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Al-Dawood E, Zafar M. Association between metabolic syndrome and bone mineral density among menopausal Saudi women: Case-control study. Med J Islam Repub Iran 2021; 35:26. [PMID: 34169038 PMCID: PMC8214043 DOI: 10.47176/mjiri.35.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Metabolic syndrome (MetS) and osteoporosis are two of the world's major healthcare issues. There are several studies which explored the association between MetS and bone mineral density (BMD), but all of them are cross-sectional. These studies cover all populations, including expatriated, which did not determine the actual problem among Saudi women. This is the first case-control study that determines the causal relationship between MetS and BMD. The objective of this study is to determine the relationship between metabolic syndrome and bone mass density among Saudi menopausal women in Eastern Province - Saudi Arabia.
Methods: It’s a case-control study and 380 menopausal Saudi women were selected through simple random sampling. They were divided into 190 cases with osteoporosis and 190 without osteoporosis. Bone Mineral Density (BMD) at the total hip was determined using dual-energy X-ray absorptiometry (DEXA). T score was calculated. The association between the risk factors of MetS and bone mineral density was determined by binary logistic regression analysis using SPSS (statistical package of social science) software.
Results: Among women, the prevalence of MetS was substantially higher in those with osteoporosis. The Mets is positively correlated with bone mineral density. (r=0.08, p=0.051). The occurrence of MetS was associated with increased osteoporosis among Saudi women (B=0.004; p=0.005) after adjustment of confounders. The existence of obesity was significantly associated with increased odds of Bone marrow density among women (OR 2.56; 95 % CI, 2.22-3.44; p=0.030) after adjustment of confounders.
Conclusion: The incidence of MetS was associated with osteoporosis in Saudi women.
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Affiliation(s)
- Essra Al-Dawood
- Primary Health Care Centre, Ministry of Health, Al-Jubail, KSA
| | - Mubashir Zafar
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
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Aldawood E, Zafar M. Metabolic Syndrome In Saudi Women With Low Bone Mineral Density. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background ― Metabolic syndrome (MetS) is the world's major public health problem. Objectives ― Assessment of metabolic syndrome impact on bone mineral density (BMD) among Saudi menopausal women in Eastern Province – Saudi Arabia. Material and Methods ― It’s a case control study and 380 menopausal Saudi women were selected through stratified random sampling; they are divided into 190 cases with osteoporosis and 190 without osteoporosis. BMD at the total hip were determined using dual-energy X-ray absorptiometry (DEXA). The T score was calculated, the relationship between the risk factors of MetS and bone mineral density were analyzed by statistical methods. Results ― Prevalence of MetS was substantially higher among osteoprotic women. The MetS is significantly correlated with bone mineral density (r=0.08, P=0.05). The occurrence of MetS was associated with increased osteoporosis among Saudi women (B=0.004; 0.05) after adjustment of confounders. The presence of obesity (component of MetS) was significantly associated with increased odds of Bone marrow density among women (OR 2.56, 95% CI, 2.22–3.44, P=0.030) after adjustment of confounders. Conclusion ― MetS was significantly associated with an osteoporosis in Saudi women.
