" in the femoral region. SUBJECTS AND METHODS Two hundred and twenty adolescent and young women from 18 to 35 years old were enrolled in this study: 128 patients with obesity and 92 age-matched (±6 months) normal-weight controls. aBMD was determined with DXA, whereas hip geometry and strength parameters were assessed by hip structural analysis (HSA) and volumetric BMD by 3D-SHAPER® software. RESULTS Compared with controls, subjects with obesity presented significantly higher aBMD at all bone sites, but the difference was greater at hip compared with lumbar spine or radius. Bone size estimates (i.e. cortical thickness), as well as strength estimates (i.e. cross-sectional area) were higher at all femoral subregions including femoral neck, intertrochanteric region and femoral shaft in young women with obesity. In whole proximal femur and all femoral compartments, vBMD was also higher in subjects with obesity, but the difference between groups was greater for cortical vBMD compared with trabecular vBMD. When hip bone parameters were modelled for each group from individual values, maximal values were reached between 20 and 26 years in both groups but, whatever the age, subjects with obesity presented higher values than controls. In both groups, lean body mass (LBM) was the parameter most positively associated with the greatest number of bone parameters studied. CONCLUSION Our study confirmed that young women with obesity presented higher aBMD, better hip geometry and greater strength compared with normal-weight controls. Additionally, cortical and trabecular compartments measured by 3D-SHAPER® were favourably and concomitantly modified. However, it remains to be demonstrated whether the evaluation of these new parameters would provide better prediction of fracture risk in this population than aBMD.
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Affiliation(s)
- Laurent Maïmoun
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.
| | - Eric Renard
- Departement d'Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France; CIC INSERM 1001, Hôpital Gui de Chauliac, CHRU Montpellier, Montpellier cedex 5, France; Institut de Génomique Fonctionnelle, CNRS UMR 5203/INSERM U661/Université Montpellier, Montpellier, France
| | | | - Safa Aouinti
- Unité de Recherche Clinique et Epidémiologie, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | - Thibault Mura
- Unité de Recherche Clinique et Epidémiologie, Hôpital Carémeau, CHRU Nîmes, Nîmes, France
| | - Vincent Boudousq
- Département de Médecine Nucléaire, Hôpital Carémeau, CHRU Nîmes, Nîmes, France
| | - Patrick Lefebvre
- Departement d'Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France
| | | | - Pascal Philibert
- Département de Biochimie et d'Hormonologie, Hôpital Carémeau, CHRU Nîmes, Nîmes, France
| | | | - Antoine Avignon
- Département Endocrinologie, Nutrition, Diabète, Equipe Nutrition, Diabète, CHRU Montpellier, Montpellier, France
| | - Sébastien Guillaume
- Département d'Urgence et Post-Urgence Psychiatrique, Hôpital Lapeyronie, CHRU Montpellier, UMI, INSERM U1061, 34295 Montpellier, France
| | - Ariane Sultan
- Département Endocrinologie, Nutrition, Diabète, Equipe Nutrition, Diabète, CHRU Montpellier, Montpellier, France
| | - David Nocca
- Département de Chirurgie Digestive, Hôpital St Eloi, CHRU Montpellier, Montpellier, France
| | - Denis Mariano-Goulart
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
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Jensen VFH, Mølck AM, Dalgaard M, McGuigan FE, Akesson KE. Changes in bone mass associated with obesity and weight loss in humans: Applicability of animal models. Bone 2021; 145:115781. [PMID: 33285255 DOI: 10.1016/j.bone.2020.115781] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/05/2020] [Accepted: 11/27/2020] [Indexed: 12/21/2022]
Abstract
The implications of obesity and weight loss for human bone health are not well understood. Although the bone changes associated with weight loss are similar in humans and rodents, that is not the case for obesity. In humans, obesity is generally associated with increased bone mass, an outcome which is exacerbated by advanced age and menopause. In rodents, by contrast, bone mass decreases in proportion to severity and duration of obesity, and is influenced by sex, age and mechanical load. Despite these discrepancies, rodents are frequently used to model the situation in humans. In this review, we summarise the existing knowledge of the effects of obesity and weight loss on bone mass in humans and rodents, focusing on the translatability of findings from animal models. We then describe how animal models should be used to broaden the understanding of the relationship between obesity, weight loss, and skeletal health in humans. Specifically, we highlight the aspects of study design that should be considered to optimise translatability of the rodent models of obesity and weight loss. Notably, the sex, age, and nutritional status of the animals should ideally match those of interest in humans. With these caveats in mind, and depending on the research question asked, our review underscores that animal models can provide valuable information for obesity and weight-management research.
