Low Obesity-Related Indices Are Associated with a Low Baseline Calcaneus Ultrasound T-Score, and a Rapid Decline in T-Score in a Large Taiwanese Population Follow-Up Study

Overview

Journal Nutrients

Date 2023 Feb 11

PMID 36771312

Authors

Li-Han Chen

Yi-Hsueh Liu

Szu-Chia Chen

Ho-Ming Su

Affiliations

Soon will be listed here.

Abstract

Osteoporosis results in reduced bone strength and an elevated risk of fractures. Both overweight and underweight have been associated with osteoporosis; however, few studies have examined associations between osteoporosis and indices related to obesity. Therefore, the aim of this study was to investigate the associations of obesity-related indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), body adiposity index (BAI), abdominal volume index (AVI), lipid accumulation product (LAP), and visceral adiposity index (VAI), with baseline and change in calcaneus ultrasound T-score between baseline and follow-up (ΔT-score). T-score was measured using ultrasound. A total of 26,983 subjects were enrolled (mean age 51.2 ± 10.4 years). Multivariable analysis showed significant associations between low BMI (per 1 kg/m; β, 0.065), WHR (per 1%; β, 0.012), WHtR (per 1%; β, 0.024), BRI (per 1; β, 0.079), BAI (per 1; β, 0.032), AVI (per 1; β, 0.049), and LAP (per 1; β, 0.005) with low baseline T-scores (all < 0.001). Furthermore, there were significant associations between low BMI (per 1 kg/m; β, 0.005; = 0.036), BAI (per 1; β, 0.010; < 0.001), and VAI (per 1; β, 0.017; = 0.002) with low ΔT-scores. A low baseline T-score was significantly associated with low values of LAP, AVI, BAI, BMI, BRI, WHR, and WHtR but not VAI. In addition, low BMI, BAI, and VAI were significantly associated with low ΔT-scores, representing a rapidly decreasing T-score. Consequently, avoiding being underweight may help prevent osteoporosis in the Taiwanese population.

Citing Articles

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PMID: 39744530 PMC: 11688312. DOI: 10.3389/fmed.2024.1486611.

References

Qin K, He M, Cao X, Yang H, Yang Y, Wang Y . [Obesity and Osteoporosis in Men Aged Above 50]. Sichuan Da Xue Xue Bao Yi Xue Ban. 2017; 48(1):17-22. View

Gaffney-Stomberg E, Insogna K, Rodriguez N, Kerstetter J . Increasing dietary protein requirements in elderly people for optimal muscle and bone health. J Am Geriatr Soc. 2009; 57(6):1073-9. DOI: 10.1111/j.1532-5415.2009.02285.x. View

Kahn S, Hull R, Utzschneider K . Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006; 444(7121):840-6. DOI: 10.1038/nature05482. View

Chandran M, Lau T, Gagnon-Arpin I, Dobrescu A, Li W, Leung M . The health and economic burden of osteoporotic fractures in Singapore and the potential impact of increasing treatment rates through more pharmacological options. Arch Osteoporos. 2019; 14(1):114. DOI: 10.1007/s11657-019-0664-4. View

Padwal R, Leslie W, Lix L, Majumdar S . Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality: A Cohort Study. Ann Intern Med. 2016; 164(8):532-41. DOI: 10.7326/M15-1181. View

Ou Y, Lee M, Lin I, Wen W, Hsu W, Chen S . Obesity-related indices are associated with albuminuria and advanced kidney disease in type 2 diabetes mellitus. Ren Fail. 2021; 43(1):1250-1258. PMC: 8409948. DOI: 10.1080/0886022X.2021.1969247. View

Bergmann P, Body J, Boonen S, Boutsen Y, Devogelaer J, Goemaere S . Loading and skeletal development and maintenance. J Osteoporos. 2011; 2011:786752. PMC: 3010667. DOI: 10.4061/2011/786752. View

Bischoff H, Stahelin H, Dick W, Akos R, Knecht M, Salis C . Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003; 18(2):343-51. DOI: 10.1359/jbmr.2003.18.2.343. View

Compston J . Obesity and bone. Curr Osteoporos Rep. 2013; 11(1):30-5. DOI: 10.1007/s11914-012-0127-y. View

10.

Lin Y, Chen Y, Tsao Y, Yeh W, Li W, Tzeng I . Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross-sectional study. BMJ Open. 2019; 9(10):e031660. PMC: 6830829. DOI: 10.1136/bmjopen-2019-031660. View

11.

Nishida C, Ko G, Kumanyika S . Body fat distribution and noncommunicable diseases in populations: overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist-Hip Ratio. Eur J Clin Nutr. 2009; 64(1):2-5. DOI: 10.1038/ejcn.2009.139. View

12.

NILSSON B . Spinal osteoporosis and femoral neck fracture. Clin Orthop Relat Res. 1970; 68:93-5. View

13.

Tengstrand B, Cederholm T, Soderqvist A, Tidermark J . Effects of protein-rich supplementation and nandrolone on bone tissue after a hip fracture. Clin Nutr. 2007; 26(4):460-5. DOI: 10.1016/j.clnu.2007.03.007. View

14.

Jao H, Wung C, Yu H, Lee M, Chen P, Chen S . Sex Difference in the Associations among Obesity-Related Indices with Metabolic Syndrome in Patients with Type 2 Diabetes Mellitus. Int J Med Sci. 2021; 18(15):3470-3477. PMC: 8436103. DOI: 10.7150/ijms.63180. View

15.

Rizzoli R, Bonjour J . [Malnutrition and osteoporosis]. Z Gerontol Geriatr. 1999; 32 Suppl 1:I31-7. DOI: 10.1007/s003910050178. View

16.

Amato M, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M . Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010; 33(4):920-2. PMC: 2845052. DOI: 10.2337/dc09-1825. View

17.

Galvard H, Elmstahl S, Elmstahl B, SAMUELSSON S, Robertsson E . 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). 1996; 8(4):282-6. DOI: 10.1007/BF03339580. View

18.

Chiu T, Huang Y, Chiu H, Wu P, Chiou H, Huang J . Comparison of Various Obesity-Related Indices for Identification of Metabolic Syndrome: A Population-Based Study from Taiwan Biobank. Diagnostics (Basel). 2020; 10(12). PMC: 7763700. DOI: 10.3390/diagnostics10121081. View

19.

Chen C, Yang J, Chiang C, Hsiung C, Wu P, Chang L . Population structure of Han Chinese in the modern Taiwanese population based on 10,000 participants in the Taiwan Biobank project. Hum Mol Genet. 2016; 25(24):5321-5331. PMC: 6078601. DOI: 10.1093/hmg/ddw346. View

20.

Lane N . Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol. 2006; 194(2 Suppl):S3-11. DOI: 10.1016/j.ajog.2005.08.047. View