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Effect of the body mass index, basal metabolic rate, and body fat on the radiofrequency echographic multi-spectrometry (REMS)-based bone mineral density and fracture risk: a cross-sectional study

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Abstract

Radiofrequency echographic multi-spectrometry (REMS) is a method to assess bone mineral density (BMD) of the axial skeleton, fragility score (FS), body mass index (BMI), basal metabolic rate (BMR), and body fat (BF) in %. The aim of the study was to investigate the influence of the BMI, BMR, and BF on the BMD and fracture risk with REMS. We conducted a cross-sectional study among 313 women, aged 20–90 years who underwent a screening for osteoporosis with REMS. Kruskal–Wallis was used to analyze the differences in BMI, BMR, and BF between the groups according to the BMD: normal BMD, osteopenia and osteoporosis and differences in the FS, fracture risk assessment (FRAX) for major osteoporotic fractures and for hip fractures (HF) according to the BMI groups: underweight, normal weight, overweight, obese, and extreme obese. Linear regression was used to assess the correlations BMI–BMD, BMR–BMD, and BF–BMD. BMI, BMR, and BF differed significantly between the groups according to the BMD (p < 0.001, p = 0.028, and p < 0.001, respectively). BMR showed high positive correlation to BMD (R = 0.765) with 95% confidence interval (CI) [0.715, 0.807] and significance of p < 0.001. BMI correlated significantly to BMD (p < 0.001), the correlation was low positive (R = 0.362) with 95% CI [0.262, 0.455]. In the BMI groups, there was significant difference in FRAX for HF and FS with p value 0.014 and < 0.001, respectively. Subjects with low BMI, BMR, and BF are at high risk for osteoporosis. Underweight women show significantly high fracture risk, assessed with FRAX and FS.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, University Hospital “UMBAL Dr. Georgi Stranski”, Medical University—Pleven, Pleven, Bulgaria

    Nikola Kirilov

  2. Department of Health Care, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria

    Stoyanka Vladeva

  3. Rheumatology Practice IPSMP, Stara Zagora, Bulgaria

    Fabian Bischoff

  4. Department of Internal Diseases, Medical University of Plovdiv, Clinic of Rheumatology, University Hospital ‘Kaspela’, Plovdiv, Bulgaria

    Zguro Batalov & Anastas Batalov

  5. Department of Internal Diseases, Pharmacology, Paediatrics, Social Medicine, Emergency Medicine, Computer Technology, Infectious Diseases, Physiotherapy and Rehabilitation, Epidemiology and Tropical Diseases, Faculty of Medicine, University “Prof. Dr. Assen Zlatarov”—Burgas, Burgas, Bulgaria

    Elena Bischoff

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Correspondence to Nikola Kirilov.

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All authors of this research paper have directly participated in the planning, execution, analysis of this study and contributed equally to this work. All authors take full responsibility for the integrity and accuracy of all aspects of the work and have approved the final version to be published.

The study was approved by the ethics commission for scientific research of the Medical Faculty, Trakia University, Stara Zagora, Bulgaria. (Protocol number: 26, date 01.06.2023).

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Kirilov, N., Vladeva, S., Bischoff, F. et al. Effect of the body mass index, basal metabolic rate, and body fat on the radiofrequency echographic multi-spectrometry (REMS)-based bone mineral density and fracture risk: a cross-sectional study. Rheumatol Int 43, 2271–2279 (2023). https://doi.org/10.1007/s00296-023-05460-w

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