Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women: A transiliac bone biopsy study

Adi Cohen, David W. Dempster, Robert R. Recker, Joan M. Lappe, Hua Zhou, Alexander Zwahlen, Ralph Müller, Binsheng Zhao, Xiaotao Guo, Thomas Lang, Isra Saeed, X. Sherry Liu, X. Edward Guo, Serge Cremers, Clifford J. Rosen, Emily M. Stein, Thomas L. Nickolas, Donald J. McMahon, Polly Young, Elizabeth Shane

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Context: The conventional view that obesity is beneficial for bone strength has recently been challenged by studies that link obesity, particularly visceral obesity, to low bone mass and fractures. It is controversial whether effects of obesity on bone are mediated by increased bone resorption or decreased bone formation. Objective: The objective of the study was to evaluate bone microarchitecture and remodeling in healthy premenopausal women of varying weights. Design: We measured bone density and trunk fat by dual-energy x-ray absorptiometry in 40women and by computed tomography in a subset. Bone microarchitecture, stiffness, remodeling, and marrow fat were assessed in labeled transiliac bone biopsies. Results: Body mass index (BMI) ranged from 20.1 to 39.2 kg/m2. Dual-energy x-ray absorptiometry-trunk fat was directly associated with BMI (r = 0.78, P <.001) and visceral fat by computed tomography (r = 0.79, P <.001). Compared with women in the lowest tertile of trunk fat, those in the highest tertile had inferior bone quality: lower trabecular bone volume (20.4 ± 5.8 vs 29.1 ± 6.1%; P = .001) and stiffness (433 ± 264 vs 782 ± 349MPa; P = .01) and higher cortical porosity (8.8 ± 3.5 vs 6.3 ± 2.4%; P = .049). Bone formation rate (0.004 ± 0.002 vs 0.011 ± 0.008 mm 2/mm·year; P = .006) was 64% lower in the highest tertile. Trunk fat was inversely associated with trabecular bone volume (r = -0.50; P <.01) and bone formation rate (r = -0.50; P <.001). The relationship between trunk fat and bone volume remained significant after controlling for age and BMI. Conclusions: At the tissue level, premenopausal women with more central adiposity had inferior bone quality and stiffness and markedly lower bone formation. Given the rising levels of obesity, these observations require further investigation.

Original languageEnglish
Pages (from-to)2562-2572
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number6
DOIs
StatePublished - Jun 2013

Fingerprint

Abdominal Fat
Biopsy
Osteogenesis
Bone
Fats
Bone and Bones
Obesity
Body Mass Index
Tomography
X-Rays
Intra-Abdominal Fat
Abdominal Obesity
Bone Remodeling
Porosity
Bone Fractures
Adiposity
Bone Resorption
Bone Density
Stiffness
Bone Marrow

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women : A transiliac bone biopsy study. / Cohen, Adi; Dempster, David W.; Recker, Robert R.; Lappe, Joan M.; Zhou, Hua; Zwahlen, Alexander; Müller, Ralph; Zhao, Binsheng; Guo, Xiaotao; Lang, Thomas; Saeed, Isra; Liu, X. Sherry; Guo, X. Edward; Cremers, Serge; Rosen, Clifford J.; Stein, Emily M.; Nickolas, Thomas L.; McMahon, Donald J.; Young, Polly; Shane, Elizabeth.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 98, No. 6, 06.2013, p. 2562-2572.

