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Bone characteristics and metabolic phenotypes of obesity in an Iranian Elderly population: Bushehr Elderly Health Program (BEHP)

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Abstract

Introduction

Obesity and osteoporosis are health problems with high impact on the morbidity and mortality rate. While the association between BMI and bone density is known, the combined effects of obesity and metabolic components on bone health have not yet been revealed. The objectives of this study were to determine the association between bone health and different phenotypes of obesity in an elderly population.

Methods

This cross-sectional study was conducted on the data collected in the Bushehr Elderly Health Program (BEHP). The participants were classified in four groups based on the metabolic phenotypes of obesity (metabolic healthy obese (MHO), metabolic non-healthy non-obese (MNHNO), metabolic non-healthy obese (MNHO), and metabolic healthy non-obese (MHNO)). The association between osteoporosis and TBS and the metabolic phenotypes of obesity were assessed using multiple variable logistic regression models.

Results

Totally, 2378 people (1227 women) were considered for analyses. The prevalence of MHNO, MHO, MNHNO, and MNHO were 902 (39.9%), 138 (6.1%), 758 (33.5%), and 464 (20.5%), respectively. In the multivariate logistic regression models, those with MHO (OR 0.22; 95% CI 0.12–0.36), MNHNO (OR 0.52; 95% CI 0.4–0.66), and MNHO phenotypes (OR 0.22; 95% CI 0.16–0.3) had a significantly lower risk of osteoporosis. Likewise, those having MHO (OR 2.38; 95% CI 1.51–3.76), MNHNO (OR 1.49; 95% CI 1.11–2), and MNHO (OR 2.50; 95% CI 1.82–3.42) phenotypes were found to had higher risk of low bone quality as confirmed by TBS.

Conclusions

The obese subjects have lower bone quality, regardless of their obesity phenotype.

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References

  1. Collaborators GO (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377(1):13–27

    Article  Google Scholar 

  2. Jafari-Adli S et al (2014) Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord 13(1):121

    Article  Google Scholar 

  3. Zhao L-J et al (2007) Relationship of obesity with osteoporosis. J Clin Endocrinol Metab 92(5):1640–1646

    Article  CAS  Google Scholar 

  4. Genant HK et al (1999) Interim report and recommendations of the World Health Organization task-force for osteoporosis. Osteoporos Int 10(4):259–264

    Article  CAS  Google Scholar 

  5. Irani AD et al (2013) Prevalence of osteoporosis in Iran: a meta-analysis. J Res Med Sci 18(9):759

    PubMed  PubMed Central  Google Scholar 

  6. Silva BC et al (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29(3):518–530

    Article  Google Scholar 

  7. Martineau, P. and W. Leslie, Trabecular bone score (TBS): method and applications. Bone, 2017.

  8. Bousson V et al (2015) Trabecular bone score: where are we now? Joint Bone Spine 82(5):320–325

    Article  Google Scholar 

  9. Harvey N et al (2015) Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. Bone 78:216–224

    Article  CAS  Google Scholar 

  10. Kim, Y.-S., et al., The correlation between bone mineral density/trabecular bone score and body mass index, height, and weight. Osteoporosis and Sarcopenia, 2017.

  11. Hasani-Ranjbar S et al (2019) Association of osteoporosis with anthropometric measures in a representative sample of iranian adults: the Iranian Multicenter Osteoporosis Study. Int J Prev Med 10:157

    Article  Google Scholar 

  12. Bredella MA et al (2012) Determinants of bone microarchitecture and mechanical properties in obese men. J Clin Endocrinol Metab 97(11):4115–4122

    Article  CAS  Google Scholar 

  13. Amininezhad F et al (2015) Evaluation of the validity of the FRAX® algorithm for predicting risk of osteoporotic fracture in Iran. Osteologie 24(03):183–186

    Article  Google Scholar 

  14. Gilsanz V et al (2009) Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab 94(9):3387–3393

    Article  CAS  Google Scholar 

  15. Cohen A et al (2013) Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women: a transiliac bone biopsy study. J Clin Endocrinol Metab 98(6):2562–2572

    Article  CAS  Google Scholar 

  16. Cao JJ (2011) Effects of obesity on bone metabolism. J Orthop Surg Res 6(1):30

    Article  Google Scholar 

  17. Wisse BE (2004) The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked to obesity. J Am Soc Nephrol 15(11):2792–2800

    Article  CAS  Google Scholar 

  18. Ebrahimpur M et al (2019) Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program. J Diabetes Metab Disord 18:99–106

    Article  CAS  Google Scholar 

  19. Bagherzadeh, M., et al., Effects of metabolic syndrome on bone health in older adults: the Bushehr Elderly Health (BEH) program. Osteoporosis International: a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020.

