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Discordant effect of body mass index on bone mineral density and speed of sound.

Steinschneider M, Hagag P, Rapoport MJ, Weiss M - BMC Musculoskelet Disord (2003)

Bottom Line: Mean SOS at all measurement sites was similar in both groups and did not correlate with BMI.Bone turnover was similar in the two study groups.The high BMI of postmenopausal women may result in spuriously high BMD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, Assaf Harofeh" Medical Center, Israel. msteinsneider@asaf.health.gov.il

ABSTRACT

Background: Increased BMI may affect the determination of bone mineral density (BMD) by dual X-ray absorptiometry (DXA) and speed of sound (SOS) measured across bones. Preliminary data suggest that axial SOS is less affected by soft tissue. The purpose of this study is to evaluate the effect of body mass index (BMI) on BMD and SOS measured along bones.

Methods: We compared axial BMD determined by DXA with SOS along the phalanx, radius and tibia in 22 overweight (BMI > 27 kg/m2), and 11 lean (BMI = 21 kg/m2) postmenopausal women. Serum bone specific alkaline phosphatase and urinary deoxypyridinoline excretion determined bone turnover.

Results: Mean femoral neck--but not lumbar spine BMD was higher in the overweight--as compared with the lean group (0.70 +/- 0.82, -0.99 +/- 0.52, P < 0.00001). Femoral neck BMD in the overweight--but not in the lean group highly correlated with BMI (R = 0.68. P < 0.0001). Mean SOS at all measurement sites was similar in both groups and did not correlate with BMI. Bone turnover was similar in the two study groups.

Conclusions: The high BMI of postmenopausal women may result in spuriously high BMD. SOS measured along bones may be a more appropriate means for evaluating bones of overweight women.

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Spearman rank order correlation coefficient of body mass index (BMI) and bone mineral density (BMD) at the femoral neck (a) and speed of sound (SOS) at the radius (b). Lean patient marked as filled squares and overweight women in open squares. The correlation between BMI and femoral neck BMD is statistically significant (R = 0.68, P < 0.0001).
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Figure 1: Spearman rank order correlation coefficient of body mass index (BMI) and bone mineral density (BMD) at the femoral neck (a) and speed of sound (SOS) at the radius (b). Lean patient marked as filled squares and overweight women in open squares. The correlation between BMI and femoral neck BMD is statistically significant (R = 0.68, P < 0.0001).

Mentions: Mean BMC, bone mineral area and the derived BMD of the lumbar spine were similar in both study groups. However, the corresponding BMC and BMD of the femoral neck were higher in the Overweight group as compared with the Lean group (Table 2). Bone area of the femoral neck was similar in both study groups. Bone SOS at the RAD, PLX and TIB did not differ significantly in both groups of patients. In the Lean group, SOS Z score at the RAD was higher than the age-adjusted BMD of the femoral neck (P < 0.01) and the lumbar spine (P < 0.05). The SOS Z-score at the TIB was higher than the femoral neck BMD Z-score of the femoral neck in the Lean group (P < 0.05), but lower in the Overweight group (P < 0.005). Whereas BMD of the femoral neck was highly correlated with BMI, SOS was unrelated to BMI at any measurement site (Fig. 1). In the Overweight group, SOS at the PLX positively correlated with BMD of the lumbar spine (Table 3), but not at the other two SOS measurement sites. In contrast, in the Lean group, SOS at the RAD and PLX positively correlated with BMD at both femoral neck and lumbar spine. It is worthwhile noting that in few cases SOS measurements at some sites are impossible (Table 3)


Discordant effect of body mass index on bone mineral density and speed of sound.

Steinschneider M, Hagag P, Rapoport MJ, Weiss M - BMC Musculoskelet Disord (2003)

Spearman rank order correlation coefficient of body mass index (BMI) and bone mineral density (BMD) at the femoral neck (a) and speed of sound (SOS) at the radius (b). Lean patient marked as filled squares and overweight women in open squares. The correlation between BMI and femoral neck BMD is statistically significant (R = 0.68, P < 0.0001).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC183832&req=5

Figure 1: Spearman rank order correlation coefficient of body mass index (BMI) and bone mineral density (BMD) at the femoral neck (a) and speed of sound (SOS) at the radius (b). Lean patient marked as filled squares and overweight women in open squares. The correlation between BMI and femoral neck BMD is statistically significant (R = 0.68, P < 0.0001).
Mentions: Mean BMC, bone mineral area and the derived BMD of the lumbar spine were similar in both study groups. However, the corresponding BMC and BMD of the femoral neck were higher in the Overweight group as compared with the Lean group (Table 2). Bone area of the femoral neck was similar in both study groups. Bone SOS at the RAD, PLX and TIB did not differ significantly in both groups of patients. In the Lean group, SOS Z score at the RAD was higher than the age-adjusted BMD of the femoral neck (P < 0.01) and the lumbar spine (P < 0.05). The SOS Z-score at the TIB was higher than the femoral neck BMD Z-score of the femoral neck in the Lean group (P < 0.05), but lower in the Overweight group (P < 0.005). Whereas BMD of the femoral neck was highly correlated with BMI, SOS was unrelated to BMI at any measurement site (Fig. 1). In the Overweight group, SOS at the PLX positively correlated with BMD of the lumbar spine (Table 3), but not at the other two SOS measurement sites. In contrast, in the Lean group, SOS at the RAD and PLX positively correlated with BMD at both femoral neck and lumbar spine. It is worthwhile noting that in few cases SOS measurements at some sites are impossible (Table 3)

Bottom Line: Mean SOS at all measurement sites was similar in both groups and did not correlate with BMI.Bone turnover was similar in the two study groups.The high BMI of postmenopausal women may result in spuriously high BMD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, Assaf Harofeh" Medical Center, Israel. msteinsneider@asaf.health.gov.il

ABSTRACT

Background: Increased BMI may affect the determination of bone mineral density (BMD) by dual X-ray absorptiometry (DXA) and speed of sound (SOS) measured across bones. Preliminary data suggest that axial SOS is less affected by soft tissue. The purpose of this study is to evaluate the effect of body mass index (BMI) on BMD and SOS measured along bones.

Methods: We compared axial BMD determined by DXA with SOS along the phalanx, radius and tibia in 22 overweight (BMI > 27 kg/m2), and 11 lean (BMI = 21 kg/m2) postmenopausal women. Serum bone specific alkaline phosphatase and urinary deoxypyridinoline excretion determined bone turnover.

Results: Mean femoral neck--but not lumbar spine BMD was higher in the overweight--as compared with the lean group (0.70 +/- 0.82, -0.99 +/- 0.52, P < 0.00001). Femoral neck BMD in the overweight--but not in the lean group highly correlated with BMI (R = 0.68. P < 0.0001). Mean SOS at all measurement sites was similar in both groups and did not correlate with BMI. Bone turnover was similar in the two study groups.

Conclusions: The high BMI of postmenopausal women may result in spuriously high BMD. SOS measured along bones may be a more appropriate means for evaluating bones of overweight women.

Show MeSH
Related in: MedlinePlus