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Bagherzadeh M, Sajjadi-Jazi SM, Sharifi F, Ebrahimpur M, Amininezhad F, Ostovar A, Shafiee G, Heshmat R, Mehrdad N, Razi F, Nabipour I, Larijani B. Effects of metabolic syndrome on bone health in older adults: the Bushehr Elderly Health (BEH) program. Osteoporos Int 2020; 31:1975-1984. [PMID: 32440891 DOI: 10.1007/s00198-020-05455-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/05/2020] [Indexed: 12/24/2022]
Abstract
UNLABELLED Based on the clinical, BMD, and TBS data of 2380 participants aged ≥ 60 which was gathered during the BEH program, stage II, we showed that MetS was positively associated with BMD, while a negative or no association was observed between MetS and TBS depending on the sex and the adjustment model. INTRODUCTION The results of previous reports in regard to the effect of metabolic syndrome (MetS) on bone health are not conclusive. This study aimed to evaluate the association between MetS with bone mineral density (BMD) and trabecular bone score (TBS) as an indicator of bone quantity and quality, respectively. METHODS Using a cross-sectional design, this study was carried out based on the data collected during the BEH Program, stage II. MetS was defined according to NCEP-ATP III criteria. BMD (at the lumbar spine and the hip) and lumbar spine TBS were assessed by dual-energy X-ray absorptiometry device. RESULTS The data of 2380 participants (women = 1228, men = 1152) aged ≥ 60 were analyzed. In the fully adjusted regression models (including BMI), significant associations between MetS and mean BMD were observed across all locations in men (P values ≤ 0.001) and in the lumbar spine in women (P value = 0.003). In addition, the prevalence of osteoporosis (based on BMD) was significantly lower in those with MetS than those without MetS in both sexes, even after full adjustments (women, OR = 0.707, P value = 0.013; men, OR = 0.563, P value = 0.001). In contrast, in age-adjusted regression analyses, the prevalence of degraded bone microarchitecture (TBS ≤ 1.2) was significantly increased in those with MetS than those without, irrespective of the participants' sex (P values < 0.05). The mean TBS was also negatively associated with MetS in women (β = - 0.075, P value = 0.007) but not in men (β = - 0.052, P value = 0.077), in age-adjusted regression models. However, after including BMI in the adjusted models, all significant associations between TBS values and MetS disappeared. CONCLUSION It seems that a positive association exists between MetS and BMD, while MetS is either not associated or negatively correlated with bone quality as measured by TBS.
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Affiliation(s)
- M Bagherzadeh
- Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - S M Sajjadi-Jazi
- Cell therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Ebrahimpur
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Amininezhad
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - G Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - R Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - N Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - I Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - B Larijani
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Coexistence of metabolic syndrome and osteopenia associated with social inequalities and unhealthy lifestyle among postmenopausal women in South Korea: the 2008 to 2011 Korea National Health and Nutritional Examination Survey (KNHANES). ACTA ACUST UNITED AC 2020; 27:668-678. [PMID: 32464045 DOI: 10.1097/gme.0000000000001518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The prevalence of metabolic syndrome (MetS) and osteoporosis (OP) among postmenopausal women has been rapidly increasing. We examined the associations between socioeconomic status-related factors, unhealthy lifestyle, and the coexistence of MetS and osteopenia or OP. METHODS One thousand nine hundred ninety-one postmenopausal women aged 45 to 65 years were used to select a representative sample of the civilian, noninstitutionalized South Korean population from the 2008 to 2011 Korea National Health and Nutrition Examination Survey data. Women were grouped as neither MetS nor OP (normal), MetS, OP, and both MetS and OP (MetS + OP). Socioeconomic status (education, household income, place of residence, employment status), health-related behaviors (physical activity, alcohol consumption, smoking), and diet-related factors (intake of nutrients and food groups, eating habits, food insecurity) were obtained. Logistic regression models were used to examine the odds ratio (OR) and 95% confidence interval (CI). RESULTS The prevalence of MetS + OP was 32.5%. The average number of MetS risk factors in MetS + OP was 3.5, higher than that of normal and OP groups (P < 0.001). Bone mineral density at all sites was significantly lower in MetS + OP than normal and MetS groups (P < 0.001). Also, calcium, phosphorus, vitamin A, riboflavin, and niacin levels were lowest in the MetS + OP group compared with the three other groups (P < 0.05). After controlling for covariates, low-income and low-education women were more likely to have MetS + OP (OR 1.97, 95% CI 1.04-3.72); high-income and high-education group was 70% less likely to have MetS + OP (OR 0.30, 95% CI 0.10-0.86) compared with the middle-income and middle-education group. CONCLUSIONS Social inequalities might be powerful contributors in Korean postmenopausal women with coexistence of MetS and OP. Therefore, social and political perspective approaches are required in this population for prevention and treatment of MetS and OP. Future studies should explore to find controllable factors and thereby improve health status in postmenopausal women.
