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Liu Y, Liu Y, Huang Y, Le S, Jiang H, Ruan B, Ao X, Shi X, Fu X, Wang S. The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis. Clin Nutr 2023; 42:2457-2467. [PMID: 37925778 DOI: 10.1016/j.clnu.2023.10.013] [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: 02/03/2023] [Revised: 08/17/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent. OBJECTIVE Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis. METHODS From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis. RESULTS There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096). CONCLUSIONS General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.
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Affiliation(s)
- Yupeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Yi Liu
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Yufeng Huang
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Siyu Le
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Huinan Jiang
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Binye Ruan
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Xuemei Ao
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Xudong Shi
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyi Fu
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.
| | - Shuran Wang
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.
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Dastmanesh S, Karimi M, Ghahremani L, Seif M, Zare E. A health communication campaign for prevention of osteoporosis in rural elderly women. BMC Womens Health 2023; 23:124. [PMID: 36959583 PMCID: PMC10037817 DOI: 10.1186/s12905-023-02282-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Osteoporosis, as the most common metabolic disease and the leading cause of death among older people, affects more than 200 million women throughout the world. This study aimed to evaluate the effect of a health communication campaign on knowledge, attitude, and practice of older women towards prevention and control of osteoporosis. METHODS In this multi-stage mixed methods study, 30 days' health communication campaign for prevention of osteoporosis was conducted on 60- 75-year-old women, in rural areas of Fasa, Iran. Subjects were divided into two groups, control (n = 103) and intervention (n = 98). Data were collected using a researcher-made questionnaire and analyzed by SPSS 25.0. The significance level was set at < 0.05. RESULTS Inter-group group analysis revealed that the mean scores of knowledge, attitude, and practice were not significantly different between the two groups before the intervention, but after the intervention, unlike the behavior (P = 0.569), mean scores of knowledge (p < 0.001) and attitude (p < 0.001) of the intervention group were significantly more than the control group. Intra-group comparisons showed that, unlike the control group, the mean scores of knowledge (p < 0.001), attitudes (p < 0.001), and behavior (P < 0.001) increased significantly in the intervention group. CONCLUSIONS Health communication campaign is an effective way to change the knowledge and attitude and to a lesser extent the practice of the eldery toward prevention and control of osteoporosis.
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Affiliation(s)
- Solmaz Dastmanesh
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Karimi
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Leila Ghahremani
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elahe Zare
- MSc, Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Lv X, Jiang Y, Yang D, Zhu C, Yuan H, Yuan Z, Suo C, Chen X, Xu K. The role of metabolites under the influence of genes and lifestyles in bone density changes. Front Nutr 2022; 9:934951. [PMID: 36118775 PMCID: PMC9481263 DOI: 10.3389/fnut.2022.934951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Osteoporosis is a complex bone disease influenced by numerous factors. Previous studies have found that some metabolites are related to bone mineral density (BMD). However, the associations between metabolites and BMD under the influence of genes and lifestyle have not been fully investigated. Methods We analyzed the effect of metabolites on BMD under the synergistic effect of genes and lifestyle, using the data of 797 participants aged 55–65 years from the Taizhou Imaging Study. The cumulative sum method was used to calculate the polygenic risk score of SNPs, and the healthful plant-based diet index was used to summarize food intake. The effect of metabolites on BMD changes under the influence of genes and lifestyle was analyzed through interaction analysis and mediation analysis. Results Nineteen metabolites were found significantly different in the osteoporosis, osteopenia, and normal BMD groups. We found two high-density lipoprotein (HDL) subfractions were positively associated with osteopenia, and six very-low-density lipoprotein subfractions were negatively associated with osteopenia or osteoporosis, after adjusting for lifestyles and genetic factors. Tea drinking habits, alcohol consumption, smoking, and polygenic risk score changed BMD by affecting metabolites. Conclusion With the increased level of HDL subfractions, the risk of bone loss in the population will increase; the risk of bone loss decreases with the increased level of very-low-density lipoprotein subfractions. Genetic factors and lifestyles can modify the effects of metabolites on BMD. Our results show evidence for the precise prevention of osteoporosis.
