Association between body composition and bone mineral density assessed by whole body dual-energy X-ray absorptiometry
Nikolov et al. PDF (EN)
Nikolov et al. PDF (Български)

Keywords

body composition, fat mass, lean mass, body mass index, bone mineral density

How to Cite

Nikolov, M., Lambova, S., & Nikolov, N. (2022). Association between body composition and bone mineral density assessed by whole body dual-energy X-ray absorptiometry. Rheumatology (Bulgaria), 30(3), 3-14. https://doi.org/10.35465/30.3.2022.pp3-14

Abstract

Introduction: Despite the observation that higher body weight has protective effect against the development of osteoporosis, accumulating evidence suggest presence of negative impact of obesity on bone function associated with the low-grade inflammation and production of proinflammatory cytokines from dysfunctional adipose tissue in obese individuals. These data stimulate the interest and suggest need for clarifying studies about the association between the body composition and bone mineral density.

The aim of the study: The aim of the current study was to evaluate the association between body mass index (BMI), body composition (fat mass and lean body mass) and the bone mineral density of the lumbar spine and femoral neck assessed by whole body scan using DXA (dual-energy x-ray absorptiometry).

Materials and methods: A retrospective study was performed with analysis of patient data who have undergone whole body scan in Medical Center “Avis Medica” Pleven, device Lunar prodigy. The values of T-score of the lumbar spine and femoral neck were analyzed and their associations with body composition and BMI.

Results and discussion: 111 women at mean age 59±8 years were included in the study. In the patients with T-score values ​​≤ /-2.5/ of the lumbar spine and femoral neck BMI was significantly lower. In the group of patients with T-score values of the lumbar spine ≤ /-2.5/ (n=27), significantly lower fat mass was found (2239.90±607.63 grams) in comparison with the cases with T-score > /-2.5/ (n=84) (fat mass 2510.41±570.68 grams; p=0.037). The lean body mass in the patients with T-score ≤ /-2.5/ of the lumbar spine (4025.30±862.58 grams) was also significantly lower vs the group with T-score > /-2.5/ (4760.09±607.63 grams; p=0.000). A significant difference of body lean mass was also found between the groups with different T-score of femoral neck (4110.60±832.01 grams in patients with T-score of femoral neck ≤2.5, n=15; 4802.01±862.87 grams in those with T-score>2.5, n=96, p=0.004). Regarding the fat mass and fat percentage in the groups with different T-score of the femoral neck, they were lower in the patients with osteoporosis with T-score < /-2.5/, but the difference reached statistical significance only for the fat percentage (31 vs 38%, p=006) but not for the fat mass (p=0.081).

Conclusion: The results of the current study confirm the protective effect of the higher lean and fat mass against the development of osteoporosis with possible leading role of the lean mass.

https://doi.org/10.35465/30.3.2022.pp3-14
Nikolov et al. PDF (EN)
Nikolov et al. PDF (Български)