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Affiliation(s)
- Vivi F H Jensen
- Lund University, Department of Clinical Sciences Malmö and Skåne University Hospital, Department of Orthopedics, Inga Marie Nilssons Gata 22, 205 02 Malmö, Sweden.
| | - Anne-Marie Mølck
- Novo Nordisk A/S, Department of Safety Sciences, Imaging & Data Management, Novo Nordisk Park 1, 2760 Maaloev, Denmark
| | - Majken Dalgaard
- Novo Nordisk A/S, Department of Safety Sciences, Imaging & Data Management, Novo Nordisk Park 1, 2760 Maaloev, Denmark
| | - Fiona E McGuigan
- Lund University, Department of Clinical Sciences Malmö and Skåne University Hospital, Department of Orthopedics, Inga Marie Nilssons Gata 22, 205 02 Malmö, Sweden
| | - Kristina E Akesson
- Lund University, Department of Clinical Sciences Malmö and Skåne University Hospital, Department of Orthopedics, Inga Marie Nilssons Gata 22, 205 02 Malmö, Sweden
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Healthy eating index-2015 and bone mineral density among adult Iranian women. Arch Osteoporos 2020; 15:151. [PMID: 33005974 DOI: 10.1007/s11657-020-00826-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/15/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED This is the first study to examine the potential association of adherence to the healthy eating index-2015 (HEI-2015) and bone health. Findings suggest that better diet quality (i.e., a higher HEI-2015 score) is significantly associated with a small but clinically important increase in bone mineral density among adult Iranian women. PURPOSE The HEI-2015 is a multidimensional measure of diet quality used to assess how well people's dietary behaviors align with key recommendations of the 2015-2020 Dietary Guidelines for Americans for achieving a healthy dietary pattern. We examined the potential association of the HEI-2015 and bone mineral density (BMD) among adult Iranian women, hypothesizing that a higher HEI-2015 score is associated with greater BMD. METHODS Four-hundred sixteen participants (mean age 48.0 years; 64.7% premenopausal) participated in this cross-sectional study. Lumbar spine and femoral neck BMDs were measured via dual-energy X-ray absorptiometry. Dietary intakes were assessed using a valid and reliable food frequency questionnaire. The HEI-2015 score was calculated based on dietary intakes of 13 components emphasized or minimized in the HEI-2015. The higher the HEI-2015 score, the better the diet quality. RESULTS After adjusting for potential covariates in the multiple linear regression analysis, higher HEI-2015 scores were associated with greater lumbar spine and femoral neck BMDs (lumbar spine: standardized beta-coefficient [β] = 0.292; femoral neck: β = 0.192; both P < 0.001). Similar significant associations were found among premenopausal (lumbar spine: β = 0.337; femoral neck: β = 0.262; both P < 0.001) and postmenopausal women (lumbar spine: β = 0.198; femoral neck: β = 0.287; both P < 0.050). Overall, every 10-unit increase in the HEI-2015 score was associated with a 0.03 g/cm2 higher multivariable-adjusted BMD at both lumbar spine and femoral neck (both P < 0.001). CONCLUSION Findings suggest that better diet quality, as indicated by a higher HEI-2015 score, is significantly associated with a small but clinically important increase in BMD among adult Iranian women.
