Bone Mineral Density and Body Composition are Associated with Circulating Angiogenic Factors in Post-menopausal Women.

A Spangenberg,A E Moore,N Maghsoodi,D Dulnoan,G Hampson,M L Frost,S Edwards

doi:10.1007/s00223-016-0186-7

A Spangenberg, A E Moore + Show 5 more

Open Access

https://doi.org/10.1007/s00223-016-0186-7

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Abstract

Lean mass (LM) and fat mass (FM) are closely related to bone mass (BM) in post-menopausal women, although their relative importance is unclear. Angiogenic factors which control angiogenesis may influence BM, LM and FM. The aim of the study was to compare the contribution of LM and FM to bone mineral density (BMD) and the association between these tissues and circulating angiogenic factors. The study population comprised of 392 post-menopausal women aged mean [SD] 61.8 [6.4] years. BMD was measured at the lumbar spine (LS), neck of femur and total hip (TH) by dual-energy X-ray absorptiometry (DXA). DXA scan was also used to determine LM and FM. Angiopoietin-1 and 2 (ANG-1, ANG-2) were measured by sandwich enzyme-linked immunosorbent assay. Following adjustment for confounders, significant positive independent associations were seen between LM with BMD at all skeletal sites (TH: p < 0.0001) and FM with BMD at the hip sites (TH: p = 0.004). When BMD and LM were regressed against the angiogenic factors, positive associations were seen between ANG-2 with LM (p = 0.002) and LS BMD (p = 0.05). Negative associations were observed between the ratio of ANG-1/ANG-2 with LS BMD (p = 0.014), TH BMD (p = 0.049) and LM (p = 0.029). FM and fat distribution (android/gynoid fat ratio) were negatively associated with ANG-1 (p = 0.006) and ANG-2 (p = 0.004), respectively. ANG-1 and ANG-2 may be involved in the maintenance of bone, muscle and fat mass.

Highlights

Several cross-sectional studies have demonstrated significant associations between body composition and bone mass in post-menopausal women [1, 2]
Our data show that both Lean mass (LM) and fat mass (FM) were positively associated with bone mineral density (BMD) in post-menopausal women, the relationship with LM was closer at all skeletal sites
Significant but contrasting associations were observed between ANG-1, ANG-2 and their ratio with BMD, LM and FM suggesting that these angiogenic factors may have a role in the regulation of bone mass and body composition

Summary

Introduction

Several cross-sectional studies have demonstrated significant associations between body composition and bone mass in post-menopausal women [1, 2]. Menopause has been known to be associated with an increased loss of bone mass, increased adipose mass and decreased muscle mass. Some studies report that lean mass may be a stronger predictor of BMD than fat mass, the extent of the association may be age and sex dependent [3]. The association of lean mass with bone health is evident clinically in subjects with sarcopenia, defined as loss of muscle as a consequence of ageing. The association seems stronger in postmenopausal women, the effect of fat mass may be related to its distribution as subcutaneous fat and visceral adipose tissue (VAT) may have differential effect on bone [6]. Cortical area and thickness were significantly associated with lean mass whilst trabecular number and density were related to fat mass [7]

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