Relationship between Body Composition and Osteoporosis among Postmenopausal Women

  • Mandana Gholami Assistant Professor, Department of Physical Education and Athletics, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
  • Neda Ghasem-Bagloo MSc in Sport Physiology, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
  • Hojjatollah Nikbakht Associate Professor, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
  • Fariba Eslamian Associate Professor, Specialist of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Keywords: Osteoporosis; Bone density; Body composition; Women

Abstract

Background: Osteoporosis is a skeletal system disease characterized by decrease in bone mass density. The main outcome of this disease is the increased risk of fracture of the bones in areas tolerating the body weight, including the vertebrae, femurs, and even joints, such as the wrists, that do not tolerate weight. The present study was conducted with the objective to describe the relationship between body composition and osteoporosis among postmenopausal women.

Methods: This cross-sectional study was carried out on 50 postmenopausal women with osteoporosis in the age range of 45-65 years referred to Sina Hospital in Tabriz, Iran. Body mass, fat body mass, lean body mass, and bone density of the spine and femurs were measured. The skin fold thickness (SKF) was assessed using a caliper. Bone density was measured using the Dual Energy X-ray Absorptiometry (DEXA) method in the spinal column and femoral head areas. A multiple regression model was exploited to investigate the relationship between the components of body composition and the spinal bone density of the vertebrae and femurs.

Results: Among the components of body composition, a significant relationship was only observed between lean body mass and femoral neck bone density (P < 0.050, R2 = 0.271) and spine bone density (P < 0.050 and P = 0.088).

Conclusion: The findings of this study suggested that lean body mass was one of the most powerful predictors of osteoporosis. Hence, women at risk of osteoporosis can be identified using this model and earlier preventative and therapeutic measures can be taken. Moreover, additional diagnostic costs for those who are not at risk can be prevented.

