Changes of Central Obesity is the Major Determinant of Influences of Weight Reduction on Bone Mineral Density
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Objectives: Obesity and osteoporosis have been increasing for decades but their relationship to bone mineral density (BMD) and fat mass has not been defined. The aim of this study was to investigate how changes in body composition affect BMD after a weight reduction. Materials and Methods: We reviewed 48 middle-aged obese women who had participated in our diet program and succeeded in reducing their weight. Body composition was measured by the dual-energy X-ray absorptiometry method, and metabolic syndrome was defined as described in the ATP-III guidelines. All differences between baseline and 12 weeks later were expressed as [{12th week data–baseline data}/baseline data×100]. Results: The mean age of the participants was 38.29±10.89 years, and the mean follow-up time was 85 days. The mean body mass index was 31.50±5.19 kg/m^2. Basal BMD decreased with age and increased with weight and appendicular lean mass. In a regression analysis, appendicular lean mass was positively correlated with leg BMD (R^62=0.235, B=0.015, P<0.001) and age (B=-0.002, P=0.046), and appendicular lean mass (B=0.019, P=0.049) was the main determinant of total BMD (R^2=0.272). After weight reduction, the total body BMD change ratio (R^2=0.281) was negatively related to the change of fat mass, trunk fat mass (B=-0.042, P=0.087) and waist circumference (B=-0.108, P=0.014)Conclusions: Our findings suggest that BMD is determined by muscle mass, and that changes in central obesity may also affect BMD.
Abstract
Objectives: Obesity and osteoporosis have been increasing for decades but their relationship to bone mineral density (BMD) and fat mass has not been defined. The aim of this study was to investigate how changes in body composition affect BMD after a weight reduction. Materials and Methods: We reviewed 48 middle-aged obese women who had participated in our diet program and succeeded in reducing their weight. Body composition was measured by the dual-energy X-ray absorptiometry method, and metabolic syndrome was defined as described in the ATP-III guidelines. All differences between baseline and 12 weeks later were expressed as [{12th week data–baseline data}/baseline data×100]. Results: The mean age of the participants was 38.29±10.89 years, and the mean follow-up time was 85 days. The mean body mass index was 31.50±5.19 kg/m^2. Basal BMD decreased with age and increased with weight and appendicular lean mass. In a regression analysis, appendicular lean mass was positively correlated with leg BMD (R^62=0.235, B=0.015, P<0.001) and age (B=-0.002, P=0.046), and appendicular lean mass (B=0.019, P=0.049) was the main determinant of total BMD (R^2=0.272). After weight reduction, the total body BMD change ratio (R^2=0.281) was negatively related to the change of fat mass, trunk fat mass (B=-0.042, P=0.087) and waist circumference (B=-0.108, P=0.014)Conclusions: Our findings suggest that BMD is determined by muscle mass, and that changes in central obesity may also affect BMD.
참고문헌 (36)
- Hannan MT, "Bone mineral density in elderly men and women: results from the Framingham osteoporosis study", J Bone Miner Res, 7(5), pp.547~553 (1992)
- Compston JE, "Effect of diet-induced weight loss on total body bone mass", Clin Sci (Lond), 82(4), pp.429~432 (1992)
- De Laet C, "Body mass index as a predictor of fracture risk: a meta-analysis", Osteoporos Int, 16(11), pp.1330~1338 (2005)
- Holbrook TL, "The association of lifetime weight and weight control patterns with bone mineral density in an adult community", Bone Miner, 20(2), pp.141~149 (1993)
- Beck TJ, "Structural adaptation to changing skeletal load in the progression toward hip fragility: the study of osteoporotic fractures", J Bone Miner Res, 16(6), pp.1108~1119 (2001)
- Faulkner RA, "Regional and total body bone mineral content, bone mineral density, and total body tissue composition in children 8-16 years of age", Calcif Tissue Int, 53(1), pp.7~12 (1993)
- Burr DB, "Muscle strength, bone mass, and agerelated bone loss", J Bone Miner Res, 12(10), pp.1547~1551 (1997)
- Schoenau E, "From mechanostat theory to development of the “Functional Muscle-Bone-Unit”", J Musculoskelet Neuronal Interact, 5(3), pp.232~238 (2005)
