Bone density, microarchitecture and strength estimates in white versus African American youth with obesity

Reyes, Karen J. Campoverde; Stanford, Fatima Cody; Singhal, Vibha; Animashaun, Abisayo; Bose, Amita; Gleeson, Elizabeth L.; Bredella, Miriam A.; Misra, Madhusmita

doi:10.1016/j.bone.2020.115514

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…Several studies have shown an inverse association between MAT and BMD and this reciprocal relationship was observed in White adolescents/young adults in our study, while no such relationship was observed in Blacks, suggesting that obesity may disrupt the physiologic reduction of MAT in states of higher BMD. This is consistent with a prior study that showed that racial differences in BMD and bone microarchitecture as well as strength estimates were less pronounced in adolescents with moderate to severe obesity ( Campoverde Reyes et al, 2020 ), suggesting that effects of obesity may blunt the effect of race on bone measures.…”

Section: Discussionsupporting

confidence: 92%

“…QCT assesses vBMD and is more accurate in obesity than is DXA ( Yu et al, 2012 ). Prior studies have shown higher vBMD in the peripheral skeleton (distal radius and tibia) in Blacks compared to Whites ( Campoverde Reyes et al, 2020 ; Misra et al, 2017 ; Popp et al, 2017 ; Putman et al, 2013 ). Ours is the first study that has evaluated vBMD of the lumbar spine in adolescents and confirmed racial differences in lumbar vBMD with higher vBMD in Blacks compared to Whites of similar age, sex distribution, weight, height, BMI, abdominal fat and muscle mass.…”

Section: Discussionmentioning

confidence: 87%

“…Clinical characteristics have been reported in a subset of study participants ( Campoverde Reyes et al, 2020 ), however, no racial differences in vBMD of the lumbar spine or MAT have been reported.…”

Section: Methodsmentioning

confidence: 95%

“…Quantitative computed tomography (QCT) assesses volumetric bone mineral density (vBMD) and is less susceptible to measurement errors in obesity compared to DXA ( Yu et al, 2012 ). Racial difference in vBMD and bone microarchitecture of the extremities have been described in adolescents and young adults of normal weight and with obesity ( Campoverde Reyes et al, 2020 ; Misra et al, 2017 ; Popp et al, 2017 ; Putman et al, 2013 ). Those studies revealed higher vBMD and improved bone microarchitecture and strength estimates of the distal radius and tibia in Blacks compared to Whites ( Campoverde Reyes et al, 2020 ; Misra et al, 2017 ; Popp et al, 2017 ; Putman et al, 2013 ), although these differences were less marked in moderate to severe obesity, suggesting that obesity may blunt the positive effect of race on bone endpoints ( Campoverde Reyes et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Racial differences in lumbar marrow adipose tissue and volumetric bone mineral density in adolescents and young adults with obesity

et al. 2020

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Background Areal bone mineral density (BMD) of the lumbar spine by DXA is greater in Black compared to White adolescents. Bone strength is determined not only by BMD but also its microenvironment, and marrow adipose tissue (MAT) has been shown to be an important determinant of skeletal integrity, independent of BMD. Racial differences in volumetric BMD (vBMD) and MAT in adolescents and young adults with obesity are unknown. Objective To assess racial differences in lumbar vBMD and MAT in Black and White adolescents and young adults with obesity and to assess body composition determinants of bone parameters. We hypothesized that Blacks will have higher vBMD and lower MAT of the lumbar spine compared to Whites. Methods The study group comprised 77 adolescents/young adults, 25 Black and 52 White, (mean age 18.2 ± 2.5 years, range 13 to 24 years) with moderate to severe obesity (mean body mass index (BMI) 46.2 ± 7.3 kg/m 2 , range 35.5 to 69.7 kg/m 2 ). Groups were similar in age, BMI, and sex distribution (p > 0.84). Subjects underwent QCT of the lumbar spine (L1−L2) for assessment of vBMD with the use of a calibration phantom and 1H-MRS/MRI for quantification of lumbar MAT content (L1-L2) and abdominal fat and thigh muscle mass. Groups were compared by Student's t -test or Wilcoxon test. Correlation analysis was performed to assess associations between bone parameters and body composition. Results Black adolescents/young adults with obesity had higher vBMD compared to Whites (p < 0.0001), while there was no significant difference in lumbar MAT (p = 0.64). There were also no significant differences in body composition measures between groups (p ≥ 0.28). An inverse association between MAT and vBMD was observed in Whites (r = −0.47, P = 0.001) but not in Blacks (p = 0.6). There were no significant associations between body composition measures and bone parameters (p > 0.1). Conclusion There are racial differences in lumbar vBMD in adolescents and young adults with moderate to severe obesity, with Blacks having higher vBMD than Whites, while there were no differences in MAT content. The known inverse association between BMD and MAT was only observed in Whites but not in Blacks, suggesting possible racial differences in stem cell differentiation into the bone and fat lineages.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Racial differences in lumbar marrow adipose tissue and volumetric bone mineral density in adolescents and young adults with obesity

