2532
Views & Citations1532
Likes & Shares
There is a
need to simplify the means of identifying people at low risk of developing
osteoporosis in order to exclude them from screening to assess bone mineral
density, since this procedure is expensive and time consuming for general use
in the non-target population selected. Michaelsson et al. [1] determined the
relationship between body measurements (weight, height, body mass index, lean
tissue mass, fat mass, waist to hip ratio) and mineral bone density in 175
women aged 28-74 years in one Cross-sectional study in a county in central
Sweden. A weight over 71 kg was associated with a very low risk of osteopenia
compared to women weighing less than 64 kg. In addition, a specific sensitivity
analysis revealed that in this population, a woman weighing more than 70 kg is
not likely to have osteoporosis. All women who were defined as having total
body osteoporosis weighed over 62 kg. These data indicate that weight could be
used to exclude women from a screening program for postmenopausal osteoporosis.
Osteoporosis
is characterized by a reduction in mineral bone density (MBD). Women more than
men are at risk for fractures related to osteoporosis, especially in the
wrists, lumbar spine and hips. Numerous factors of diet and lifestyle,
including body weight, influence of MBD, and in turn, risk of fracture. The MBD
in the whole body, hip, lumbar spine and radius is weak to moderately correlate
to body weight, fat mass, and lean body mass in premenopausal, adolescent, and
elderly women, possibly as a result of skeletal stress from mechanical loading
of body weight alone. In addition, a larger lean body mass may be a cause.
Other explanations include increased hormonal circulation in obese women and a
greater conversion of adrenal androgens to estrogen linked to a greater mass of
adipose tissue. No value currently agrees that weight and height are related to
osteoporosis and risk of fracture, but some extra fat mass that yields a body
mass index >26-28 confers limited protection, since a thin figure that
yields a body mass index <22-24 increases the risk [2].
Klemetti and
Kolmakow [3] in their study, in order to determine if the mineral bone density
(MBD) of the mandibular cortex is correlated with an ordinal classification of
the inferior cortex morphology in panoramic radiographs, concluded that the use
of an ordinal classification of the mandibular cortex on panoramic radiographs
may be useful for general clinical dentists in assessing the local quality of
cortical bone.
The relationship between bone mineral density
and tooth loss was assessed in elderly women by Taguchi et al. [5]. The authors
concluded that the loss of posterior teeth is related not only to the decrease
of alveolar bone but also to its mineral bone density.
During
adulthood, the amount and quality of muscle and bone minerals decrease, as fat
increases. Men have larger mean amounts of muscle and bone and a higher mean
bone density than women. In women, the normal decrease in body mass and bone
quality is accentuated by menopause. On average, blacks have a greater number
of muscles and higher bone density than whites. Ethyl life, diet and exercise
are important for maintaining a healthy body and good bone quality. Physically
active people have increased levels of muscle and bone density. Age, sex, race
and lifestyle affect level and changes in body mass and bone mineral density
[6].
Low weight
(low percentage of body fat, low body mass index or low body weight) was
evaluated by Ravn et al. [7] in their study as a risk factor for low bone
mineral density (MBD) or increased bone loss in a randomized trial with
“alendronate” for the prevention of osteoporosis in postmenopausal women with
normal bone mass. The percentage of body fat, BMI and body weight was
correlated with the mean MBD. They concluded that a small increase in bone loss
was an important risk factor for low weight and that there was no association
between the parameters.
According to
Coin et al. [8] underweight individuals are associated with malnutrition and
osteoporosis. Other factors correlated to malnutrition such as protein shortage
may be involved in the relationship between low weight and osteoporosis.
Dietary calcium intake and physical activity
are considered to be practical measures for the prevention of osteoporosis.
However, its associations with mineral bone density (MBD) in elderly people are
unclear. The study by Nguyen et al. [9]
examined the association between osteoporosis and these two factors in relation
to body mass index (BMI) cross-sectional, epidemiological study involving 1075
women and 690 men, from 69 to +/- 6, 7 years old (mean +/- SD). Among
individuals with lower BMI (< or = 23 kg/m2 for females and < or
= 24 kg/m2 for males), quadriceps strength (< or = 15 kg for
females and < or = 28 kg for men) and dietary intake of calcium (< or =
465 mg/day), 64% and 40% of women and men, respectively, were classified as
having osteoporosis (based on a reduction of 2.5-SD men The prevalence was only
12% in women and 1.5% in men among those in the highest values of the three
factors. Adequate dietary intake of calcium and maintenance of a physically
active lifestyle in past decades of life could potentially translate into a
reduction in the risk of osteoporosis and consequently improve the quality and
perhaps the quantity of life in the elderly
population.