  20. Ebrahimpur M et al (2020) Osteoporosis and cognitive impairment interwoven warning signs: community-based study on older adults-Bushehr Elderly Health (BEH) Program. Arch Osteoporos 15(1):140

    Article  Google Scholar 

  21. Gower BA, Casazza K (2013) Divergent effects of obesity on bone health. J Clin Densitom 16(4):450–454

    Article  Google Scholar 

  22. Nielson CM et al (2011) BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). J Bone Miner Res 26(3):496–502

    Article  Google Scholar 

  23. Gonnelli S, Caffarelli C, Nuti R (2014) Obesity and fracture risk. Clin Cases Miner Bone Metab 11(1):9

    PubMed  PubMed Central  Google Scholar 

  24. Ostovar A et al (2015) Bushehr Elderly Health (BEH) Programme, phase I (cardiovascular system). BMJ Open 5(12):e009597

    Article  Google Scholar 

  25. Shafiee G et al (2017) Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II). BMJ Open 7(8):e013606. https://doi.org/10.1136/bmjopen-2016-013606

    Article  PubMed  PubMed Central  Google Scholar 

  26. Organization WH. Expert Committee on Physical Status. Physical status: the use and interpretation of anthropometry. WHO technical report 854. Geneva: World Health Organization (1995), p. 420.

  27. Kanis JA et al (1994) The diagnosis of osteoporosis. J Bone Miner Res 9(8):1137–1141

    Article  CAS  Google Scholar 

  28. Shafiee G et al (2020) The reference value of trabecular bone score (TBS) in the Iranian population. J Diabetes Metab Disord 19(1):493–498. https://doi.org/10.1007/s40200-020-00537-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Grundy SM et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 112(17):2735–2752

    Article  Google Scholar 

  30. Lv S et al (2016) Assessment of fat distribution and bone quality with trabecular bone score (TBS) in healthy Chinese men. Sci Rep 6:24935

    Article  CAS  Google Scholar 

  31. Looker A et al (2016) Trabecular bone scores and lumbar spine bone mineral density of US adults: comparison of relationships with demographic and body size variables. Osteoporos Int 27(8):2467–2475

    Article  CAS  Google Scholar 

  32. Kim Y-S et al (2017) The correlation between bone mineral density/trabecular bone score and body mass index, height, and weight. Osteoporosis and Sarcopenia 3(2):98–103

    Article  Google Scholar 

  33. Povoroznyuk, V., et al., Bone mineral density and trabecular bone score in Ukrainian women with obesity. 2016.

  34. Povoroznyuk V et al (2017) Bone mineral density and trabecular bone score in Ukrainian men with obesity. Maturitas 100:141–142

    Article  Google Scholar 

  35. Mazzetti G et al (2017) Densitometer-specific differences in the correlation between body mass index and lumbar spine trabecular bone score. J Clin Densitom 20(2):233–238

    Article  Google Scholar 

  36. Ayoub M-L et al (2017) Trabecular Bone Score in obese, overweight and normal-weight young men. Sci Sports 32(1):33–38

    Article  Google Scholar 

  37. Hsu Y-H et al (2006) Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women–. Am J Clin Nutr 83(1):146–154

    Article  CAS  Google Scholar 

  38. Romagnoli E et al (2016) Assessment of trabecular bone score (TBS) in overweight/obese men: effect of metabolic and anthropometric factors. Endocrine 54(2):342–347

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to express their gratefulness to the staff and researchers of the Bushehr Elderly Health Program for their thoughtful contribution.

Funding

This article was a part of a larger project which was granted by the Endocrinology and Metabolism Research Institute (EMRI).

Author information

Authors and Affiliations

  1. Endocrinology, and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Jalal-AL-Ahmad St, Chmaran HWY, 14117-13137, Tehran, Iran

    Farzaneh Amininezhad, Firouzeh Hajipour & Bagher Larijani

  2. Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Moloud Payab

  3. Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Farshad Sharifi, Zhaleh Shadman & Mahbube Ebrahimpur

  4. Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Afshin Ostovar

  5. Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Neda Mehrdad

  6. Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran

    Neda Mehrdad

  7. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Ramin Heshmat & Gita Shafiee

  8. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Hadizadeh

  9. Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran

    Mohammad Bagherzadeh

  10. Yas Diabetes and Metabolic Diseases Research Center, Tehran, Iran

    Sedigheh Ziaei

  11. Center for Microsystems Technology, Imec & Ghent University, Zwijnaarde - Gent, Belgium

    Patricia Khashayar

  12. The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran

    Iraj Nabipour

Authors
  1. Farzaneh Amininezhad
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  2. Moloud Payab
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  3. Farshad Sharifi
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  16. Mahbube Ebrahimpur
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Correspondence to Bagher Larijani or Mahbube Ebrahimpur.

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Amininezhad, F., Payab, M., Sharifi, F. et al. Bone characteristics and metabolic phenotypes of obesity in an Iranian Elderly population: Bushehr Elderly Health Program (BEHP). Arch Osteoporos 16, 92 (2021). https://doi.org/10.1007/s11657-021-00953-2

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