In obese postmenopausal women, bone microarchitecture and strength are not commensurate to greater body weight: the Os des Femmes de Lyon (OFELY) study
Abstract
Obesity is associated with higher areal bone density (aBMD) but its protective effect on the risk of fracture is controversial. We aimed to analyze bone microarchitecture and biomechanical properties in obese (OB) postmenopausal French women compared with normal weight (NW) women. A matched case-control study from the Os des Femmes de Lyon (OFELY) cohort was conducted in 63 OB women (body mass index [BMI] > 30, mean age 69 ± 8 years) age-matched with 126 NW women (19 ≤ BMI ≤ 25). Bone architecture was measured with high-resolution pQCT at the distal radius and tibia and bone strength was assessed by micro–finite element analysis (µFEA). aBMD, total body fat mass (FM) and lean mass (LM) were measured by dual-energy X-ray absorptiometry (DXA). aBMD was 15% higher at the total hip in OB compared with NW women. At the radius, OB had 13% and 14% higher volumetric total and trabecular bone densities, 11% higher cortical thickness, 13% greater trabecular number, and 22% lower distribution of trabecular separation compared with NW (p adjusted for height, physical activity, and medication use, <0.01 for all). Differences of a similar magnitude were found at the distal tibia. At both sites, µFEA showed significant higher values of bone strength in OB compared to controls. After normalizing values for individual body weight, we observed that all the parameters were relatively lower in OB compared to NW women. The increase of FM was fourfold greater than the increase of LM in OB. The effect of FM on bone parameters was more pronounced at the tibia compared to the non–weight-bearing site. Nevertheless, the coefficients of correlation were about one-half of those of LM for the biomechanical parameters. We conclude that higher absolute values of bone densities, cortical and trabecular architecture, and strength indices were not in proportion to the excess of BMI and particularly of FM in obese postmenopausal French women.
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Obese patients may have increased fracture risk, especially at peripheral sites.
“While data are limited, obese patients may be at increased fracture risk, particularly at peripheral sites24-27.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [26]
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- Authors
- Sornay-Rendu, E., Boutroy, S., Vilayphiou, N., Claustrat, B., & Chapurlat, R. D.
- Affiliations
- INSERM Research Unit 1033Hospices Civils de Lyon, Université de LyonLyonFrance
- Inserm (FR)
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-01-31
- Volume
- 28
- Issue
- 7
- Pages
- 1679-1687
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W1607536434
- Cited by
- 114
- References
- 51
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 13 · 2021: 10 · 2020: 5 · 2019: 12 · 2018: 8 · 2017: 11 · 2016: 7 · 2015: 11 · 2014: 11 · 2013: 2
- FWCI
- 10.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mutuelle Générale de l'Education Nationale
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- obesity, postmenopausal women, bone microarchitecture, bone strength, areal bone mineral density, fat mass, lean body mass, trabecular bone, cortical thickness, distal radius, distal tibia, micro-finite element analysis, fracture risk, body weight
- MeSH terms
- Adult, Aged, Aged, 80 and over, Body Weight, Female, France, Humans, Middle Aged, Obesity, Radius, Retrospective Studies, Tibia, Absorptiometry, Photon, Bone Density, Postmenopause
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