Association of Muscle Health Impairment and Atherosclerosis with Major Osteoporotic Fracture Risk in Taiwanese Vegetarians

Overview

Journal Tzu Chi Med J

Specialty General Medicine

Date 2024 Jul 12

PMID 38993831

Authors

Chia-Ching Chen

Li-Yun Teng

Sou-Hsin Chien

Sen-Wei Tsai

Affiliations

Soon will be listed here.

Abstract

Objectives: Despite the beneficial effects of "vegetarian style" diet on atherosclerosis, it is also proven potentially detrimental to bone health. The influence of muscle health or atherosclerosis on major osteoporotic fracture (MOF) risk in vegetarians has rarely been explored. This prospective study aimed to investigate an association of MOF risk with muscle health and atherosclerosis in vegetarians.

Materials And Methods: We conducted a questionnaire survey with the Mini-Nutritional Assessment (MNA) on 39 vegetarians. The 10-year probability of MOF was determined using the Taiwanese Fracture Risk Assessment (FRAX) calculator. Appendicular skeletal muscle (ASM) mass and bone mineral density were measured with dual-energy X-ray absorptiometry. Physical performance was evaluated using the 6-min walk test (6MWT). Common carotid artery intima-media thickness (ccIMT) was determined using sonography. Serum levels of parathyroid hormone (PTH), Vitamin D, adiponectin, and leptin were measured.

Results: Eleven (28.2%) of 39 vegetarians had a moderate-high risk of MOF, defined by FRAX-calculated risk ≥10%. These subjects had lower ASM ( < 0.005) and 6MWT distances ( < 0.01) but greater ccIMT than those with low risk. The MOF risk was negatively correlated with ASM ( = -0.51, < 0.001) and 6MWT distances ( = -0.62, < 0.001) but positively correlated with ccIMT ( = 0.56, < 0.001). Linear regression analysis revealed that MOF risk scores were negatively associated with ASM and 6MWT distance while positively associated with ccIMT. There was no significant association of MOF risk with MNA scores, serum levels of PTH, Vitamin D, adiponectin, or leptin.

Conclusion: Decreased ASM mass, reduced physical performance, and atherosclerosis are significantly associated with MOF risk in vegetarians.

References

Giangregorio L, Papaioannou A, MacIntyre N, Ashe M, Heinonen A, Shipp K . Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int. 2013; 25(3):821-35. PMC: 5112023. DOI: 10.1007/s00198-013-2523-2. View

Stanghelle B, Bentzen H, Giangregorio L, Pripp A, Skelton D, Bergland A . Effects of a resistance and balance exercise programme on physical fitness, health-related quality of life and fear of falling in older women with osteoporosis and vertebral fracture: a randomized controlled trial. Osteoporos Int. 2020; 31(6):1069-1078. DOI: 10.1007/s00198-019-05256-4. View

Edwards C, Hart D, Spector T . Oral statins and increased bone-mineral density in postmenopausal women. Lancet. 2000; 355(9222):2218-9. DOI: 10.1016/s0140-6736(00)02408-9. View

Libby P . Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol. 2012; 32(9):2045-51. PMC: 3422754. DOI: 10.1161/ATVBAHA.108.179705. View

Parhami F, Morrow A, Balucan J, Leitinger N, Watson A, Tintut Y . Lipid oxidation products have opposite effects on calcifying vascular cell and bone cell differentiation. A possible explanation for the paradox of arterial calcification in osteoporotic patients. Arterioscler Thromb Vasc Biol. 1997; 17(4):680-7. DOI: 10.1161/01.atv.17.4.680. View

Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y . Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. Am J Clin Nutr. 2006; 83(5):1185-92. DOI: 10.1093/ajcn/83.5.1185. View

Kuchta A, Lebiedzinska A, Fijalkowski M, Galaska R, Kreft E, Toton M . Impact of plant-based diet on lipid risk factors for atherosclerosis. Cardiol J. 2016; 23(2):141-8. DOI: 10.5603/CJ.a2016.0002. View

Bagger Y, Tanko L, Alexandersen P, Qin G, Christiansen C . Radiographic measure of aorta calcification is a site-specific predictor of bone loss and fracture risk at the hip. J Intern Med. 2006; 259(6):598-605. DOI: 10.1111/j.1365-2796.2006.01640.x. View

Alajlouni D, Bliuc D, Tran T, Eisman J, Nguyen T, Center J . Decline in Muscle Strength and Performance Predicts Fracture Risk in Elderly Women and Men. J Clin Endocrinol Metab. 2020; 105(9). DOI: 10.1210/clinem/dgaa414. View

10.

Lin Y, Pan W . Bone mineral density in adults in Taiwan: results of the Nutrition and Health Survey in Taiwan 2005-2008 (NAHSIT 2005-2008). Asia Pac J Clin Nutr. 2011; 20(2):283-91. View

11.

Tucker K . Vegetarian diets and bone status. Am J Clin Nutr. 2014; 100 Suppl 1:329S-35S. DOI: 10.3945/ajcn.113.071621. View

12.

Touboul P, Hennerici M, Meairs S, Adams H, Amarenco P, Bornstein N . Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany,.... Cerebrovasc Dis. 2012; 34(4):290-6. PMC: 3760791. DOI: 10.1159/000343145. View

13.

DAgostino Sr R, Vasan R, Pencina M, Wolf P, Cobain M, Massaro J . General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008; 117(6):743-53. DOI: 10.1161/CIRCULATIONAHA.107.699579. View

14.

Enright P . The six-minute walk test. Respir Care. 2003; 48(8):783-5. View

15.

Chan D, McCloskey E, Chang C, Lin K, Lim L, Tsai K . Establishing and evaluating FRAX probability thresholds in Taiwan. J Formos Med Assoc. 2016; 116(3):161-168. DOI: 10.1016/j.jfma.2016.03.006. View

16.

Becker D, Kilgore M, Morrisey M . The societal burden of osteoporosis. Curr Rheumatol Rep. 2010; 12(3):186-91. DOI: 10.1007/s11926-010-0097-y. View

17.

Kim H, Oh B, Park-Min K . Regulation of Osteoclast Differentiation and Activity by Lipid Metabolism. Cells. 2021; 10(1). PMC: 7825801. DOI: 10.3390/cells10010089. View

18.

Hardcastle A, Aucott L, Fraser W, Reid D, Macdonald H . Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. Eur J Clin Nutr. 2010; 65(3):378-85. DOI: 10.1038/ejcn.2010.264. View

19.

Hansen T, Madsen M, Jorgensen N, Cohen A, Hansen T, Vestergaard H . Bone turnover, calcium homeostasis, and vitamin D status in Danish vegans. Eur J Clin Nutr. 2018; 72(7):1046-1054. DOI: 10.1038/s41430-017-0081-y. View

20.

Cawthon P, Peters K, Cummings S, Orwoll E, Hoffman A, Ensrud K . Association Between Muscle Mass Determined by D -Creatine Dilution and Incident Fractures in a Prospective Cohort Study of Older Men. J Bone Miner Res. 2022; 37(7):1213-1220. PMC: 9283198. DOI: 10.1002/jbmr.4505. View