Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity-A Clinical Paradox.

Antresa Jose,Stephen A Jiwanmall,Munaf Babajan Nandyal,Thomas V Paul,Kripa Elizabeth Cherian,Nitin Kapoor,Dheeraj Kattula

doi:10.3390/medsci9040069

Antresa Jose, Stephen A Jiwanmall + Show 5 more

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https://doi.org/10.3390/medsci9040069

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Journal: Medical Sciences	Publication Date: Nov 9, 2021
Citations: 3	License type: CC BY 4.0

Affiliation: Christian Medical College & Hospital

Abstract

Obesity has long been considered to have a protective effect on bone, but specific complications in those with morbid obesity are known to have a detrimental impact on bone architecture. We aimed to study the bone microarchitecture (TBS—trabecular bone score) and bone mineral density (BMD) in postmenopausal women with morbid obesity compared to obese and non-obese age-matched women. Eighty-five consecutive postmenopausal women with morbid obesity (body mass index (BMI) ≥ 35 kg/m2) were enrolled and compared to age-matched obese (n = 80) and non-obese postmenopausal controls (n = 85). The BMD and TBS were assessed in all subjects using a Hologic-QDR 4500-W Discovery-A DXA scanner. The mean BMD (gm/cm2) at the femoral neck in women with morbid obesity was found to be significantly lower as compared to the age-matched postmenopausal obese controls (0.723 versus 0.762, p-value = 0.002). The BMD at the lumbar spine and hip showed similar trends but were not statistically significant. The bone microarchitecture was found to be significantly lower in those with morbid obesity (1.205) as compared to the other two groups (obesity 1.244; non-obese 1.228) (p < 0.013). Though obesity was associated with a better bone density and bone microarchitecture in postmenopausal women, a paradoxical lower value was seen in those with morbid obesity.

Highlights

Obesity and osteoporosis are two rapidly emerging public health problems [1,2].Conventionally, increased body fat is believed to restrain bone loss and prevent osteoporotic fragility fractures [3]
Tukey’s post hoc test revealed that the mean bone mineral density (BMD) at the femoral neck in women with morbid obesity was found to be significantly lower as compared to the age-matched postmenopausal obese controls (0.723 versus 0.762, p-value = 0.002)
The present study indicates that individuals with morbid obesity have a lower bone mineral density than those with obesity

Summary

Introduction

Obesity and osteoporosis are two rapidly emerging public health problems [1,2].Conventionally, increased body fat is believed to restrain bone loss and prevent osteoporotic fragility fractures [3]. There is emerging literature to suggest that some individuals with obesity may be prone to have certain peripheral fractures [9,10]. This concern may be compounded in individuals who have morbid obesity, as they bear a much larger weight on peripheral bones. They have nutritional restrictions, limited mobility, poor sunlight exposure, and higher inflammatory cytokines, which may have a detrimental impact on the bone mineral density [11]

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