Is age or the body mass index (BMI) more determinant of the bone mineral density (BMD) in geriatric women and men?

Doğan, Asuman; Nakipoğlu-Yüzer, Güldal Funda; Yıldızgören, Mustafa Turgut; Özgirgin, Neşe

doi:10.1016/j.archger.2010.01.015

Cited by 30 publications

(33 citation statements)

References 24 publications

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“…The stronger effect of BMI on BMD in older compared with younger adults is not easily explained but was also observed by others . One could assume that comorbidities that are not present in younger age groups could be confounding the BMI‐BMD relationship in older age, although this theory is not supported by all . Being slim is a well‐established and important risk factor for osteoporosis and osteoporotic fractures in both sexes .…”

Section: Discussionmentioning

confidence: 86%

“…(32) One could assume that comorbidities that are not present in younger age groups could be confounding the BMI-BMD relationship in older age, although this theory is not supported by all. (33) Being slim is a well-established and important risk factor for osteoporosis and osteoporotic fractures in both sexes. (6) Interestingly, BMI ¼ 18 kg/m 2 was associated with low BMD in all lifestyle profiles included in the present analyses.…”

Section: Discussionmentioning

confidence: 99%

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Impacts of Body Mass Index, Physical Activity, and Smoking on Femoral Bone Loss: The Tromsø Study

Emaus

Wilsgaard

Ahmed

2014

Journal of Bone and Mineral Research

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Bone mineral density (BMD) is a reflection of bone strength and lifestyles that preserve bone mass and may reduce fracture risk in old age. This study examined the effect of combined profiles of smoking, physical activity, and body mass index (BMI) on lifetime bone loss. Data were collected from the population-based Tromsø Study. BMD was measured as g/cm 2 by dual-energy X-ray absorptiometry (DXA) at the total hip and femoral neck in 2580 women and 2084 men aged 30 to 80 years in the 2001-02 survey, and repeated in 1401 women and 1113 men in the 2007-08 survey. Height and weight were measured and lifestyle information was collected through questionnaires. Data were analyzed using linear mixed models with second-degree fractional polynomials. From the peak at the age around 40 years to 80 years of age, loss rates varied between 4% at the total hip and 14% at femoral neck in nonsmoking, physically active men with a BMI of 30 kg/m 2 to approximately 30% at both femoral sites in heavy smoking, physically inactive men with a BMI value of 18 kg/m 2 . In women also, loss rates of more than 30% were estimated in the lifestyle groups with a BMI value of 18 kg/m 2 . BMI had the strongest effect on BMD, especially in the oldest age groups, but a BMI above 30 kg/m 2 did not exert any additional effect compared with the population average BMI of 27 kg/m 2 . At the age of 80 years, a lifestyle of moderate BMI to light overweight, smoking avoidance, and physical activity of 4 hours of vigorous activity per week through adult life may result in 1 to 2 standard deviations higher BMD levels compared with a lifestyle marked by heavy smoking, inactivity, and low weight. In the prevention of osteoporosis and fracture risk, the effect of combined lifestyles through adult life should be highlighted.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Impacts of Body Mass Index, Physical Activity, and Smoking on Femoral Bone Loss: The Tromsø Study

Emaus

Wilsgaard

Ahmed

2014

Journal of Bone and Mineral Research

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“…Figure 8 offers a visual representation of femoral neck cross-sectional geometry in normal (Kaptoge et al, 2003;Rivadeneira et al, 2007;Zhang et al, 2011). A similar pattern has been documented in females; overweight and obese females maintain higher bone mineral density, greater cortical area, and stronger bones than normal BMI females regardless of age (Warming et al, 2002;Beck et al, 2009;Do gan et al, 2010). The greater cortical area in obese males in the >50 age group may imply that cortical bone is deposited on the endosteal surface to achieve greater strength or that less cortical bone is resorbed from the endosteal surface compared to normal BMI individuals.…”

Section: Discussionmentioning

confidence: 59%

“…With the rise of obesity in the American population the effect of excess body weight on the skeletal system has become an area of research interest (Beck et al, 2009;Iwaniec et al, 2009;Moore, 2009;Do gan et al 2010;Moore and Schaefer, 2011;El Hage, 2012;Reeves, 2014Reeves, , 2015. Rest periods between load-bearing activities are important for proper ossification (Turner, 2007); however, increased body weight acts as a chronic load on the skeletal system.…”

