Influence of obesity on vertebral fracture prevalence and vitamin D status in postmenopausal women

Abstract

BackgroundIt is well established that weight is an important determinant of bone health. Whereas obesity is associated with increased mortality and morbidity from diabetes and cardiovascular diseases, high body weight is widely believed to be associated to hypovitaminosis D and protective against the development of osteoporosis and fracture risk. The objective of the study was to evaluate the effect of BMI on vitamin D status and on densitometric vertebral fractures (VFs) in a large series of asymptomatic women aged over 50 who had a VFA examination during their bone mineral density (BMD) testing.MethodsWe enrolled 429 postmenopausal women (mean age, weight and BMI of 59.5 ± 8.3 (50 to 83) years, 75.8 ± 13.3 (35 to 165) kgs and 29.9 ± 5.2 (14.6 to 50.8) kg/m2, respectively. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy densitometer. VFs were defined using the Genant semiquantitative (SQ) approach. Clinical risk factors of osteoporosis were collected and 25-hydroxivitamin D was measured using electrochimiluminescence (Roche).ResultsPrevalence of osteoporosis and hypovitaminosis D (<20 ng/ml) was 21.0 % and 78.1 % respectively. VFs grade 2/3were identified in 76 (17.7 %). Comparison between women according to their BMI showed that obese women had a higher BMD and less proportion of women with osteoporosis and VFs grade 2/3 than lean and overweight women. The prevalence of VFs globally increased with age and as BMI and BMD declined. Stepwise regression analysis showed that the presence of osteoporosis was independently related to BMI and history of fractures while the presence of grade 2/3 VFs was independently related to age, hypovitaminosis D and years of menopause.ConclusionObese women had a higher BMD and lower prevalence of VFs. VFs were significantly related to age, hypovitaminosis D and years since menopause. However, among obese women, prevalence of VFs was increased in osteoporotic women.

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

“…A lower trend was detected in Palestinians with a FRAX of major osteoporotic and hip fractures of 3.7%, and 0.3% respectively [27]. Furthermore, OP was an independent risk factor for asymptomatic vertebral fractures in Moroccan postmenopausal women [33,120]. In addition, prevalence of vertebral fractures in apparently healthy Lebanese subjects was estimated at 19.9% in women and 12% in men.…”

“…The prevalence of OP in postmenopausal women in rural areas of Upper Egypt was higher reaching 47.8% [31]. Prevalence of OP in Moroccan postmenopausal women varied from 21-31% [32,33] being slightly higher (35.8%) among Algerian women [34]. In Tunis, 25% of postmenopausal women had OP [35] and a comparable prevalence (23.3%) was found in healthy Tunisian women [36].…”

“…Data indicated that overweight and obesity are associated with BMD [32,58,66], and decreased the risk for OP [16]. Comparison between postmenopausal women according to their BMI showed that obese women had a higher BMD and lower prevalence of vertebral fractures [33,75]. Physical inactivity and low BMI are major risk factors of low BMD in both women and men [13,43,56,57,65,76].…”

Bioimpedance analysis vs. DEXA as a screening tool for osteosarcopenia in lean, overweight and obese Caucasian postmenopausal females

“…Of note, subjects with normal bone density demonstrated increased BMI, FM in kgs and as BW %, by both BIA-ACC ® and DEXA, when compared with the other two groups, indicating a possibly protective role of obesity and increased body weight in osteoporosis development, in accordance with other studies. 29,30 Increased weight-related changes in body composition, metabolic and hormonal factors or the observed decline in physical activity might provide pathophysiologic mechanisms for populations prone to gain fat mass and lose muscle and bone mass. 31 However, the relation of obesity with osteoporosis has been questioned and several studies have supported an aggravating role of obesity in osteoporosis.…”

Obesity and fragility fractures

“…Maghraoui ve ark. 47 göre osteoporotik obez ve nonobez kadınlar arasında vertebra kırığı sıklığı açısından fark bulunmamaktadır. Premaor ve ark.…”