Comparing body mass index, fat mass, and lean mass in predicting cardiometabolic risk factors and bone mineral density in osteopenic postmenopausal women
Date
2021
Authors
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Publisher
University of Delaware
Abstract
Postmenopausal women have significantly lower estrogen levels than premenopausal women. Reduced estrogen levels affect body weight and adipose tissue distribution in postmenopausal women. Obesity is a risk factor for cardiovascular disease (CVD), though thought to have protective effects on bone health. This study aimed to investigate the associations between body mass index (BMI), fat mass (FM), and lean mass (LM) with CVD risk factors, bone turnover markers (BTM), and bone mineral density (BMD) in osteopenic postmenopausal women. Overnight fasting blood and urine were collected from 132 osteopenic postmenopausal (1 to 10 years) women not on hormone therapy and drugs known to affect bone metabolism. BMI, FM, and LM were assessed using dual-energy X-ray absorptiometry (DEXA). Multiple linear regression and Pearson correlation analysis were conducted to examine the associations between variables of interest and one-way ANOVA was conducted to compare the means of CVD risk factors between BMI categories. The present study found that BMI and FM, but not LM, were positively and significantly associated with CVD risk factors including fasting plasma glucose (p=0.002 for both), c-reactive protein (p<0.001 for both), apolipoprotein B (p=0.003 & p=0.002, respectively), total cholesterol (p=0.008 & p=0.004, respectively), low-density lipoprotein (p<0.001 for both), and triglycerides (p=0.005 & p=0.023, respectively) levels. BMI and LM, but not FM, were positively and significantly associated with BMD of multiple sites including L3 (p=0.024 & p=0.004, respectively), radius (p<0.001 & p=0.001, respectively), ulna (p=006 for both), legs (p=0.014 & p<0.001, respectively), ribs (p=0.002 & p=0.043, respectively), spine (p=0.002 for both), whole-body (p=0.019 & p=0.001, respectively), and trochanter bones (p=0.004 & p<0.001, respectively), though LM had bigger effect sizes than BMI for most sites. BMI, FM, and LM were not significantly associated with BTMs. These data suggest that BMI can be a simple, inexpensive, and reliable tool in predicting cardiometabolic risk factors whereas LM is a better predictor of BMD than BMI in osteopenic postmenopausal women.
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Keywords
Body mass index, Bone mineral density, Cardiometabolic risk factors, Post-menopause,