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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2015

01-12-2015 | Original Article

Gender comparison of factors associated with age-related differences in bone mineral density

Published in: Archives of Osteoporosis | Issue 1/2015

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Abstract

Summary

We found that age-related decline in bone mineral density (BMD) is more pronounced in women than in men, that lean mass was the most important determinant of BMD in all age groups in both sexes, and that different factors may be important for bone health of men and women and at different ages.

Introduction

Multiple factors may affect bone mineral density (BMD). Our objective was to identify the correlates of age-related differences in BMD among men and women.

Methods

We performed a cross-sectional study involving 490 men and 517 women between the age of 29 and 87 years that were free of medication and diseases known to affect bone metabolism. BMD was measured at various sites using dual-energy X-ray absorptiometry, and factors possibly associated with skeletal status were assessed by direct measurements and a detailed questionnaire.

Results

BMD was lower with advancing age at all BMD measurement sites, the greatest difference being for the femoral neck where in women BMD was 37.5 % lower in the oldest compared to that in the youngest age group, but the difference was 22.9 % in men. Levels of free estradiol were sharply lower after age of 40 among women; free testosterone declined gradually with age among men but was not independently associated with BMD. Factors including lean mass, physical activity, ionized calcium, C-terminal telopeptide (CTX), serum sodium, free estradiol, and smoking explained a large fraction of difference in BMD in different age groups but to a varying degree in men and women. Lean mass was the strongest independent factor associated with BMD at all sites among men and women.