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Tanaka H, Miura T, Yamashita T, Yoneda M, Takagi S. Characteristics of Bone Strength and Metabolism in Type 2 Diabetic Model Nagoya Shibata Yasuda Mice. Biol Pharm Bull 2018; 41:1567-1573. [PMID: 30012927 DOI: 10.1248/bpb.b18-00275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We evaluated the suitability of Nagoya Shibata Yasuda (NSY) mice as an animal model for examining the influence of a glucose metabolism disorder on bone integrity, using Institute of Cancer Research (ICR) mice as controls. We selected six NSY and ICR mice each that were matched for weight, and measured serum glucose levels, serum insulin levels, and conducted an oral glucose tolerance test. Histological sections of the femurs of both mouse lines were prepared, and the bone strength, mass, and microstructure of the femur were compared, along with bone metabolism. Serum glucose levels were significantly higher in the NSY mice than in the control mice, but body weight and serum insulin levels did not differ between the groups. Bone mass, microstructure, and strength of the femur, and bone metabolism were lower in the NSY mice than in the control mice. In the cortical bone of the femur in the NSY mice, several parts were not stained with eosin, demonstrating a strong negative correlation between serum glucose levels and bone mineral density; however, there was a negative correlation between serum glucose levels and bone metabolic markers. The bone turnover rate in the NSY mice was decreased by hyperglycemia, resulting in a thinner and shorter femur, reduced cortical and trabecular areas, and lower bone mass compared to those of the control mice. Collectively, these results suggest deteriorated bone strength of the femur in NSY mice, serving as a useful model for studying the link between glucose metabolism and bone integrity.
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Affiliation(s)
- Hiroaki Tanaka
- Graduate School of Health Science, Suzuka University of Medical Science
| | - Toshihiro Miura
- Graduate School of Health Science, Suzuka University of Medical Science
| | - Takenori Yamashita
- Department of Radiological Technology, Faculty of Health Science, Suzuka University of Medical Science
| | - Misao Yoneda
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science
| | - Satoshi Takagi
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University
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Turan E, Kızılkaya H, Aral Y. Is metabolic syndrome related to postmenopausal osteoporosis? A retrospective study. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.419847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Guo Y, Tang CY, Man XF, Tang HN, Tang J, Wang F, Zhou CL, Tan SW, Feng YZ, Zhou HD. Insulin receptor substrate-1 time-dependently regulates bone formation by controlling collagen Iα2 expression via miR-342. FASEB J 2016; 30:4214-4226. [PMID: 27623927 PMCID: PMC5102111 DOI: 10.1096/fj.201600445rr] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/01/2016] [Indexed: 12/24/2022]
Abstract
Insulin promotes bone formation via a well-studied canonical signaling pathway. An adapter in this pathway, insulin-receptor substrate (IRS)-1, has been implicated in the diabetic osteopathy provoked by impaired insulin signaling. To further investigate IRS-1’s role in the bone metabolism, we generated Irs-1-deficient Irs-1smla/smla mice. These null mice developed a spontaneous mutation that led to an increase in trabecular thickness (Tb.Th) in 12-mo-old, but not in 2-mo-old mice. Analyses of the bone marrow stromal cells (BMSCs) from these mice revealed their differential expression of osteogenesis-related genes and miRNAs. The expression of miR-342, predicted and then proven to target the gene encoding collagen type Iα2 (COL1A2), was reduced in BMSCs derived from Irs-1-null mice. COL1A2 expression was then shown to be age dependent in osteoblasts and BMSCs derived from Irs-1smla/smla mice. After the induction of osteogenesis in BMSCs, miR-342 expression correlated inversely with that of Col1a2. Further, Col1a2-specific small interfering RNA (siRNA) reduced alkaline phosphatase (ALP) activity and inhibited BMSC differentiation into osteocyte-like cells, both in wild-type (WT) and Irs-1smla/smla mice. Conversely, in Irs-1smla/smla osteocytes overexpressing COL1A2, ALP-positive staining was stronger than in WT osteocytes. In summary, we uncovered a temporal regulation of BMSC differentiation/bone formation, controlled via Irs-1/miR-342 mediated regulation of Col1a2 expression.—Guo, Y., Tang, C.-Y., Man, X.-F., Tang, H.-N., Tang, J., Wang, F., Zhou, C.-L., Tan, S.-W., Feng, Y.-Z., Zhou, H.-D. Insulin receptor substrate-1 time-dependently regulates bone formation by controlling collagen Iα2 expression via miR-342.