Low
pre-menopausal mineral bone density (MBD), a decrease in MBD and an increase in
bone fragility that occur as a result of aging and menopause, are major
determinants of the risk following osteoporosis fracture. In addition, low body
mass index (BMI), low calcium intake, low physical activity and smoking may
affect MBD [10].
Prospective
studies have shown that the incidence of osteoporotic fractures is inversely
related to bone mass. Peak bone mass is considered a major determinant of
mineral bone density (MBD) in adulthood; thus maximizing peak bone mass is
important for the prevention of osteoporosis. It has generally been accepted
that the highest peak of bone mass throughout the skeleton is reached during
the 35 years in both sexes, but in the lumbar spine and femoral neck, bone mass
accumulation is virtually complete by late adolescence and early adulthood.
Thus, failure to gain sufficient bone mass during skeletal growth and the
period of bone consolidation may predispose to the development of senile
osteoporosis. Some years ago and until recently it has been suggested that
senile osteoporosis is a pediatric disease. Consequently, assessment of bone
mineral status during childhood and adolescence may be a useful tool in
identifying individuals with reduced bone mass who might be exposed to an
increased risk of osteoporosis in adulthood [11].
Blum et al.
[12] in their study to assess the association of body size during adolescence
with subsequent bone mass in the adult led a continuation of a cohort study in
a base community of girls who participated in growth and sexual maturity in a
study 30 years ago. They concluded that low body weight and low BMI at menarche
appear to be significant predictors of reduced bone mass in healthy
premenopausal women aged 40-45 years old.
Yahata et
al. [13] in their study investigated the influence of modifiable risk factors
(body weight and lifestyle) for bone loss in mineral bone density (MBD).
Specific age changes in the metacarpal and their associations with body mass
index and lifestyle among 532 post-menopausal Japanese women's housing
communities were examined. The MBD of the metacarpal decreased significantly with
increasing age. A simple correlation analysis indicated that the metacarpal MBD
correlated significantly with BMI and physical activity index. Multiple
regression analysis showed that an increase in age was associated with MBD in
the decreased metacarpal and a larger BMI increased the MBD in the metacarpal.
Human bones decrease
in density and increase in porosity beginning
approximately in the third decade of life. Zlataric et al. [14]
in order to determine if mineral bone density of the mandible (MBD) and some
linear radiomorphometric measurements in the panoramic dental radiograph (PDR)
are correlated with different categories of body mass index (BMI) in elderly
individuals. Patients with BMIs of 20 to 25 kg/m2 were classified as
category 1 (generally accepted scale of normal BMI), and patients with BMIs greater than 25 were classified as category
2 (individuals with a skeletal heavy and a lot of body fat). The results
revealed statistically significant differences in all indices measured between
the different categories of BMI. The differences found were also statistically
significant in MBD values among different BMI categories; the differences were
more pronounced in women. Patients with category 3 BMI had significantly lower
MBD values compared to BMI category 2. They concluded that heavy people have
larger MBD and larger values in linear radiomorphometric measurements than
lighter people.
In the study, patients with generalized
osteoporosis were older (mean age: 72.2 vs. 54.7 years, p<0.001), lower
(height 153.1 vs. 161.7 cm, p<0.001) and had an index lower body mass (BMI)
(23.7 vs. 28.5 kg/m2; p<0.001) compared to patients with normal
BMD.
In their study, Knoke and Barrett-Connor [15]
evaluated the sex-specific effect of weight change on the change in total bone
mineral density of the hip during 4 years (1992-1996) in 1,214 adults in a
community dwelling whose average of age was 71 years. In the analyzes
controlled by age, average weight and lifestyle, weight loss was the strongest
independent predictor of bone loss. In analysis of invariable logistic
regression, hip bone loss of at least 1 percent per year increased with age in
both men and women. Similarly, in the simple linear regression analysis,
measured continuously, bone loss in the hip increased with age in both men and
women. A lower mean body mass index was significant in both men and women, but
only in linear regression analysis. The results of multivariate analyzes of
logistic and linear regression, including age and all other significant
remaining risk factors for p=0.05, weight loss was the most significant risk
factor, and a lower mean body mass index was also independently associated with
bone loss in both sexes.