Research output: Contribution to journalArticle

Cohen, A, Dempster, DW, Recker, RR, Lappe, JM, Zhou, H, Zwahlen, A, Müller, R, Zhao, B, Guo, X, Lang, T, Saeed, I, Liu, XS, Guo, XE, Cremers, S, Rosen, CJ, Stein, EM, Nickolas, TL, McMahon, DJ, Young, P & Shane, E 2013, 'Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women: A transiliac bone biopsy study', Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 6, pp. 2562-2572. https://doi.org/10.1210/jc.2013-1047
Cohen, Adi ; Dempster, David W. ; Recker, Robert R. ; Lappe, Joan M. ; Zhou, Hua ; Zwahlen, Alexander ; Müller, Ralph ; Zhao, Binsheng ; Guo, Xiaotao ; Lang, Thomas ; Saeed, Isra ; Liu, X. Sherry ; Guo, X. Edward ; Cremers, Serge ; Rosen, Clifford J. ; Stein, Emily M. ; Nickolas, Thomas L. ; McMahon, Donald J. ; Young, Polly ; Shane, Elizabeth. / Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women : A transiliac bone biopsy study. In: Journal of Clinical Endocrinology and Metabolism. 2013 ; Vol. 98, No. 6. pp. 2562-2572.
@article{6698eb765b224a53ba3e331bcb11d7fd,
title = "Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women: A transiliac bone biopsy study",
abstract = "Context: The conventional view that obesity is beneficial for bone strength has recently been challenged by studies that link obesity, particularly visceral obesity, to low bone mass and fractures. It is controversial whether effects of obesity on bone are mediated by increased bone resorption or decreased bone formation. Objective: The objective of the study was to evaluate bone microarchitecture and remodeling in healthy premenopausal women of varying weights. Design: We measured bone density and trunk fat by dual-energy x-ray absorptiometry in 40women and by computed tomography in a subset. Bone microarchitecture, stiffness, remodeling, and marrow fat were assessed in labeled transiliac bone biopsies. Results: Body mass index (BMI) ranged from 20.1 to 39.2 kg/m2. Dual-energy x-ray absorptiometry-trunk fat was directly associated with BMI (r = 0.78, P <.001) and visceral fat by computed tomography (r = 0.79, P <.001). Compared with women in the lowest tertile of trunk fat, those in the highest tertile had inferior bone quality: lower trabecular bone volume (20.4 ± 5.8 vs 29.1 ± 6.1{\%}; P = .001) and stiffness (433 ± 264 vs 782 ± 349MPa; P = .01) and higher cortical porosity (8.8 ± 3.5 vs 6.3 ± 2.4{\%}; P = .049). Bone formation rate (0.004 ± 0.002 vs 0.011 ± 0.008 mm 2/mm·year; P = .006) was 64{\%} lower in the highest tertile. Trunk fat was inversely associated with trabecular bone volume (r = -0.50; P <.01) and bone formation rate (r = -0.50; P <.001). The relationship between trunk fat and bone volume remained significant after controlling for age and BMI. Conclusions: At the tissue level, premenopausal women with more central adiposity had inferior bone quality and stiffness and markedly lower bone formation. Given the rising levels of obesity, these observations require further investigation.",
author = "Adi Cohen and Dempster, {David W.} and Recker, {Robert R.} and Lappe, {Joan M.} and Hua Zhou and Alexander Zwahlen and Ralph M{\"u}ller and Binsheng Zhao and Xiaotao Guo and Thomas Lang and Isra Saeed and Liu, {X. Sherry} and Guo, {X. Edward} and Serge Cremers and Rosen, {Clifford J.} and Stein, {Emily M.} and Nickolas, {Thomas L.} and McMahon, {Donald J.} and Polly Young and Elizabeth Shane",
year = "2013",
month = "6",
doi = "10.1210/jc.2013-1047",
language = "English",
volume = "98",
pages = "2562--2572",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "6",

}

TY - JOUR

T1 - Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women

T2 - A transiliac bone biopsy study

AU - Cohen, Adi

AU - Dempster, David W.

AU - Recker, Robert R.

AU - Lappe, Joan M.

AU - Zhou, Hua

AU - Zwahlen, Alexander

AU - Müller, Ralph

AU - Zhao, Binsheng

AU - Guo, Xiaotao

AU - Lang, Thomas

AU - Saeed, Isra

AU - Liu, X. Sherry

AU - Guo, X. Edward

AU - Cremers, Serge

AU - Rosen, Clifford J.

AU - Stein, Emily M.

AU - Nickolas, Thomas L.

AU - McMahon, Donald J.