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Affiliation(s)
- Yue Guo
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Chen-Yi Tang
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Xiao-Fei Man
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Hao-Neng Tang
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Jun Tang
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Fang Wang
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Ci-La Zhou
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Shu-Wen Tan
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
| | - Yun-Zhi Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Hunan, China
| | - Hou-De Zhou
- Department of Endocrinology and Metabolism, National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; and
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Qin L, Yang Z, Zhang W, Gu H, Li X, Zhu L, Lu S, Xing Y, Zhang H, Niu Y, Ning G, Su Q. Metabolic syndrome and osteoporotic fracture: a population-based study in China. BMC Endocr Disord 2016; 16:27. [PMID: 27233999 PMCID: PMC4882795 DOI: 10.1186/s12902-016-0106-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 05/15/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Associations between metabolic syndrome (MetS) and osteoporotic fracture have been reported. However, the epidemiological studies are not conclusive. The objective of the study was to determine whether metabolic syndrome associates with osteoporotic fracture. METHODS This was a cross-sectional study of 9930 Chinese adults aged 40 year or older in the Chongming District, Shanghai, China. A questionnaire, anthropometric measurements and laboratory tests were conducted. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. A history of fractures was collected with an interviewer-assisted questionnaire. Osteoporotic fractures were defined as fractures that occurred due to low-trauma in 2 years prior to the study. RESULTS Among women, the prevalence of osteoporotic fractures was significantly higher in those with MetS (3.5 vs. 2.6 %, P =0.028). However, the difference was not found in men (2.6 vs. 2.4 %, P =0.737). The presence of Mets was significantly associated with increased odds of osteoporotic fracture among women (odds ratio 1.22; 95 % confidence interval 1.12-1.54; P = 0.039) after controlling for potential confounders. The significant associations were not detected in men. CONCLUSIONS The presence of MetS was significantly associated with a recent history of osteoporotic fracture in middle-aged and elderly Chinese women.
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Affiliation(s)
- Li Qin
- Department of Endocrinology, Xinhua hospital Chongming branch, School of medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zhen Yang
- Department of Endocrinology, Xinhua hospital Chongming branch, School of medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China.
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China.
| | - Weiwei Zhang
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hongxia Gu
- Department of Endocrinology, Xinhua hospital Chongming branch, School of medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Xiaoyong Li
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Lingfei Zhu
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shuai Lu
- Department of Endocrinology, Xinhua hospital Chongming branch, School of medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Yin Xing
- Department of Endocrinology, Xinhua hospital Chongming branch, School of medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Hongmei Zhang
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yixin Niu
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guang Ning
- Department of Endocrinology, Ruijin hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qing Su
- Department of Endocrinology, Xinhua hospital Chongming branch, School of medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China.
- Department of Endocrinology, Xinhua hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China.
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Lee K. Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass. Calcif Tissue Int 2015; 97:487-94. [PMID: 26156754 DOI: 10.1007/s00223-015-0033-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/02/2015] [Indexed: 01/03/2023]
Abstract
This study aimed to examine the relationship between metabolic syndrome (MetS) and osteoporosis according to muscle mass levels and the joint relationship of MetS and muscle mass with osteoporosis in a representative population-based sample from the Korea National Health and Nutrition Examination Survey in 2010-2011. In 1654 men and 1979 women aged 50-93 years, body composition and bone mineral density at the femur and lumbar spine were measured using dual-energy X-ray absorptiometry. Low- and high-muscle mass groups were identified using the mean sex-specific muscle mass of appendicular muscle mass/height(2). The covariates were age, health behaviors, serum 25-OH vitamin D and parathyroid hormone, calcium intake, and hormone replacement therapy for women. Men and women with MetS (defined by the Adult Treatment Panel III) had 43 and 31% lower odds for osteoporosis, respectively, compared with their MetS-free counterparts after adjusting for muscle mass and covariates. When stratified by muscle mass, MetS was not associated with osteoporosis in men, while associated in women with higher muscle mass (OR 0.65, 95% CI 0.46-0.91). Compared with MetS-free men and women with lower muscle mass, the odds for osteoporosis were 45% and 23, 52 and 15%, and 72 and 46% lower among those with low muscle mass and MetS, high muscle mass without MetS, and high muscle mass and MetS, respectively (P for trend <0.001). Combination of high muscle mass and MetS was associated with lower prevalence of osteoporosis in Korean men and women.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, 633-165 Gaegum-dong, Busan Jin-Gu, Busan, 614-735, Korea.