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Trevisan C, Alessi A, Girotti G, Zanforlini BM, Bertocco A, Mazzochin M, Zoccarato F, Piovesan F, Dianin M, Giannini S, Manzato E, Sergi G. The Impact of Smoking on Bone Metabolism, Bone Mineral Density and Vertebral Fractures in Postmenopausal Women. J Clin Densitom 2020; 23:381-389. [PMID: 31350204 DOI: 10.1016/j.jocd.2019.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Smoking is recognized among the risk factors for osteoporosis, but only few studies have comprehensively explored its influence on bone metabolism and strength. We aimed to evaluate smoking effects on calcium-phosphate metabolism, bone mineral density (BMD) and fracture risk in postmenopausal women. METHODS Our sample included 1067 postmenopausal women who arrived to our osteoporosis outpatient clinic. Anamnestic data, smoking habits (categorized as never, former, and current; and by smoking intensity and duration), biochemical parameters, lumbar/femoral BMD, and presence of vertebral fractures were recorded. In a subsample of 357 women, the changes in BMD after a 2-yr follow-up period were also assessed. RESULTS Current smokers had shorter reproductive age, lower body mass index, and higher prevalence of heavy alcohol consumption than former/never smokers. They also had lower PTH values and weaker linear association between serum vitamin D and parathyroid hormone (current β = -0.11[SE = 0.004]; former β = -0.14[SE = 0.01]; never β = -0.20[SE = 0.003]; p < 0.01 for all). Baseline BMD did not reflect differences based on smoking habits, duration or intensity. However, after 2 years, only current smokers significantly worsened in femural BMD. After adjustment for confounders, the chance of having sustained vertebral fractures at the first evaluation increased by 74% (95% confidence interval:1.07-2.83) in current compared with never smokers, especially among heavy smokers. CONCLUSIONS Smoking may negatively affect bone by inhibiting vitamin D-parathyroid hormone axis, reducing estrogen exposure, promoting risky health behaviors, and accelerating bone loss, especially at the femur. No significant differences were observed in these outcomes among former smokers, suggesting that quitting smoking has beneficial effects on bone health.
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Affiliation(s)
- Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy.
| | - Agnese Alessi
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Gaia Girotti
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | | | - Anna Bertocco
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Mattia Mazzochin
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Francesca Zoccarato
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Francesca Piovesan
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Marta Dianin
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Sandro Giannini
- Department of Medicine, ClinicaMedica 1, University of Padua and Regional Centre for Osteoporosis, Padua, Italy
| | - Enzo Manzato
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy; National Research Council, Neuroscience Institute, Padua, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
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Engberg E, Koivusalo SB, Huvinen E, Viljakainen H. Bone health in women with a history of gestational diabetes or obesity. Acta Obstet Gynecol Scand 2020; 99:477-487. [DOI: 10.1111/aogs.13778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Elina Engberg
- Folkhälsan Institute of Genetics Folkhälsan Research CenterHelsinki Finland
- Department of Sports and Exercise Medicine Clinicum Faculty of Medicine University of Helsinki Helsinki Finland
| | - Saila B. Koivusalo
- Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Emilia Huvinen
- Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Heli Viljakainen
- Folkhälsan Institute of Genetics Folkhälsan Research CenterHelsinki Finland
- Department of Food and Environmental Sciences University of Helsinki Helsinki Finland
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Zhao Y, Qin R, Ma X, Qin Z, Yang Z, Hong H, Lv H, Ye K, Wei Y, Zheng W, Qi H, Ni Y, Zhang L, Yan J, Liu G, Wu A. Adiposity is not beneficial to bone mineral density in 0-5 year old Chinese children: The Jiangsu bone health study. Obes Res Clin Pract 2019; 14:39-46. [PMID: 31879074 DOI: 10.1016/j.orcp.2019.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 10/07/2019] [Accepted: 10/30/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Data on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD. SUBJECTS AND METHODS This was a large population-based multicenter study in which the representative children aged 0-5 years were recruited from 13 Children's Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson's correlation and further tested using partial correlation in the additive model. RESULTS A total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r=0.711, P<0.001; r=0.727, P<0.001; r=-0.318, P<0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2kg, but started to gain slowlyand even decreased when the weight was over 21.2kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P<0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (β=-47.45, 95%CI=-85.07, -9.83, P=0.013). CONCLUSIONS Adiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.
