Relation between body composition and biochemical markers of bone turnover among early postmenopausal women

Vitamin D inadequacy combined with high BMI affects paraspinal muscle atrophy and pain intensity in postmenopausal women

OBJECTIVE

This study was performed to assess the effects of vitamin D deficiency/insufficiency combined with a high body mass index (BMI) on paraspinal muscle (PSM) atrophy and pain intensity in postmenopausal women with lower back pain (LBP).

METHODS

In total, 365 postmenopausal women were analyzed in the study. We divided the women into four groups according to BMI and vitamin D status. Outcome measurements included PSM atrophy, fatty infiltration (FI) and severity of LBP. Binary logistic regression was used to analyze the odds ratio (OR), and the interaction between the BMI and vitamin D status was tested.

RESULTS

Compared with the control group, the high BMI with vitamin D deficiency/insufficiency group had a significantly increased risk of FI > grade 2 (OR = 10.69, p < 0.001), hand grip strength of <16 kg (OR = 8.96, p < 0.001), Short Physical Performance Battery score of ≤8 (OR = 3.69, p < 0.001) and visual analog scale (VAS) score of >3 (OR = 4.76, p < 0.001). A significant positive additive interaction was found between the BMI and vitamin D status on PSM atrophy.

CONCLUSION

Vitamin D deficiency/insufficiency combined with a high BMI was associated with PSM atrophy and LBP intensity in postmenopausal women. The interaction analysis showed a positive additive interaction between BMI and vitamin D status.

Age determines longitudinal changes in body composition better than menopausal and bone status: the OFELY study

Long-term body composition (BC) changes and their determinants have been rarely explored. We aimed to evaluate BC changes in French women from the Os des Femmes de Lyon (OFELY) cohort and to explore several determinants of those changes. At baseline, premenopausal (PreM) women (n = 145) had lower fat body mass (FM) and greater lean body mass (LM), relative skeletal muscle mass index (RASM), and total body bone mineral content (TBBMC) compared with untreated postmenopausal (PostM) women (n = 412). During a 6-year follow-up, LM and RASM did not change, whereas a significant increase of FM and a decrease of TBBMC were observed in PreM (n = 88) and PeriM women (n = 44; women who became PostM during the follow-up). In untreated PostM women, FM increased, whereas LM, RASM, and TBBMC decreased (p < 0.0001). Age was a significant determinant of the changes in BC. After controlling for age, menopausal status was still a significant determinant only for changes in TBBMC. FM, LM, RASM, and TBBMC were higher in women with normal bone mineral density (BMD) compared with women with osteopenia or osteoporosis (p < 0.0001), but after adjusting for age, changes of BC were not significantly different according to the bone status. After controlling for age and menopausal status, levels of P1NP in the highest quartile were associated with a greater decrease of LM and RASM compared with lower levels. In conclusion, BC changes in French women over a 6-year follow-up showed a high interindividual variability. Aging may be the most important determinant of changes in body composition, rather than menopausal and bone status.

Association between the Healthy Eating Index and bone turnover markers in US postmenopausal women aged ≥45 y

BACKGROUND

Some studies have reported that overall diet quality affects bone status in postmenopausal women; however, the findings are inconsistent.

OBJECTIVES

Our primary objective was to examine the association between overall diet quality and bone turnover markers (BTMs) in postmenopausal women aged ≥45 y by using the Healthy Eating Index 2005 (HEI-2005)-a diet quality-assessment tool-developed by the US Department of Agriculture. Our secondary objective was to explore the associations between the components of the HEI-2005 and the MyPyramid food groups and BTMs.

DESIGN

We used cross-sectional data from NHANES 1999-2002. Multiple regression models with adjustments for relevant confounders were used to examine the relation between the total HEI-2005 score and its components and food groups and serum bone-specific alkaline phosphatase (BAP), a biomarker of bone formation, and urinary N-telopeptides/creatinine (uNTx/Cr), a biomarker of bone resorption.

RESULTS

No association was found between the total HEI-2005 score and BTMs. The milk group component of HEI-2005 had a significant negative linear relation with uNTx/Cr. Women in the lowest tertile of the MyPyramid milk group had the highest uNTx/Cr. Those in the highest tertile of energy-adjusted added sugar intake had the highest BAP.

CONCLUSIONS

Our results support the ability of a healthy diet with adequate dairy intake to promote bone health in aging women. However, we found that the HEI-2005 is not a good measure of healthy eating for optimal bone health. Further research is needed to develop an overall dietary assessment tool in relation to bone health for postmenopausal women.

Influence of obesity on bone density in postmenopausal women

OBJECTIVE: To evaluate the influence of obesity, age, and years since menopause on bone density. METHODS: A retrospective analysis of bone mineral density (BMD) obtained from 588 women, 41 to 60 years, previously menopaused (1-10 years before). RESULTS: Positive influence of obesity was confirmed by the significant differences in BMD at lumbar spine, femoral neck (FN), and trochanter (TR) between the groups (p < 0.01). Age and years since menopause (YSM) were negatively correlated with BMD at all sites (p = 0.000). Comparing patients within 1 to < 6 YSM versus 6 to 10 YSM, BMD was higher in the former at LS and FN (p < 0.005), despite the higher BMI in the older group (p = 0.01). Obese patients had a lower prevalence of osteoporosis at LS and FN (p = 0.009). Regression analysis identified BMI as the strongest determinant of FN and TR BMD, while YSM was the strongest determinant of LS BMD. CONCLUSION: The protective effect of obesity is overtaken by age and estradiol deficiency. We recommend that even obese postmenopausal women should be screened for osteoporosis.