Association of calcaneal quantitative ultrasound parameters with metabolic syndrome in middle-aged and elderly Chinese: a large population-based cross-sectional study

Abstract

BackgroundThe possible association between metabolic syndrome (MS) and bone mineral density (BMD) has been highlighted recently. However, the exact effects of MS on calcaneal quantitative ultrasound (QUS) parameters remains uncertain. The aim of this study was to assess the impact of MS states, different componets of MS, as well as the number of MS componets on QUS.MethodsA total of 7489 Chinese adults aged 40 years or older in Nanjing were enrolled in this cross-sectional study. MS was defined according to recommendations generated by the International Diabetes Federation (IDF) in 2005. QUS was measured for each participant.ResultsThe prevalence of MS was 34.6% in men and 42.8% in women (over 40 years old). In postmenopausal women with MS, 25-hydroxyvitamin D[25(OH)D], age adjusted quantitative ultrasound index (QUI) and broadband ultrasound attenuation (BUA) were all lower than those without (p < 0.001, p = 0.023, p = 0.021, respectively), the difference of QUI and BUA disappeared after adjustment for body mass index (BMI) and waist circumference (WC). In stepwise analysis, BMI, WC, high density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were related to QUS (p < 0.05). The number of MS components had no influence on QUS. Fragile fracture incidence was higher in women with MS (6.8% VS. 5.3%, P = 0.034).ConclusionChinese postmenopausal women with MS have worse BMD measured by QUS and more chances to develop osteoporotic fractures than the controls, which partially due to central obesity as well as vitamin D deficiency. People having less central obesity, higher FPG or HDL-C are less likely to have bone mineral loss.

<p>Relationship Between Metabolic Syndrome and Bone Health – An Evaluation of Epidemiological Studies and Mechanisms Involved</p>

“…Cross-sectional study 938 post-menopausal women from Eastern China risk of any fractures compared to non-MetS women. 57 Other studies among the Chinese population also obtained similar findings. 58,59 In contrast to the studies mentioned earlier, the Camargo cohort study found no significant difference in the prevalence of VF and NVF between MetS and non-MetS subjects of either sex.…”

“… 46 A Chinese study (2814 males and 4675 females, ≥40 years) also showed that women with MetS experienced an increased risk of any fractures compared to non-MetS women. 57 Other studies among the Chinese population also obtained similar findings. 58 , 59 …”

Effects of fructose-induced metabolic syndrome on rat skeletal cells and tissue, and their responses to metformin treatment

“…However, less is known about the effects of MS on bone metabolism. Different reports reveal conflicting results regarding MS or its individual components, with bone mineral density and/or fracture risk [6,7].…”

Metabolic syndrome and osteoporotic fracture: a population-based study in China

“…MetS is associated with a higher risk of cardiovascular morbidity and mortality and a higher risk of onset of type 2 diabetes. Although the relationship between cardiovascular disease and osteoporosis has been widely studied, the particular association between metabolic syndrome, a strong risk factor for cardiovascular disease, and osteoporotic fractures has not been so extensively addressed and present several studies results were inconsistent [ 5 – 15 ]. Epidemiological studies on fracture incidence or prevalence are therefore needed in order to show the real pattern of fractures in MetS.…”