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Affiliation(s)
- Yan Zhao
- Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Rui Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China.
| | - Xianghua Ma
- Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China.
| | - Zhenying Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Zi Yang
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Hong Hong
- Department of Child Health Care, Drum Tower Maternity and Child Health Care Institute, Nanjing, 210009, China
| | - Heyu Lv
- Department of Child Health Care, Jiangning Maternity and Child Health Care Institute, Nanjing, 211100, China
| | - Kan Ye
- Department of Child Health Care, Suzhou Municipal Hospital, Suzhou, 215000, China
| | - Yarong Wei
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, 214000, China
| | - Wen Zheng
- Department of Child Health Care, Yancheng Maternity and Child Health Care Institute, Yancheng, 224000, China
| | - Hongxia Qi
- Department of Child Health Care, Xuzhou Children's Hospital, Xuzhou, 221000, China
| | - Yufei Ni
- Department of Child Health Care, Nantong Maternity and Child Health Care Hospital, Nantong, 226000, China
| | - Li Zhang
- Department of Child Health Care, Huai'an Maternity and Child Health Care Hospital, Huai'an, 223001, China
| | - Juhua Yan
- Department of Child Health Care, Kunshan Maternity and Child Health Care Institute, Kunshan, 215300, China
| | - Guoqin Liu
- Department of Child Health Care, Dafeng Maternity and Child Health Care Hospital, Dafeng, 224100, China
| | - Aiping Wu
- Department of Child Health Care, Xinghua Maternity and Child Health Care Hospital, Xinghua, 225700, China
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Bierhals IO, Dos Santos Vaz J, Bielemann RM, de Mola CL, Barros FC, Gonçalves H, Wehrmeister FC, Assunção MCF. Associations between body mass index, body composition and bone density in young adults: findings from a southern Brazilian cohort. BMC Musculoskelet Disord 2019; 20:322. [PMID: 31288773 PMCID: PMC6617655 DOI: 10.1186/s12891-019-2656-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/27/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the association of body composition components and obesity with bone density. METHODS Prospective study with data on 2968 members of the 1993 Pelotas Birth Cohort from follow-ups at 18 and 22 years of age. Areal bone mineral density (aBMD, g/cm2) was evaluated for whole body, lumbar spine, and femoral neck at 22 years using dual-energy X-ray absorptiometry. Simple and multiple linear regression, stratified by sex, were used to assess the effect of BMI, fat mass (FMI) and lean mass index (LMI), evaluated at 18 and 22 years, and obesity trajectories classified by FMI and categorized as "never", "only at 18 years", "only at 22 years" or "always" on aBMD. RESULTS Among men, the largest coefficients were observed for BMI, followed by lean mass and fat mass. Compared to fat mass, lean mass presented the largest coefficients for all sites, with the strongest associations observed for the femoral neck (β: 0.035 g/cm2; 95% CI: 0.031; 0.039 for both follow-ups), while the largest effect for FMI was observed for whole-body aBMD at 18 years (β: 0.019 g/cm2; 95% CI: 0.014; 0.024). Among women, the strongest associations were observed for LMI. The largest coefficients for LMI and FMI were observed for femoral neck at age 18, presented β: 0.030 g/cm2, 95% CI: 0.026, 0.034 for LMI and β: 0.012 g/cm2; 95% CI: 0.009; 0.015) for FMI. Men who were "always obese" according to FMI had smallest aBMD for spine (β: -0.014; 95%CI: - 0.029; - 0.001). Women who were obese "only at 18 years" had smallest aBMD for the whole-body (β: -0.013; 95%CI: - 0.023; - 0.002), whereas those who were obese "only at 22 years" had larger whole-body and femoral neck aBMD (β: 0.013; 95%CI: 0.009; 0.017 and β: 0.027; 95%CI: 0.016; 0.038, respectively) and those "always obese" for whole-body aBMD (β: 0.005; 95%CI: 0.001; 0.011) compared to the reference category. CONCLUSIONS The indexes were positively associated with aBMD in this sample. Fat mass had smaller positive influence on these outcomes than lean mass, suggesting the most important body composition component for bone density is the lean mass.
