Osteoporosis International

, Volume 17, Issue 8, pp 1202–1207 | Cite as

Correlations between bone mineral density and demographic, lifestyle, and biochemical variables in community-dwelling Japanese women 69 years of age and over

  • K. Nakamura
  • T. Saito
  • T. Nishiwaki
  • K. Ueno
  • M. Nashimoto
  • Y. Okuda
  • Y. Tsuchiya
  • R. Oshiki
  • K. Muto
  • M. Yamamoto
Original Article



A few epidemiologic studies have comprehensively attempted to identify risk factors for low bone mineral density (BMD) in elderly Asian women. The purpose of this study was to identify demographic, lifestyle, and biochemical factors correlated with BMD in elderly Japanese women 69 years of age and over.


The study design was cross-sectional. The subjects were 583 ambulatory women aged 69 years and over, and their average age was 74.3 (SD 4.4) years. Predictor variables were age, reproductive history, anthropometric indices, grip strength, calcium intake, lifestyle information, and serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D), osteocalcin (OC), and undercarboxylated osteocalcin (ucOC) values. The outcome variable was forearm BMD measured with a DTX-200 osteometer.


Simple linear regression analyses showed that BMD was significantly positively associated with body height, weight, body mass index, grip strength, serum albumin concentration, and “housework,” and negatively associated with age, years since menopause, age at menarche, number of children, serum 1,25(OH)2D concentration, serum OC concentration, and ucOC concentration. The stepwise multiple regression analysis showed that weight (β=0.00316, SE=0.00028, R2=0.180), age (β=−0.00321, SE=0.00050, R2=0.108), log-transformed serum OC (β=−0.0445, SE=0.0064, R2=0.053), log-transformed serum 1,25(OH)2D (β=−0.0401, SE=0.0074, R2=0.050), “farmwork” (β=0.00904, SE=0.00426, R2=0.005), and serum 25(OH)D concentration (β=0.000281, SE=0.000120, R2=0.003) were significantly associated with BMD.


It was concluded that body weight is a major predictor of forearm BMD among the factors measured in this study in independent Japanese women 69 years of age and over and that serum 1,25(OH)2D concentration may be associated with cortical BMD. Maintenance of body weight is very important for maintaining BMD in this population, unless a large weight aggravates obesity-related diseases. A follow-up study is needed to confirm these findings.


Body weight Bone density Elderly Epidemiology Vitamin D Vitamin K 



We wish to thank the staff of Muramatsu Health Center for their help in data collection. We are also indebted to Kyowa Medex Co. and Eisai Co. for the determinations of serum 25(OH)D and serum ucOC, respectively, and to Toyo Medic for their assistance in making the BMD measurements. This study was supported in part by a grant for scientific research relating to health promotion focusing on physical exercise from the Nakatomi Foundation (2003), a grant from the Japan Rheumatism Foundation (2003), a grant from the Japan Dairy Association (2004), and the Japan Osteoporosis Society Encouragement Award (2004).


