Abstract
Purpose
The knowledge of factors modulating the behaviour of bone mass is crucial for preventing and treating osteoporotic disease; among these factors, body weight (BW) has been shown to be of primary importance in postmenopausal women. Nevertheless, the relative effects of body composition indices are still being debated. Our aim was to analyze the relationship between body mass index (BMI), fat and lean mass and bone mineral density (BMD) in a large population of women. Moreover, this study represents a first important report on reference standard values for body composition in Italian women.
Materials and methods
Between 2005 and 2008, weight and height of 6,249 Italian women (aged 30–80 years) were measured and BMI was calculated; furthermore BMD, bone mineral content, fat and lean mass were measured by dual-energy X-ray absorptiometry. Individuals were divided into five groups by decades (group 1, 30.0–39.9; group 2, 40.0–49.9; group 3, 50.0–59.9; group 4, 60.0–69.9; group 5, 70.0–79.9). Differences among decades for all variables were calculated using a one-way analysis of variance (ANOVA) and Bonferroni test by the SPSS programme.
Results
Mean BW was 66.8±12.1 kg, mean height 159.1±6.3 cm and mean BMI 26.4±4.7 kg/m2. According to BW and BMI, there was an increase of obesity with age, especially in women older than 50 years (p<0.001). Lean mass increased until 50 years of age but significantly decreased after this age (p<0.001). The percentage of osteopenia and osteoporosis in the examined population was 43.0% and 16.7%, respectively.
Conclusions
Our data show that obesity significantly decreased the risk for osteoporosis but did not decrease the risk for osteopenia. It is strongly recommended that a strong policy regarding prevention of osteopenia and osteoporosis be commenced. An overall examination of our results suggests that both fat and lean body mass can influence bone mass and that their relative effect on bone could be modulated by their absolute amount and ratio to total BW.
Riassunto
Obiettivo
La conoscenza dei fattori che modulano il comportamento della massa ossea è cruciale nella prevenzione e nel trattamento della malattia osteoporotica; tra questi fattori, il peso corporeo (BW) ha dimostrato di essere di primaria importanza nelle donne in postmenopausa. Tuttavia gli effetti relativi degli indici di composizione corporea sono oggi ancora dibattuti. Il nostro obiettivo è stato quello di analizzare la relazione tra l’indice di massa corporea (BMI), la massa grassa, la massa magra e la densità minerale ossea (BMD) in una vasta popolazione di donne. Inoltre questo studio rappresenta un primo importante report sui valori di riferimento standard di composizione corporea nella popolazione femminile italiana.
Materiali e metodi
Nel periodo compreso tra il 2005 e il 2008 sono stati rilevati peso e altezza di 6249 donne italiane (età 40–80 anni), ed è stato calcolato il BMI; inoltre sono stati misurati BMD, contenuto minerale osseo, massa grassa e massa magra attraverso assorbimetria a raggi X a doppia energia. La popolazione dello studio è stata ripartita in 5 gruppi per decade di età (gruppo 1 da 30,0 a 39,9; gruppo 2 da 40,0 a 49,9; gruppo 3 da 50,0 a 59,9; gruppo 4 da 60,0 a 69,9; gruppo 5 da 70,0 a 79,9). Per tutte le variabili sono state calcolate le differenze e la loro significatività tra le decadi di età attraverso l’analisi della varianza a una via (ANOVA) e il test di Bonferroni, utilizzando il software SPSS.
Risultati
Il BW medio è stato 66,8±12,1 kg, l’altezza media 159,1±6,3 cm, e il BMI medio 26,4±4,7 kg/ m2. Con l’aumento del BW e del BMI si è osservato un aumento dell’obesità con l’età, soprattutto sopra i 50 anni (p<0,001). La massa magra ha dimostrato di aumentare fino ai 50 anni ma è significativamente diminuita dopo questa età (p<0,001). La percentuale di osteopenia e osteoporosi nell’intera popolazione è stata rispettivamente del 43,0% e 16,7%.
