What Is the Influence of Weight Change on Forearm Bone Mineral Density in Peri- and Postmenopausal Women? The Health Study of Nord-Trøndelag, Norway

Abstract

Weight loss in the elderly increases bone loss and the risk of fractures, especially at the hip and spine. The influence of weight change on non-weight-bearing parts of the skeleton is less well known. The purpose of this study was to investigate an association between weight change during the peri- and postmenopausal years and forearm bone mineral density (BMD). Among 8,856 women aged 45-60 years attending the first Health Study of Nord-Trøndelag, Norway (HUNT I, 1984-1986), a random sample of 2,795 women was invited to forearm densitometry (single x-ray absorptiometry technology) at HUNT II (1995-1997), after a mean period of 11.3 years. A total of 2,005 women (mean age: 65.1 years) were eligible. The mean weight had increased 3.4 kg; the gain was greater in the youngest women. A total of 382 women (19.1%) had lost and 1,331 women (66.3%) had gained weight. Weight change explained little of the BMD variance, 0.7% and 0.4% for weight loss and weight gain, respectively. Weight loss was an independent and statistically significant negative predictor of BMD, adjusted for body weight, age, age at menopause, smoking, and ovarian hormone treatment, particularly among women with a baseline body mass index greater than 25 kg/m2. No independent association between weight gain and forearm BMD was found.

Weight loss and distal forearm fractures in postmenopausal women

“…A recent publication from our cohort showed that weight loss during the perimenopausal and postmenopausal years adversely affected forearm BMD [17], and this has also been supported by another study [18]. Moreover, corresponding associations between weight change and hip BMD or spine BMD have also been shown [18,19].…”

“…Scans of the non-dominant forearm were performed by three bone densitometers of the same type (DTX-100; Osteometer MediTech Inc., Hawthorne, CA, USA). Quality assessments, participation rates, and densitometry procedure have been described in detail elsewhere [17,26]. A total of 5,688 women had valid distal forearm BMD; whereas, 5,686 had valid ultradistal radius BMD.…”

Circulating adiponectin represents a biomarker of the association between adiposity and bone mineral density

“…Our study consisted of a postmenopausal group, while the aferomentioned studies either investigated a wide age range (18-81 years old) women or a mixed womenand-men study population. The different study populations may partially explain the inconsistent findings of our results, since in postmenopausal women, no independent association between weight gain and forearm BMD was found [35]. Moreover, during perimenopausal period, in general, radius is metabolically less active compared to trabecular bone.…”

Excess mortality after hip fracture among elderly women in Norway

“…All sites for measurement were manually controlled and corrected, and data were adjusted according to correction factors derived from a cross-calibration study of the three units. The densitometry procedure and quality assessments have been described in detail previously [16][17][18].…”