Calcified Tissue International

, Volume 95, Issue 1, pp 19–28

Bone Structure and Estimated Bone Strength in Obese Patients Evaluated by High-Resolution Peripheral Quantitative Computed Tomography

  • Stine Andersen
  • Katrine Diemer Frederiksen
  • Stinus Hansen
  • Kim Brixen
  • Jeppe Gram
  • René Klinkby Støving
Original Research

DOI: 10.1007/s00223-014-9857-4

Cite this article as:
Andersen, S., Frederiksen, K.D., Hansen, S. et al. Calcif Tissue Int (2014) 95: 19. doi:10.1007/s00223-014-9857-4

Abstract

Obesity is associated with high bone mineral density (BMD), but whether obesity-related higher bone mass increases bone strength and thereby protect against fractures is uncertain. We estimated effects of obesity on bone microarchitecture and estimated strength in 36 patients (12 males and 24 females, age 25–56 years and BMI 33.2–57.6 kg/m2) matched with healthy controls (age 25–54 years and BMI 19.5–24.8 kg/m2) in regard to gender, menopausal status, age (±6 years) and height (±6 cm) using high resolution peripheral quantitative computed tomography and dual energy X-ray absorptiometry. In radius, total bone area and trabecular area were significantly higher in obese patients (both p < 0.04). In tibia, cortical area was larger in obese patients (p < 0.001) compared with controls. Total BMD was higher in tibia (p = 0.03) but not in radius. Trabecular integrity was strengthened in obese patients compared with controls in radius and tibia with higher trabecular number (p = 0.002 and p < 0.001) and lower trabecular spacing (p = 0.01 and p < 0.001). Finite element analysis estimated failure load (FL) was higher in tibia (p < 0.001), but not in radius in obese patients. FL was significantly lower per kg body weight in radius and tibia in obese patients compared with controls (p = 0.007 and p < 0.001). Furthermore, the ratios of FLs between groups were comparable in both sites. These findings suggest that mechanical loading is not the primary mediator of the effects of obesity on estimated FL, and suggest that bone strength adaptations in morbid obesity may be inadequate with respect to the increased mechanical demands.

Keywords

ObesityBone microarchitectureBone strengthHigh resolution pQCTFinite element analysis

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Stine Andersen
    • 1
  • Katrine Diemer Frederiksen
    • 1
  • Stinus Hansen
    • 1
    • 2
    • 3
  • Kim Brixen
    • 1
    • 4
  • Jeppe Gram
    • 3
  • René Klinkby Støving
    • 1
    • 5
  1. 1.Department of EndocrinologyOdense University HospitalOdense CDenmark
  2. 2.University of Southern DenmarkOdense MDenmark
  3. 3.Department of EndocrinologyHospital of Southwest DenmarkEsbjergDenmark
  4. 4.Institute of Clinical ResearchUniversity of Southern DenmarkOdense CDenmark
  5. 5.Center for Eating DisordersOdense University HospitalOdense CDenmark