Visceral fat is more important than peripheral fat for endometrial thickness and bone mass in healthy postmenopausal women

Warming, Lise; Ravn, Pernille; Christiansen, Claus

doi:10.1067/mob.2003.93

Cited by 30 publications

(23 citation statements)

References 17 publications

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“…In addition to diet, these changes during perimenopause can be modified to some degree by HT and exercise [23,24]. However, it is still unclear to what extent body composition changes can be explained by female hormonal deficiency and by decreases in physical activity with age.…”

Section: Discussionmentioning

confidence: 97%

Muscle Strength and Body Composition Are Clinical Indicators of Osteoporosis

et al. 2012

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We examined the role of muscle strength, lean tissue distribution, and overall body composition as indicators of osteoporosis (OP) in a pooled sample of 979 Finnish postmenopausal women (mean age 68.1 years) from the Kuopio Osteoporosis Risk Factor and Prevention study. Bone mineral density (BMD) at the femoral neck (FN) and total body composition were assessed by dual-energy X-ray absorptiometry scans. The women (n = 979) were divided into three groups according to WHO criteria, based on FN BMD T score: normal (n = 474), osteopenia (n = 468), and OP (n = 37). Soft tissue proportions, fat mass index (FMI, fat/height²), lean mass index (LMI, lean/height²), and appendicular skeletal muscle mass (ASM, (arms + legs)/height²) were calculated. Handgrip and knee extension strength measurements were made. OP subjects had significantly smaller LMI (p = 0.001), ASM (p = 0.001), grip strength (p < 0.0001), and knee extension strength (p < 0.05) but not FMI (p > 0.05) compared to other subjects. Grip and knee extension strength were 19 and 16 % weaker in OP women compared to others, respectively. The area under the receiver operating characteristic curve was 69 % for grip and 71 % for knee extension strength. In tissue proportions only LMI showed predictive power (63 %, p = 0.016). An overall linear association of LMI (R² = 0.007, p = 0.01) and FMI (R² = 0.028, p < 0.001) with FN BMD remained significant. In the multivariate model, after adjusting for age, grip strength, leg extension strength, FMI, LMI, number of medications, alcohol consumption, current smoking, dietary calcium intake, and hormone therapy, grip strength (adjusted OR = 0.899, 95 % CI 0.84-0.97, p < 0.01), leg extension strength (OR = 0.998, 95 % CI 0.99-1, p < 0.05), and years of hormone therapy (OR = 0.905, 95 % CI 0.82-1, p < 0.05) remained as significant determinants of OP. Muscle strength tests, especially grip strength, serve as an independent and useful tool for postmenopausal OP risk assessment. In addition, lean mass contributes to OP in this age group. Muscle strength and lean mass should be considered separately since both are independently associated with postmenopausal BMD.

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Section: Discussionmentioning

confidence: 97%

Muscle Strength and Body Composition Are Clinical Indicators of Osteoporosis

et al. 2012

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“…23,24 However, few studies have documented the results of lean and fat distribution, whereas the large number of studies looking at relationships between body composition and BMD have assessed only total FM and LM. 10,23 Although in a previous study from Warming et al, 25 AFM was also found to be correlated to bone mass, their findings suggested that abdominal fat is more important than peripheral fat for endometrial thickness and bone mass in postmenopausal women. 25 In our regression analysis, android fat, gynoid fat, and android fatYtoYgynoid fat ratio were not considered as significant independent predictors of BMD although in the univariate regression analyses, they were all positively associated with femoral neck BMD.…”

Section: Discussionmentioning

confidence: 79%

“…10,23 Although in a previous study from Warming et al, 25 AFM was also found to be correlated to bone mass, their findings suggested that abdominal fat is more important than peripheral fat for endometrial thickness and bone mass in postmenopausal women. 25 In our regression analysis, android fat, gynoid fat, and android fatYtoYgynoid fat ratio were not considered as significant independent predictors of BMD although in the univariate regression analyses, they were all positively associated with femoral neck BMD. Despite suggestions that android fat deposition has a negative association with BMD, 7,8 the relative effect of android fat, gynoid fat, and their ratio on BMD is inconsistent.…”

Section: Discussionmentioning

confidence: 79%

“…Despite suggestions that android fat deposition has a negative association with BMD, 7,8 the relative effect of android fat, gynoid fat, and their ratio on BMD is inconsistent. For instance, several studies have revealed that abdominal fat and waist-to-hip ratio were positively and significantly associated with bone mass, 25,26 whereas others found no statistically significant association between fat distribution and BMD in older non-Hispanic white women. 9 In contrast, Zillikens et al 7 suggested that after removing the effect of BMI, android fat deposition as measured by the waistto-hip ratio, waist-to-thigh ratio, and dual-energy x-ray absorptiometryYbased android fatYtoYgynoid fat ratio has no association or a negative association with BMD.…”

Section: Discussionmentioning

confidence: 97%

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Appendicular fat mass is positively associated with femoral neck bone mineral density in older women

et al. 2012

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“…This may be related to lower 25(OH)D 3 levels, but the mechanisms for these alterations may be independent of each other. In addition, serum mineral levels of phosphate and calcium may be influenced by both obesity and fat distribution [29], whereas visceral fat accumulation is associated with greater bone mass [30,31].…”

Section: Endocrine Changes In Obesitymentioning

confidence: 99%