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Published in: Clinical Rheumatology 3/2019

01-03-2019 | Original Article

Clinical and body composition predictors of bone turnover and mineral content in obese postmenopausal women

Authors: Rim Cherif, Feten Mahjoub, Hela Sahli, Elhem Cheour, Mohsen Sakly, Nebil Attia

Published in: Clinical Rheumatology | Issue 3/2019

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Abstract

The purpose of this study was to determine the predictors of bone mineral density (BMD), bone mineral content (BMC), and bone turnover markers in obese postmenopausal women. In this cross-sectional study, 81 postmenopausal women aged 58.40 ± 6.08 years were analyzed. Anthropometric parameters were recorded. Serum glucose parameters, serum lipid profiles, adipokines, renal, hepatic parameters, and bone markers concentrations were determined by well-validated laboratory routine methods. BMD, BMC, and body composition were measured by Dual X-ray Absorptiometry. We found a significant correlation of BMD with age, years since menopause, anthropometric parameters, glycemia, alkaline phosphatase, fat mass, and lean mass. Multiple regression analysis demonstrated that years since menopause, waist circumference, alkaline phosphatase, trunk fat, and lean mass were independently associated to BMD. Also, age, years since menopause, anthropometric parameters, total cholesterol, alkaline phosphatase, fat mass, and lean mass were correlated to BMC. However, only waist circumference and trunk fat were independently related to BMC. Bone turnover markers were significantly correlated to the age, glycemia, HbA1c, adipokines, hepatic parameters, and lean mass. Nevertheless, only adipokines, gamma glutamyl transferase (GGT), and alkaline phosphatase were independently associated to bone turnover markers. These observations suggest that number of years since menopause, waist circumference, alkaline phosphatase, trunk fat, and lean mass were the only significant predictors of BMD. However, waist circumference seems to be a stronger predictor than trunk fat for BMC. Moreover, adiponectin, resistin, GGT, and alkaline phosphatase were significant predictors of the bone resorption (CTX-I) and the bone formation (P1NP) markers.
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Literature
3.
go back to reference Mazess RB, Barden HS, Ettinger M et al (1987) Spine and femur density using dual-photon absorptiometry in US white women. Bone Miner Res 2:211–219 Mazess RB, Barden HS, Ettinger M et al (1987) Spine and femur density using dual-photon absorptiometry in US white women. Bone Miner Res 2:211–219
4.
go back to reference Greco EA, Fornari R, Rossi F, Rossi F, Santiemma V, Prossomariti G, Annoscia C, Aversa A, Brama M, Marini M, Donini LM, Spera G, Lenzi A, Lubrano C, Migliaccio S (2010) Is obesity protective for osteoporosis? Evaluation of bone mineral density in individuals with high body mass index. Int J Clin Pract 64(6):817–820CrossRefPubMed Greco EA, Fornari R, Rossi F, Rossi F, Santiemma V, Prossomariti G, Annoscia C, Aversa A, Brama M, Marini M, Donini LM, Spera G, Lenzi A, Lubrano C, Migliaccio S (2010) Is obesity protective for osteoporosis? Evaluation of bone mineral density in individuals with high body mass index. Int J Clin Pract 64(6):817–820CrossRefPubMed
5.
go back to reference Kim KC, Shin DH, Lee SY, Im JA, Lee DC (2010) Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women. Yonsei Med J 51(6):857–863CrossRefPubMedPubMedCentral Kim KC, Shin DH, Lee SY, Im JA, Lee DC (2010) Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women. Yonsei Med J 51(6):857–863CrossRefPubMedPubMedCentral
6.
go back to reference Douchi T, Kuwahata R, Matsuo T et al (2003) Relative contribution of lean and fat mass component to bone mineral density in males. J Bone Miner Metab 21:17e21CrossRef Douchi T, Kuwahata R, Matsuo T et al (2003) Relative contribution of lean and fat mass component to bone mineral density in males. J Bone Miner Metab 21:17e21CrossRef
7.
go back to reference Wang MC, Bachrach LK, Van Loan M et al (2005) The relative contributions of lean tissue mass and fat mass to bone density in young women. Bone 37:474e481 Wang MC, Bachrach LK, Van Loan M et al (2005) The relative contributions of lean tissue mass and fat mass to bone density in young women. Bone 37:474e481
8.
