In Elderly Women Weight is the Best Predictor of a Very Low Bone Mineral Density: Evidence from the EPIDOS Study

Dargent-Molina, Patricia; Poitiers, Franck; Breart, Gérard

doi:10.1007/s001980070048

Cited by 97 publications

(41 citation statements)

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“…There is more consistent evidence regarding the positive association between depressive symptoms and abdominal or centralized obesity as measured by waist-hip-ratio [60,61]. Body weight is positively associated with BMD [62] and is thought to preserve BMD by two mechanisms: first, synthesis of estrogen in adipose cells [63], which in turn promotes bone formation [35,49], and second, through providing physical resistance to skeletal movement, which stimulates osteoblast activity [36]. The centralization of body weight is associated with alterations in markers of HPA axis and SNS dysregulation [64,65].…”

Section: Behaviorsmentioning

confidence: 99%

Depression and osteoporosis: epidemiology and potential mediating pathways

2007

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Introduction-There have been numerous studies examining the association between depression and bone mineral density (BMD), but the underlying nature of this relationship remains unclear. Independent of this association, there is a growing body of evidence that depression impacts the risk for fracture in older adults. This article reviews the current epidemiological evidence regarding comorbidity of depression, low bone mineral density, and fracture.

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Section: Behaviorsmentioning

confidence: 99%

Depression and osteoporosis: epidemiology and potential mediating pathways

2007

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“…11 In this study, we selected 5 established clinical risk factors for hip fracture that we expected would be easy to ascertain and prevalent among elderly women. 4,5,9,[12][13][14] By combining only 4 of these factors and creating risk indices, we aimed to facilitate risk factor assessment during routine consultations. The goal of our study was to develop and validate a practical tool for hip fracture risk assessment and assess its ability to predict fractures and total mortality.…”

Section: Introductionmentioning

confidence: 99%

Validation of a 4-Item Score Predicting Hip Fracture and Mortality Risk Among Elderly Women

Albertsson

Mellström²,

Petersson³

et al. 2007

The Annals of Family Medicine

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PURPOSE One in 4 Swedish women experiences a hip fracture, an event that has high concomitant morbidity and mortality. We developed and validated a clinical predictor of fracture and mortality risk, the Fracture and Mortality (FRAMO) Index. METHODSThis was a population-based prospective cohort study with a baseline questionnaire and 2-year outcomes of hip fracture, fragility fracture, and death. The questionnaire was sent to 1,498 women aged 70 years or older in 3 rural populations, asking them about their age, weight, height, mobility, previous fractures, smoking, medication use, and housing. Some women were also asked about previous vertebral radiographs. We defi ned 2 risk models before outcome data collection and subsequently renamed 1 model (age ≥80 years, weight <60 kg, previous fragility fracture, and the need to use arms to rise from the sitting position) the FRAMO Index. We used logistic regression analysis to study the association between the FRAMO Index and outcomes in all participants. RESULTSThe participation rate was 83% in this elderly female population (N = 1,248). The 63% of women with 0 to 1 risk factor had a 2-year hip fracture risk of 0.8% and mortality risk of 3.2%. In contrast, women with 2 to 4 risk factors had a 2-year hip fracture risk of 5.4% (odds ratio = 7.5; 95% confi dence interval, 3.0-18.4) and mortality risk of 23.7% (odds ratio = 9.5; 95% confi dence interval, 6.0-14.9). These differences remained signifi cant after adjustment for age as a continuous variable. Mortality increased with the number of risk factors. The proportion of women reporting previous vertebral fractures was higher among the group specifi cally questioned about vertebral radiographs (P <.001).CONCLUSIONS The FRAMO Index identifi ed the majority of women who experienced hip fractures during a 2-year follow-up, who might have been candidates for intensifi ed preventive measures. The FRAMO Index, based on 4 binary risk factors, would be practical for routine use in primary care. 2007;5:48-56. DOI: 10.1370/afm.602. Ann Fam Med INTRODUCTIONH ip fracture is an increasing problem worldwide.1 One in 4 Swedish women (23%) experiences a hip fracture during her lifetime, an event that is associated with 20% mortality within 1 year. 2,3 There are several methods for fracture prevention, although they are underused in routine health care.Combinations of low bone mineral density (BMD) with certain clinical risk factors are associated with an increased risk of hip fracture, 4-8 but low BMD alone is less predictive of fracture. 4,9,10 Many individuals who have an elevated risk of hip fracture might be identifi ed by clinical risk factors alone. 4,5,11 Previously described risk factor models for hip fracture are fairly complicated, requiring several weighted variables. Six clinical risk factors (2 weighted) and BMD assessment predicted fractures in the PR EDIC T ING HIP FR AC T UR EStudy of Osteoporotic Fractures (SOF), and this risk factor combination was validated in another elderly community-based female populatio...

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“…The inverse association between body weight (or BMI) and bone turnover markers has been reported by others (22)(23)(24) . A number of studies have also shown that low body weight is a major predictor of bone mineral density and bone loss of the elderly (21,25,26) and that this association may be mediated by increased bone turnover.…”

Section: Discussionmentioning

confidence: 99%

Low calcium intake is associated with increased bone resorption in postmenopausal Japanese women: Yokogoshi Study

Nakamura

Saito

Yoshihara

et al. 2009

Public Health Nutr.

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Objective: Low Ca intake is common among Japanese women, but its effect on bone metabolism has not been fully elucidated. The aim of the present study was to determine the relationship between Ca intake and serum markers of bone turnover in postmenopausal Japanese women. Design: A cross-sectional study. Setting: A community setting. Subjects: Subjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ. Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed. Results: The average age of the subjects was 64?5 (SD 5?8) years and the mean Ca intake was 527 (SD 160) mg/d. Ca intake was significantly associated with serum NTX (P 5 0?0104), but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (,417 mg/d) was significantly higher than in the fourth, referent quartile. Among these Japanese postmenopausal women, very low Ca intake (less than ,400 mg/d) was associated with increased bone resorption but not bone formation. Conclusions: Increased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

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In Elderly Women Weight is the Best Predictor of a Very Low Bone Mineral Density: Evidence from the EPIDOS Study

Cited by 97 publications

References 0 publications

Depression and osteoporosis: epidemiology and potential mediating pathways

Depression and osteoporosis: epidemiology and potential mediating pathways

Validation of a 4-Item Score Predicting Hip Fracture and Mortality Risk Among Elderly Women

Low calcium intake is associated with increased bone resorption in postmenopausal Japanese women: Yokogoshi Study

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