In 2003,
Watanabe [16] related three bone quality indicators: the fractal dimension, the
percentage of trabeculation and the bone connectivity, correlating them with
the mineral bone density and concluded that, it is possible to refer patients
to search for a low bone mineral mass, by the analyzes lower cortical mandible
and trabecular morphological pattern.
Blain et al.
[17], studying risk factors for the change in mineral bone density in older
women, show that maintenance of body weight throughout the postmenopausal
period and body fat mass have protective roles against bone loss in the
proximal femur in women aged 75 years old or older and suggest the value in
including weight change assessment throughout postmenopausal and percentage
body fat mass in screening programs for elderly women who are at a higher risk
of accelerated loss of bone.
Barrera et
al. [18] analyzed the possible protective effect of obesity on the development
of osteoporosis, confirming that a high body mass index (BMI) is a protective
factor of osteoporosis in the mineral bone density of the femoral neck among
the elderly. The risk for osteoporosis among men and women with a BMI above 30
kg/m2 was approximately 33% compared to a normal BMI of obesity in the
development of osteoporosis.
Ensrud et
al. [19] in their study tested the hypothesis that weight loss in elderly men
is associated with careless increase in rates of hip bone loss, adiposity and
intention to lose weight. They measured body weight, body composition, hip bone
mineral density and intention to lose weight in a cohort study of 1342 elderly
men enrolled in a study called “Osteoporotic Fractures in Men (MrOS)” and
followed them prospectively in a mean of 1.8 years for changes in weight and
MBD. Higher rates of bone loss in the hip were observed in men with careless
weight loss from the category of body mass index, body composition or intent to
lose weight. Even among obese (body mass index, >30 kg/m2), men
attempting to lose weight, those with documented voluntary weight loss,
experienced an increase in hip bone loss. Elderly men with experience of weight
loss had increased hip bone loss rates, equally among overweight and obese men
who undergo voluntary weight reduction.
A strong
positive association between body mass index and mineral bone density is well
defined in postmenopausal osteoporosis but not in men. Toth et al. [20]
investigating this association in men, concluded that bone density at femoral
neck sites is lower in normal weight males than in obese individuals,
consequently the risk factors for proximal femoral osteoporosis are higher in
these men cases.
Cobayashi et
al. [21], in their study: “Bone Mineral Density in overweight and obese
adolescents”, concluded that overweight and obese adolescents in the final
stages of sexual maturity had higher bone mineral density in relation to normal
weight; however, cohort studies were necessary to evaluate the influence of
such a characteristic on bone strength in adulthood and, consequently, on the
incidence of osteopenia and osteoporosis at more advanced ages.
Although
obesity is associated with an increased risk of many chronic diseases including
cardiovascular disease, diabetes, hypertension and cancer, there is little
evidence to suggest that obesity increases the risk of osteoporosis. In fact,
both weight and body mass index (BMI) is positive predictors of bone mass in
adults, suggesting that those who are overweight or obese may be at a lower
risk for osteoporosis. However, recent evidence suggests that in children and
adolescents, obesity may be associated with lower bone mass better than larger
bone mass [22].
Obesity is
associated with increased bone mineral density and a decrease in osteoporosis
and hip fracture in older men and women. Both fat mass and fat mass free (FMF)
are directly correlated with MBD; the relationship between fat mass and MBD is
stronger in women than in men. In addition, elevated body mass index (BMI)
values are associated with a slower rate of bone loss induced by postmenopausal
estrogen deficiency, presumably because of the increased conversion of adrenal
precursors to estrogen in adipose tissue. Although increased MBD in obese
individuals has been attributed to mechanical loading, protective effects have
also been observed in non-weight bearing bones. Consequently, hormonal factors
that are elevated in obese people, such as circulating estrogen, insulin and
leptin, may contribute to the beneficial effects of obesity on MBD, stimulating
bone growth and inhibiting bone remodeling. Both the increase in MBD and the
extra cushioning around the femur's outer prominence can provide protection
against hip fracture during a fall in obese elderly people. Data from a
prospective cohort study found that a 1-SD decrease in fat mass was associated
with a 30% increase in the risk of hip fracture. In addition, weight loss, loss
of body fat and decrease in BMI are associated with an increased risk of hip
fracture. Weight loss can have adverse effects on bone status. Data from many
studies conducted on pre-and post-menopausal obese women between the ages of 37
and 72 found that diet-induced weight loss caused significant clinical
decreases in total MBD. In addition, bone loss may be proportional to the
amount of weight loss. Weight loss changes the plasma concentration of hormones
involved in bone metabolism and increases markers of bone turnover. Although
involuntary 10% weight loss in a community of elderly men and women is
associated with an increased risk of hip fracture, it is not known whether bone
loss associated with intentional weight loss increases the risk of fractures
osteoporosis in obese people [23].
