Abstract
BackgroundThe prevalence of osteoporosis is rising steadily as the aging population increases. Bone mineral density (BMD) assessment is a golden standard to establish the diagnosis of osteoporosis. However, the accessibility and radiation exposure limited its role in community screening. A more convenient approach for screening is suggested.MethodsA total of 363 postmenopausal women over the age of 50 were included in this study and assessed with the body composition [including fat-free mass (FFM), fat mass (FM), and basal metabolic rate (BMR)] and BMD. Normal distributions and correlation coefficients among variables were calculated using the Shapiro-Wilk test and Pearson’s correlation analysis, respectively. A receiver operating characteristic (ROC) curve was plotted, and the area under ROC curves (AUC) was determined to obtain the optimal cutoff values of the body composition variables for osteoporosis prediction.ResultsThe correlation coefficient of FFM, FM, FM ratio, and BMR with femur neck T-score was 0.373, 0.266, 0.165, and 0.369, respectively, while with spine T-score was 0.350, 0.251, 0.166, and 0.352, respectively (p < 0.01 for all). FFM, FM, and BMR showed an optimal cutoff value of 37.9 kg, 18.6 kg, and 1187.5 kcal, respectively, for detecting osteoporosis.ConclusionsThe present study provided a model to predict osteoporosis in postmenopausal women, and the optimal cutoff value of FFM, FM, and BMR could be calculated in the Asian population. Among these factors, BMR seemed a better predictor than others. The BMR could be a target for exercise intervention in postmenopausal women for maintaining or improving BMD.Trial registrationClinicalTrials.gov, NCT02936336. Retrospectively registered on13 October 2016.
Highlights
The prevalence of osteoporosis is rising steadily as the aging population increases
Higher fat mass (FM) went along with higher Bone mineral density (BMD) as an effective predator for osteoporosis, but some studies showed that FM was not effective for osteoporosis prediction in middle-aged and elderly people in Asia [24, 25], and the increased central body FM was negatively associated with BMD [26]
Our results showed that the area under ROC curves (AUC) of basal metabolic rate (BMR) is higher than fat-free mass (FFM) and FM, suggesting that BMR might be a good predictor for osteoporosis
Summary
The prevalence of osteoporosis is rising steadily as the aging population increases. The accessibility and radiation exposure limited its role in community screening. Osteoporosis is a common and silent skeletal disease characterized by bone mineral density (BMD) loss, resulting in fragile bone and high fracture risk [1,2,3]. It is more prevalent in postmenopausal women as a result of estrogen deficiency. Dual-energy X-ray absorptiometry (DXA) is a hospital-based examination to estimate the BMD, while disadvantaged by its radiation exposure and limited accessibility in the community. It is possible to improve osteoporosis detection through BIA because of its accessibility in the community
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