Association between metabolic syndrome and bone mineral density in Korea: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008

Park, Sangshin; Pak, Yun-Suk; Lee, Sang Yoon; Lee, Eun-Hee

doi:10.1007/s00774-013-0459-4

Cited by 26 publications

(25 citation statements)

References 39 publications

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“…In another study involving Korean men aged 40 years or older and postmenopausal women, MetS was associated with a lower bone mineral density at the femoral neck [4]. Similarly, a negative relationship between bone mineral density and waist circumference was reported among Korean men after adjusting for age, weight, height, and lifestyle-related variables [5]. In contrast, a longitudinal study involving postmenopausal Korean women indicated that those with MetS had a lower annual decrease in bone mineral density compared with MetS-free women after adjusting for age, lifestyle, and baseline bone mineral density.…”

Section: Discussionmentioning

confidence: 83%

“…However, in population-based studies, the association between MetS and osteoporosis/ low bone mineral density has been controversial. Some studies have shown that MetS or its components are a detrimental factor [3][4][5]. In other studies, MetS was a beneficial factor before adjusting for weight and height or for body mass index [6][7][8][9] and was not a risk factor by gender [10].…”

Section: Introductionmentioning

confidence: 95%

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Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass

Lee

2015

Calcif Tissue Int

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This study aimed to examine the relationship between metabolic syndrome (MetS) and osteoporosis according to muscle mass levels and the joint relationship of MetS and muscle mass with osteoporosis in a representative population-based sample from the Korea National Health and Nutrition Examination Survey in 2010-2011. In 1654 men and 1979 women aged 50-93 years, body composition and bone mineral density at the femur and lumbar spine were measured using dual-energy X-ray absorptiometry. Low- and high-muscle mass groups were identified using the mean sex-specific muscle mass of appendicular muscle mass/height(2). The covariates were age, health behaviors, serum 25-OH vitamin D and parathyroid hormone, calcium intake, and hormone replacement therapy for women. Men and women with MetS (defined by the Adult Treatment Panel III) had 43 and 31% lower odds for osteoporosis, respectively, compared with their MetS-free counterparts after adjusting for muscle mass and covariates. When stratified by muscle mass, MetS was not associated with osteoporosis in men, while associated in women with higher muscle mass (OR 0.65, 95% CI 0.46-0.91). Compared with MetS-free men and women with lower muscle mass, the odds for osteoporosis were 45% and 23, 52 and 15%, and 72 and 46% lower among those with low muscle mass and MetS, high muscle mass without MetS, and high muscle mass and MetS, respectively (P for trend <0.001). Combination of high muscle mass and MetS was associated with lower prevalence of osteoporosis in Korean men and women.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 95%

Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass

Lee

2015

Calcif Tissue Int

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“…Model 4 was adjusted for the covariates of model 3 and metabolic syndrome and periodontitis [6], which are known to be related to increased systemic inflammation [41]. Moreover, metabolic syndrome and periodontitis are associated with BMD in some studies [11][12][13]17]. The relationship between metabolic syndrome and BMD is controversial in men and women [42][43][44][45][46][47], but the results were mostly consistent in men.…”

Section: Discussionmentioning

confidence: 97%

“…The risk factors for the development of osteoporosis are old age, postmenopausal women, low calcium intake, low vitamin D level, and health behaviors such as smoking, alcohol intake, and physical activities [8][9][10]. Cardiometabolic abnormalities including dyslipidemia and metabolic syndrome are also known to be associated with the prevalence of osteoporosis [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 97%

Oral health behaviors and bone mineral density in South Korea: the 2008–2010 Korean National Health and Nutrition Examination Survey