References

1. Larijani B, Hossein-Nezhad A, Mojtahedi A, Pajouhi M, Bastanhagh MH, Soltani A, et al. Normative data of bone mineral density in healthy population of Tehran, Iran: A cross sectional study. BMC Musculoskelet Disord 2005; 6: 38.
2. Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993; 94(6): 646-50.
3. Bedayat B. Osteoarthritis and osteoporosis. Tehran, Iran: Tabib Publications; 2005. p. 12-3. [In Persina].
4. Compston JE, McConachie C, Stott C, Hannon RA, Kaptoge S, Debiram I, et al. Changes in bone mineral density, body composition and biochemical markers of bone turnover during weight gain in adolescents with severe anorexia nervosa: A 1-year prospective study. Osteoporos Int 2006; 17(1): 77-84.
5. Hu FB. Overweight and obesity in women: Health risks and consequences. J Womens Health (Larchmt) 2003; 12(2): 163-72.
6. Lanyon LE. Control of bone architecture by functional load bearing. J Bone Miner Res 1992; 7(Suppl 2): S369-S375.
7. Reid IR, Plank LD, Evans MC. Fat mass is an important determinant of whole body bone density in premenopausal women but not in men. J Clin Endocrinol Metab 1992; 75(3): 779-82.
8. Jurimae T, Soot T, Jurimae J. Relationships of anthropometrical parameters and body composition with bone mineral content or density in young women with different levels of physical activity. J Physiol Anthropol Appl Human Sci 2005; 24(6): 579-87.
9. Holbrook TL, Barrett-Connor E. The association of lifetime weight and weight control patterns with bone mineral density in an adult community. Bone Miner 1993; 20(2): 141-9.
10. Gnudi S, Sitta E, Fiumi N. Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass. J Bone Miner Metab 2007; 25(5): 326-32.
11. Slemenda CW, Hui SL, Williams CJ, Christian JC, Meaney FJ, Johnston CC, Jr. Bone mass and anthropometric measurements in adult females. Bone Miner 1990; 11(1): 101-9.
12. Zhao LJ, Liu YJ, Liu PY, Hamilton J, Recker RR, Deng HW. Relationship of obesity with osteoporosis. J Clin Endocrinol Metab 2007; 92(5): 1640-6.
13. Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu T, Li Z, et al. 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 2006; 83(1): 146-54.
14. Weiler HA, Janzen L, Green K, Grabowski J, Seshia MM, Yuen KC. Percent body fat and bone mass in healthy Canadian females 10 to 19 years of age. Bone 2000; 27(2): 203-7.
15. Lazcano-Ponce E, Tamayo J, Cruz-Valdez A, Diaz R, Hernandez B, Del Cueto R, et al. Peak bone mineral area density and determinants among females aged 9 to 24 years in Mexico. Osteoporos Int 2003; 14(7): 539-47.
16. Kim KC, Shin DH, Lee SY, Im JA, Lee DC. Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women. Yonsei Med J 2010; 51(6): 857-63.
17. Rico H, Revilla M, Villa LF, Alvarez del Buergo M, Ruiz-Contreras D. Determinants of total-body and regional bone mineral content and density in postpubertal normal women. Metabolism 1994; 43(2): 263-6.
18. Ellis KJ, Abrams SA, Wong WW. Body composition of a young, multiethnic female population. Am J Clin Nutr 1997; 65(3): 724-31.
19. Bedogni G, Mussi C, Malavolti M, Borghi A, Poli M, Battistini N, et al. Relationship between body composition and bone mineral content in young and elderly women. Ann Hum Biol 2002; 29(5): 559-65.
20. Nichols DL, Sanborn CF, Bonnick SL, Gench B, DiMarco N. Relationship of regional body composition to bone mineral density in college females. Med Sci Sports Exerc 1995; 27(2): 178-82.
21. Robergs R, Roberts S. Fundamental principles of exercise physiology: For fitness, performance and health. Trans. Dabidi Roshan V, Gaeeini AA. 5th ed. Tehran, Iran: SAMT Publications; 2006. [In Persian].
22. Shojaei F. Investigating Mineral Concentration among Female Athletes of Iranian National Team and Comparing it to the Standards of Non-Athletes in Iran and the World [PhD Thesis]. Tehran, Iran: Science and Research Branch, Islamic Azad University; 1997. [In Persian].
23. Gudmundsdottir SL, Oskarsdottir D, Indridason OS, Franzson L, Sigurdsson G. Risk factors for bone loss in the hip of 75-year-old women: A 4-year follow-up study. Maturitas 2010; 67(3): 256-61.
24. Lindsay R, Cosman F, Herrington BS, Himmelstein S. Bone mass and body composition in normal women. J Bone Miner Res 1992; 7(1): 55-63.
25. Kirchengast S, Peterson B, Hauser G, Knogler W. Body composition characteristics are associated with the bone density of the proximal femur end in middle- and old-aged women and men. Maturitas 2001; 39(2): 133-45.