  1. 1.
    Morita Y, Endo N, Iga T, Tokunaga K, Ohkawa Y (2002) The incidence of cervical and trochanteric fractures of the proximal femur in 1999 in Niigata Prefecture, Japan. J Bone Miner Metab 20:311–318PubMedCrossRefGoogle Scholar
  2. 2.
    Health and Welfare Statistics Association (2004) Kokumin-eisei-no-doko (Health and Welfare Statistics in Japan). Health and Welfare Statistics Association, Tokyo (in Japanese)Google Scholar
  3. 3.
    Kanis JA, Adami S (1994) Bone loss in the elderly. Osteoporos Int 4(Suppl 1):59–65PubMedCrossRefGoogle Scholar
  4. 4.
    Ooms ME, Lips P, Van Lingen A, Valkenburg HA (1993) Determinants of bone mineral density and risk factors for osteoporosis in healthy elderly women. J Bone Miner Res 8:669–675PubMedGoogle Scholar
  5. 5.
    Dargent-Molina P, Poitiers F, Breart G, EPIDOS Group (2000) In elderly women weight is the best predictor of a very low bone mineral density: evidence from the EPIDOS study. Osteoporos Int 11:881–888PubMedCrossRefGoogle Scholar
  6. 6.
    Sherman SS, Tobin JD, Hollis BW, Gundberg CM, Roy TA, Plato CC (1992) Biochemical parameters associated with low bone density in healthy men and women. J Bone Miner Res 7:1123–1130PubMedGoogle Scholar
  7. 7.
    Ooms ME, Lips P, Roos JC, van der Vijgh WJ, Popp-Snijders C, Bezemer PD, Bouter LM (1995) Vitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women. J Bone Miner Res 10:1177–1184PubMedGoogle Scholar
  8. 8.
    Hannan MT, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, Kiel DP (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res 15:710–720PubMedCrossRefGoogle Scholar
  9. 9.
    Nakamura K, Tanaka Y, Saitou K, Nashimoto M, Yamamoto M (2000) Age and sex differences in the bone mineral density of the distal forearm based on health check-up data of 6343 Japanese. Osteoporos Int 11:772–777PubMedCrossRefGoogle Scholar
  10. 10.
    Yoshida S, Nakamura K, Motonaga K, Kogashiwa M, Kagawa K (2004) Development of a semiquantitative food frequency questionnaire to estimate calcium intake of elderly Japanese. J Kink Welf 6:112–116 (in Japanese)Google Scholar
  11. 11.
    Black DM, Cummings SR, Genant HK, Nevitt MC, Palermo L, Browner W (1992) Axial and appendicular bone density predict fractures in older women. J Bone Miner Res 7:633–638PubMedGoogle Scholar
  12. 12.
    Nevitt MC, Johnell O, Black DM, Ensrud K, Genant HK, Cummings SR (1994) Bone mineral density predicts non-spine fractures in very elderly women. Osteoporos Int 4:325–331PubMedCrossRefGoogle Scholar
  13. 13.
    Riis BJ, Christiansen C (1988) Measurement of spinal or peripheral bone mass to estimate early postmenopausal bone loss? Am J Med 84:646–653PubMedCrossRefGoogle Scholar
  14. 14.
    Ooms ME, Lips P, Van Lingen A, Valkenburg HA (1993) Determinants of bone mineral density and risk factors for osteoporosis in healthy elderly women. J Bone Miner Res 8:669–675PubMedGoogle Scholar
  15. 15.
    Nakamura K, Nashimoto M, Matsuyama S, Hatakeyama M, Yamamoto M (2002) Correlates of bone mineral density in elderly women living in nursing homes for the disabled in Japan. Aging Clin Exp Res 14:485–490PubMedGoogle Scholar
  16. 16.
    Parikh SJ, Edelman M, Uwaifo GI, Freedman RJ, Semega-Janneh M, Reynolds J, Yanovski JA (2004) The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 89:1196–1199PubMedCrossRefGoogle Scholar
  17. 17.
    Garnero P, Sornay-Rendu E, Chapuy MC, Delmas PD (1996) Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 11:337–349PubMedCrossRefGoogle Scholar
  18. 18.
    Garnero P, Sornay-Rendu E, Duboeuf F, Delmas PD (1999) Markers of bone turnover predict postmenopausal forearm bone loss over 4 years: the OFELY Study. J Bone Miner Res 14:1614–1621PubMedCrossRefGoogle Scholar
  19. 19.
    Burckhardt P, Dawson-Hughes B, Heaney RP (eds) (2001) Nutritional aspects of osteoporosis. Academic Press, San DiegoGoogle Scholar
  20. 20.
    Ministry of Health, Labour and Welfare, Japan (2003) The National Nutrition Survey in Japan, 2001. Ministry of Health, Labour and Welfare, TokyoGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Authors and Affiliations

  • K. Nakamura
    • 1
  • T. Saito
    • 2
  • T. Nishiwaki
    • 3
  • K. Ueno
    • 3
  • M. Nashimoto
    • 4
  • Y. Okuda
    • 1
  • Y. Tsuchiya
    • 1
  • R. Oshiki
    • 5
  • K. Muto
    • 1
  • M. Yamamoto
    • 1
  1. 1.Department of Community Preventive MedicineNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Department of Health and NutritionNiigata University of Health and WelfareNiigataJapan
  3. 3.Department of Nursing, School of Health SciencesNiigata UniversityNiigataJapan
  4. 4.Nagaoka Nursing SchoolNagaokaJapan
  5. 5.Department of Physical TherapyNiigata University of Health and WelfareNiigataJapan

Personalised recommendations