The Relationship Between Body Mass Index and Bone Mineral Density: A Mendelian Randomization Study

Song, Jidong; Zhang, Rupeng; Lv, Leifeng; Liang, Jialin; Wang, Wei; Liu, Ruiyu; Dang, Xiaoqian

doi:10.1007/s00223-020-00736-w

Cited by 40 publications

(30 citation statements)

References 36 publications

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“…In contrast, higher genetically predicted BMI was associated with a modest lower risk of osteoporosis, possibly explained by mechanical stresses mediated through gravitational action. This finding confirms previous MR studies that have shown a positive association between genetically predicted BMI and bone mineral density [ 66 , 67 ]. Genetically predicted BMI was also inversely associated with the risk of Dupuytren’s disease in an MR study based on data from a genome-wide association study on this outcome [ 30 ].…”

Section: Discussionsupporting

confidence: 92%

Causal role of high body mass index in multiple chronic diseases: a systematic review and meta-analysis of Mendelian randomization studies

Larsson

Burgess

2021

BMC Med

140

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Background Obesity is a worldwide epidemic that has been associated with a plurality of diseases in observational studies. The aim of this study was to summarize the evidence from Mendelian randomization (MR) studies of the association between body mass index (BMI) and chronic diseases. Methods PubMed and Embase were searched for MR studies on adult BMI in relation to major chronic diseases, including diabetes mellitus; diseases of the circulatory, respiratory, digestive, musculoskeletal, and nervous systems; and neoplasms. A meta-analysis was performed for each disease by using results from published MR studies and corresponding de novo analyses based on summary-level genetic data from the FinnGen consortium (n = 218,792 individuals). Results In a meta-analysis of results from published MR studies and de novo analyses of the FinnGen consortium, genetically predicted higher BMI was associated with increased risk of type 2 diabetes mellitus, 14 circulatory disease outcomes, asthma, chronic obstructive pulmonary disease, five digestive system diseases, three musculoskeletal system diseases, and multiple sclerosis as well as cancers of the digestive system (six cancer sites), uterus, kidney, and bladder. In contrast, genetically predicted higher adult BMI was associated with a decreased risk of Dupuytren’s disease, osteoporosis, and breast, prostate, and non-melanoma cancer, and not associated with Alzheimer’s disease, amyotrophic lateral sclerosis, or Parkinson’s disease. Conclusions The totality of the evidence from MR studies supports a causal role of excess adiposity in a plurality of chronic diseases. Hence, continued efforts to reduce the prevalence of overweight and obesity are a major public health goal.

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Section: Discussionsupporting

confidence: 92%

Causal role of high body mass index in multiple chronic diseases: a systematic review and meta-analysis of Mendelian randomization studies

Larsson

Burgess

2021

BMC Med

140

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“…A positive association was found between BMI and BMD. When BMI was <26 (kg/m 2 ), for each unit increased in BMI, the BMD of the femur and spine increased by 0.023 (g/cm 2 ) and 0.018 (g/cm 2 ), which was consistent with the previous studies (20,21). A cross-sectional study in a Polish population also showed a positive association between BMI and BMD (22).…”

Section: Discussionsupporting

confidence: 88%

The Saturation Effect of Body Mass Index on Bone Mineral Density for People Over 50 Years Old: A Cross-Sectional Study of the US Population

Feng

Liu

et al. 2021

Front. Nutr.

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Background: Previous studies had revealed that Body Mass Index (BMI) positively affected Bone Mineral Density (BMD). However, an excessively high BMI was detrimental to health, especially for the elderly. Moreover, it was elusive how much BMI was most beneficial for BMD in older adults to maintain.Objective: To investigate whether there was a BMI saturation effect value that existed to maintain optimal BMD.Methods: A cross-sectional study was conducted using the datasets of the National Health and Nutrition Examination Survey (NHANES) 2005–2006, 2007–2008, 2009–2010, 2013–2014, and 2017–2018. After adjusting for covariates, an analysis of the association between BMI and BMD in different femoral regions (Total femur, Femoral neck, Trochanter, Intertrochanter, and Ward's triangle) and lumbar spine regions (Total spine, L1, L2, L3, and L4) in the whole population was performed using the multivariate linear regression models, smoothing curve fitting, and saturation effects analysis models. Then, subgroup analyses were performed according to gender, age, and race.Results: A total of 10,910 participants (5,654 males and 5,256 females) over 50 years were enrolled in this population-based study. Multivariate linear regression analyses in the population older than 50 years showed that BMI was positively associated with femoral BMD and lumbar spine BMD (P < 0.001, respectively). Smoothing curve fitting showed that the relationship between BMI and BMD was not simply linear and that a saturation value existed. The saturation effect analysis showed that the BMI saturation value was 26.13 (kg/m2) in the total femur, 26.82 (kg/m2) in the total spine, and showed site-specificity in L1 (31.90 kg/m2) and L2 (30.89 kg/m2). The saturation values were consistent with the whole participants in males, while there was high variability in the females. BMI saturation values remained present in subgroup analyses by age and race, showing specificity in some age (60–70 years old) groups and in some races.Conclusions: Our study showed a saturation value association between BMI and BMD for people over 50 years old. Keeping the BMI in the slightly overweight value (around 26 kg/m2) might reduce other adverse effects while obtaining optimal BMD.