26. Yoo HJ, Park MS, Yang SJ, Kim TN, Lim KI, Kang HJ, et al. The differential relationship between fat mass and bone mineral density by gender and menopausal status. J Bone Miner Metab 2012; 30(1): 47-53.
27. Cui LH, Shin MH, Kweon SS, Park KS, Lee YH, Chung EK, et al. Relative contribution of body composition to bone mineral density at different sites in men and women of South Korea. J Bone Miner Metab 2007; 25(3): 165-71.
28. Lekamwasam S, Weerarathna T, Rodrigo M, Arachchi WK, Munidasa D. Association between bone mineral density, lean mass, and fat mass among healthy middle-aged premenopausal women: A cross-sectional study in southern Sri Lanka. J Bone Miner Metab 2009; 27(1): 83-8.
29. Pasco JA, Henry MJ, Kotowicz MA, Collier GR, Ball MJ, Ugoni AM, et al. Serum leptin levels are associated with bone mass in nonobese women. J Clin Endocrinol Metab 2001; 86(5): 1884-7.
30. Leslie WD, Miller N, Rogala L, Bernstein CN. Body mass and composition affect bone density in recently diagnosed inflammatory bowel disease: The Manitoba IBD Cohort Study. Inflamm Bowel Dis 2009; 15(1): 39-46.
31. Wu F, Ames R, Clearwater J, Evans MC, Gamble G, Reid IR. Prospective 10-year study of the determinants of bone density and bone loss in normal postmenopausal women, including the effect of hormone replacement therapy. Clin Endocrinol (Oxf) 2002; 56(6): 703-11.
32. Yamauchi M, Sugimoto T, Yamaguchi T, Nakaoka D, Kanzawa M, Yano S, et al. Plasma leptin concentrations are associated with bone mineral density and the presence of vertebral fractures in postmenopausal women. Clin Endocrinol (Oxf) 2001; 55(3): 341-7.
33. Kontogianni MD, Dafni UG, Routsias JG, Skopouli FN. Blood leptin and adiponectin as possible mediators of the relation between fat mass and BMD in perimenopausal women. J Bone Miner Res 2004; 19(4): 546-51.
34. Capozza RF, Cointry GR, Cure-Ramirez P, Ferretti JL, Cure-Cure C. A DXA study of muscle-bone relationships in the whole body and limbs of 2512 normal men and pre- and post-menopausal women. Bone 2004; 35(1): 283-95.
35. Di Monaco M, Vallero F, Di Monaco R, Tappero R, Cavanna A. Skeletal muscle mass, fat mass, and hip bone mineral density in elderly women with hip fracture. J Bone Miner Metab 2007; 25(4): 237-42.
36. Elefteriou F, Takeda S, Ebihara K, Magre J, Patano N, Kim CA, et al. Serum leptin level is a regulator of bone mass. Proc Natl Acad Sci USA 2004; 101(9): 3258-63.
37. Cornish J, Reid IR. Effects of amylin and adrenomedullin on the skeleton. J Musculoskelet Neuronal Interact 2001; 2(1): 15-24.
38. Siiteri PK. Adipose tissue as a source of hormones. Am J Clin Nutr 1987; 45(1 Suppl): 277-82.
39. Sherk VD, Palmer IJ, Bemben MG, Bemben DA. Relationships between body composition, muscular strength, and bone mineral density in estrogen-deficient postmenopausal women. J Clin Densitom 2009; 12(3): 292-8.
40. Blum M, Harris SS, Must A, Naumova EN, Phillips SM, Rand WM, et al. Leptin, body composition and bone mineral density in premenopausal women. Calcif Tissue Int 2003; 73(1): 27-32.
41. Rayalam S, Della-Fera MA, Baile CA. Synergism between resveratrol and other phytochemicals: implications for obesity and osteoporosis. Mol Nutr Food Res 2011; 55(8): 1177-85.
42. Russell M, Mendes N, Miller KK, Rosen CJ, Lee H, Klibanski A, et al. Visceral fat is a negative predictor of bone density measures in obese adolescent girls. J Clin Endocrinol Metab 2010; 95(3): 1247-55.
43. Gilsanz V, Chalfant J, Mo AO, Lee DC, Dorey FJ, Mittelman SD. Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab 2009; 94(9): 3387-93.
44. Liu JM, Zhao HY, Ning G, Zhao YJ, Zhang LZ, Sun LH, et al. Relationship between body composition and bone mineral density in healthy young and premenopausal Chinese women. Osteoporos Int 2004; 15(3): 238-42.
45. Sheng Z, Xu K, Ou Y, Dai R, Luo X, Liu S, et al. Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. Clin Endocrinol (Oxf) 2011; 74(3): 319-24.
46. Frost HM. On our age-related bone loss: insights from a new paradigm. J Bone Miner Res 1997; 12(10): 1539-46.
47. Barrett-Connor E. Epidemiology and the menopause: A global overview. Int J Fertil Menopausal Stud 1993; 38(Suppl 1): 6-14.
48. Edelstein SL, Barrett-Connor E. Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 1993; 138(3): 160-9.
Published
2019-06-01
Section
Original Article(s)