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Affiliation(s)
- Isabel Oliveira Bierhals
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil.
| | - Juliana Dos Santos Vaz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Renata Moraes Bielemann
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Christian Loret de Mola
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Fernando Celso Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Fernando César Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Maria Cecília Formoso Assunção
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
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10
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Laakso S, Viljakainen H, Lipsanen-Nyman M, Turpeinen U, Ivaska KK, Anand-Ivell R, Ivell R, Mäkitie O. Testicular Function and Bone in Young Men with Severe Childhood-Onset Obesity. Horm Res Paediatr 2018; 89:442-449. [PMID: 29961074 DOI: 10.1159/000489818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies suggest increased risk for hypoandrogenism and fractures in men with obesity. We aimed to describe the effects of severe childhood-onset obesity on the cross talk between metabolic state, testes, and skeleton at late puberty. METHODS A cohort of adolescent and young adult males with severe childhood-onset obesity (n = 21, mean age 18.5 years) and an age-matched control group were assessed for testicular hormones and X-ray absorptiometry-derived bone mass. RESULTS Current median body mass indexes for the obese and control subjects were 37.4 and 22.9. Severe early-onset obesity manifested with lower free testosterone (median [interquartile range] 244 [194-332] vs. 403 [293-463] pmol/L, p = 0.002). Lower insulin-like 3 (1.02 [0.82-1.23] vs. 1.22 [1.01-1.46] ng/mL, p = 0.045) and lower ratio of testosterone to luteinizing hormone (2.81 [1.96-3.98] vs. 4.10 [3.03-5.83] nmol/IU, p = 0.008) suggested disrupted Leydig cell function. The degree of current obesity inversely correlated with free testosterone (τ = -0.516, p = 0.003), which in turn correlated positively with bone area at all measurement sites in males with childhood-onset obesity. CONCLUSIONS Severe childhood-onset obesity is associated with impaired Leydig cell function in young men and lower free testosterone may contribute to impaired skeletal characteristics.
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Affiliation(s)
- Saila Laakso
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Heli Viljakainen
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Biomedicum, Helsinki, Finland
| | - Marita Lipsanen-Nyman
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Kaisa K Ivaska
- Department of Cell Biology and Anatomy, University of Turku, Turku, Finland
| | | | - Richard Ivell
- School of Biosciences, University of Nottingham, Nottingham, United Kingdom
| | - Outi Mäkitie
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Biomedicum, Helsinki, Finland.,Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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11
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Abstract
The interaction between obesity and bone metabolism is complex. The effects of fat on the skeleton are mediated by both mechanical and biochemical factors. Though obesity is characterized by higher bone mineral density, studies conducted on bone microarchitecture have produced conflicting results. The majority of studies indicate that obesity has a positive effect on skeletal strength, even though most likely the effects are site-dependent and, in fact, obese individuals might be at risk of certain types of fractures. Mechanical loading and higher lean mass are associated with improved outcomes, whereas systemic inflammation, observed especially with abdominal obesity, may exert negative effects. Weight loss interventions likely lead to bone loss over time. Pharmacological treatment options seem to be safe in terms of skeletal health; however, the skeletal effects of bariatric surgery are dependent on the type of surgical procedure. Malabsorptive procedures are associated with higher short-term adverse effects on bone health. In this narrative review, we discuss the effects of obesity and weight loss interventions on skeletal health.
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Affiliation(s)
- Christos Savvidis
- Department of Endocrinology, Hippokrateion General Hospital, Athens, Greece
| | - Symeon Tournis
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", KAT hospital, Medical school, Athens, Greece
| | - Anastasia D Dede
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", KAT hospital, Medical school, Athens, Greece.
- Department of Endocrinology and Diabetes, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.