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Muka T, Trajanoska K, Kiefte-de Jong JC, Oei L, Uitterlinden AG, Hofman A, Dehghan A, Zillikens MC, Franco OH, Rivadeneira F. The Association between Metabolic Syndrome, Bone Mineral Density, Hip Bone Geometry and Fracture Risk: The Rotterdam Study. PLoS One 2015; 10:e0129116. [PMID: 26066649 PMCID: PMC4466576 DOI: 10.1371/journal.pone.0129116] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 05/05/2015] [Indexed: 11/28/2022] Open
Abstract
The association between metabolic syndrome (MS) and bone health remains unclear. We aimed to study the association between MS and hip bone geometry (HBG), femoral neck bone mineral density (FN-BMD), and the risk of osteoporosis and incident fractures. Data of 2040 women and 1510 men participants in the third visit (1997–1999) of the Rotterdam Study (RSI-3), a prospective population based cohort, were available (mean follow-up 6.7 years). MS was defined according to the recent harmonized definition. HBG parameters were measured at the third round visit whereas FN-BMD was assessed at the third round and 5 years later. Incident fractures were identified from medical registry data. After correcting for age, body mass index (BMI), lifestyle factors and medication use, individuals with MS had lower bone width (β = -0.054, P = 0.003), lower cortical buckling ratio (β = -0.81, P = 0.003) and lower odds of having osteoporosis (odds ratio =0.56, P = 0.007) in women but not in men. Similarly, MS was associated with higher FN-BMD only in women (β = 0.028, P=0.001). In the analyses of MS components, the glucose component (unrelated to diabetes status) was positively associated with FN-BMD in both genders (β = 0.016, P = 0.01 for women and β = 0.022, P = 0.004 for men). In men, waist circumference was inversely associated with FN-BMD (β = -0.03, P = 0.004). No association was observed with fracture risk in either sex. In conclusion, women with MS had higher FN-BMD independent of BMI. The glucose component of MS was associated with high FN-BMD in both genders, highlighting the need to preserve glycemic control to prevent skeletal complications.
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Affiliation(s)
- Taulant Muka
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Katerina Trajanoska
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Ling Oei
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den Ijssel, the Netherlands
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Consortium for Healthy Ageing, Netherlands Genomics Inititiative, The Hague, the Netherlands
- * E-mail:
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The relationship between bone mineral density and metabolic syndrome in peri- and post-menopausal Thai women. Arch Gynecol Obstet 2015; 292:1127-33. [PMID: 25832845 DOI: 10.1007/s00404-015-3698-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 03/20/2015] [Indexed: 11/27/2022]
Abstract
PURPOSES To compare the bone mineral density (BMD) measured in the lumbar spine and femoral neck in peri- and post-menopausal Thai women with and without metabolic syndrome, and to determine which contributory factors associated with metabolic syndrome influence BMD. METHODS 427 peri- or post-menopausal Thai women were screened against the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) for Asian populations' criteria for metabolic syndrome. The BMD of those with and without metabolic syndrome was compared, and potential relationships between the factors associated with metabolic syndrome and BMD were sought. RESULTS There was no difference in lumbar spine or femoral neck BMD between the groups (p = 0.605 and 0.415, respectively), but women with central obesity (waist circumference ≥80 cm, p = 0.004 and >88 cm, p = 0.002), low serum high-density lipoprotein cholesterol (HDL-C) concentration (p = 0.011) and a greater number of contributory factors to metabolic syndrome (p = 0.007) had significantly higher BMD at the femoral neck. CONCLUSIONS A diagnosis of metabolic syndrome did not correlate with either lumbar spine or femoral neck BMD. However, higher femoral neck BMD was significantly associated with increased waist circumference, low serum HDL-C concentration and the number of contributory factors to metabolic syndrome.