Low body
mass index (BMI) is a well-documented risk factor for future fracture. De Laet
et al. [24] in their study, aimed to quantify this effect and to explore the
association of fracture-related BMI with age, gender, and mineral bone density
from an international perspective using world-wide data. They concluded that a
low BMI confers a risk of substantial importance for all fractures which is
mostly independent of age and sex, but dependent on the MBD. The significance
of BMI as a risk factor varies according to the level of BMI.
The estrogen receptor alpha (ER-alpha) plays
an important role in mediating estrogen signaling. Studies in Caucasian
populations have shown that it is involved in endocrine-related diseases, such
as osteoporosis and obesity. In the current study, Jian et al. [25] first used
a quantitative transmission imbalance (QTI) test to examine the relationship
between this gene and both osteoporosis-related phenotype bone mineral density
and obesity-related phenotype body mass index (BMI), in 384 Chinese nuclear
families. The study did not support any association of the ER-alpha gene with
MBD and BMI in the Chinese population.
Ozeraitiene
and Butenaite [26] in their study aimed to examine the relationship between
bone mineral density and nutritional status, age and anthropometric data in
elderly women and had as results that the anthropometric parameters (height,
weight, body mass index, thickness measured from the fold of the skin) in
elderly women with osteoporosis were the lowest. They determined that the more
fats and proteins stored in the body, the greater the bone mineral density.
Nutritional status and age had a significant influence on bone mineral density.
Women with osteoporosis were older and heavier, had smaller height and body
weight. Their BMI values, skin fold thickness and percentage of body fat were
lower. This study showed that bone mineral density was related to body mass
index and triceps, waist and thigh skin fold thickness. Individuals with
BMI=25.1-30 kg/m2 were considered overweight and those with
BMI>30.1 kg/m2 were considered obese. The national research study
evaluating the risk of osteoporosis in the US has indicated that the
possibility of developing osteoporosis is lower when body mass index is higher.
Obesity and overweight in postmenopausal women can protect them from
osteoporosis. It has been reported that a high body mass index and bone mineral
density are preventive factors.
Yasar and
Akgu¨nlu [27] evaluated postmenopausal women and considered aspects such as
mineral bone density and number of teeth in the mandible. The menopausal status,
age and weight were recorded in a questionnaire. There was a statistically
significant relationship between individuals with osteoporosis and without
osteoporosis only for the age factor. Patients with osteoporosis have more
morphological changes in the lower cortex and age is a risk factor for
osteoporosis.
Deng et al.
[28] evaluated the importance of genetic determination, mineral bone density,
and body mass index of the spine and hip and explored the genetic,
environmental and phenotypic correlations between the above phenotypes in the
Chinese Han ethnic group. A significant genetic, environmental and phenotypic
correlation was observed. When MBD in the spine and hip has significant genetic
determination, BMI is more likely to be affected by environmental factors than
MBD. In addition, MBD in the spine and hip shares more genetic effect than BMI
and MBD do in the Chinese Han ethnic group, although the effects are
significant for both. Important is the significant genetic correlation between
BMI and MBD found in the current study provides meanings to appropriately
adjust the effect of BMI on MBD when performing linkage analysis and/or BMD
association. BMI was shown to be a significantly positive determinant of MBD.
Low body
mass index is associated with a high risk of osteoporosis and fractures, but
its impact on functional recovery after fractures is unknown. When
investigating the association between BMI and both, functional recovery and
rehabilitation period in women with hip fractures. Di Monaco et al. [29]
concluded that BMI can affect function after hip fracture, regardless of
fracture risk: individuals with a higher BMI and low risk of hip fracture may
have a poorer functional recovery in fracture of the hip, despite prolonged
rehabilitation. Conversely, individuals with lower BMI and high risk of hip
fracture may have better functional recovery in cases of hip fracture.