- Pang MY, "Reduced hip bone mineral density is related to physical fitness and leg lean mass in ambulatory individuals with chronic stroke", Osteoporos Int, 16(12), pp.1769~1779 (2005)
- Marin RV, "Association between lean mass and handgrip strength with bone mineral density in physically active postmenopausal women", J Clin Densitom, 13(1), pp.96~101 (2010)
- Galvard H, "Differences in body composition between female geriatric hip fracture patients and healthy controls: body fat is more important as explanatory factor for the fracture than body weight and lean body mass", Aging (Milano), 8(4), pp.282~286 (1996)
- Reid IR, "Determinants of total body and regional bone mineral density in normal postmenopausal women--a key role for fat mass", J Clin Endocrinol Metab, 75(1), pp.45~51 (1992)
- Taes YE, "Fat mass is negatively associated with cortical bone size in young healthy male siblings", J Clin Endocrinol Metab, 94(7), pp.2325~2331 (2009)
- Zhao LJ, "Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis", J Bone Miner Res, 23(1), pp.17~29 (2008)
- Hamrick MW, "Leptin and the sympathetic connection of fat to bone", Osteoporos Int, 19(7), pp.905~912 (2008)
- Bjorntorp P, "Metabolic implications of body fat distribution", Diabetes Care, 14(12), pp.1132~1143 (1991)
- Douchi T, "Lean body mass and bone mineral density in physically exercising postmenopausal women", Maturitas, 45(3), pp.185~190 (2003)
- Crespo NC, "Anthropometric and Lifestyle Associations of Bone Mass in Healthy Pre-Menopausal Mexican and Asian American Women", J Immigr Minor Health, 13(1), pp.74~80 (2011)
- Snow-Harter C, "Muscle strength as a predictor of bone mineral density in young women", J Bone Miner Res, 5(6), pp.589~595 (1990)
- Sinaki M, "Relationship between bone mineral density of spine and strength of back extensors in healthy postmenopausal women", Mayo Clin Proc, 61(2), pp.116~122 (1986)
- Stikkelbroeck NM, "Normal bone mineral density and lean body mass, but increased fat mass, in young adult patients with congenital adrenal hyperplasia", J Clin Endocrinol Metab, 88(3), pp.1036~1042 (2003)
- Kim CJ, "Relationship between body composition and bone mineral density (BMD) in perimenopausal Korean women", Clin Endocrinol (Oxf), 71(1), pp.18~26 (2009)
- Yamaguchi T, "Associations between components of the metabolic syndrome versus bone mineral density and vertebral fractures in patients with type 2 diabetes", Bone, 45(2), pp.174~179 (2009)
- Gilsanz V, "Reciprocal relations of subcutaneous and visceral fat to bone structure and strength", J Clin Endocrinol Metab, 94(9), pp.3387~3393 (2009)
- Douchi T, "The effect of body composition on bone density in pre-and postmenopausal women", Maturitas, 27(1), pp.55~60 (1997)
- Hsu YH, "Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women", Am J Clin Nutr, 83(1), pp.146~154 (2006)
- Zhao LJ, "Relationship of obesity with osteoporosis", J Clin Endocrinol Metab, 92(5), pp.1640~1646 (2007)
- Ryan AS, "Regional bone mineral density after resistive training in young and older men and women", Scand J Med Sci Sports, 14(1), pp.16~23 (2004)
- Uusi-Rasi K, "Influence of weight reduction on muscle performance and bone mass, structure and metabolism in obese premenopausal women", J Musculoskelet Neuronal Interact, 9(2), pp.72~80 (2009)
- Daly RM, "Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes", Osteoporos Int, 16(12), pp.1703~1712 (2005)
- Elefteriou F, "Serum leptin level is a regulator of bone mass", Proc Natl Acad Sci USA, 101(9), pp.3258~3263 (2004)
- Fontana L, "Visceral fat adipokine secretion is associated with systemic inflammation in obese humans", Diabetes, 56(4), pp.1010~1013 (2007)
- Pou KM, "Visceral and subcutaneous adipose tissue volumes are crosssectionally related to markers of inflammation and oxidative stress: the Framingham Heart Study", Circulation, 116(11), pp.1234~1241 (2007)
- Cartier A, "Visceral obesity and plasma glucose-insulin homeostasis: contributions of interleukin-6 and tumor necrosis factor-alpha in men", J Clin Endocrinol Metab, 93(5), pp.1931~1938 (2008)
- Hwang DK, "The relationship between low bone mass and metabolic syndrome in Korean women", Osteoporos Int, 21(3), pp.425~431 (2010)
- Holmberg-Marttila D, "Changes in bone mineral density during pregnancy and postpartum: prospective data on five women", Osteoporos Int, 10(1), pp.41~46 (1999)