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Erschienen in: Osteoporosis International 6/2016

08.02.2016 | Original Article

Changes in bone mineral density over time by body mass index in the health ABC study

verfasst von: J. T. Lloyd, D. E. Alley, M. C. Hochberg, S. R. Waldstein, T. B. Harris, S. B. Kritchevsky, A. V. Schwartz, E. S. Strotmeyer, C. Womack, D. L. Orwig, For the Health ABC Study

Erschienen in: Osteoporosis International | Ausgabe 6/2016

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Abstract

Summary

Obesity appears protective against osteoporosis in cross-sectional studies. However, results from this longitudinal study found that obesity was associated with bone loss over time. Findings underscore the importance of looking at the longitudinal relationship, particularly given the increasing prevalence and duration of obesity among older adults.

Introduction

Cross-sectional studies have found a positive association between body mass index (BMI) and bone mineral density (BMD), but little is known about the longitudinal relationship in US older adults.

Methods

We examined average annual rate of change in BMD by baseline BMI in the Health, Aging, and Body Composition Study. Repeated measurement of BMD was performed with dual-energy X-ray absorptiometry (DXA) at baseline and years 3, 5, 6, 8, and 10. Multivariate generalized estimating equations were used to predict mean BMD (femoral neck, total hip, and whole body) by baseline BMI (excluding underweight), adjusting for covariates.

Results

In the sample (n = 2570), 43 % were overweight and 24 % were obese with a mean baseline femoral neck BMD of 0.743 g/cm2, hip BMD of 0.888 g/cm2, and whole-body BMD of 1.09 g/cm2. Change in total hip or whole-body BMD over time did not vary by BMI groups. However, obese older adults lost 0.003 g/cm2 of femoral neck BMD per year more compared with normal weight older adults (p < 0.001). Femoral neck BMD change over time did not differ between the overweight and normal weight BMI groups (p = 0.74). In year 10, adjusted femoral neck BMD ranged from 0.696 g/cm2 among obese, 0.709 g/cm2 among normal weight, and 0.719 g/cm2 among overweight older adults.

