Lean mass as a predictor of bone density and microarchitecture in adult obese individuals with metabolic syndrome

Madeira, Eduardo; Mafort, Thiago Thomáz; Madeira, Miguel; Guedes, Erika Paniago; Moreira, Rodrigo O.; Mendonça, Laura Maria Carvalho de; Lima, I.; Pinho, Paulo Roberto Alves de; Lopes, Agnaldo José; Farias, Maria Lúcia Fleiuss

doi:10.1016/j.bone.2013.11.004

Cited by 34 publications

(29 citation statements)

References 33 publications

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“…In a small study of 50 obese nondiabetic adults under age 50 years with metabolic syndrome, fat mass measured by DXA was not associated with any HR-pQCT measures, but there were no measures of VAT available. (24) …”

Section: Discussionmentioning

confidence: 99%

Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study

Liu¹,

Broe

Zhou³

et al. 2017

Journal of Bone and Mineral Research

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Obesity has been traditionally considered to protect the skeleton against osteoporosis and fracture. Recently, body fat, specifically visceral adipose tissue (VAT), has been associated with lower bone mineral density (BMD) and increased risk for some types of fractures. We studied VAT and bone microarchitecture in 710 participants (58% women, age 61.3 ± 7.7 years) from the Framingham Offspring cohort to determine whether cortical and trabecular BMD and microarchitecture differ according to the amount of VAT. VAT was measured from CT imaging of the abdomen. Cortical and trabecular BMD and microarchitecture were measured at the distal tibia and radius using high-resolution peripheral quantitative computed tomography (HR-pQCT). We focused on 10 bone parameters: cortical BMD (Ct.BMD), cortical tissue mineral density (Ct.TMD), cortical porosity (Ct.Po), cortical thickness (Ct.Th), cortical bone area fraction (Ct.A/Tt.A), trabecular density (Tb.BMD), trabecular number (Tb.N), trabecular thickness (Tb.Th), total area (Tt.Ar), and failure load (FL) from micro–finite element analysis. We assessed the association between sex-specific quartiles of VAT and BMD, microarchitecture, and strength in all participants and stratified by sex. All analyses were adjusted for age, sex, and in women, menopausal status, then repeated adjusting for body mass index (BMI) or weight. At the radius and tibia, Ct.Th, Ct.A/Tt.A, Tb.BMD, Tb.N, and FL were positively associated with VAT (all p-trend <0.05), but no other associations were statistically significant except for higher levels of cortical porosity with higher VAT in the radius. Most of these associations were only observed in women, and were no longer significant when adjusting for BMI or weight. Higher amounts of VAT are associated with greater BMD and better microstructure of the peripheral skeleton despite some suggestions of significant deleterious changes in cortical measures in the non–weight bearing radius. Associations were no longer significant after adjustment for BMI or weight, suggesting that the effects of VAT may not have a substantial effect on the skeleton independent of BMI or weight. © 2016 American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 99%

Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study

Liu¹,

Broe

Zhou³

et al. 2017

Journal of Bone and Mineral Research

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“…However, lean body mass positively affected structural parameters at the tibia. A recent study on 40 younger women and ten men with MetS has demonstrated that lean mass was positively associated with HRpQCT-derived bone parameters at both tibia and radius (50). Unfortunately, they did not perform QCT at the hip or spine and did not have the opportunity to investigate effects of VAT and SAT separately.…”

Section: Discussionmentioning

confidence: 99%

Adipose tissue, estradiol levels, and bone health in obese men with metabolic syndrome

