Skip to main content
Log in

Structural equation modeling of the relationship of bone mineral density and its risk factors in Japanese women

  • Original Article
  • Published:
Environmental Health and Preventive Medicine Aims and scope

Abstract

Several factors have been reported as risk factors for the development of osteoporosis. In this study, we aimed to examine the relationship among lifestyle factors, biologic factors, and bone mineral density (BMD) using structural equation modeling (SEM). The subjects in the present study consisted of 866 postmenopausal Japanese women aged between 40 and 80 years old. In the analysis by the SEM, we employed a multiple basic model. As the structural variables, lifestyle factors and biologic factors were selected.

The goodness of fit index (GFI) of the final model was 0.991 and the Akaike’s information criteria (AIC) showed the lowest value in the peripheral models. The degree of association between biologic factors and BMD was −0.576 (direct association), 0.012 (indirect association), and −0.564 (total association). With regard to the correlation between lifestyle factors and BMD, the degrees of association were 0.085, −0.084, and 0.001, respectively.

This study defined a pilot model for factors influencing BMD. Although is remains necessary to conduct further analyses with more valid measurements and constructs, this model indicated that the correlation between BMD and lifestyle factors was lower than that between BMD and biologic factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Willhite L, Osteoporosis in woman: prevention and treatment. J. Am. Pharm. Assoc. 1998; 38: 614–624.

    CAS  Google Scholar 

  2. Suzuki T, Yoshida H, Ishizaki T. Epidemiology of osteoporosis: incidence, prevalence, and prognosis. Jpn. J. Clin. Med. 1998; 56: 1563–1568. (in Japanese)

    CAS  Google Scholar 

  3. Looker AC, Orwoll ES, Johnston CC Jr, Lindsay RL, Wahner HW, Dunn WL, et al. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J. Bone Miner. Res. 1997; 12: 1761–1768.

    Article  PubMed  CAS  Google Scholar 

  4. Cook DJ, Guyatt GH, Adachi JD, Clifton J, Griffith LE, Epstein RS, et al. Quality of life issues in woman with vertebral fractures due to osteoporosis. Arthritis. Rheum. 1993; 36: 750–756.

    Article  PubMed  CAS  Google Scholar 

  5. Greendale GA, Silverman SL, Hays RD, Cooper D, Spector T, Kiel D, Reuben DB. Health-related quality of life in osteoporosis clinical trials. Calif. Tissue. Int. 1993; 53: 75–77.

    Article  CAS  Google Scholar 

  6. Gold DT, Drenzner MK. Quality of life. In Riggs BL, Melton LJ (eds). Osteoporosis: etiology, diagnosis, and management. 2nd ed. 1995, Philadelphia, Lippincott-Raven, 475–486.

    Google Scholar 

  7. Kanis JA, Minne WH, Meunier PJ, Ziegler R, Allender E. Quality of life and vertebral osteoporosis. Osteoporos. Int. 1992; 2: 161–163.

    Article  PubMed  CAS  Google Scholar 

  8. Begerow B, Pfeifer M, Pospeschill M, Scholz M, Schlotthauer T, Lazarescu A, et al. Time since vertebral fracture: an important variable concerning quality of life in patients with postmenopausal osteoporosis. Osteoporos. Int. 1999; 10: 26–33.

    Article  PubMed  CAS  Google Scholar 

  9. Lindsay R. The growing problem of osteoporosis. Osteoporos. Int. 1992; 2: 267–268.

    Article  PubMed  CAS  Google Scholar 

  10. Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Numbers, costs, and potential effects of post-menopausal estrogen. Clin. Orthop. 1990; 252: 163–166.

    PubMed  Google Scholar 

  11. Toyokawa S, Douglas Osei-Hyiaman, Ueji M, Takahashi H, Kano K. An epidemiological study of the relationship between bone mineral density and sever obesity. Igaku to Seibutsugaku 1997; 134: 217–221. (in Japanese)

    Google Scholar 

  12. Kanis JA, McCloskey EV. Risk factors in osteoporosis. Maturitas 1998; 30: 229–233.

    Article  PubMed  CAS  Google Scholar 

  13. Kanis JA. Osteoporosis: a view into the next century. Neth. J. Med. 1997; 50: 198–203.

    Article  PubMed  CAS  Google Scholar 

  14. Riggs BL, Melton LJ III. Involutional osteoporosis. N. Engl. J. Med. 1986; 314: 1676–1685.

    PubMed  CAS  Google Scholar 

  15. Bollen KA. Structural equations with latent variables. John Wiley and Sons, New York, 1989.

    Google Scholar 

  16. Bollen KA, Long JS. Testing Structural equations Models. SAGE Publications, Newbury Park, 1993.

    Google Scholar 

  17. Toyoda H. Covariance Structure Analysis with SAS (Stastical data analysis using SAS3). University of Tokyo press, Tokyo, 1992 (in Japanese)

    Google Scholar 

  18. Kano K. Relationship between exercise and bone mineral density between over 5,000 women aged 40 years and above. J. Epidemiol. 1998; 8: 28–32.