Conclusions

Findings underscore the importance of looking at the longitudinal relationship between body composition and bone mineral density among older adults, indicating that high body mass may not be protective for bone loss over time.
Literatur
1.
Zurück zum Zitat Albala C, Yanez M, Devoto E, Sostin C, Zeballos L, Santos JL (1996) Obesity as a protective factor for postmenopausal osteoporosis. Int J Obes Relat Metab Disord 20:1027–32PubMed Albala C, Yanez M, Devoto E, Sostin C, Zeballos L, Santos JL (1996) Obesity as a protective factor for postmenopausal osteoporosis. Int J Obes Relat Metab Disord 20:1027–32PubMed
2.
Zurück zum Zitat Asomaning K, Bertone-Johnson ER, Nasca PC, Hooven F, Pekow PS (2006) The association between body mass index and osteoporosis in patients referred for a bone mineral density examination. J Womens Health (Larchmt) 15:1028–34CrossRef Asomaning K, Bertone-Johnson ER, Nasca PC, Hooven F, Pekow PS (2006) The association between body mass index and osteoporosis in patients referred for a bone mineral density examination. J Womens Health (Larchmt) 15:1028–34CrossRef
3.
Zurück zum Zitat Beck TJ, Petit MA, Wu G, LeBoff MS, Cauley JA, Chen Z (2009) Does obesity really make the femur stronger? BMD, geometry, and fracture incidence in the Women’s Health Initiative-observational study. J Bone Miner Res 24:1369–79CrossRefPubMedPubMedCentral Beck TJ, Petit MA, Wu G, LeBoff MS, Cauley JA, Chen Z (2009) Does obesity really make the femur stronger? BMD, geometry, and fracture incidence in the Women’s Health Initiative-observational study. J Bone Miner Res 24:1369–79CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Burger H, de Laet CE, van Daele PL, Weel AE, Witteman JC, Hofman A, Pols HA (1998) Risk factors for increased bone loss in an elderly population: the Rotterdam study. Am J Epidemiol 147:871–9CrossRefPubMed Burger H, de Laet CE, van Daele PL, Weel AE, Witteman JC, Hofman A, Pols HA (1998) Risk factors for increased bone loss in an elderly population: the Rotterdam study. Am J Epidemiol 147:871–9CrossRefPubMed
5.
Zurück zum Zitat Holecki M, Chudek J, Titz-Bober M, Wiecek A, Zahorska-Markiewicz B, Dulawa J (2012) Changes of bone mineral density in obese perimenopausal women during 5-year follow-up. Pol Arch Med Wewn 122:139–47PubMed Holecki M, Chudek J, Titz-Bober M, Wiecek A, Zahorska-Markiewicz B, Dulawa J (2012) Changes of bone mineral density in obese perimenopausal women during 5-year follow-up. Pol Arch Med Wewn 122:139–47PubMed
6.
Zurück zum Zitat Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309:691–5CrossRefPubMedPubMedCentral Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309:691–5CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Ribot C, Tremollieres F, Pouilles JM (1994) The effect of obesity on postmenopausal bone loss and the risk of osteoporosis. Adv Nutr Res 9:257–71PubMed Ribot C, Tremollieres F, Pouilles JM (1994) The effect of obesity on postmenopausal bone loss and the risk of osteoporosis. Adv Nutr Res 9:257–71PubMed
8.
Zurück zum Zitat Saarelainen J, Kiviniemi V, Kroger H, Tuppurainen M, Niskanen L, Jurvelin J, Honkanen R (2012) Body mass index and bone loss among postmenopausal women: the 10-year follow-up of the OSTPRE cohort. J Bone Miner Metab 30:208–16CrossRefPubMed Saarelainen J, Kiviniemi V, Kroger H, Tuppurainen M, Niskanen L, Jurvelin J, Honkanen R (2012) Body mass index and bone loss among postmenopausal women: the 10-year follow-up of the OSTPRE cohort. J Bone Miner Metab 30:208–16CrossRefPubMed
9.
Zurück zum Zitat Tremollieres F, Pouilles JM, Ribot C (1993) Effect of long-term administration of progestogen on post-menopausal bone loss: result of a two-year, controlled randomized study. Clin Endocrinol (Oxf) 38:627–31CrossRef Tremollieres F, Pouilles JM, Ribot C (1993) Effect of long-term administration of progestogen on post-menopausal bone loss: result of a two-year, controlled randomized study. Clin Endocrinol (Oxf) 38:627–31CrossRef
10.
Zurück zum Zitat Ravn P, Cizza G, Bjarnason NH, Thompson D, Daley M, Wasnich RD, McClung M, Hosking D, Yates AJ, Christiansen C (1999) Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group. J Bone Miner Res 14:1622–7CrossRefPubMed Ravn P, Cizza G, Bjarnason NH, Thompson D, Daley M, Wasnich RD, McClung M, Hosking D, Yates AJ, Christiansen C (1999) Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group. J Bone Miner Res 14:1622–7CrossRefPubMed