Ørnstrup

Kjær

Harsløf

et al. 2015

European Journal of Endocrinology

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Objective: Visceral adipose tissue (VAT) is associated with an increased risk of metabolic syndrome (MetS). Recent studies have suggested that VAT negatively affects bone. However, MetS has also been associated with higher estradiol (E 2 ) levels, which is bone protective. We therefore investigated the impact of VAT and E 2 levels on bone density, structural parameters, and strength estimates. Design: A cross-sectional study was conducted in 72 obese men with MetS to investigate the impact of VAT and E 2 levels on bone. Methods: Bone parameters were assessed by dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and high-resolution peripheral QCT (HRpQCT) at lumbar spine, proximal femur, radius, and tibia. VAT volume was measured by magnetic resonance imaging (MRI) and sexual hormones were measured in blood samples. Results: Men with high VAT had a lower bone density at the hip (P!0.05), lower cortical thickness, and higher buckling ratio at femoral neck (FN) (PZ0.008 and PZ0.02), compared with men with low VAT, despite a similar body weight and BMI. Generally, E 2 levels were low (median 43 pmol/l), and men with E 2 levels below median had reduced bone density at lumbar spine (PZ0.04), and impaired structural parameters at radius and tibia, compared with men with E 2 levels above median. At the hip, VAT volume and E 2 levels affected bone density independently and additively, and 50% of men with high VAT and low E 2 levels had osteopenia with significantly lower T-score at FN (PZ0.004). Conclusions: High VAT and low E 2 negatively affect bone in obese men with MetS. VAT and E 2 affect bone density at the hip independently and additively, revealing an unexpected high prevalence of osteopenia in middle-aged men with MetS.

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“…Fat tissue, mainly visceral fat tissue, may increase bone resorption through the production of inflammatory cytokines such as IL- 6 and TNF-α, which stimulate OC activity through the regulation of the RANKL/RANK/OPG pathway [84]. Leptin and adiponectin act on the bone through different signaling pathways with contrasting effects [90] (Table 2 ). Leptin signaling regulates osteogenesis by skeletal stem cells.…”

Section: Correlations With Other Systems and Functionsmentioning

confidence: 99%

“…In obese subjects, especially with central obesity, in which the visceral fat is increased, there is a significant increase of several markers of inflammation such as C reactive protein (CRP), IL-1, IL-6 and TNF-α, that can alter the quality of the bone, making it more fragile. Therefore, these new clinical and experimental evidences definitively connect obesity and other related pathological conditions, such as metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) and diabetes, to impaired bone health and fragility fractures [90-93]. In conclusion, it is currently emerging that adipose tissue, liver, bone and immune system modulate each other through a complex network of interconnected signals.…”

Section: Correlations With Other Systems and Functionsmentioning

confidence: 99%

Osteoimmunology and Beyond

Ginaldi

Martinis²

2016

CMC

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ObjectiveOsteoimmunology investigates interactions between skeleton and immune system. In the light of recent discoveries in this field, a new reading register of osteoporosis is actually emerging, in which bone and immune cells are strictly interconnected. Osteoporosis could therefore be considered a chronic immune mediated disease which shares with other age related disorders a common inflammatory background. Here, we highlight these recent discoveries and the new landscape that is emerging.MethodExtensive literature search in PubMed central.ResultsWhile the inflammatory nature of osteoporosis has been clearly recognized, other interesting aspects of osteoimmunology are currently emerging. In addition, mounting evidence indicates that the immunoskeletal interface is involved in the regulation of important body functions beyond bone remodeling. Bone cells take part with cells of the immune system in various immunological functions, configuring a real expanded immune system, and are therefore variously involved not only as target but also as main actors in various pathological conditions affecting primarily the immune system, such as autoimmunity and immune deficiencies, as well as in aging, menopause and other diseases sharing an inflammatory background.ConclusionThe review highlights the complexity of interwoven pathways and shared mechanisms of the crosstalk between the immune and bone systems. More interestingly, the interdisciplinary field of osteoimmunology is now expanding beyond bone and immune cells, defining new homeostatic networks in which other organs and systems are functionally interconnected. Therefore, the correct skeletal integrity maintenance may be also relevant to other functions outside its involvement in bone mineral homeostasis, hemopoiesis and immunity.

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Lean mass as a predictor of bone density and microarchitecture in adult obese individuals with metabolic syndrome

Cited by 34 publications

References 33 publications

Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study

Visceral Adipose Tissue Is Associated With Bone Microarchitecture in the Framingham Osteoporosis Study

Adipose tissue, estradiol levels, and bone health in obese men with metabolic syndrome

Osteoimmunology and Beyond

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