    PubMed  CAS  Google Scholar 

  19. Matsumoto C, Kushida K, Yamazaki K, Imose K, Inoue T. Metacarpal bone mass in normal and osteoporotic Japanese women using computed X-ray densitometry. Calcif. Tissue Int. 1994; 55: 324–329.

    Article  PubMed  CAS  Google Scholar 

  20. Matsumoto C, Kushida K, Orimo H, Kosikawa Shouzou, Shiraki M, Akimoto T, et al. A new computed x-ray densitometor and its performance. J. Clin. Exp. Med. 1991; 156: 741–742. (in Japanese)

    Google Scholar 

  21. Osei-Hyiaman D, Toyokawa S, Ueji M, Takahashi H, Kano K. Timing of menopause, reproductive years, and bone mineral density. A cross-sectional study of postmenopausal Japanese Woman. Am. J. Epidemiol. 1998; 148: 1055–1061.

    PubMed  CAS  Google Scholar 

  22. Osei-Hyiaman D, Ueji M, Toyokawa S, Takahashi H, Kano K. Influence of grip strength on metacarpal bone mineral density in postmenopausal Japanese woman: a cross-sectional study. Calcif. Tissue Int. 1999; 64: 263–266.

    Article  PubMed  CAS  Google Scholar 

  23. Melton LJ. Epidemiology of osteoporosis. Baillieres Clin. Obstet. Gynaecol. 1991; 5: 785–805.

    Article  PubMed  Google Scholar 

  24. Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J. Bone Miner. Res. 1994; 9: 1137–1141.

    PubMed  CAS  Google Scholar 

  25. Wei C, Yonemitsu H, Shibayama H, Ueda A. Investigation in Japanese using dual-energy x-ray absorptiometry. Jpn. J. Hyg. 1997; 51: 742–748. (in Japanese)

    CAS  Google Scholar 

  26. Sowers M. Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis. J. Bone Miner. Res. 1996; 11: 1052–1060.

    Article  PubMed  CAS  Google Scholar 

  27. Edelstein SL, Barrett-Conner E. Relationship between body size and bone mineral density in elderly men and women. Am. J. Epidemiol. 1993; 138: 160–169.

    PubMed  CAS  Google Scholar 

  28. Harris SS, Dawson-Hughes B. Weight, body composition, and bone density in postmenopausal women. Calcif. Tissue Int. 1996; 59: 428–432.

    PubMed  CAS  Google Scholar 

  29. Ribot C, Tremollieres F, Pouilles JM. The effect of obesity on postmenopausal bone loss and the risk of osteoporosis. Adv. Nutr. Res. 1994; 9: 257–271.

    PubMed  CAS  Google Scholar 

  30. Puente A, Postiglione A, Puente AE, Carpinelli A, Romano M, Oriente P. Peripheral body fat has a protective role on bone mineral density in elderly women. Eur. J. Clin. Nutr. 1998; 52: 690–693.

    Article  PubMed  Google Scholar 

  31. Preisinger E, Alacamioglu Y, Saradeth T, Resch KL, Gerold H, Metka M. Forearm bone density and grip strength in woman after menopause, with and without estrogen replacement therapy. Maturitas 1995; 21: 57–63.

    Article  PubMed  CAS  Google Scholar 

  32. Nelson M, Mayer AB, Rutherford O, Jones D. Calcium intake, physical activity and bone mass in pre-menopausal woman. J. Hum. Nutr. Diet. 1991; 4: 171–178.

    Article  Google Scholar 

  33. Bauer DC, Browner WS, Cauley JA, Orwoll ES, Scott JC, Black DM, et al. Factors associated with appendicular bone mass in older woman. Ann. Intern. Med. 1993; 118: 657–665.

    PubMed  CAS  Google Scholar 

  34. Kano K, Haga M, Hosoda T, Suzuki M, Ueji M, Takahashi H, et al. A study of osteoporosis among females aged 50 years and over using mass screening data. Jpn. J. Health Hum. Ecol. 1996; 62: 186–196. (in Japanese)

    Google Scholar 

  35. Pritchard JE, Nowson CA, Wark JD. Bone loss accompanying diet-induced or exercise-induced weight loss: a randomized controlled study. Int. J. Obes. 1996; 20: 513–520.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Toyokawa, S., Nishikawa, H., Ueji, M. et al. Structural equation modeling of the relationship of bone mineral density and its risk factors in Japanese women. Environ Health Prev Med 6, 41–46 (2001). https://doi.org/10.1007/BF02897308

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02897308

Key words

Navigation