Body composition predictors of skeletal integrity in obesity

Abstract

Objective To determine body composition predictors of skeletal integrity in overweight/obese subjects using DXA. We hypothesized that visceral adiposity would be negatively, and lean mass positively, associated with DXA measures of skeletal integrity in obesity. Materials and Methods Our study was IRB approved and HIPAA compliant and written informed consent was obtained. We studied 82 overweight or obese but otherwise healthy premenopausal women and men of similar age who were part of a clinical trial (mean age: 37±10 years, mean BMI: 34±7kg/m2). All subjects underwent DXA of the spine and hip for assessment of bone mineral density (BMD), trabecular bone score (TBS), and hip structural analysis (HSA) and of the whole body for assessment of body composition, including estimated visceral adipose tissue (VAT). Results Sixty-three subjects (77%) had normal BMD and 19 subjects (23%) had osteopenia. There were strong age-, sex-, and BMD-independent positive associations between lean mass and HSA parameters (r=0.50 to r=0.81, p<0.0001), while there was no association with TBS. There were strong age-, sex- and BMD-independent inverse association between total fat and VAT mass and TBS (r= −0.60 and r=−0.72, p<0.0001 for both correlations), while there were no associations with HSA parameters. Conclusion Lean mass is a positive predictor of hip geometry while fat and VAT mass are negative predictors of trabecular microarchitecture in overweight/obese subjects.

The relationship between adiposity, bone density and microarchitecture is maintained in young women irrespective of diabetes status

“…Although the underlying pathophysiology of diabetic osteopathy is complex and multifactorial, there is a growing body of evidence that suggests that the interplay between fat and bone may generally plays an important role in conferring skeletal fragility . Previous studies have reported an inverse association of bone marrow adiposity (BMA) with bone mineral density (BMD) in elderly people with osteoporosis and other metabolic conditions . Several clinical and experimental studies indicate that adipose tissue itself is not functionally uniform, and different adipose depots have distinctive characteristics including adipocytokine production with visceral adipose tissue (VAT) playing an important role in the maintenance of bone health .…”

“…6 Previous studies have reported an inverse association of bone marrow adiposity (BMA) with bone mineral density (BMD) in elderly people with osteoporosis and other metabolic conditions. 7,8 Several clinical and experimental studies indicate that adipose tissue itself is not functionally uniform, and different adipose depots have distinctive characteristics including adipocytokine production 9 with visceral adipose tissue (VAT) playing an important role in the maintenance of bone health. 10,11 Thorough, in vivo assessment of adiposity at multiple sites, including abdominal, total body and bone marrow, requires several methods of imaging and hitherto this has rarely been performed in humans.…”

Artificial Intelligence in the Evaluation of Body Composition

“…Increased VAT was shown to be linked to metabolic derangements including impaired glucose and lipid metabolism, 2,3,5 contributing to cardiometabolic risk and all-cause mortality. 3,6,7 It was also shown to be associated with decreased bone mineral density, 8,9 nonalcoholic fatty liver disease, 10,11 and increased risk of malignancies. [12][13][14] Muscle More recently, body composition studies have increasingly emphasized the importance of muscle mass.…”

Genetically determined vitamin D levels and change in bone density during a weight-loss diet intervention: the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) Trial

“…Body mass has been linked to bone health (1)(2)(3)(4). Weightloss diets have shown metabolic benefits, but the data relating weight loss to bone health are controversial (5).…”