go back to reference Reid IR, Ames R, Evans MC et al (1992) Determinants of total body and regional bone mineral density in normal postmenopausal women a key role for fat mass. J Clin Endocrinol Metab 75:45e51 Reid IR, Ames R, Evans MC et al (1992) Determinants of total body and regional bone mineral density in normal postmenopausal women a key role for fat mass. J Clin Endocrinol Metab 75:45e51
9.
go back to reference Reid IR, Evans MC, Ames RW (1994) Volumetric bone density of the lumbar spine is related to fat mass but not lean mass in normal postmenopausal women. Osteoporos Int 4:362e367CrossRef Reid IR, Evans MC, Ames RW (1994) Volumetric bone density of the lumbar spine is related to fat mass but not lean mass in normal postmenopausal women. Osteoporos Int 4:362e367CrossRef
10.
go back to reference Orozco P (2004) Atherogenic lipid profile and elevated lipoprotein (a) are associated with lower bone mineral density in early postmenopausal overweight women. Eur J Epidemiol 19(12):1105–1112CrossRefPubMed Orozco P (2004) Atherogenic lipid profile and elevated lipoprotein (a) are associated with lower bone mineral density in early postmenopausal overweight women. Eur J Epidemiol 19(12):1105–1112CrossRefPubMed
11.
go back to reference Adami S, Braga V, Gatti D (2001) Association between bone mineral density and serum lipids in men. J Am Med Assoc 286(7):791–792CrossRef Adami S, Braga V, Gatti D (2001) Association between bone mineral density and serum lipids in men. J Am Med Assoc 286(7):791–792CrossRef
12.
go back to reference Suzuki K, Sugimoto C, Takizawa M, Ishizuka S, Kikuyama M, Togawa H, Taguchi Y, Nosaka K, Seino Y, Ishida H (2000) Correlations between bone mineral density and circulating bone metabolic markers in diabetic patients. Diabetes Res Clin Pract 48(3):185–191CrossRefPubMed Suzuki K, Sugimoto C, Takizawa M, Ishizuka S, Kikuyama M, Togawa H, Taguchi Y, Nosaka K, Seino Y, Ishida H (2000) Correlations between bone mineral density and circulating bone metabolic markers in diabetic patients. Diabetes Res Clin Pract 48(3):185–191CrossRefPubMed
14.
go back to reference Farr JN, Drake MT, Amin S, Melton LJ, McCready LK, Khosla S (2014) In vivo assessment of bone quality in postmenopausal women with type 2 diabetes. J Bone Miner Res 29(4):787–795CrossRefPubMedPubMedCentral Farr JN, Drake MT, Amin S, Melton LJ, McCready LK, Khosla S (2014) In vivo assessment of bone quality in postmenopausal women with type 2 diabetes. J Bone Miner Res 29(4):787–795CrossRefPubMedPubMedCentral
15.
go back to reference Saito M, Marumo K (2010) Collagen cross-links as a determinant of bone quality: a possible explanation for bone fragility in aging, osteoporosis, and diabetes mellitus. Osteoporosis Int 21(2):195–214CrossRef Saito M, Marumo K (2010) Collagen cross-links as a determinant of bone quality: a possible explanation for bone fragility in aging, osteoporosis, and diabetes mellitus. Osteoporosis Int 21(2):195–214CrossRef
16.
go back to reference Cherif R, Mahjoub F, Sahli H, Cheour E, Vico L, Sakly M, Attia N (2018) Positive association of obesity and insulin resistance with bone mineral density in Tunisian postmenopausal women. J Clin Densitom 21(2):163–171CrossRefPubMed Cherif R, Mahjoub F, Sahli H, Cheour E, Vico L, Sakly M, Attia N (2018) Positive association of obesity and insulin resistance with bone mineral density in Tunisian postmenopausal women. J Clin Densitom 21(2):163–171CrossRefPubMed
17.
go back to reference Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18(6):499–502PubMed Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18(6):499–502PubMed
18.
go back to reference Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419CrossRefPubMed Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419CrossRefPubMed
19.
go back to reference Yao WJ, Wu CH, Wang ST, Chang CJ, Chiu NT, Yu CY (2001) Differential changes in regional bone mineral density in healthy Chinese: age-related and sex-dependent. Calcified Tissue Int 68(6):330–336CrossRef Yao WJ, Wu CH, Wang ST, Chang CJ, Chiu NT, Yu CY (2001) Differential changes in regional bone mineral density in healthy Chinese: age-related and sex-dependent. Calcified Tissue Int 68(6):330–336CrossRef
20.
go back to reference Cui R, Zhou L, Li Z, Li Q, Qi Z, Zhang J (2016) Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density. Clin Interv Aging 11:887–895CrossRefPubMedPubMedCentral Cui R, Zhou L, Li Z, Li Q, Qi Z, Zhang J (2016) Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density. Clin Interv Aging 11:887–895CrossRefPubMedPubMedCentral