11.
Zurück zum Zitat Flegal KM, Carroll MD, Ogden CL, Curtin LR (2010) Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303:235–41CrossRefPubMed Flegal KM, Carroll MD, Ogden CL, Curtin LR (2010) Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303:235–41CrossRefPubMed
12.
Zurück zum Zitat Ding J, Kritchevsky SB, Newman AB, Taaffe DR, Nicklas BJ, Visser M, Lee JS, Nevitt M, Tylavsky FA, Rubin SM, Pahor M, Harris TB, Health ABC Study (2007) Effects of birth cohort and age on body composition in a sample of community-based elderly. Am J Clin Nutr 85:405–10 Ding J, Kritchevsky SB, Newman AB, Taaffe DR, Nicklas BJ, Visser M, Lee JS, Nevitt M, Tylavsky FA, Rubin SM, Pahor M, Harris TB, Health ABC Study (2007) Effects of birth cohort and age on body composition in a sample of community-based elderly. Am J Clin Nutr 85:405–10
13.
Zurück zum Zitat Leveille SG, Wee CC, Iezzoni LI (2005) Trends in obesity and arthritis among baby boomers and their predecessors, 1971–2002. Am J Public Health 95:1607–13CrossRefPubMedPubMedCentral Leveille SG, Wee CC, Iezzoni LI (2005) Trends in obesity and arthritis among baby boomers and their predecessors, 1971–2002. Am J Public Health 95:1607–13CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Flegal KM, Graubard BI, Williamson DF, Gail MH (2005) Excess deaths associated with underweight, overweight, and obesity. JAMA 293:1861–7CrossRefPubMed Flegal KM, Graubard BI, Williamson DF, Gail MH (2005) Excess deaths associated with underweight, overweight, and obesity. JAMA 293:1861–7CrossRefPubMed
15.
Zurück zum Zitat Cao JJ (2011) Effects of obesity on bone metabolism. J Orthop Surg Res 6:30–37 Cao JJ (2011) Effects of obesity on bone metabolism. J Orthop Surg Res 6:30–37
16.
Zurück zum Zitat Looker AC, Dawson-Hughes B, Tosteson AN, Johansson H, Kanis JA, Melton LJ 3rd (2010) Hip fracture risk in older US adults by treatment eligibility status based on new National Osteoporosis Foundation guidance. Osteoporos Int 25:64–71 Looker AC, Dawson-Hughes B, Tosteson AN, Johansson H, Kanis JA, Melton LJ 3rd (2010) Hip fracture risk in older US adults by treatment eligibility status based on new National Osteoporosis Foundation guidance. Osteoporos Int 25:64–71
17.
Zurück zum Zitat Beck TJ, Oreskovic TL, Stone KL, Ruff CB, Ensrud K, Nevitt MC, Genant HK, Cummings SR (2001) Structural adaptation to changing skeletal load in the progression toward hip fragility: the study of osteoporotic fractures. J Bone Miner Res 16:1108–19CrossRefPubMed Beck TJ, Oreskovic TL, Stone KL, Ruff CB, Ensrud K, Nevitt MC, Genant HK, Cummings SR (2001) Structural adaptation to changing skeletal load in the progression toward hip fragility: the study of osteoporotic fractures. J Bone Miner Res 16:1108–19CrossRefPubMed
18.
Zurück zum Zitat Cauley JA, Lui LY, Stone KL, Hillier TA, Zmuda JM, Hochberg M et al (2005) Longitudinal study of changes in hip bone mineral density in Caucasian and African-American women. J Am Geriatr Soc 53:183–189CrossRefPubMed Cauley JA, Lui LY, Stone KL, Hillier TA, Zmuda JM, Hochberg M et al (2005) Longitudinal study of changes in hip bone mineral density in Caucasian and African-American women. J Am Geriatr Soc 53:183–189CrossRefPubMed
19.
Zurück zum Zitat Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner HW (2000) Structural trends in the aging femoral neck and proximal shaft: analysis of the Third National Health and Nutrition Examination Survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15:2297–304CrossRefPubMed Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner HW (2000) Structural trends in the aging femoral neck and proximal shaft: analysis of the Third National Health and Nutrition Examination Survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15:2297–304CrossRefPubMed
20.
Zurück zum Zitat Looker AC, Orwoll ES, Johnston CC Jr, Lindsay RL, Wahner HW, Dunn WL et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768CrossRefPubMed Looker AC, Orwoll ES, Johnston CC Jr, Lindsay RL, Wahner HW, Dunn WL et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768CrossRefPubMed
21.
