The Association of Body Composition and Sex Hormones with Quantitative Ultrasound Parameters at the Calcaneus and Phalanxes in Elderly Women

Abstract

We investigated the associations of body composition and sex hormones with quantitative ultrasound (QUS) parameters carried out at different skeletal sites. In 897 postmenopausal women (64.1 ± 6.6 years) we measured QUS at the calcaneus (stiffness) by Achilles-GE and at phalanxes (amplitude-dependent speed of sound [AD-SOS], bone transmission time [BTT], and ultrasound bone profile index [UBPI]) by Bone Profiler-IGEA. In all subjects we measured fat mass (FM), lean mass (LM), android fat, and gynoid fat by DXA. In all subjects we also assessed serum testosterone (T), estradiol (E(2)), sex-hormone binding globulin, free estrogen index (FEI), free androgen index, 25-hydroxyvitamin D (25OHD), bone alkaline phosphatase (B-ALP), and type I collagen β carboxy telopeptide. Both E(2) and FEI showed weak but significant correlations with stiffness and QUS parameters at phalanxes. No significant relationships were found between T and QUS. BMI and LM were positively correlated with stiffness (r = 0.14 and r = 0.17, respectively), whereas BMI and FM showed negative correlations with AD-SOS, BTT, and UBPI. 25OHD showed positive relationships with stiffness and QUS at phalanxes. In multivariate models LM and age were associated with stiffness whereas E(2) and age were significant predictors of BTT. AD-SOS was negatively associated with FM, B-ALP, and age but positively with E(2) and 25OHD. In postmenopausal women QUS parameters at the calcaneus and at phalanxes are significantly, but diversely, associated with body composition, sex hormones, 25OHD, and bone turnover markers.

Factors Associated with Bone Health in Malaysian Middle-Aged and Elderly Women Assessed via Quantitative Ultrasound

“…The skeleton responds to mechanical loading by increasing its mass [ 42 ]. Thus, higher BMD values or QUS indices in subjects with higher BMI was a common finding in previous epidemiological studies [ 26 , 27 , 43 , 44 ]. However, BMI is not the most accurate obesity index [ 45 ].…”

Sex hormones and quantitative ultrasound parameters at the heel in men and women from the general population

“…But, except DHEAS and FT, none of the alternatively measured sex hormones were associated with bone ultrasound parameters. In contrast to our results, previous studies among post-menopausal women reported positive association of DHEAS with SI ( Hosoda et al, 2008 ) and an association of estradiol with QUS ( Gonnelli et al, 2011 ).…”

“…Previous research suggested a potential link between sex hormones and bone metabolism ( Venken et al, 2008 ). Exemplarily, estrogen and dehydroepiandrosterone sulphate (DHEAS) exposure in adolescence have been related to skeletal maturation and bone mineral density, same as estrogen deficiency and decreasing sex hormone concentrations to bone loss ( Dhuper et al, 1990 , Porcu et al, 1994 , Gonnelli et al, 2011 ). Beside well-established risk factors for osteoporosis, including aging, female sex, pre-existing fractures and physical inactivity, previous experimental research suggests a bi-directional link between sex hormones and bone metabolism ( Oury et al, 2011 ).…”

Effect of Antidiabetic Treatment on Bone

“…This might contribute to bone loss, in part, due to the direct effect of reduced soft-tissue mass on bone through reduced mechanical loading (Martin 2007). Additionally, decreased fat tissue might lead to reductions in aromatase activity, which lowers the production of estradiol and consequently increases bone turnover (Gonnelli et al 2011, Liu et al 2014. The decrease in estradiol in women with canagliflozin is consistent with this hypothesis (Bilezikian et al 2016).…”