AU - Young, Polly

AU - Shane, Elizabeth

PY - 2013/6

Y1 - 2013/6

N2 - Context: The conventional view that obesity is beneficial for bone strength has recently been challenged by studies that link obesity, particularly visceral obesity, to low bone mass and fractures. It is controversial whether effects of obesity on bone are mediated by increased bone resorption or decreased bone formation. Objective: The objective of the study was to evaluate bone microarchitecture and remodeling in healthy premenopausal women of varying weights. Design: We measured bone density and trunk fat by dual-energy x-ray absorptiometry in 40women and by computed tomography in a subset. Bone microarchitecture, stiffness, remodeling, and marrow fat were assessed in labeled transiliac bone biopsies. Results: Body mass index (BMI) ranged from 20.1 to 39.2 kg/m2. Dual-energy x-ray absorptiometry-trunk fat was directly associated with BMI (r = 0.78, P <.001) and visceral fat by computed tomography (r = 0.79, P <.001). Compared with women in the lowest tertile of trunk fat, those in the highest tertile had inferior bone quality: lower trabecular bone volume (20.4 ± 5.8 vs 29.1 ± 6.1%; P = .001) and stiffness (433 ± 264 vs 782 ± 349MPa; P = .01) and higher cortical porosity (8.8 ± 3.5 vs 6.3 ± 2.4%; P = .049). Bone formation rate (0.004 ± 0.002 vs 0.011 ± 0.008 mm 2/mm·year; P = .006) was 64% lower in the highest tertile. Trunk fat was inversely associated with trabecular bone volume (r = -0.50; P <.01) and bone formation rate (r = -0.50; P <.001). The relationship between trunk fat and bone volume remained significant after controlling for age and BMI. Conclusions: At the tissue level, premenopausal women with more central adiposity had inferior bone quality and stiffness and markedly lower bone formation. Given the rising levels of obesity, these observations require further investigation.

AB - Context: The conventional view that obesity is beneficial for bone strength has recently been challenged by studies that link obesity, particularly visceral obesity, to low bone mass and fractures. It is controversial whether effects of obesity on bone are mediated by increased bone resorption or decreased bone formation. Objective: The objective of the study was to evaluate bone microarchitecture and remodeling in healthy premenopausal women of varying weights. Design: We measured bone density and trunk fat by dual-energy x-ray absorptiometry in 40women and by computed tomography in a subset. Bone microarchitecture, stiffness, remodeling, and marrow fat were assessed in labeled transiliac bone biopsies. Results: Body mass index (BMI) ranged from 20.1 to 39.2 kg/m2. Dual-energy x-ray absorptiometry-trunk fat was directly associated with BMI (r = 0.78, P <.001) and visceral fat by computed tomography (r = 0.79, P <.001). Compared with women in the lowest tertile of trunk fat, those in the highest tertile had inferior bone quality: lower trabecular bone volume (20.4 ± 5.8 vs 29.1 ± 6.1%; P = .001) and stiffness (433 ± 264 vs 782 ± 349MPa; P = .01) and higher cortical porosity (8.8 ± 3.5 vs 6.3 ± 2.4%; P = .049). Bone formation rate (0.004 ± 0.002 vs 0.011 ± 0.008 mm 2/mm·year; P = .006) was 64% lower in the highest tertile. Trunk fat was inversely associated with trabecular bone volume (r = -0.50; P <.01) and bone formation rate (r = -0.50; P <.001). The relationship between trunk fat and bone volume remained significant after controlling for age and BMI. Conclusions: At the tissue level, premenopausal women with more central adiposity had inferior bone quality and stiffness and markedly lower bone formation. Given the rising levels of obesity, these observations require further investigation.

UR - http://www.scopus.com/inward/record.url?scp=84878495700&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878495700&partnerID=8YFLogxK

U2 - 10.1210/jc.2013-1047

DO - 10.1210/jc.2013-1047

M3 - Article

C2 - 23515452

AN - SCOPUS:84878495700

VL - 98

SP - 2562

EP - 2572

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 6

ER -