22.
go back to reference Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR, Orwig DL (2014) Body mass index is positively associated with bone mineral density in US older adults. Arch Osteoporos 9:175CrossRefPubMed Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR, Orwig DL (2014) Body mass index is positively associated with bone mineral density in US older adults. Arch Osteoporos 9:175CrossRefPubMed
23.
go back to reference Douchi T, Yamamoto S, Oki T, Maruta K, Kuwahata R, Yamasaki H et al (2000) Difference in the effect of adiposity on bone density between pre- and postmenopausal women. Maturitas 34:261–266CrossRefPubMed Douchi T, Yamamoto S, Oki T, Maruta K, Kuwahata R, Yamasaki H et al (2000) Difference in the effect of adiposity on bone density between pre- and postmenopausal women. Maturitas 34:261–266CrossRefPubMed
24.
go back to reference Frost HM (1992) The role of changes in mechanical usage set points in the pathogenesis of osteoporosis. J Bone Miner Res 7:253–261CrossRefPubMed Frost HM (1992) The role of changes in mechanical usage set points in the pathogenesis of osteoporosis. J Bone Miner Res 7:253–261CrossRefPubMed
25.
26.
go back to reference Khosla S, Atkinson EJ, Riggs BL, Melton LJ (1996) Relationship between body composition and bone mass in women. J Bone Miner Res 11:857–863CrossRefPubMed Khosla S, Atkinson EJ, Riggs BL, Melton LJ (1996) Relationship between body composition and bone mass in women. J Bone Miner Res 11:857–863CrossRefPubMed
27.
go back to reference Saarelainen J, Honkanen R, Kröger H, Tuppurainen M, Jurvelin JS, Niskanen L (2011) Body fat distribution is associated with lumbar spine bone density independently of body weight in postmenopausal women. Maturitas 69(1):86–90CrossRefPubMed Saarelainen J, Honkanen R, Kröger H, Tuppurainen M, Jurvelin JS, Niskanen L (2011) Body fat distribution is associated with lumbar spine bone density independently of body weight in postmenopausal women. Maturitas 69(1):86–90CrossRefPubMed
28.
go back to reference Nur H, Toraman NF, Arica Z, Sarier N, Samur A (2013) The relationship between body composition and bone mineral density in postmenopausal Turkish women. Rheumatol Int 33(3):607–612CrossRefPubMed Nur H, Toraman NF, Arica Z, Sarier N, Samur A (2013) The relationship between body composition and bone mineral density in postmenopausal Turkish women. Rheumatol Int 33(3):607–612CrossRefPubMed
29.
go back to reference Liu S, Li J, Sheng Z, Wu X, Liao E (2011) Relationship between body composition and age, menopause and its effects on bone mineral density at segmental regions in Central Southern Chinese postmenopausal elderly women with and without osteoporosis. Arch Gerontol Geriatr 53:192–197CrossRef Liu S, Li J, Sheng Z, Wu X, Liao E (2011) Relationship between body composition and age, menopause and its effects on bone mineral density at segmental regions in Central Southern Chinese postmenopausal elderly women with and without osteoporosis. Arch Gerontol Geriatr 53:192–197CrossRef
30.
go back to reference Jurimae J, Rembel K, Jurimae T, Rehand M (2005) Adiponectin is associated with bone mineral density in perimenopausal women. Horm Metab Res 37:297–302CrossRefPubMed Jurimae J, Rembel K, Jurimae T, Rehand M (2005) Adiponectin is associated with bone mineral density in perimenopausal women. Horm Metab Res 37:297–302CrossRefPubMed
31.
go back to reference Thommesen L, Stunes A, Monjo M, Grosvik K, Tamburstuen M, Kjobli E et al (2006) Expression and regulation of resistin in osteoblasts and osteoclasts indicate a role in bone metabolism. J Cell Biochem 99:824–834CrossRefPubMed Thommesen L, Stunes A, Monjo M, Grosvik K, Tamburstuen M, Kjobli E et al (2006) Expression and regulation of resistin in osteoblasts and osteoclasts indicate a role in bone metabolism. J Cell Biochem 99:824–834CrossRefPubMed
32.
go back to reference Cheng Q, Zhu YX, Zhang MX, Li LH, Du PY, Zhu MH (2012) Age and sex effects on the association between body composition and bone mineral density in healthy Chinese men and women. Menopause 19:448–455CrossRefPubMed Cheng Q, Zhu YX, Zhang MX, Li LH, Du PY, Zhu MH (2012) Age and sex effects on the association between body composition and bone mineral density in healthy Chinese men and women. Menopause 19:448–455CrossRefPubMed