References

  1. Gkastaris K, Goulis DG, Potoupnis M et al. Obesity, osteoporosis and bone metabolism. J Musculoskelet Neuronal Interact. 2020;20(3):372-81.
  2. He H, Liu Y, Tian Q, et al. Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int. 2016;27(2):473-82.
  3. Roubenoff R, Kehayias JJ. The meaning and measurement of lean body mass. Nutr Rev. 1991;49(6):163-75.
  4. Thomas R, Shinagare AB, Rosenthal MH, et al. Computed tomographic assessment of lean body mass in patients on selective androgen receptor modulator. Clin Imaging. 2020;59(2):100-3.
  5. Lemos T, Gallagher D. Current body composition measurement techniques. Curr Opin Endocrinol Diabetes Obes. 2017;24(5):310-4.
  6. Neeland IJ, Grundy SM, Li X, et al. Comparison of visceral fat mass measurement by dual-X-ray absorptiometry and magnetic resonance imaging in a multiethnic cohort: the Dallas Heart Study. Nutr Diabetes. 2016;6(7):e221.
  7. Shen J, Nielson CM, Marshall LM, et al. The association between BMI and QCT-derived proximal structure and strength in older men: a cross-sectional study. 2016;30(7):1301-8.
  8. Siiteri K. Adipose tissue as a source of hormones. Am J Clin Nutr. 1987;45:277-82.
  9. Gillette-Guyonnet S, Nourhashemi F, Lauque S, et al. Body composition and osteoporosis in elderly women. Gerontology. 2000;46(4):189-93.
  10. Almeida M, Laurent MR, Dubois V, et al. Estrogens and androgens in skeletal physiology and pathophysiology. Physiol Rev. 2017;97(1):135-87.
  11. Hong C, Choi S, Park M, et al. Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses. J Cachexia Sarcopenia Muscle. 2021;12(6):2247-58.
  12. Cao JJ. Effects of obesity on bone metabolism. J Orthop Surg Res. 2011;6(1):30.
  13. Das UN. Is obesity an inflammatory condition? Nutrition. 2001;17(11-12):953-66.
  14. Schneider JG, Tompkins C, Blumenthal RS, Mora S. The metabolic syndrome in women. Cardiol Rev. 2006;14(6):286-91.
  15. Blüher M. Adipose tissue dysfunction in obesity. Exp Clin Endocrinol Diabetes. 2009;117(6):241-50.
  16. Gilsanz V, Chalfant J, Mo AO, et al. Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab. 2009;94(9):3387-93.
  17. Wang L, Wang W, Xu L, et al. Relation of visceral and subcutaneous adipose tissue to bone mineral density in Chinese women. Int J Endocrinol. 2013;2013:378632.
  18. Beck TJ, Petit MA, Wu G, et al. Does obesity really make the femur stronger? BMD, geometry, and fracture incidence in the women’s health initiative-observational study. J Bone Miner Res. 2009;24(8):1369-79.
  19. Crivelli M, Chain A, Da Silva ITF, et al. Association of Visceral and Subcutaneous Fat Mass With Bone Density and Vertebral Fractures in Women With Severe Obesity. J Clin Densitom. 2021;24(3):397-405.
  20. Rudman HA, Birrel F, Pearce MS, et al. Obesity, bone density for weight and prevalent vertebral fracture at age 62 years: the Newcastle Thousand Families Study. J Clin Densitom. 2018;21(4):606.
  21. Johansson H, Kanis JA, Odén A, et al. A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res. 2014;29(1):223-33.
  22. Oreopoulos A, Kalantar-Zadeh K, Sharma AM, Fonarow GC. The Obesity Paradox in the Elderly: Potential Mechanisms and Clinical Implications. Clin Geriatr Med. 2009;25(4):643-59.
  23. Schultheis L. The mechanical control system of bone in weightless spaceflight and in aging. Exp Gerontol. 1991;26(2–3):203-14.
  24. Kendler DL, Borges JLC, Fielding RA, et al. The Official Positions of the International Society for Clinical Densitometry: Indications of Use and Reporting of DXA for Body Composition. J Clin Densitom. 2013;16(4):496-507.
  25. Shepherd JA, Baim S, Bilezikian JP, Schousboe JT. Executive Summary of the 2013 International Society for Clinical Densitometry Position Development Conference on Body Composition. J Clin Densitom. 2013;16(4):489-95.
  26. Ho-Pham LT, Nguyen UDT, Nguyen TV. Association between lean mass, fat mass, and bone mineral density: A meta-analysis. J Clin Endocrinol Metab. 2014;99(1):30-8.
  27. Nguyen HG, Pham MT, Ho-Pham LT, Nguyen TV. Lean mass and peak bone mineral density. Osteoporos Sarcopenia. 2020;6(4):212-6.
  28. Hetherington-Rauth M, Bea JW, Blew RM, et al. Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls. Bone. 2018;113:144–50.
  29. Leslie WD, Orwoll ES, Nielson CM, et al. Estimated lean mass and fat mass differentially affect femoral bone density and strength index but are not FRAX independent risk fac-tors for fracture. J Bone Miner Res. 2014;29(11):2511-9.
  30. Clynes MA, Gregson CL, Bruyère O, et al. Osteosarcopenia: Where osteoporosis and sarcopenia collide. Rheumatol. 2021;60(2):529-37.
  31. Pisani P, Renna MD, Conversano F, et al. Major osteoporotic fragility fractures: Risk factor updates and societal impact. World J Orthop. 2016;7(3):171-81.
  32. Apostu D, Lucaciu O, Oltean-Dan D, et al. The influence of thyroid pathology on osteoporosis and fracture risk: A review. Diagnostics. 2020;10(3).
  33. Giangregorio LM, Leslie WD, Lix LM, et al. FRAX undere-timates fracture risk in patients with diabetes. J Bone Miner Res. 2012;27(2):301-8.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Downloads

Download data is not yet available.