White et al.
[30] in their cohort study examined a baseline population for risk factors for
hip, wrist and spine fractures in men and women and concluded that high body
mass index was protective at all 3 fracture sites in women, but those who used
vitamin A supplements had increased rates of hip and wrist fracture.
The influence of weight loss on continued
growth in children and on bone mass and quality is not known. Although there
appears to be agreement that bone loss occurs with weight loss in older women
and possibly older men, it is unclear whether there is any detriment to bone
health in young individuals or in children with weight reduction. The risk for
bone loss may depend on initial body weight, age, gender, physical activity and dietary conditions such as
the extent of energy restriction or specific levels of nutrients ingested.
Osteoporosis
and obesity are two common disorders that affect a large number of elderly in
the general population. Approximately 30% of women and 12% of men are affected
by osteoporosis or low bone mass at some point during life. In addition,
approximately 31% of elderly men and 35% of elderly women are classified as
having obesity in the US Several lines of epidemiological evidence suggest that
the two disorders may be inversely associated with obese individuals who have
high bone mineral density and reduced risk of fracture than non-obese individuals.
Indeed, it has been well known that the variation between 23% and 47% of MBD in
the general population can be “explained” by variation in body mass index
(BMI), making BMI one of the strongest and most consistent predictors of DOM.
Both body weight (BMI) and MBD are partly genetically determined. In the same
way, between 43 and 70% of the BMI variation is attributed to genetic factors
[31].
Low body
weight is associated with an increased risk for osteoporosis and fractures, but
the contribution of other lifestyle factors has not been previously studied
within lean elderly women. Korpelainen et al. [32] evaluating the association
between lifelong lifestyle factors and bone density, falls and postmenopausal
fractures in elderly women with low body mass index, concluded that poor
functional ability and symptoms of depression were associated with the recent
drop. In elderly women with low BMI, lifelong physical activity may protect
against fractures, when low bone mass of the heel and solitary life appear to be
associated with an increased risk for fractures. Poor functional ability and
the presence of depression may be associated with a risk of falling. Type 2
diabetes can modify the risk of low bone mass and post-menopausal low trauma
fractures. Several studies have shown that low body weight and low body mass
index are associated with low MBD and fractures.
Body weight is considered a strong predictor
of mineral bone density regardless of age and
gender. It is not clear whether the
influence of body weight on MBD is dependent on the balance between expenditure
and energy input. Body weight can be height-related by calculating body mass index (BMI, kg/m2), which
serves to distinguish overweight from normal body weight and between normal
body weight and energy deficiency, i.e., BMI<18.7. It has been suggested
that the optimal BMI scale for women between 18.7 and 23.8 years old and a bone
scan is recommended if BMI<19. Despite body weight, women tend to refer to
their weight, which influence eating habits, dieting and physical activity. The body weight of young women
may be associated with a variety of underlying lifestyle behaviors, such as
eating habits, physical activity and dieting and may be potential predictors of
significant variation of MBD depending on body weight and balance energy. In addition, the significance of
potential predictors, such as lifestyle behaviors and psychological factors in
the MBD of above, normal, and underweight young women need to be considered in
order to form a knowledge base for prevention and coping strategies, health
promotion. Elgan and Fridlund [33] with the aim of identifying important
predictors between lifestyle behaviors and psychological factors of bone
mineral density in relation to body mass index among young women over a 2 year
period, that in the BMI<19 category, women
had a lower level of Deoxypyridinoline (DPD)
(p=0.017), a lower level of MBD (p=0.001), lower fat intake
reported by them (p=0.011)
and a lower hormone age (p=0.015) on average than those in the BMI category >24.
Women in the category with a BMI between 19 and 24 consumed less alcohol/month
(p=00017) and had a lower MBD (p=0.002) than women with a BMI>24.
