Korean J Community Nutr.  2016 Jun;21(3):284-292. 10.5720/kjcn.2016.21.3.284.

Relationship between Bone Mineral Density and Bone Metabolic Biochemical Markers and Diet Quality Index-International(DQI-I) in Postmenopausal Obese Women

Affiliations
  • 1Department of Nutrition Services, Wonkwnag University Hospital, Iksan, Korea.
  • 2Department of Food and Nutrition, Wonkwang University, Iksan, Korea. ccha@wku.ac.kr
  • 3Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea.
  • 4Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Korea.

Abstract


OBJECTIVES
This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density.
METHODS
The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than 25 kg/m2 and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed.
RESULTS
Normal weight women were 56.03 ± 3.76 years old and obese women were 58.09 ± 5.13 years old and there was no significant difference in age between the two groups. The T-score of bone mineral density was 0.03 ± 1.06 in normal weight women and -0.60 ± 1.47 in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women (6.09 ± 3.37 ng/mL) compared to obese women in (9.01 ± 4.99 ng/mL) (p<0.05). The total score of diet quality index-international was 70.41±9.34 in normal weight women and 64.93 ± 7.82 in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (β=-0.048, p<0.05), triglyceride (β=-0.005, p<0.05) and HDL-cholesterol (β=0.034, p<0.01), moderation of DQI-I (β=-0.231, p<0.05) affected T-score significantly.
CONCLUSIONS
The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.

Keyword

bone mineral density; bone metabolic markers; diet quality index-international; postmenopausal; obesity

MeSH Terms

Adipose Tissue
Anthropometry
Biomarkers*
Body Mass Index
Bone Density*
Cholesterol
Diet*
Female
Humans
Leptin
Metabolism
Methods
Obesity
Reference Values
Sodium
Triglycerides
Biomarkers
Cholesterol
Leptin
Sodium