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12
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Viljakainen HT, Koistinen HA, Tervahartiala T, Sorsa T, Andersson S, Mäkitie O. Metabolic milieu associates with impaired skeletal characteristics in obesity. PLoS One 2017. [PMID: 28640843 PMCID: PMC5480955 DOI: 10.1371/journal.pone.0179660] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
High leptin concentration, low-grade inflammation, and insulin resistance often coexist in obese subjects; this adverse metabolic milieu may be the main culprit for increased fracture risk and impaired bone quality seen in patients with type 2 diabetes. We examined the associations of leptin, hs (high sensitivity)- CRP and insulin resistance with bone turnover markers (BTMs) and bone characteristics in 55 young obese adults (median BMI 40 kg/m2) and 65 non-obese controls. Mean age of the subjects was 19.5 ± 2.5 years (mean ± SD). Concentrations of leptin, adiponectin, hs-CRP, MMP-8 and TIMP-1, fasting plasma glucose and insulin (to calculate HOMA), BTMs (BAP, P1NP, CTX-1, and TRAC5b) were measured. Bone characteristics were determined with pQCT at radius and tibia, and with DXA for central sites. Leptin, hs-CRP and HOMA correlated inversely with BTMs: the partial coefficients were 1.5–1.9 fold higher in males than in females. After adjusting for age, BMI, and other endocrine factors, leptin displayed an independent effect in males on radial bone mass (p = 0.019), tibial trabecular density (p = 0.025) and total hip BMD (p = 0.043), with lower densities in males with high leptin. In females, the model adjusting for age, BMI, and other endocrine factors, revealed that hs-CRP had independent effects on radial bone mass (p = 0.034) and lumbar spine BMD (p = 0.016), women with high hs-CRP having lower values. Partial correlations of adiponectin and TIMP-1 with bone characteristics were discrepant; MMP-8 showed no associations. In conclusion, in young obese adults and their controls, leptin, hs-CRP and HOMA associate inversely with BTMs and bone characteristics. Leptin appears to be the key independent effector in males, whereas hs-CRP displayed a predominant role in females.
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Affiliation(s)
- Heli T. Viljakainen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- * E-mail:
| | - Heikki A. Koistinen
- Department of Medicine and Abdominal Center: Endocrinology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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13
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Hauta-alus HH, Holmlund-Suila EM, Rita HJ, Enlund-Cerullo M, Rosendahl J, Valkama SM, Helve OM, Hytinantti TK, Surcel HM, Mäkitie OM, Andersson S, Viljakainen HT. Season, dietary factors, and physical activity modify 25-hydroxyvitamin D concentration during pregnancy. Eur J Nutr 2017; 57:1369-1379. [DOI: 10.1007/s00394-017-1417-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 02/19/2017] [Indexed: 11/29/2022]
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14
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Stagi S, Cavalli L, Cavalli T, de Martino M, Brandi ML. Peripheral quantitative computed tomography (pQCT) for the assessment of bone strength in most of bone affecting conditions in developmental age: a review. Ital J Pediatr 2016; 42:88. [PMID: 27670687 PMCID: PMC5037897 DOI: 10.1186/s13052-016-0297-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/15/2016] [Indexed: 12/13/2022] Open
Abstract
Peripheral quantitative computed tomography provides an automatical scan analysis of trabecular and cortical bone compartments, calculating not only their bone mineral density (BMD), but also bone geometrical parameters, such as marrow and cortical Cross-Sectional Area (CSA), Cortical Thickness (CoTh), both periosteal and endosteal circumference, as well as biomechanical parameters like Cross-Sectional Moment of Inertia (CSMI), a measure of bending, polar moment of inertia, indicating bone strength in torsion, and Strength Strain Index (SSI). Also CSA of muscle and fat can be extracted. Muscles, which are thought to stimulate bones to adapt their geometry and mineral content, are determinant to preserve or increase bone strength; thus, pQCT provides an evaluation of the functional 'muscle-bone unit', defined as BMC/muscle CSA ratio. This functional approach to bone densitometry can establish if bone strength is normally adapted to the muscle force, and if muscle force is adequate for body size, providing more detailed insights to targeted strategies for the prevention and treatment of bone fragility. The present paper offers an extensive review of technical features of pQCT and its possible clinical application in the diagnostic of bone status as well as in the monitoring of the skeleton's health follow-up.
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Affiliation(s)
- Stefano Stagi
- Health Sciences Department, University of Florence, Anna Meyer Children’s University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Loredana Cavalli
- Department of Surgery and Translational Medicine, Endocrinology Unit, University of Florence, Florence, Italy
| | - Tiziana Cavalli
- Department of Surgery and Translational Medicine, Emergency and Digestive Surgery with Oncological and Functional Address Unit, University of Florence, Florence, Italy
| | - Maurizio de Martino
- Health Sciences Department, University of Florence, Anna Meyer Children’s University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, Endocrinology Unit, University of Florence, Florence, Italy
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