Conclusioni
I nostri dati hanno mostrato che l’obesità diminuisce il rischio di osteoporosi ma non diminuisce il rischio di osteopenia. È fortemente raccomandato iniziare una rigorosa politica di prevenzione dell’osteopenia e dell’osteoporosi. Un’analisi generale dei nostri risultati suggerisce quindi che sia la massa grassa sia la massa magra possono influenzare la massa ossea e che gli effetti relativi sull’osso possono essere modulati dalla loro quantità assoluta e dal rapporto sul peso corporeo complessivo.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References/Bibliografia
Wallace LS, Ballard JE (2002) Lifetime physical activity and calcium intake related to bone density in young women. J Womens Health Gend Based Med 11:389–398
Crepaldi G, Romanato G, Tonin P, Maggi S (2007) Osteoporosis and body composition. J Endocrinol Invest 30(6 Suppl):42–47
Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332:767–773
Porthouse J, Birks YF, Torgerson DJ et al (2004) Risk factors for fracture in a UK population: a prospective cohort study. QJM 97:569–574
Chu SP, Kelsey JL, Keegan TH et al (2004) Risk factors for proximal humerus fracture. Am J Epidemiol 160:360–367
Gnudi S, Sitta E, Lisi L (2009) Relationship of body mass index with main limb fragility fractures in postmenopausal women. J Bone Miner Metab 27:479–484
Beck TJ, Petit MA, Wu G et al (2009) Does obesity really make the femur stronger? Bone mineral density, geometry and fracture incidence in the Women’s Health Initiative-Observational Study. J Bone Miner Res 24:1369–1379
WHO (1995) Physical status: the use and interpretation of anthropometry. Technical Report Series 854. WHO, Geneva
Pedrazzoni M, Girasole G, Bertoldo F et al (2003) Definition of a population-specific DXA reference standard in Italian women: the Densitometric Italian Normative Study (DINS). Osteoporos Int 14:978–982
Guglielmi G, Giannatempo GM, Blunt BA et al (1995) Spinal bone mineral density by quantitative CT in a normal Italian population. Eur Radiol 5:269–275
Guglielmi G, De Serio A, Fusilli S et al (2000) Age-related changes assessed by peripheral QCT in healthy Italian women. Eur Radiol 10:609–614
Andreoli A, Scalzo G, Masala S et al (2009) Body composition assessment by dual-energy X-ray absorptiometry (DXA). Radiol Med 114:286–300
Chumlea WC, Guo SS (1999) Body mass and bone mineral quality Curr Opin Rheumatol 11:307–311
De Laet C, Kanis JA, Odén A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338
Capozza RF, Cointry GR, Cure-Ramírez P et al (2004) A DXA study of muscle-bone relationships in the whole body and limbs of 2512 normal men and pre- and post-menopausal women. Bone 35:283–295
Cure-Cure C, Capozza RF, Cointry GR et al (2005) Ferretti Reference charts for the relationships between dual-energy X-ray absorptiometry-assessed bone mineral content and lean mass in 3,063 healthy men and premenopausal and postmenopausal women. Osteoporos Int 16:2095–2106
Hsu YH, Venners SA, Terwedow HA et al (2006)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 83:146–154
WHO (1998) Obesity: preventing and managing the global epidemic. Report on a WHO Consultation on Obesity, Geneva, 3–5 June, 1997 WHO/NUT/NCD/98.1. WHO, Geneva
De Lorenzo A, Deurenberg P, Pietrantuono M et al (2003) How fat is obese? Acta Diabetol 40:S254–S257
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Andreoli, A., Bazzocchi, A., Celi, M. et al. Relationship between body composition, body mass index and bone mineral density in a large population of normal, osteopenic and osteoporotic women. Radiol med 116, 1115–1123 (2011). https://doi.org/10.1007/s11547-011-0689-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11547-011-0689-2