Alfaro-Acha et al. [34] examining the
interactive effect of cognition and body weight with hip fracture, concluded
that low cognitive function increased the conditional association between body
mass index and hip fracture in elderly Mexican Americans. The relationship
between BMI and cognition is potentially important in identifying people at
risk for hip fracture and supports the need to include cognitive and
anthropometric measures in the assessment of hip fracture risk in osteoporosis
screening programs. The body mass index was computed by dividing the weight in
kilograms by height in square meters. BMI was used as a continuous variable and
as a variable category, based on previously
established criteria. Four categories of BMI were created: low weight (<22.0
kg/m2), normal (22.0-24.9 kg/m2), overweight (25.0-29.9
kg/m2), and obese (30 kg/m2). Low-weight individuals
(BMI<22) were at greater risk for hip fracture and this risk was higher in
people with the lower “Mini-Mental State Examination” (MSE) scores. For people
in the higher and lower MSE groups, a larger BMI was associated with a lower
risk of hip fracture. For those categorized as obese (BMI > or = 30), the
risk of hip fracture was approximately equal in the higher and lower MSE
groups. Previous studies have reported an inverse relationship between body
weight and hip fracture risk. It was found that a 10% loss in weight
significantly increased the risk of hip fracture in people 65 years of age or older. In a study of elderly, white, non-Hispanic women, it was found that a higher BMI
significantly reduced the risk of hip fracture. However, these studies did not
examine whether cognition modulates the risk of hip fracture in low-weight,
elderly adults. Several mechanisms have been proposed to explain the
association between BMI and hip fracture. One hypothesis suggests that low
weight may be a marker of underlying clinical circumstances, including decline
in healthy physical status, weakness, subclinical disease or chronic
inflammation that may increase the risk of falls and fractures. Another
hypothesis suggests that low weight is associated with loss of MBD, which
increases the risk of hip fracture. Numerous studies have found a higher MBD in
heavier individuals and, conversely, a lower MBD in those who are underweight.
The results of the current study confirm that low BMI is a marker for hip
fracture in older Mexican- American adults, although it may be necessary to
consider BMI in combination with other potential risk factors, including
cognitive ability, when the incidence of fracture of the hip, especially in
older adults, is high.
Some
researchers in their study, state that body mass index is often used to predict
DOM. This may fail. Large epidemiological studies with BMI and MBD data were
analyzed. Weight alone is a better predictor of MBD than BMI. While others
evaluated the relationship between quality of life and bone status, including
bone metabolism, in Japanese postmenopausal women in the community. Although
chance is not clear, in addition to low BMI, the role of limitations due to
poor emotional status and low physical function are related to the low mineral
bone index in Japanese postmenopausal women in the community.
It is well established that a minority of
celiac patients present with “classical” symptoms due to mal-absorption.
However, few studies have focused on the distribution of BMI in celiac
populations and their relationship to clinical characteristics, or their
response to treatment. Dickey and Kearney [35] reviewed measures of BMI and
other clinical and pathological features of a database of 371 celiac patients
diagnosed over a 10 years period and seen by a single gastroenterologist. To assess the response to gluten
exclusion, they compared BMI at diagnosis and after a 2-year treatment in
patients with serologic support for dietary compliance. There was an impressive
relationship between BMI and measures of bone density.
Only 6% of overweight patients had osteoporosis in the lumbar spine or
neck of the femur compared to 48% of patients with BMI<20.
According to
Asomaning et al. [36], individuals with BMI<18.5, those overweight with
those with BMI > or = 25 and obese, individuals with BMI > or = 30 are considered
as underweight.
Thus, in
order to estimate if the prevalence of excess weight is likely to reduce
osteoporosis among elderly women, concluded that the increasing prevalence of
excess weight of weight among older women in the US seems unlikely to be
accompanied by a significant reduction in osteoporosis.
Osteoporosis
affects 4-6 million (13%-8%) of postmenopausal white women in the United States
of America. Most studies point to risk factors for osteoporosis and have
considered body mass index (BMI) only as a possible contributory factor. In
their study, Asomaning et al. [36] evaluated the direct relationship between
BMI and osteoporosis. BMI was inversely associated with the MBD status. They
concluded that women with low BMI are at increased risk for osteoporosis. The
change in risk associated with a change of drive in BMI (approximately 5-8
pounds) is of greater magnitude than most other modifiable risk factors. To
help reduce the risk of osteoporosis, patients should be advised to maintain a
normal weight.
Several
studies have shown that low BMI is associated with low MBD and low fracture
rates. However, the results that have been published are from studies in which
reproductive factors and mineral bone density are extremely controversial, with
some showing a beneficial effect, while others show a detrimental impact of
these factors on bone mass [37].
1. Michaelsson K, Bergstrom R,
Mallmin H, Holmberg L, Wolk A, et al. (1996) Screening for osteopenia and
osteoporosis: Selection by body composition. Osteoporosis International 6:
120-126.
