Exercise and its interaction with genetic influences in the determination of bone mineral density (original) (raw)
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Factors affecting bone mineral density in postmenopausal women
Archives of Osteoporosis, 2015
This study aimed to determine the relationship between bone mineral density (BMD) and demographic, biochemical, and clinical features according to BMD measurement sites. The results indicated that BMD correlates negatively with menopause duration, parity, and history of fractures but positively correlates with obesity, physical activity, education, and serum ferritin. Purpose/Introduction Osteoporosis (OP) is an important cause of morbidity and mortality in the elderly people. The impacts of various factors on bone mineral density (BMD) differ across diverse population. We hypothesized that the influences of factors which affect BMD vary according to BMD measurement sites. The aim of this study was to determine the relationship between BMD in the femoral neck (FN) and lumbar spine (LS) with some common clinical, demographic, and biochemical parameters in postmenopausal women. Methods In this cross-sectional case-control study, all postmenopausal women of the Amirkola Health and Ageing Project (AHAP) who performed bone densitometry were included. BMD at FN and LS was measured by DXA method. Data regarding clinical, demographic, and biochemical characteristics were provided. OP was diagnosed by the International Society for Clinical Densitometry criteria. Pearson correlation and multivariate regression analyses with simultaneous adjustment were performed to determine relationship. Results Five hundred thirty-seven women with mean age of 67.9±6.7 years and mean menopause duration (MD) of 15.8± 5.1 years were studied. MD correlated negatively with FN-BMD and LS-BMD g/cm 2 (r = −0.405, p = 0.001 and r = −0.217, p=0.001). Body mass index (BMI) correlated positively with FN and LS-BMD g/cm 2 (r=0.397, p=0.001 and r=0.311, p=0.001). The association of MD with risk of FN-OP was stronger than LS-OP. Obesity and metabolic syndrome (MS) and higher serum ferritin reduced the risk of OP at both LS and FN similarly, whereas the impacts of parity, prior fracture, high level of education, and physical activity were significantly different across BMD measurement sites. Conclusion The results of this study indicated a significant association between OP and MD, obesity, parity, MS, history of fracture, serum ferritin, level of education, and physical activity. However, the direction and the strength of association varied across BMD measurement sites.
Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis
Journal of Bone and Mineral Research, 2009
Changes of bone turnover with aging are responsible for bone loss and play a major role in osteoporosis. Although an increase of bone turnover has been documented at the time of menopause, the subsequent abnormalities of bone resorption and formation and their potential role in determining bone mass in the elderly have not been investigated. To address this issue, we have measured a battery of new sensitive and specific markers of bone turnover in a population-based study of 653 healthy women analyzed cross-sectionally, including 432 women postmenopausal from 1 to 40 years, and the data were correlated with bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) at different skeletal sites. Bone formation was assessed by serum osteocalcin (OC), serum bone-specific alkaline phosphatase (B-ALP), serum C-propeptide of type I collagen (PICP), and bone resorption by the urinary excretion of two pyridinoline cross-linked peptides (NTX and CTX). Bone turnover increased in perimenopausal women with both irregular menses and elevated serum follicle stimulating hormone (FSH). Menopause induced a 37-52% and 79-97% increase in the bone formation and bone resorption marker levels, respectively (p < O.OOO1 except for PICP). In postmenopausal women, bone formation markers did not decrease with age. When resorption markers were corrected by whole body bone mineral content (BMC), the fraction of bone resorbed per day was not correlated with age in postmenopausal women and remained elevated for up to 40 years after menopause. In premenopausal women, the bone turnover rate accounted for only 0-lW of the variation in whole body BMC, total hip, distal radius, and lumbar spine BMD. With increasing time after menopause, the importance of the bone turnover rate as a determinant of bone mass increased at all sites and accounted for up to 52% of the BMD variance in elderly women. Thus, in women 20 years or more postmenopause, bone turnover was higher in those in the lowest quartile than in those in the highest quartile of BMD. In elderly women, 20 years since menopause and over, but not in younger ones, serum FTH was negatively correlated with serum 25-hydroxyvitamin D (r =-0. 2 2 ,~ < 0.05) and explained only 5 4 % of the bone turnover variance (p < 0.01-0.001). These data indicate that the overall rates of both bone formation and bone resorption remain high in elderly women. The rate of bone turnover appears to play an increasing role as a determinant of bone mass with increasing time since menopause with a high bone turnover rate being associated with a low bone mass. Thus assessing bone marker levels may be useful in the evaluation of osteoporosis risk. In elderly women, secondary hyperparathyroidism caused in part by reduced serum 25-hydroxyvitamin D appears to be a marginal determinant of an increased bone turnover rate.