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Terzi R, Dindar S, Terzi H, Demirtaş Ö. Relationships Among the Metabolic Syndrome, Bone Mineral Density, Bone Turnover Markers, and Hyperglycemia. Metab Syndr Relat Disord 2015; 13:78-83. [DOI: 10.1089/met.2014.0074] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Rabia Terzi
- Department of Physical Medicine and Rehabilitation, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Sevim Dindar
- Department of Internal Medicine, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Hasan Terzi
- Department of Obstetrics and Gynecology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ömer Demirtaş
- Department of Obstetrics and Gynecology, Pamukkale University, Medical Faculty, Denizli, Turkey
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El Maghraoui A, Rezqi A, El Mrahi S, Sadni S, Ghozlani I, Mounach A. Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women. BMC Endocr Disord 2014; 14:93. [PMID: 25492884 PMCID: PMC4268881 DOI: 10.1186/1472-6823-14-93] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 12/01/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The combined effect of the metabolic syndrome (MS) risk factors on bone health has led to controversial results and it is still not clear whether this effect is protective or detrimental. The study aimed to examine the association between MS and bone mineral density (BMD), osteoporosis, and vertebral fractures (VFs) among ambulatory older postmenopausal women. METHODS 270 post-menopausal women with a mean age of 61.0 years ± 7.8 (50 to 90) with no prior known diagnosis of osteoporosis were recruited. BMD and Lateral vertebral fracture assessment (VFA) images were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. RESULTS The MS as defined by the NCEP-ATP III was present in 62 women (23.0%). According to the WHO classification, 82 had osteoporosis at any site (30.4%). VFs were identified in 116 (43.0%): 80 (29.6%) had grade 1 and 36 (13.3%) had grade 2 or 3. Women with MS had a significantly higher BMD and lower prevalence of osteoporosis (17.7% vs. 34.1%) than those without MS. No significant statistical difference was noted in prevalence of VFs (14.5 vs. 13.0%). There were significantly less women with MS among the group of osteoporotic women (13% vs. 27%; p = 0.018). Conditional regression binary analysis assessing the presence of osteoporosis as the dependent variable showed that women with a MS had a significant 71% decrease in the odds of being osteoporotic by BMD compared with women who had not MS accounting for age, BMI, number of parities and years since menopause. CONCLUSION Women with MS had higher BMD at the hip and spine, suggesting a protective effect of MS on bone. However, the prevalence of VFs was similar between women with or without MS.
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Affiliation(s)
| | - Asmaa Rezqi
- Rheumatology Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco
| | - Salwa El Mrahi
- Rheumatology Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco
| | - Siham Sadni
- Rheumatology Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco
| | - Imad Ghozlani
- Rheumatology Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco
| | - Aziza Mounach
- Rheumatology Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco
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14
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Association Between Metabolic Syndrome and Osteoporotic Fracture in Middle-aged and Elderly Chinese Peoples. Cell Biochem Biophys 2014; 70:1297-303. [DOI: 10.1007/s12013-014-0054-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tintut Y, Demer LL. Effects of bioactive lipids and lipoproteins on bone. Trends Endocrinol Metab 2014; 25:53-9. [PMID: 24183940 PMCID: PMC3946677 DOI: 10.1016/j.tem.2013.10.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/30/2013] [Accepted: 10/02/2013] [Indexed: 12/11/2022]
Abstract
Although epidemiological studies from the past two decades show a link between atherosclerotic vascular disease and bone loss, that is independent of age, the mechanism is still unclear. This review focuses on evidence that suggests a role for atherogenic lipids and lipoproteins in the pathogenesis of bone loss, including direct effects of these bioactive lipids/lipoproteins on bone cells, inhibiting osteoblastic differentiation and promoting osteoclastic differentiation. It also addresses recent evidence that suggests that bioactive lipids blunt the effects of bone anabolic agents such as teriparatide and bone morphogenetic proteins. Systemic and intracellular oxidant stress and inflammation are implicated in mediating the effects of bioactive lipids/lipoproteins.