Conclusions

Age-related decline in BMD is more pronounced in women than in men, but determinants of BMD are multiple and interrelated. Our study indicates that different factors may be important for bone health of men and women and at different ages.
Appendix
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Literature
1.
Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA, Epidemiology ICWGoF (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288PubMedPubMedCentralCrossRef
2.
Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332:767–773PubMedCrossRef
3.
Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674PubMedCrossRef
4.
Nguyen TV, Center JR, Eisman JA (2000) Osteoporosis in elderly men and women: effects of dietary calcium, physical activity, and body mass index. J Bone Miner Res 15:322–331CrossRef
5.
Cooper C, Eriksson JG, Forsen T, Osmond C, Tuomilehto J, Barker DJ (2001) Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study. Osteoporos Int 12:623–629PubMedCrossRef
6.
7.
Riggs BL, Melton LJ III, Robb RA, Camp JJ, Atkinson EJ, Peterson JM, Rouleau PA, McCollough CH, Bouxsein ML, Khosla S (2004) Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res 19:1945–1954PubMedCrossRef
8.
Mazess RB, Barden HS, Drinka PJ, Bauwens SF, Orwoll ES, Bell NH (1990) Influence of age and body weight on spine and femur bone mineral density in U.S. white men. J Bone Miner Res 5:645–652PubMedCrossRef
9.
Christiansen C (1994) Postmenopausal bone loss and the risk of osteoporosis. Osteoporos Int 4(Suppl 1):47–51PubMedCrossRef
10.
Melton LJ 3rd, Atkinson EJ, O’Connor MK, O’Fallon WM, Riggs BL (2000) Determinants of bone loss from the femoral neck in women of different ages. J Bone Miner Res 15:24–31PubMedCrossRef
11.
LeBlanc ES, Nielson CM, Marshall LM, Lapidus JA, Barrett-Connor E, Ensrud KE, Hoffman AR, Laughlin G, Ohlsson C, Orwoll ES, Osteoporotic Fractures in Men Study G (2009) The effects of serum testosterone, estradiol, and sex hormone binding globulin levels on fracture risk in older men. J Clin Endocrinol Metab 94:3337–3346PubMedPubMedCentralCrossRef
12.
Khosla S, Melton LJ 3rd, Atkinson EJ, O’Fallon WM, Klee GG, Riggs BL (1998) Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab 83:2266–2274PubMed
13.
Mosekilde L, Vestergaard P, Rejnmark L (2013) The pathogenesis, treatment and prevention of osteoporosis in men. Drugs 73:15–29PubMedCrossRef
14.
Legrand E, Hedde C, Gallois Y, Degasne I, Boux de Casson F, Mathieu E, Basle MF, Chappard D, Audran M (2001) Osteoporosis in men: a potential role for the sex hormone binding globulin. Bone 29:90–95PubMedCrossRef
15.
Lormeau C, Soudan B, d’Herbomez M, Pigny P, Duquesnoy B, Cortet B (2004) Sex hormone-binding globulin, estradiol, and bone turnover markers in male osteoporosis. Bone 34:933–939PubMedCrossRef
16.
Martinez Diaz-Guerra G, Hawkins F, Rapado A, Ruiz Diaz MA, Diaz-Curiel M (2001) Hormonal and anthropometric predictors of bone mass in healthy elderly men: major effect of sex hormone binding globulin, parathyroid hormone and body weight. Osteoporos Int 12:178–184PubMedCrossRef
17.
Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294:2336–2341PubMedCrossRef
18.
Sodergard R, Backstrom T, Shanbhag V, Carstensen H (1982) Calculation of free and bound fractions of testosterone and estradiol-17 beta to human plasma proteins at body temperature. J Steroid Biochem 16:801–810PubMedCrossRef
19.
Wetmore JB, Palsson R, Belmont JM, Sigurdsson G, Franzson L, Indridason OS (2010) Discrepancies between creatinine- and cystatin C-based equations: implications for identification of chronic kidney disease in the general population. Scand J Urol Nephrol 44:242–250PubMedCrossRef
20.
Siggeirsdottir K, Aspelund T, Jonsson BY, Mogensen B, Gudmundsson EF, Gudnason V, Sigurdsson G (2014) Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989-2008. Osteoporos Int 25:211–219PubMedCrossRef
21.
Warming L, Hassager C, Christiansen C (2002) Changes in bone mineral density with age in men and women: a longitudinal study. Osteoporos Int 13:105–112PubMedCrossRef
22.
Liu G, Peacock M, Eilam O, Dorulla G, Braunstein E, Johnston CC (1997) Effect of osteoarthritis in the lumbar spine and hip on bone mineral density and diagnosis of osteoporosis in elderly men and women. Osteoporos Int 7:564–569PubMedCrossRef
23.
Szulc P, Marchand F, Duboeuf F, Delmas PD (2000) Cross-sectional assessment of age-related bone loss in men: the MINOS study. Bone 26:123–129PubMedCrossRef
24.
Sigurdsson G, Halldorsson BV, Styrkarsdottir U, Kristjansson K, Stefansson K (2008) Impact of genetics on low bone mass in adults. J Bone Miner Res 23:1584–1590PubMedCrossRef
25.
Lanyon L, Skerry T (2001) Postmenopausal osteoporosis as a failure of bone’s adaptation to functional loading: a hypothesis. J Bone Miner Res 16:1937–1947PubMedCrossRef
26.
Lopes RF, Ferreira SA, Coeli CM, Farias ML (2009) Low body mass index and declining sex steroids explain most age-related bone loss in Brazilian men. Osteoporos Int 20:1175–1182PubMedCrossRef
27.
Garnero P, Sornay-Rendu E, Delmas PD (2000) Low serum IGF-1 and occurrence of osteoporotic fractures in postmenopausal women. Lancet 355:898–899PubMedCrossRef
28.
Szulc P, Joly-Pharaboz MO, Marchand F, Delmas PD (2004) Insulin-like growth factor I is a determinant of hip bone mineral density in men less than 60 years of age: MINOS study. Calcif Tissue Int 74:322–329
29.
Ayus JC, Negri AL, Kalantar-Zadeh K, Moritz ML (2012) Is chronic hyponatremia a novel risk factor for hip fracture in the elderly? Nephrol Dial Transplant Off Publ Eur Dial Transplant Assoc Eur Ren Assoc 27:3725–3731
30.
Hoorn EJ, Rivadeneira F, van Meurs JB, Ziere G, Stricker BH, Hofman A, Pols HA, Zietse R, Uitterlinden AG, Zillikens MC (2011) Mild hyponatremia as a risk factor for fractures: the Rotterdam Study. J Bone Miner Res Off J Am Soc Bone Miner Res 26:1822–1828CrossRef
31.
Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670–676
32.
Gudmundsdottir SL, Oskarsdottir D, Indridason OS, Franzson L, Sigurdsson G (2010) Risk factors for bone loss in the hip of 75-year-old women: a 4-year follow-up study. Maturitas 67:256–261PubMedCrossRef
33.
Uusi-Rasi K, Sievanen H, Pasanen M, Oja P, Vuori I (2001) Maintenance of body weight, physical activity and calcium intake helps preserve bone mass in elderly women. Osteoporos Int 12:373–379PubMedCrossRef
34.
Emaus N, Wilsgaard T, Ahmed LA (2014) Impacts of body mass index, physical activity, and smoking on femoral bone loss. The Tromso study. J Bone Miner Res
Metadata
Title
Gender comparison of factors associated with age-related differences in bone mineral density
Publication date
01-12-2015
Published in
Archives of Osteoporosis / Issue 1/2015
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-015-0214-7

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