Bone mineral density in old age: the influence of age at menarche and menopause
Journal of Bone and Mineral Metabolism, 2004
Being aware that age at menarche, age at menopause, and length of fertile period influence bone mineral density (BMD) in the early postmenopausal period, we have failed to find any earlier studies where such an influence on the axial skeleton has been studied in old age when the incidence of hip fracture starts to increase. A large cohort of women, all 75 years old (n ϭ 1044) participated in the Malmö Osteoporosis Prospective Risk Assessment (OPRA) Study. The BMD of the lumbar spine and femoral neck was assessed by a dual-energy X-ray absorptiometry (DXA) technique. Age at menarche and at menopause was recalled with a questionnaire. Also, data on estrogen medication was collected. We found that, after excluding ever-users of potent estrogens (n ϭ 49), there was a small but significant correlation of early menarcheal age with high BMD of the lumbar spine (r ϭ Ϫ0.08; P ϭ 0.017) and femoral neck (r ϭ Ϫ0.10; P ϭ 0.002) at age 75. Excluding the extremes (5% of the women) with very early or very late menarche, age at menarche no longer influenced the BMD in old age (r ϭ Ϫ0.06; P ϭ 0.113). Age at menopause had no influence on the BMD of the lumbar spine (r ϭ 0.04; P ϭ 0.246) or femoral neck (r ϭ 0.00; P ϭ 0.985), at age 75. The length of the fertile period did not influence BMD in old age. The influence of menarcheal or menopausal age on BMD at age 75 was not substantially altered after including body mass index (BMI) in a multiple regression model. Age at menarche or menopause seems to be of limited or no importance as a risk factor for osteoporosis when subjects are age 75 or older.
Multifactorial analysis of risk factors for reduced bone mineral density among postmenopausal women
Archives of Medical Science, 2012
Introduction: The study aimed to determine the risk factors for reduced bone mineral density (BMD) among postmenopausal women. Material and methods: Two hundred and fifty-three postmenopausal women were included to the study. The study group consisted of 85 women with osteoporosis (mean age: 59.9 years) and 168 with osteopenia (mean age: 57.8 years). Patients were assigned to groups according to their BMD measured in the lumbar spine, hip and femoral neck by dual X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorption by measuring serum C-terminal type I α-collagen chain telopeptide. Results: Multiple regression analysis for lumbar spine showed association of age (p = 0.001), parental history of fracture (p = 0.05), use of hormone replacement therapy (p = 0.034), bisphosphonates therapy (p < 0.001), calcium and vitamin D supplements therapy (p = 0.001), oestradiol level (p = 0.007) and body mass index (p < 0.001). Multiple regression analysis for femoral neck and hip total showed association of age (p = 0.001), parental history of fracture (p = 0.049), use of bisphosphonates (p < 0.03)) use of calcium and vitamin D supplements (p = 0.039), oestradiol level (p = 0.047). All the variables together explain 40.4% of variance in BMD for the lumbar spine and 25.6% of variance in BMD for femoral neck and hip total. Conclusions: The present study demonstrated correlations between the variables and BMD, which are known and widely described in the literature. Osteoporosis and osteopenia in Polish subjects appear to be associated with several known risk factors that are well described in the literature.
Clinics in Sports Medicine, 2000
Osteoporosis is the most common skeletal disease in humans. It is characterized by low bone mass and microarchitectural deterioration of the bone tissue, leading to decreased bone strength and increased risk of low-energy fractures, or so-called fragility fractures. Osteoporosis affects a large number of people of both sexes and all races and its prevalence increases with age. Osteoporosis is a risk factor for fracture just as hypertension is for stroke. The most common osteoporotic-related fractures are those of the vertebrae (spine), proximal femur (hip), and distal forearm (wrist). This article focuses on postmenopausal bone health and osteoporosis. It provides guidance for providers of health care to women on proper screening, identification of secondary causes, and appropriate treatment of osteoporosis. PATHOPHYSIOLOGY The skeleton is one of the largest organ systems in the body. It consists of a mineralized matrix with a small but highly active cellular fraction. Bone is formed by Disclosure: The authors have nothing to disclose.
Age-related decrements in bone mineral density in women over 65
Journal of Bone and Mineral Research, 2009
Age-related changes in bone density contribute to the risk of fractures. To describe the relationship between age and bone mass in elderly women, we studied a large cohort of women over age 65 years who were recruited from population-based lists in four cities in the United States. Bone density in g/cma was measured by single-photon absorptiometry (SPA) and dual x-ray absorptiometry (DXA) at the distal and proximal radius, the calcaneus, the lumbar spine, and the proximal femur. Centralized data collection was used to control data quality and consistency. We found a strong inverse relationship between bone density and age for most sites. Decrements in bone density between women aged 65-69 years and women 85 years and older exceeded 16% in nll regions except the spine, where the difference between the two age groups was 6Vo. Ward's triangle and the cnlcaneus exhibited the largest decrements, with 26 and 21%' respectively. The estimates of annual changes in bone mineral density by linear regression at sites other than the spine ranged from-0.82% at the femoral neck and trochanter to-1.30% at Ward's triangle. Correlations between the diffetent regions ranged from r = 0.51 between the proximal radius and Ward's triangle to r = 0.66 between the distal radius and dcaneus. We conclude that the inverse relationship between age and bone mass measured by absorptiometry techniques in white women continues into the ninth decade of life. The relationship is strongest for bone density of Ward's triangle and the calcaneus and weakest for the spine.