Zurück zum Zitat Greenspan SL, Maitland LA, Myers ER, Krasnow MB, Kido TH (1994) Femoral bone loss progresses with age: a longitudinal study in women over age 65. J Bone Miner Res 9:1959–65CrossRefPubMed Greenspan SL, Maitland LA, Myers ER, Krasnow MB, Kido TH (1994) Femoral bone loss progresses with age: a longitudinal study in women over age 65. J Bone Miner Res 9:1959–65CrossRefPubMed
22.
Zurück zum Zitat Cummings SR (1993) Bone mass and bone loss in the elderly: a special case? Int J Fertil Menopausal Stud 38:92–7PubMed Cummings SR (1993) Bone mass and bone loss in the elderly: a special case? Int J Fertil Menopausal Stud 38:92–7PubMed
23.
Zurück zum Zitat Marin RV, Pedrosa MA, Moreira-Pfrimer LD, Matsudo SM, Lazaretti-Castro M (2010) Association between lean mass and handgrip strength with bone mineral density in physically active postmenopausal women. J Clin Densitom 13:96–101CrossRefPubMed Marin RV, Pedrosa MA, Moreira-Pfrimer LD, Matsudo SM, Lazaretti-Castro M (2010) Association between lean mass and handgrip strength with bone mineral density in physically active postmenopausal women. J Clin Densitom 13:96–101CrossRefPubMed
24.
Zurück zum Zitat Reid IR, Ames RW, Evans MC, Sharpe SJ, Gamble GD (1994) Determinants of the rate of bone loss in normal postmenopausal women. J Clin Endocrinol Metab 79:950–4PubMed Reid IR, Ames RW, Evans MC, Sharpe SJ, Gamble GD (1994) Determinants of the rate of bone loss in normal postmenopausal women. J Clin Endocrinol Metab 79:950–4PubMed
25.
Zurück zum Zitat Wu F, Ames R, Clearwater J, Evans MC, Gamble G, Reid IR (2002) 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) 56:703–11CrossRef Wu F, Ames R, Clearwater J, Evans MC, Gamble G, Reid IR (2002) 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) 56:703–11CrossRef
26.
Zurück zum Zitat Etherington J, Harris PA, Nandra D, Hart DJ, Wolman RL, Doyle DV, Spector TD (1996) The effect of weight-bearing exercise on bone mineral density: a study of female ex-elite athletes and the general population. J Bone Miner Res 11:1333–8CrossRefPubMed Etherington J, Harris PA, Nandra D, Hart DJ, Wolman RL, Doyle DV, Spector TD (1996) The effect of weight-bearing exercise on bone mineral density: a study of female ex-elite athletes and the general population. J Bone Miner Res 11:1333–8CrossRefPubMed
27.
Zurück zum Zitat Rikkonen T, Salovaara K, Sirola J, Karkkainen M, Tuppurainen M, Jurvelin J, Honkanen R, Alhava E, Kroger H (2010) Physical activity slows femoral bone loss but promotes wrist fractures in postmenopausal women—a 15-year follow-up of OSTPRE study. J Bone Miner Res 25:2332–40CrossRefPubMed Rikkonen T, Salovaara K, Sirola J, Karkkainen M, Tuppurainen M, Jurvelin J, Honkanen R, Alhava E, Kroger H (2010) Physical activity slows femoral bone loss but promotes wrist fractures in postmenopausal women—a 15-year follow-up of OSTPRE study. J Bone Miner Res 25:2332–40CrossRefPubMed
28.
Zurück zum Zitat Wilsgaard T, Emaus N, Ahmed LA, Grimnes G, Joakimsen RM, Omsland TK, Berntsen GR (2009) Lifestyle impact on lifetime bone loss in women and men: the Tromso study. Am J Epidemiol 169:877–86CrossRefPubMed Wilsgaard T, Emaus N, Ahmed LA, Grimnes G, Joakimsen RM, Omsland TK, Berntsen GR (2009) Lifestyle impact on lifetime bone loss in women and men: the Tromso study. Am J Epidemiol 169:877–86CrossRefPubMed
29.
Zurück zum Zitat Taaffe DR, Cauley JA, Danielson M, Nevitt MC, Lang TF, Bauer DC, Harris TB (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the health, aging, and body composition study. J Bone Miner Res 16:1343–52CrossRefPubMed Taaffe DR, Cauley JA, Danielson M, Nevitt MC, Lang TF, Bauer DC, Harris TB (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the health, aging, and body composition study. J Bone Miner Res 16:1343–52CrossRefPubMed
30.
Zurück zum Zitat Jackson RD, LaCroix AZ, Gass M et al (2006) Women’s Health Initiative investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354:669–83CrossRefPubMed Jackson RD, LaCroix AZ, Gass M et al (2006) Women’s Health Initiative investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354:669–83CrossRefPubMed
31.
Zurück zum Zitat Karkkainen M, Tuppurainen M, Salovaara K, Sandini L, Rikkonen T, Sirola J, Honkanen R, Jurvelin J, Alhava E, Kroger H (2010) Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65–71 years: a 3-year randomized population-based trial (OSTPRE-FPS). Osteoporos Int 21:2047–55 Karkkainen M, Tuppurainen M, Salovaara K, Sandini L, Rikkonen T, Sirola J, Honkanen R, Jurvelin J, Alhava E, Kroger H (2010) Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65–71 years: a 3-year randomized population-based trial (OSTPRE-FPS). Osteoporos Int 21:2047–55