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Affiliation(s)
- Yin Tintut
- Division of Cardiology, Department of Medicine, University of California, Los Angeles, CA 90095, USA.
| | - Linda L Demer
- Division of Cardiology, Department of Medicine, University of California, Los Angeles, CA 90095, USA; Department of Physiology, University of California, Los Angeles, CA 90095, USA; Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
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Kim H, Oh HJ, Choi H, Choi WH, Lim SK, Kim JG. The association between bone mineral density and metabolic syndrome: a Korean population-based study. J Bone Miner Metab 2013; 31:571-8. [PMID: 23529801 DOI: 10.1007/s00774-013-0446-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 02/19/2013] [Indexed: 02/06/2023]
Abstract
This study was conducted to investigate the association between the metabolic syndrome (MS), which includes a cluster of major risk factors for cardiovascular diseases, and bone mineral density (BMD) from a population-based study. This cross-sectional study was based on a nationwide representative survey data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008. A total of 3,207 subjects were included from the KNHANES 2008 and composed of men (mean age 48.4 years), premenopausal women (mean age 36.5 years) and postmenopausal women (mean age 64.8 years). The MS was identified according to the new criteria from a joint scientific statement endorsed by major organizations including the National Heart, Lung, and Blood Institute. The mean age of study participants was significantly different according to MS status (58.2 years in the MS group vs. 45.7 years in the non-MS group, P < 0.001). The association between MS and BMD at the lumbar spine and proximal femur was analyzed with adjustment for potential confounders. Although the adjusted BMD at all skeletal sites was not significantly different between participants with and without MS, an increased number of MS components was associated with low adjusted femoral neck (FN) BMD only in men (P = 0.01). After adjusting confounding factors, the triglyceride component of MS was related to low FN BMD in men, but to high BMD at all of the skeletal sites measured in postmenopausal women. The glucose component of MS showed an association with high adjusted BMD at total hip in men. Men with MS had significantly higher odds for pooled osteopenia and osteoporosis (odds ratio: 1.49, 95 % confidence interval: 1.04-2.14). In conclusion, low BMD is associated with MS in Korean men, and the association between the MS component and the BMD is different according to gender.
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Affiliation(s)
- Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yeungun-dong Chongno-Ku, Seoul, 110-744, Korea
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Silva HC, Pinheiro MM, Genaro PS, Castro CHM, Monteiro CMC, Fonseca FAH, Szejnfeld VL. Higher prevalence of morphometric vertebral fractures in patients with recent coronary events independently of BMD measurements. Bone 2013; 52:562-7. [PMID: 23142805 DOI: 10.1016/j.bone.2012.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 10/28/2012] [Accepted: 11/01/2012] [Indexed: 01/27/2023]
Abstract
Cardiovascular disease and osteoporosis are important causes of morbi-mortality in the elderly and may be mutually related. Low bone mineral density (BMD) may be associated with increased risk of cardiovascular events. We investigated the prevalence of low bone mass and fractures in metabolic syndrome patients with acute coronary events. A case-control study was conducted with 150 individuals (30-80years-old) with metabolic syndrome. Seventy-one patients had had an acute coronary syndrome episode in the last 6months (cases) and the remaining 79 had no coronary event (controls). Cases and controls were matched for gender, BMI and age. DXA measurements and body composition were performed while spine radiographs surveyed for vertebral fractures and vascular calcification. Biochemical bone and metabolic parameters were measured in all patients. No statistically significant difference in BMD and the prevalence of osteopenia, osteoporosis and non-vertebral fractures was observed between cases and controls. The prevalence of vertebral fractures and all fractures was higher in the cases (14.1 versus 1.3%, p=0.003 and 22.5versus7.6%, p=0.010, respectively). Male gender (OR=0.22 95% CI 0.58 to 0.83, p=0.026) and daily intake of more than 3 portions of dairy products (OR=0.19 95% CI 0.49 to 0.75, p=0.017) were associated with lower prevalence of fractures. Cases had higher risk for fractures (OR=4.97, 95% CI 1.17 to 30.30, p=0.031). Bone mass and body composition parameters were not associated with cardiovascular risk factors or bone mineral metabolism. Patients with fragility fractures had higher OPG serum levels than those without fractures (p<0.001). Our findings demonstrated that patients with recent coronary events have a higher prevalence of vertebral fractures independently of BMD.
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Affiliation(s)
- Henrique C Silva
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
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Hernández JL, Olmos JM, de Juan J, Martínez J, Ramos C, Valero C, Nan D, González-Macías J. Heel quantitative ultrasound parameters in subjects with the metabolic syndrome: The Camargo Cohort Study. Maturitas 2011; 69:162-7. [DOI: 10.1016/j.maturitas.2011.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 02/26/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022]
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