Kim

Cho

et al. 2015

J Bone Miner Metab

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The purpose of this study was to examine the association between oral health behaviors and bone mineral density (BMD) by using data from the Korean National Health and Nutrition Examination Survey conducted in 2008-2010. We included 6,620 subjects (3,140 men aged more than 50 years and 3,480 postmenopausal women). BMD was measured at three sites-namely, the lumbar spine, total femur, and femur neck. Oral health behaviors were assessed by use of a self-administered questionnaire in the Korean National Health and Nutrition Examination Survey. After adjustment for all covariates, BMD of the lumbar spine and femur neck tended to increase as the frequency of tooth brushing increased in men (p trend = 0.020 and p trend = 0.028, respectively). Women using secondary oral products had increased lumbar spine BMD compared with women who did not use secondary oral products. However, after adjustment for all covariates, no significant relationship was observed between BMD and the use of secondary oral products. As the frequency of tooth brushing and the number of secondary oral products used increased, the prevalence of osteoporosis decreased. The frequency of tooth brushing is associated with increased lumbar spine and femur neck BMD in South Korean men.

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“…Potential contributors include greater risk of falls, adverse changes on skeletal biomechanics, alterations in energy metabolism, metabolic syndrome, and overt type 2 diabetes mellitus or its associated treatments and comorbidities. (21)(22)(23)(24)(25) Of course, this assumes that the association between obesity and fractures is causal. But what if the association is not causal at all?…”

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confidence: 99%

Untangling the Causality Knot: Another Tool for Clinical Researchers

Lix

Leslie

2014

Journal of Bone and Mineral Research

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Happy the man who has been able to learn the causes of things. -Virgil Clinical experience and a sound knowledge of pathophysiology are the traditional pillars of medicine. In recent years, new statistical methods have strengthened the ability of investigators to extract patterns from complex datasets that would otherwise remain hidden. Research to predict clinical events and the methods needed to support these analyses have evolved in tandem over the last few decades in a classical pas de deux. Indeed, the landscape of modern medicine would hardly be recognizable without such techniques. The recent development of fracture prediction tools is a prime example of one clinical application of powerful statistical methods.(1)When prediction of an event is the sole objective, the existence of an association-whether causal or not-may be sufficient. However, to understand how that association arises, and to intervene appropriately, requires a deeper understanding of the cause and effect relationships. Obesity, defined from elevated body mass index (BMI), has generated much controversy in the osteoporosis literature, variably reported to be protective, neutral, or a risk factor for osteoporosis and related fractures.(2-4) Weight and BMI are both strongly correlated with bone mineral density (BMD) as measured from dual-energy X-ray absorptiometry (DXA) in almost all studies, and it is no accident that weight or BMI are a component of virtually all fracture prediction tools.(1) However, when weight is partitioned into its components of lean mass and fat mass, the associations become more complicated. Most studies find that lean mass is positively associated with higher BMD. (5,6) For fat mass a variety of results have been found, (5,(7)(8)(9)(10)(11)(12) although a recent metaanalysis demonstrates a positive association between fat mass and bone density.(13) Meta-analytic results have also shown that among premenopausal women lean mass exerted a greater effect on femoral neck BMD than fat mass (r ¼ 0.45 versus r ¼ 0.30), whereas in postmenopausal women the effects of lean mass and fat mass were similar (r ¼ 0.33 versus r ¼ 0.31).(13) The presence of large correlations among weight, BMI, lean mass, and fat mass have fueled some of this controversy.(4) For example, if one assumes that lean mass is solely responsible for BMD and that fat mass has no effect, then a model that includes weight and fat mass would actually show the latter as having an adverse (negative) effect on BMD simply because fat is interpreted as "not lean" in the model. Body composition is a major factor impacting accuracy errors in DXA, effects that are amplified in longitudinal studies where weight, body composition, and BMD (not to mention a myriad of other factors) are changing simultaneously. (14)(15)(16) A recent meta-analysis examined the association between BMI and fracture risk in prospective cohorts from 25 countries (398,610 women with an average age of 63 years; 2.2 million person-years follow-up) with a reported 22% prevalence of obesity.(17) ...

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Association between metabolic syndrome and bone mineral density in Korea: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008

Cited by 26 publications

References 39 publications

Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass

Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass

Oral health behaviors and bone mineral density in South Korea: the 2008–2010 Korean National Health and Nutrition Examination Survey

Untangling the Causality Knot: Another Tool for Clinical Researchers

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