2. Wardlaw GM (1996) Putting body
weight and osteoporosis into perspective. Am J Clin Nutr 63: 433S-436S.
3. Klemetti E, Kolmakow S (1997)
Morphology of the mandibular cortex on panoramic radiographs as an indicator of
bone quality. Dentomaxillofacial Radiol 26: 22-25.
4. Klemetti E, Kroger H, Lassila V
(1997) Relationship between body mass index and the remaining alveolar ridge. J
Oral Rehabil 24: 808-812.
5. Taguchi A, Suei Y, Ohtsuka M,
Otani K, Tanimoto K, et al. (1999) Relationship between bone mineral density
and tooth loss in elderly Japanese women. Dentomaxillofacial Radiol 28:
219-223.
6. Chumlea WC, Guo SS (1999) Body
mass and bone mineral quality. Curr Opin Rheumatol 11: 307-311.
7. Ravn P, Cizza G, Bjarnason NH,
Thompson D, Daley M, et al. (1999) Low body mass index is an important risk
factor for low bone mass and increased bone loss in early postmenopausal women.
J Bone Mineral Res 14: 1622-1627.
8. Coin A, Sergi G, Beninca P, Lupoli
L, Cinti G, et al. (2000) Bone mineral density and body composition in
underweight and normal elderly subjects. Osteoporos Int 11: 1043-1050.
9. Nguyen TV, Center JR, Eisman JA
(2000) Osteoporosis in elderly men and women: effects of dietary calcium,
physical activity and body mass index. J Bone Mineral Res 15: 322-331.
10. Guthrie JR, Dennerstein L, Wark JD
(2000) Risk factors for osteoporosis: A review. Medscape Womens Health E1.
11. Baroncelli GI, Federico G,
Bertelloni S, De Terlizzi F, Cadossi R, et al. (2001) Bone quality assessment
by quantitative ultrasound of proximal phalanxes of the hand in healthy
subjects aged 3-21 years. Pediatr Res 49: 713-718.
12. Blum M, Harris SS, Must A,
Phillips SM, Rand WM, et al. (2001) Weight and body mass index at menarche are
associated with premenopausal bone mass. Osteoporosis Int 12: 588-594.
13. Yahata Y, Aoyagi K, Okano K,
Yoshimi I, Kusano Y, et al. (2002) Metacarpal bone mineral density, body mass
index and lifestyle among postmenopausal Japanese women: relationship of body
mass index, physical activity, calcium intake, alcohol and smoking to bone
mineral density: The Hizen-Oshima study. Tohoku J Exp Med 196: 123-129.
14. Zlataric DK, Celebic A, Kobler P
(2002) Relationship between body mass index and local quality of mandibular
bone structure in elderly individuals. J Gerontolo Series A Biol Sci Med Sci
57: M588-593.
15. Knoke JD, Barrett-Connor E (2003)
Weight loss: a determinant of hip bone loss in older men and women. The Rancho
Bernardo Study. Am J Epidemiol 158: 1132-1138.
16. Watanabe PCA (2003) Relation
between three bone quality indicators in osteoporosis research in panoramic
radiographs. Free-Teaching Thesis presented at the School of Dentistry of
Ribeirão Preto, University of São Paulo, Ribeirão Preto.
17. Blain H, Carriere I, Favier F,
Jeandel C, Papoz L (2004) Body weight change since menopause and percentage
body fat mass are predictors of subsequent bone mineral density change of the
proximal femur in women aged 75 years and older: results of a 5 year
prospective study. Calcified Tissue Int 75: 32-39.
18. Barrera G, Bunout D, Gattas V, De
La Maza MP, Leiva L, et al. (2004). A high body mass index protects against
femoral neck osteoporosis in healthy elderly subjects. Nutrition (Burbank, Los
Angeles County, Calif.) 20: 769-771.
19. Ensrud KE, Fullman RL,
Barrett-Connor E, Cauley JA, Stefanick ML, et al. (2005) Voluntary weight
reduction in older men increases hip bone loss: the osteoporotic fractures in
men study. J Clin Endocrinol Metab 90: 1998-2004.
20. Toth E, Ferenc V, Meszaros S,
Csupor E, Horvath C (2005) Effects of body mass index on bone mineral density
in men. Orvosi Hetilap 146: 1489-1493.
21. Cobayashi F, Lopes LA, Taddei JA
(2005) Bone mineral density in overweight and obese adolescents. Jornal de
Pediatria 81: 337-342.