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Affiliation(s)
- Xuewei Lv
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Dantong Yang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chengkai Zhu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Huangbo Yuan
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Ziyu Yuan
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Chen Suo
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
- Ministry of Education Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
- *Correspondence: Xingdong Chen,
| | - Kelin Xu
- Ministry of Education Key Laboratory of Public Health Safety, Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Kelin Xu,
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Polymorphisms in Genes Involved in Osteoblast Differentiation and Function Are Associated with Anthropometric Phenotypes in Spanish Women. Genes (Basel) 2021; 12:genes12122012. [PMID: 34946961 PMCID: PMC8701034 DOI: 10.3390/genes12122012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022] Open
Abstract
Much of the genetic variance associated with osteoporosis is still unknown. Bone mineral density (BMD) is the main predictor of osteoporosis risk, although other anthropometric phenotypes have recently gained importance. The aim of this study was to analyze the association of SNPs in genes involved in osteoblast differentiation and function with BMD, body mass index (BMI), and waist (WC) and hip (HC) circumferences. Four genes that affect osteoblast differentiation and/or function were selected from among the differentially expressed genes in fragility hip fracture (FOXC1, CTNNB1, MEF2C, and EBF2), and an association study of four single-nucleotide polymorphisms (SNPs) was conducted in a cohort of 1001 women. Possible allelic imbalance was also studied for SNP rs87939 of the CTNNB1 gene. We found significant associations of SNP rs87939 of the CTNNB1 gene with LS-sBMD, and of SNP rs1366594 of the MEF2C gene with BMI, after adjustment for confounding variables. The SNP of the MEF2C gene also showed a significant trend to association with FN-sBMD (p = 0.009). A possible allelic imbalance was ruled out as no differences for each allele were detected in CTNNB1 expression in primary osteoblasts obtained from homozygous women. In conclusion, we demonstrated that two SNPs in the MEF2C and CTNNB1 genes, both implicated in osteoblast differentiation and/or function, are associated with BMI and LS-sBMD, respectively.
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Bone characteristics and metabolic phenotypes of obesity in an Iranian Elderly population: Bushehr Elderly Health Program (BEHP). Arch Osteoporos 2021; 16:92. [PMID: 34101034 DOI: 10.1007/s11657-021-00953-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/19/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Obesity and osteoporosis are health problems with high impact on the morbidity and mortality rate. While the association between BMI and bone density is known, the combined effects of obesity and metabolic components on bone health have not yet been revealed. The objectives of this study were to determine the association between bone health and different phenotypes of obesity in an elderly population. METHODS This cross-sectional study was conducted on the data collected in the Bushehr Elderly Health Program (BEHP). The participants were classified in four groups based on the metabolic phenotypes of obesity (metabolic healthy obese (MHO), metabolic non-healthy non-obese (MNHNO), metabolic non-healthy obese (MNHO), and metabolic healthy non-obese (MHNO)). The association between osteoporosis and TBS and the metabolic phenotypes of obesity were assessed using multiple variable logistic regression models. RESULTS Totally, 2378 people (1227 women) were considered for analyses. The prevalence of MHNO, MHO, MNHNO, and MNHO were 902 (39.9%), 138 (6.1%), 758 (33.5%), and 464 (20.5%), respectively. In the multivariate logistic regression models, those with MHO (OR 0.22; 95% CI 0.12-0.36), MNHNO (OR 0.52; 95% CI 0.4-0.66), and MNHO phenotypes (OR 0.22; 95% CI 0.16-0.3) had a significantly lower risk of osteoporosis. Likewise, those having MHO (OR 2.38; 95% CI 1.51-3.76), MNHNO (OR 1.49; 95% CI 1.11-2), and MNHO (OR 2.50; 95% CI 1.82-3.42) phenotypes were found to had higher risk of low bone quality as confirmed by TBS. CONCLUSIONS The obese subjects have lower bone quality, regardless of their obesity phenotype.
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