Yonsei Med J.  2010 Nov;51(6):857-863. 10.3349/ymj.2010.51.6.857.

Relation between Obesity and Bone Mineral Density and Vertebral Fractures in Korean Postmenopausal Women

• Kim KC
• Shin DH
• Lee SY
• Im JA
• Lee DC

• KMID: 1779631
• DOI: http://doi.org/10.3349/ymj.2010.51.6.857

Abstract

PURPOSE
The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture.
MATERIALS AND METHODS
A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured.
RESULTS
After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p < 0.001) whereas body weight was still positively related to BMD of all sites (p < 0.001). Percentage body fat and waist circumference were much higher in the fracture group than the non-fracture group (p = 0.0383, 0.082 respectively). Serum glucose levels were postively correlated to lumbar BMD (p = 0.016), femoral neck BMD (p = 0.0335), and femoral trochanter BMD (p = 0.0082). Serum high density lipoprotein cholesterol (HDLC) was positively related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011).
CONCLUSION
In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.

Keyword

Obesity; metabolic syndrome; bone mineral density; vertebral fracture

MeSH Terms

Aged
Blood Glucose/metabolism
Body Composition
Body Mass Index
Body Weight
*Bone Density
Female
Humans
Middle Aged
Obesity/*complications/diagnosis
Overweight
*Postmenopause
Republic of Korea
Risk Factors
Spinal Fractures/*complications/diagnosis

Figure

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  Fig. 1 Odds ratios of vertebral fractures according to adiposity variables. All variables are adjusted for age, smoking status, alcohol consumption, total calcium intake, total energy expenditure, and total calorie intake and variable of Wt (kg) and BMI are additionally adjusted by body fat (%), whereas variable of body fat (%) and waist (cm) are adjusted by Wt (kg), respectively. BMI: body mass indices.

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