22. Wang CY, Nguyen ND, Morrison NA,
Eisman JA, Center JR, et al. (2006) Beta3-adrenergic receptor gene, body mass
index, bone mineral density and fracture risk in elderly men and women: The
Dubbo Osteoporosis Epidemiology Study (DOES). BMC Med Genet 57.
23. Villareal DT, Apovian CM, Kushner
RF, Klein S (2005) Obesity in older adults: Technical review and position
statement of the American Society for Nutrition and NAASO, The Obesity Society.
Obes Res 13: 1849-1863.
24. De Laet C, Kanis JA, Oden A,
Johanson H, Johnell O, et al.(2005) Body mass index as a predictor of fracture
risk: A meta-analysis. Osteoporosis Int 16: 1330-1338.
25. Jian WX, Yang YJ, Long JR, Li YN,
Deng FY, et al. (2005) Estrogen receptor alpha gene relationship with peak bone
mass and body mass index in Chinese nuclear families. J Hum Genet 50: 477-482.
26. Ozeraitiene V, Butenaite V (2006)
The evaluation of bone mineral density based on nutritional status, age and
anthropometric parameters in elderly women. Medicina (Kaunas, Lithuania) 42:
836-842.
27. Yasar F, Akgu¨nlu F (2006) The
differences in panoramic mandibular indices and fractal dimension between
patients with and without spinal osteoporosis. Dentomaxillofacial Radiol 35:
1-9.
28. Deng FY, Lei SF, Li MX, Jiang C,
Dvornyk V, et al. (2006) Genetic determination and correlation of body mass
index and bone mineral density at the spine and hip in Chinese Han ethnicity.
Osteoporosis Int 17: 119-124.
29. Di Monaco M, Vallero F, Di Monaco
R, Mautino F, Cavanna A (2006) Body mass index and functional recovery after
hip fracture: A survey study of 510 women. Aging Clin Exp Res 18: 57-62.
30. White SC, Cohen JM, Mourshed FA
(2000) Digital analisys of trabecular pattern in jaws of patients with sickle
cell anemia Dentomaxillofacial Radiol 29: 119-124.
31. Shapses SA, Riedt CS (2006) Bone,
body weight and weight reduction: What are the concerns? J Nutr 136: 1453-1456.
32. Korpelainen R, Korpelainen J,
Heikkinen J, Vaananen K, Keinanen-Kiukaanniemi S (2006) Lifelong risk factors
for osteoporosis and fractures in elderly women with low body mass index - A
population-based study. Bone 39: 385-391.
33. Elgan C, Fridlund B (2006) Bone
mineral density in relation to body mass index among young women: A prospective
cohort study. Int J Nurs Stud 43: 663-672.
34. Alfaro-Acha A, Ostir GV, Markides
KS, Ottenbacher KJ (2006) Cognitive status, body mass index and hip fracture in
older Hispanic adults. J Am Geriatr Soc 54: 1251-1255.
35. Dickey W, Kearney N (2006)
Overweight in celiac disease: Prevalence, clinical characteristics and effect
of a gluten-free diet. Am J Gastroenterol 101: 2356-2359.
36. Asomaning K, Bertone-Johnson ER,
Nasca PC, Hooven F, Pekow PS (2006) The association between body mass index and
osteoporosis in patients referred for a bone mineral density examination. J
Womens Health 15: 1028-1034.
37. El Maghraoui A, Guerboub AA,
Mounach A, Ghozlani I, Nouijai A, et al. (2006) Body mass index and
gynecological factors as determinants of bone mass in healthy Moroccan women.
Maturitas.
QUICK LINKS
- SUBMIT MANUSCRIPT
- RECOMMEND THE JOURNAL
-
SUBSCRIBE FOR ALERTS
RELATED JOURNALS
- International Journal of Internal Medicine and Geriatrics (ISSN: 2689-7687)
- Advance Research on Alzheimers and Parkinsons Disease
- Archive of Obstetrics Gynecology and Reproductive Medicine (ISSN:2640-2297)
- Journal of Allergy Research (ISSN:2642-326X)
- International Journal of Diabetes (ISSN: 2644-3031)
- Journal of Otolaryngology and Neurotology Research(ISSN:2641-6956)
- International Journal of Radiography Imaging & Radiation Therapy (ISSN:2642-0392)