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Association and relative importance of multiple obesity measures with bone mineral density: the National Health and Nutrition Examination Survey 2005–2006

Archives of Osteoporosis volume 10, Article number: 14 (2015) Cite this article

Abstract

Summary

All obesity measures were positively associated with femoral neck bone mineral density (BMD), but not with lumbar spine BMD. Hip circumference was the most important obesity measure in relation to BMD.

Purpose

Multiple measures are used to quantify obesity; different obesity measures have diverse relationship with BMD. Which obesity measure has the most important value in relation to BMD is still poorly understood. We examined the association between multiple obesity measures and BMD and determined the relative importance (RI, percentage of variation) of multiple obesity measures associated with BMD.

Methods

Data from 5287 men and women aged between 8 and 69 years (mean age = 29 years) in the National Health and Nutrition Examination Survey 2005–2006 were analyzed. Body mass index (BMI), waist circumference, hip circumference, body fat mass (FM) index, total body FM, abdominal FM, and appendicular FM were considered the exposures and femoral neck and lumbar spine BMD the outcomes.

Results

In the multivariable analysis, greater BMI and hip circumference were associated with increased BMD at the lumbar spine and femoral neck (all P < 0.001). The remaining obesity variables were positively associated with increased femoral neck BMD only (all P < 0.001). RI of all obesity measures associated with femoral neck BMD was much greater than that associated with lumbar spine BMD. Moreover, hip circumference had higher RI (19.8 for femoral neck BMD; 7.0 for lumbar spine BMD) than other obesity measures (all RIs ≤14.1 for femoral neck BMD; all RIs ≤3.5 for lumbar spine BMD) in relation to BMD.

Conclusions

All obesity measures were positively associated with femoral neck BMD, but not with lumbar spine BMD. Hip circumference was the most important obesity measure in relation to BMD.

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Acknowledgments

The current study has no funding body. We thank Dr. Ann Voung for editing our manuscript.

Conflicts of interest

None.

Author information

Affiliations

  1. Department of Internal Medicine/Community Health Sciences, University of Manitoba, P216-670 Bannatyne Ave, Winnipeg, R3E 0W2, Manitoba, Canada

    Shuman Yang

  2. Laobian People’s Hospital, Yingkou, 115005, Liaoning, China

    Xuejun Shen

Authors
  1. Shuman Yang
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  2. Xuejun Shen
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Corresponding author

Correspondence to Shuman Yang.

Electronic supplementary material

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Supplemental Table 1

Association between demographic variables, obesity variables stratified by quintiles of lumbar spine BMD. Values are means, unless otherwise specified. ±Values with skew distribution is shown in median. (DOC 48 kb)

Supplemental Table 2

Association between demographic variables, obesity variables stratified by quintiles of femoral neck BMD. Values are means, unless otherwise specified. ±Values with skew distribution is shown in median. (DOC 47 kb)

Supplemental Table 3

Association between obesity measures and BMD stratified by age. *Values are approximately 1 SD. The rest values are displayed in β (P value), and were adjusted for age (continuous), gender (male and female; only in overall analysis), body height (continuous), physical activity (in quartiles), alcohol intake (1–2 and 3+ drinks/day), smoking status (current, past and never smoker), history of diabetes (yes/no), history of hypertension (yes/no), race (Mexican American, Hispanic, Non-Hispanic White, Non-Hispanic Black, and others) and survey weights. (DOC 37 kb)

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Yang, S., Shen, X. Association and relative importance of multiple obesity measures with bone mineral density: the National Health and Nutrition Examination Survey 2005–2006. Arch Osteoporos 10, 14 (2015). https://doi.org/10.1007/s11657-015-0219-2

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  • DOI: https://doi.org/10.1007/s11657-015-0219-2

Keywords

  • Obesity
  • Fat mass
  • Waist circumference
  • Hip circumference
  • Bone mineral density