33.
go back to reference Georgescu CE, Ilie I, Brad C, Duncea I (2010) Association between body composition and bone mineral density in healthy, non-obese, young Romanian adults and effects of menopause. Maedica (Buchar) 5:24–27 Georgescu CE, Ilie I, Brad C, Duncea I (2010) Association between body composition and bone mineral density in healthy, non-obese, young Romanian adults and effects of menopause. Maedica (Buchar) 5:24–27
34.
go back to reference Li S, Wagner R, Holm K, Lehotsky J, Zinaman MJ (2006) Relationship between soft tissue body composition and bone mass in perimenopausal women. Maturitas 117:1462–1470 Li S, Wagner R, Holm K, Lehotsky J, Zinaman MJ (2006) Relationship between soft tissue body composition and bone mass in perimenopausal women. Maturitas 117:1462–1470
35.
go back to reference Weeks BK, Beck BR (2008) The BPAQ: a bone-specific physical activity assessment instrument. Osteoporos Int 19(11):1567–1577CrossRefPubMed Weeks BK, Beck BR (2008) The BPAQ: a bone-specific physical activity assessment instrument. Osteoporos Int 19(11):1567–1577CrossRefPubMed
36.
go back to reference Thrailkill KM, Lumpkin CK, Bunn RC, Kemp SF, Fowlkes JL (2005) Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues. Am J Physiol Endocrinol Metab 289(5):E735–E745CrossRefPubMedPubMedCentral Thrailkill KM, Lumpkin CK, Bunn RC, Kemp SF, Fowlkes JL (2005) Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues. Am J Physiol Endocrinol Metab 289(5):E735–E745CrossRefPubMedPubMedCentral
37.
go back to reference Van Daele PL, Stolk RP, Burger H et al (1995) Bone density in non-insulin-dependent diabetes mellitus. The Rotterdam Study. Ann Intern Med 122:409e414 Van Daele PL, Stolk RP, Burger H et al (1995) Bone density in non-insulin-dependent diabetes mellitus. The Rotterdam Study. Ann Intern Med 122:409e414
38.
go back to reference Levin ME, Boisseau VC, Avioli LV (1976) Effects of diabetes mellitus on bone mass in juvenile and adult-onset diabetes. N Engl J Med 294:241e245CrossRef Levin ME, Boisseau VC, Avioli LV (1976) Effects of diabetes mellitus on bone mass in juvenile and adult-onset diabetes. N Engl J Med 294:241e245CrossRef
39.
go back to reference Arikan S, Tuzcu A, Bahceci M, Ozmen S, Gokalp D (2012) Insulin resistance in type 2 diabetes mellitus may be related to bone mineral density. J Clin Densitom 15(2):186–190CrossRefPubMed Arikan S, Tuzcu A, Bahceci M, Ozmen S, Gokalp D (2012) Insulin resistance in type 2 diabetes mellitus may be related to bone mineral density. J Clin Densitom 15(2):186–190CrossRefPubMed
40.
go back to reference Xia MF, Lin HD, Yan HM, Bian H, Chang XX, Zhang LS, He WY, Gao X (2016) The association of liver fat content and serum alanine aminotransferase with bone mineral density in middle-aged and elderly Chinese men and postmenopausal women. J Transl Med 14(11):11CrossRefPubMedPubMedCentral Xia MF, Lin HD, Yan HM, Bian H, Chang XX, Zhang LS, He WY, Gao X (2016) The association of liver fat content and serum alanine aminotransferase with bone mineral density in middle-aged and elderly Chinese men and postmenopausal women. J Transl Med 14(11):11CrossRefPubMedPubMedCentral
41.
go back to reference Choi HS, Kim KJ, Rhee Y, Lim SK (2015) Serum γ-glutamyl transferase is inversely associated with bone mineral density independently of alcohol consumption. Endocrinol Metab 31:64–71CrossRef Choi HS, Kim KJ, Rhee Y, Lim SK (2015) Serum γ-glutamyl transferase is inversely associated with bone mineral density independently of alcohol consumption. Endocrinol Metab 31:64–71CrossRef
42.
go back to reference Cui LH, Shin MH, Chung EK, Lee YH, Kweon SS, Park KS, Choi JS (2005) Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea. Osteoporosis Int 16(12):1975–1981CrossRef Cui LH, Shin MH, Chung EK, Lee YH, Kweon SS, Park KS, Choi JS (2005) Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea. Osteoporosis Int 16(12):1975–1981CrossRef
Metadata
Title
Clinical and body composition predictors of bone turnover and mineral content in obese postmenopausal women
Authors
Rim Cherif
Feten Mahjoub
Hela Sahli
Elhem Cheour
Mohsen Sakly
Nebil Attia
Publication date
01-03-2019
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 3/2019
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-018-4343-4

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