Section: Introductionmentioning

confidence: 99%

“…Recent research suggests that obesity significantly affects skeletal morphology and the biomechanical properties of bones. Long bone diaphyses of loadbearing elements increase in cross-sectional area, robusticity, and strength, and bone mineral density is higher in obese individuals (Warming et al, 2002;Beck et al, 2009;Do gan et al, 2010;Reeves, 2014Reeves, , 2015. On the other hand, articular dimensions of bones do not differ significantly between obese and normal BMI groups (Lieberman et al, 2003;Auerbach and Ruff, 2004 ;Reeves, 2014).…”

Section: Introductionmentioning

confidence: 99%

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The effects of body mass index and age on cross‐sectional properties of the femoral neck

2015

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Research on the relationship between body mass index (BMI) and cross-sectional geometry of long bone diaphyses demonstrates that strength properties are significantly greater in obese versus normal BMI individuals. However, articular dimensions do not differ appreciably. If femoral head size remains constant, we hypothesize that the femoral neck remodels to accommodate greater loads associated with increased BMI. High-resolution CT scans (n = 170 males) were divided into three BMI groups (normal, overweight, and obese) and two age groups (21-50 and >50). OsiriX software was used to obtain a cross-sectional slice at the waist of the femoral neck. Cortical area (CA), total cross-sectional area (TA), percent cortical area (%CA), circularity index (Imax /Imin ), section modulus (Zpol ), and second moment of area (J) were measured with ImageJ software. The effects of age and BMI were evaluated statistically. Pairwise comparisons in the younger group only detected significant differences between normal and obese males in the circularity index (P = 0.022). The older cohort showed significant differences in CA (P < 0.001), %CA (P = 0.004), Zpol (P = 0.007), and J (P < 0.001) between normal and obese groups. This study shows that the effects of obesity on the cross-sectional geometry of the femoral neck are more pronounced in older males relative to younger males. Older males with increased BMI have greater cortical area and bone strength in the femoral neck relative to younger males, thus making the femoral neck less susceptible to fractures in obese individuals.

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Bone Density, Microstructure and Strength in Obese and Normal Weight Men and Women in Younger and Older Adulthood

Evans

Paggiosi

Eastell

et al. 2014

Journal of Bone and Mineral Research

213

152

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Obesity is associated with greater areal BMD (aBMD) and is considered protective against hip and vertebral fracture. Despite this, there is a higher prevalence of lower leg and proximal humerus fracture in obesity. We aimed to determine if there are site-specific differences in BMD, bone structure, or bone strength between obese and normal-weight adults. We studied 100 individuallymatched pairs of normal (body mass index [BMI] 18.5 to 24.9 kg/m 2 ) and obese (BMI >30 kg/m 2 ) men and women, aged 25 to 40 years or 55 to 75 years. We assessed aBMD at the whole body (WB), hip (TH), and lumbar spine (LS) with dual-energy X-ray absorptiometry (DXA), LS trabecular volumetric BMD (Tb.vBMD) by quantitative computed tomography (QCT), and vBMD and microarchitecture and strength at the distal radius and tibia with high-resolution peripheral QCT (HR-pQCT) and micro-finite element analysis. Serum type 1 procollagen N-terminal peptide (P1NP) and collagen type 1 C-telopeptide (CTX) were measured by automated electrochemiluminescent immunoassay (ECLIA). Obese adults had greater WB, LS, and TH aBMD than normal adults. The effect of obesity on LS and WB aBMD was greater in older than younger adults (p < 0.01). Obese adults had greater vBMD than normal adults at the tibia (p < 0.001 both ages) and radius (p < 0.001 older group), thicker cortices, higher cortical BMD and tissue mineral density, lower cortical porosity, higher trabecular BMD, and higher trabecular number than normal adults. There was no difference in bone size between obese and normal adults. Obese adults had greater estimated failure load at the radius (p < 0.05) and tibia (p < 0.01). Differences in HR-pQCT measurements between obese and normal adults were seen more consistently in the older than the younger group. Bone turnover markers were lower in obese than in normal adults. Greater BMD in obesity is not an artifact of DXA measurement. Obese adults have higher BMD, thicker and denser cortices, and higher trabecular number than normal adults. Greater differences between obese and normal adults in the older group suggest that obesity may protect against age-related bone loss and may increase peak bone mass.

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Is age or the body mass index (BMI) more determinant of the bone mineral density (BMD) in geriatric women and men?

Cited by 30 publications

References 24 publications

Impacts of Body Mass Index, Physical Activity, and Smoking on Femoral Bone Loss: The Tromsø Study

Impacts of Body Mass Index, Physical Activity, and Smoking on Femoral Bone Loss: The Tromsø Study

The effects of body mass index and age on cross‐sectional properties of the femoral neck

Bone Density, Microstructure and Strength in Obese and Normal Weight Men and Women in Younger and Older Adulthood

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