et al. 2020

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“…Since dual‐energy X‐ray absorptiometry (DXA) may overestimate aBMD values at axial sites due to excess fat tissue ( 11 ), and other factors including bone geometry and microarchitecture might also be important determinants of bone strength in addition to BMD ( 12 ), researchers have performed high-resolution peripheral quantitative computed tomography (HR-pQCT) to measure volumetric densities and the cortical and trabecular compartments in obese individuals, which is less affected by soft tissue padding. Several studies have demonstrated the bone microarchitecture characteristics in obesity, with favorable cortical and trabecular parameters ( 10 , 13 , 14 ). However, data on the bone microarchitecture across the BMI spectrum are lacking in postmenopausal Chinese women.…”

Section: Introductionmentioning

confidence: 99%

Bone Microarchitecture in Obese Postmenopausal Chinese Women: The Chinese Vertebral Osteoporosis Study (ChiVOS)

Jiang

Liu

et al. 2022

Front. Endocrinol.

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BackgroundObesity is associated with improved bone mass and microarchitecture in Caucasian individuals, but evidence in obese Asian individuals is lacking.ObjectiveTo analyze the areal bone mineral density (aBMD) and bone microarchitecture in normal-weight, overweight, and obese postmenopausal Chinese women.MethodsA total of 243 postmenopausal women from the Chinese Vertebral Osteoporosis Study (ChiVOS) were included and were divided into three groups (OB, obese group; OW, overweight group; NW, normal weight group) by BMI level. aBMD, trabecular bone score (TBS), and appendicular lean mass (ALM) were measured by dual‐energy X‐ray absorptiometry (DXA). Bone microarchitecture was measured by HR-pQCT at the distal radius and tibia. X-ray was performed to confirm vertebral fractures (VFs). Multiple linear regression was used to evaluate the correlations between bone parameters and ALM after adjusting for confounding variables.ResultsThe prevalence of VFs and clinical fractures were similar among the groups. Participants in the OB group showed a lower level of osteocalcin with comparable levels of other bone turnover markers (BTMs). The aBMD at several skeletal sites was higher in the OB group than in the NW group after adjusting for age (p<0.01 for all comparisons). At the radius, the OB group had a higher Ct.Ar, Tb.vBMD, Tb.BV/TV, Tb.N, Tb.Th, and Ct.Th than the NW group after adjusting for covariates (p<0.05 for all). Differences of a similar magnitude were found at the distal tibia. There was a trend of decreasing trend in Tb.Sp, Tb.1/N/SD, and Ct.Po among groups at both sites. However, the bone microarchitecture did not differ between participants with severe obesity (BMI≥35.0kg/m2) and those with 30.0≤BMI<35 kg/m2. Multiple linear regression revealed that the associations between ALM and most of the bone microarchitecture parameters at both sites were much stronger than the association between body weight and bone parameters.ConclusionWe have observed significant improvements in aBMD, bone geometry, and bone microarchitecture in obese postmenopausal Chinese women. Except for a lower level of osteocalcin in the OB group, no significant differences in BTMs were found among the groups. Compared with body weight, ALM may explain greater variance in the improvement of bone microarchitecture parameters.

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Racial/Ethnic Differences in Bone Mineral Density for Osteoporosis

Wu,

Dai

2023

Curr Osteoporos Rep

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Bone density, microarchitecture and strength estimates in white versus African American youth with obesity

Cited by 7 publications

References 23 publications

Racial differences in lumbar marrow adipose tissue and volumetric bone mineral density in adolescents and young adults with obesity

Racial differences in lumbar marrow adipose tissue and volumetric bone mineral density in adolescents and young adults with obesity

Bone Microarchitecture in Obese Postmenopausal Chinese Women: The Chinese Vertebral Osteoporosis Study (ChiVOS)

Racial/Ethnic Differences in Bone Mineral Density for Osteoporosis

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