32.
Zurück zum Zitat Moschonis G, Katsaroli I, Lyritis GP, Manios Y (2010) The effects of a 30-month dietary intervention on bone mineral density: the postmenopausal health study. Br J Nutr 104:100–7CrossRefPubMed Moschonis G, Katsaroli I, Lyritis GP, Manios Y (2010) The effects of a 30-month dietary intervention on bone mineral density: the postmenopausal health study. Br J Nutr 104:100–7CrossRefPubMed
33.
Zurück zum Zitat Schwartz AV, Sellmeyer DE, Strotmeyer ES, Tylavsky FA, Feingold KR, Resnick HE, Shorr RI, Nevitt MC, Black DM, Cauley JA, Cummings SR, Harris TB, Health ABC Study (2005) Diabetes and bone loss at the hip in older black and white adults. J Bone Miner Res 20:596–603 Schwartz AV, Sellmeyer DE, Strotmeyer ES, Tylavsky FA, Feingold KR, Resnick HE, Shorr RI, Nevitt MC, Black DM, Cauley JA, Cummings SR, Harris TB, Health ABC Study (2005) Diabetes and bone loss at the hip in older black and white adults. J Bone Miner Res 20:596–603
34.
Zurück zum Zitat Compston JE, Watts NB, Chapurlat R, Cooper C, Boonen S, Greenspan S, Pfeilschifter J, Silverman S, Diez-Perez A, Lindsay R, Saag KG, Netelenbos JC, Gehlbach S, Hooven FH, Flahive J, Adachi JD, Rossini M, Lacroix AZ, Roux C, Sambrook PN, Siris ES, Glow Investigators (2011) Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med 124:1043–50CrossRefPubMed Compston JE, Watts NB, Chapurlat R, Cooper C, Boonen S, Greenspan S, Pfeilschifter J, Silverman S, Diez-Perez A, Lindsay R, Saag KG, Netelenbos JC, Gehlbach S, Hooven FH, Flahive J, Adachi JD, Rossini M, Lacroix AZ, Roux C, Sambrook PN, Siris ES, Glow Investigators (2011) Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med 124:1043–50CrossRefPubMed
35.
Zurück zum Zitat Corder LS, Manton KG (1991) National surveys and the health and functioning of the elderly: the effects of design and content. J Am Stat Assoc 86:513–25CrossRef Corder LS, Manton KG (1991) National surveys and the health and functioning of the elderly: the effects of design and content. J Am Stat Assoc 86:513–25CrossRef
36.
Zurück zum Zitat Alekel DL, Mortillaro E, Hussain EA, West B, Ahmed N, Peterson CT, Werner RK, Arjmandi BH, Kukreja SC (1999) Lifestyle and biologic contributors to proximal femur bone mineral density and hip axis length in two distinct ethnic groups of premenopausal women. Osteoporos Int 9:327–38CrossRefPubMed Alekel DL, Mortillaro E, Hussain EA, West B, Ahmed N, Peterson CT, Werner RK, Arjmandi BH, Kukreja SC (1999) Lifestyle and biologic contributors to proximal femur bone mineral density and hip axis length in two distinct ethnic groups of premenopausal women. Osteoporos Int 9:327–38CrossRefPubMed
37.
Zurück zum Zitat Felson DT, Zhang Y, Hannan MT, Anderson JJ (1993) Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res 8:567–73CrossRefPubMed Felson DT, Zhang Y, Hannan MT, Anderson JJ (1993) Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res 8:567–73CrossRefPubMed
38.
Zurück zum Zitat Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP, Cardiovascular Study Research Group (2001) Weight change in old age and its association with mortality. J Am Geriatr Soc 49:1309–18CrossRef Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP, Cardiovascular Study Research Group (2001) Weight change in old age and its association with mortality. J Am Geriatr Soc 49:1309–18CrossRef
39.
Zurück zum Zitat Wallace JI, Schwartz RS (2002) Epidemiology of weight loss in humans with special reference to wasting in the elderly. Int J Cardiol 85:15–21CrossRefPubMed Wallace JI, Schwartz RS (2002) Epidemiology of weight loss in humans with special reference to wasting in the elderly. Int J Cardiol 85:15–21CrossRefPubMed
Metadaten
Titel
Changes in bone mineral density over time by body mass index in the health ABC study
verfasst von
J. T. Lloyd
D. E. Alley
M. C. Hochberg
S. R. Waldstein
T. B. Harris
S. B. Kritchevsky
A. V. Schwartz
E. S. Strotmeyer
C. Womack
D. L. Orwig
For the Health ABC Study
Publikationsdatum
08.02.2016
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 6/2016
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3506-x

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