Reference

1. Baik I, Shin C. Association of daily sleep duration with obesity, macronutrient intake, and physical activity. Korean J Community Nutr. 2011; 16(3):315–323.
2. Ministry of Health and Welfare and Korea Centers for Disease Control and Prevention. Korea Health Statistics 2014: Korea National Health and Nutrition Examination Survey [KNHANES VI-2] [internet]. 2015. cited 2016 May 01. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
3. Neeland IJ, Turer AT, Ayers CR, Powell-Wiley TM, Vega GL, Farzaneh-Far R. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA. 2012; 308(11):1150–1159.
4. Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem. 2004; 50(9):1511–1525.
5. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004; 89(6):2548–2556.
6. Christenson RH. Biochemical markers of bone metabolism: an overview. Clin Biochem. 1997; 30(8):573–593.
7. Ministry of Health and Welfare and Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey [KNHANES V-1] [internet]. 2012. cited 2016 May 01. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
8. Park JY, Choi MY, Lee SH, Choi YH, Park YK. The association between bone mineral density, bone turnover markers and nutrient intake in pre- and postmenopausal women. Korean J Nutr. 2011; 44(1):29–40.
9. Filip R, Raszewski G. Bone mineral density and bone turnover in relation to serum leptin, alpha-ketoglutarate and sex steroids in overweight and obese postmenopausal women. Clin Endocrinol (Oxf). 2009; 70(2):214–220.
10. Choi YH, Sung CJ. Effects of physiological factors and lifestyles on bone mineral density in postmenopausal women. Korean J Nutr. 2007; 40(6):517–525.
11. Oh HJ, Lim CH, Chung HY, Han KO, Chang HC, Yoon HK. Effect of obesity on BMD in postmenopausal women. Korean J Obes. 2000; 9(2):122–127.
12. Compston JE, Watts NB, Chapurlat R, Cooper C, Boonen S, Greenspan S. Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med. 2011; 124(11):1043–1050.
13. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002; 13(1):3–9.
14. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr. 2003; 133(11):3476–3484.
15. Sipila S, Narici M, Kjaer M, Pollanen E, Atkinson RA, Hansen M. Sex hormones and skeletal muscle weakness. Biogerontology. 2013; 14(3):231–245.
16. Czarkowska-Paczek B, Milczarczyk S. Age-related muscle mass loss. Przegl Lek. 2006; 63(8):658–661.
17. Christenson RH. Biochemical markers of bone metabolism: an overview. Clin Biochem. 1997; 30(8):573–593.
18. Ho-Pham LT, Nguyen ND, Lai TQ, Nguyen TV. Contributions of lean mass and fat mass to bone mineral density: a study in postmenopausal women. BMC Musculoskelet Disord. 2010; DOI: 10.1186/1471-2474-11-59.
19. Ijuin M, Douchi T, Matsuo T, Yamamoto S, Uto H, Nagata Y. Difference in the effects of body composition on bone mineral density between pre- and postmenopausal women. Maturitas. 2002; 43(4):239–244.
20. Reid IR, Ames R, Evans MC, Sharpe S, Gamble G, France JT. Determinants of total body and regional bone mineral density in normal postmenopausal women-a key role for fat mass. J Clin Endocrinol Metab. 1992; 75(1):45–51.
21. Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu T, Li Z. 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):146–154.
22. Park SJ, Ahn YJ, Min HS, Oh KS, Park C, Cho NH. Osteoporosis prevalence of radius and tibia and related factors using multiple bone sites quantitative ultrasound measurement of the Korean health and genome study cohort women. Korean J Community Nutr. 2005; 10(4):536–545.
23. Koo JO, Park SY. Analysis of BMI menopose, blood pressure and dietary habits affecting born mineral density of 30-60 years women. Korean J Community Nutr. 2010; 15(3):403–414.
24. Ducy P, Amling M, Takeda S, Priemel M, Schilling AF, Beil FT. Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell. 2000; 100(2):197–207.
25. Burguera B, Hofbauer LC, Thomas T, Gori F, Evans GL, Khosla S. Leptin reduces ovariectomy-induced bone loss in rats. Endocrinology. 2001; 142(8):3546–3553.
26. Holloway WR, Collier FM, Aitken CJ, Myers DE, Hodge JM, Malakellis M. Leptin inhibits osteoclast generation. J Bone Miner Res. 2002; 17(2):200–209.
27. Lee MY, Kim JH. Comparison of serum insulin, leptin, adiponectin and high sensitivity C-reactive protein levels according to body mass index and their associations in adult women. Korean J Community Nutr. 2011; 16(1):126–135.
28. Yeo JK, Lee SJ, Joo IW, Kim JA, Oh HJ. Age-related changes of serum bone turnover marker (osteocalcin, bone specific alkaline phosphatase and cross-linked C telopeptides of type I collagen) and the relationship with bone mineral density in Korean women. Osteoporosis. 2008; 6(1):43–50.
29. Yang R, Ma X, Pan X, Wang F, Luo Y, Gu C. Serum osteocalcin levels in relation to metabolic syndrome in Chinese postmenopausal women. Menopause. 2013; 20(5):548–553.
30. Bae SJ, Choe JW, Chung YE, Kim BJ, Lee SH, Kim HY. The association between serum osteocalcin levels and metabolic syndrome in Koreans. Osteoporos Int. 2011; 22(11):2837–2846.
31. Zeng FF, Xue WQ, Cao WT, Wu BH, Xie HL, Fan F. Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case-control study. Osteoporos Int. 2014; 25(8):2131–2141.
32. Yamaguchi T, Sugimoto T, Yano S, Yamauchi M, Sowa H, Chen Q. Plasma lipids and osteoporosis in postmenopausal women. Endocr J. 2002; 49(2):211–217.
33. Cui LH, Shin MH, Chung EK, Lee YH, Kweon SS, Park KS. Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea. Osteoporos Int. 2005; 16(12):1975–1981.
34. Luegmayr E, Glantschnig H, Wesolowski GA, Gentile MA, Fisher JE, Rodan GA. Osteoclast formation, survival and morphology are highly dependent on exogenous cholesterol/lipoproteins. Cell Death Differ. 2004; 11:Suppl 1. S108–S118.
35. Parhami F, Demer LL. Arterial calcification in face of osteoporosis in ageing: can we blame oxidized lipids? Curr Opin Lipidol. 1997; 8(5):312–314.
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