Association Between Forearm Bone Mineral Density and Metabolic Obesity in a Northern Chinese Population

Abstract

Context: The link between obesity and bone health is controversial. Most studies classify obesity based on body mass index. However, differences in metabolic status may affect bone health. Purpose: To explore the potential relationship of metabolic obesity with forearm bone mineral density (BMD) in a northern Chinese population. Methods: This is a retrospective study involving a total of 2122 subjects divided into four groups: a metabolically healthy normal-weight (MHNW) group, a metabolically healthy obesity (MHO) group, a metabolically unhealthy, but normal-weight (MUNW) group, and a metabolically unhealthy obesity (MUO) group. Analysis of covariance was performed to compare forearm BMD among the groups. The covariates included age, weight, and height, along with menopause status in women. Partial correlation analysis and multiple linear regression models were used to explore the associations of forearm BMD with clinical parameters. Results: Young middle-aged men with MHO had significantly higher forearm BMD than those in the MUO group. In addition, forearm BMD of young middle-aged women was higher in the MHNW group than in the MUNW group. Partial correlation analysis and multiple linear regression analysis suggested that homeostasis model assessment of insulin resistance (HOMA-IR) was negatively correlated with forearm BMD in young middle-aged male subjects with MUO, and waist circumference (WC) and low-density lipoprotein cholesterol (LDL-C) showed a significant negative relationship with forearm BMD in young middle-aged female MUNW subjects. Conclusions: Men in the MUO group and women in the MUNW group were more likely to have lower forearm BMD if they were of young middle age. Metabolic obesity could be a better method for defining obesity when exploring the relationship between obesity and bone health in Chinese individuals. WC, LDL-C, and insulin resistance might be negative predictors of bone health.

Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis

“…Radius aBMD by DXA . Radius aBMD measured by DXA was available in 16 studies [ 21 , 58 , 69 , 70 , 73 , 75 , 102 , 106 , 110 , 121 , 124 , 138 , 145 , 165 , 178 , 179 ], including 10,008 participants. Obesity was associated with higher aBMD at the radius in postmenopausal women (n = 6: MD = 0.07 g/cm 2 , 95% CI: 0.05, 0.08, P<0.00001, I 2 = 65%), premenopausal women (n = 10: MD = 0.03 g/cm 2 , 95% CI: 0.02, 0.04, P<0.00001, I 2 = 84%) and men (n = 2: MD = 0.02 g/cm 2 , 95% CI: 0.01, 0.03, P<0.00001, I 2 = 0%) ( S4 Fig ).…”

The Impact of Metabolic Syndrome on Bone Mass in Men: Systematic Review and Meta-Analysis

“…Wang et al [48] examined the relationship between metabolic obesity and forearm bone mineral density (BMD) in a general Chinese population divided into four groups: a metabolically healthy group with normal body weight, a metabolically healthy group with obesity, a metabolically unhealthy group with normal weight, and a metabolically unhealthy obese group. Men in the metabolically healthy obese group and women in the metabolically healthy normal-weight group were more likely to have lower forearm BMD at a younger middle age.…”