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“…[25][26][27][28] An increase in BMI may cause greater mechanical load on the lumbar spine, which activates bone formation, thus increasing BMD and consequently delaying the occurrence of osteoporosis. 25,28 A higher BMI means more adipose tissue where oestrogen is mostly produced in men and postmenopausal women, resulting in an increase in BMD. 25,27 Alternatively, low BMI indicates poor nutritional status, directly causing decreased bone density.…”

Section: Discussionmentioning

confidence: 99%

“…To date, several studies have reported that higher BMI plays a crucial role in increasing BMD. 25–28 An increase in BMI may cause greater mechanical load on the lumbar spine, which activates bone formation, thus increasing BMD and consequently delaying the occurrence of osteoporosis. 25 , 28 A higher BMI means more adipose tissue where oestrogen is mostly produced in men and postmenopausal women, resulting in an increase in BMD.…”

Section: Discussionmentioning

confidence: 99%

“… 25 , 28 A higher BMI means more adipose tissue where oestrogen is mostly produced in men and postmenopausal women, resulting in an increase in BMD. 25 , 27 Alternatively, low BMI indicates poor nutritional status, directly causing decreased bone density. 27 , 28 Furthermore, individuals with higher BMI are more likely to have hyperinsulinemia, resulting in increased IGF-1 to promote osteogenesis.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of the DXA Measurements in Patients Undergoing Lumbar Fusion for Lumbar Degenerative Diseases: A Retrospective Analysis of Over 1000 Patients

Bao¹,

Zou²,

Li³

2021

CIA

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To explore the characteristics and reliability of dual-energy x-ray absorptiometry (DXA) measurements in patients undergoing lumbar fusion for lumbar degenerative diseases (LDD). Patients and Methods: A total of 1041 patients aged ≥50 years undergoing lumbar fusion for LDD were reviewed. The BMDs and T-scores of DXA were retrospectively analysed. The diagnosis of osteoporosis was in accordance with World Health Organization (WHO) criteria. Based on the guidelines of International Society for Clinical Densitometry (ISCD), an abnormal lumbar segment is identified as having unreliable T-scores when there is more than a 1.0 T-score difference between two adjacent vertebrae. Results: The prevalence of osteoporosis diagnosed on DXA was 42.3%, and it was higher in women than in men (50.2% vs 31.8%, P < 0.001). Increasing age resulted in higher prevalence of osteoporosis in females. The prevalence of osteoporosis significantly declined with increasing BMI. The lowest lumbar T-score was mostly found at L1. Unreliable T-scores were mostly seen in the lower lumbar segment (L3-L4) and were the least common in L1-L2. The average amount of abnormal lumbar segments increased with age (P = 0.003) and BMI (P = 0.021). Furthermore, those with degenerative lumbar scoliosis had more abnormal segments (P < 0.001). Of the 95 patients with at least one fractured vertebra, 39 (41.1%) were not diagnosed as having osteoporosis on lumbar DXA. Conclusion: Female, older age and low BMI are the risk factors for osteoporosis in patients undergoing lumbar fusion for LDD. Lower lumbar segments, such as L3-L4, are more likely to have unreliable T-scores. Patients with older age, higher BMI or degenerative scoliosis have more abnormal segments with unreliable T-scores. Lumbar DXA measurements are not sensitive enough to identify patients with vertebral fracture.

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The Relationship Between Body Mass Index and Bone Mineral Density: A Mendelian Randomization Study

Cited by 40 publications

References 36 publications

Causal role of high body mass index in multiple chronic diseases: a systematic review and meta-analysis of Mendelian randomization studies

Causal role of high body mass index in multiple chronic diseases: a systematic review and meta-analysis of Mendelian randomization studies

The Saturation Effect of Body Mass Index on Bone Mineral Density for People Over 50 Years Old: A Cross-Sectional Study of the US Population

Characteristics of the DXA Measurements in Patients Undergoing Lumbar Fusion for Lumbar Degenerative Diseases: A Retrospective Analysis of Over 1000 Patients

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