Cited by 207Bone health and osteoporosis researchBone Metabolism and DiseasesHIV-related health complications and treatments

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Abdominal Fat Is Associated With Lower Bone Formation and Inferior Bone Quality in Healthy Premenopausal Women: A Transiliac Bone Biopsy Study

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Cohen, Adi, Dempster, David W., Recker, Robert R., Lappe, Joan M., Zhou, Hua, Zwahlen, Alexander, Müller, Ralph, Zhao, Binsheng, Guo, Xiaotao, Lang, Thomas, Saeed, Isra, Liu, X. Sherry, Guo, X. Edward, Cremers, Serge, Rosen, Clifford J., Stein, Emily M., Nickolas, Thomas L., McMahon, Donald J., Young, Polly, Shane, Elizabeth·2013·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2013-1047PMC PMC3667251

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Abstract

CONTEXT: The conventional view that obesity is beneficial for bone strength has recently been challenged by studies that link obesity, particularly visceral obesity, to low bone mass and fractures. It is controversial whether effects of obesity on bone are mediated by increased bone resorption or decreased bone formation. OBJECTIVE: The objective of the study was to evaluate bone microarchitecture and remodeling in healthy premenopausal women of varying weights. DESIGN: We measured bone density and trunk fat by dual-energy x-ray absorptiometry in 40 women and by computed tomography in a subset. Bone microarchitecture, stiffness, remodeling, and marrow fat were assessed in labeled transiliac bone biopsies. RESULTS: Body mass index (BMI) ranged from 20.1 to 39.2 kg/m(2). Dual-energy x-ray absorptiometry-trunk fat was directly associated with BMI (r = 0.78, P < .001) and visceral fat by computed tomography (r = 0.79, P < .001). Compared with women in the lowest tertile of trunk fat, those in the highest tertile had inferior bone quality: lower trabecular bone volume (20.4 ± 5.8 vs 29.1 ± 6.1%; P = .001) and stiffness (433 ± 264 vs 782 ± 349 MPa; P = .01) and higher cortical porosity (8.8 ± 3.5 vs 6.3 ± 2.4%; P = .049). Bone formation rate (0.004 ± 0.002 vs 0.011 ± 0.008 mm(2)/mm · year; P = .006) was 64% lower in the highest tertile. Trunk fat was inversely associated with trabecular bone volume (r = -0.50; P < .01) and bone formation rate (r = -0.50; P < .001). The relationship between trunk fat and bone volume remained significant after controlling for age and BMI. CONCLUSIONS: At the tissue level, premenopausal women with more central adiposity had inferior bone quality and stiffness and markedly lower bone formation. Given the rising levels of obesity, these observations require further investigation.

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Authors: Cohen, A., Dempster, D. W., Recker, R. R., Lappe, J. M., Zhou, H., Zwahlen, A., Müller, R., Zhao, B., Guo, X., Lang, T., Saeed, I., Liu, X. S., Guo, X. E., Cremers, S., Rosen, C. J., Stein, E. M., Nickolas, T. L., McMahon, D. J., Young, P., & Shane, E.
Affiliations: Columbia University (US)
Helen Hayes Hospital (US)
Creighton University (US)
ETH Zurich (CH)
University of California, San Francisco (US)
Maine Medical Center (US)
Corresponding author: Cohen, Adi
ORCID: Cohen, Adi
Dempster, David W.
Recker, Robert R.
Lappe, Joan M.
Zhou, Hua
Zwahlen, Alexander
Müller, Ralph
Zhao, Binsheng
Lang, Thomas
Liu, X. Sherry
Guo, X. Edward
Cremers, Serge
Rosen, Clifford J.
Stein, Emily M.
Nickolas, Thomas L.
McMahon, Donald J.
Shane, Elizabeth
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2013-06-01
Volume: 98
Issue: 6
Pages: 2562-2572
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jc.2013-1047
PMC: PMC3667251
OpenAlex: W2000962428
Semantic Scholar: 5b94125fc696b1fc9d9b43df52694c7fa3fe5caf
Cited by: 206
References: 75
Citations by year: 2026: 6 · 2025: 13 · 2024: 9 · 2023: 16 · 2022: 20 · 2021: 17 · 2020: 13 · 2019: 15 · 2018: 13 · 2017: 24 · 2016: 16 · 2015: 18 · 2014: 20 · 2013: 6
FWCI: 20.52
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institutes of Health (5k24ar052665-10)
National Institute of Diabetes and Digestive and Kidney Diseases (R24DK092759)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24 AR05266, R01AR049896, K24-AR 052665, K23AR054127)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
Keywords: abdominal fat, visceral obesity, bone formation rate, bone quality, bone microarchitecture, trabecular bone volume, cortical porosity, bone stiffness, bone remodeling, premenopausal women, abdominal obesity, bone mineral density
MeSH terms: Adolescent, Adult, Biopsy, Bone and Bones, Female, Humans, Insulin-Like Growth Factor I, Middle Aged, Osteogenesis, Regression Analysis, Absorptiometry, Photon, Bone Density, Body Mass Index, Premenopause, Abdominal Fat

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Abdominal Fat Is Associated With Lower Bone Formation and Inferior Bone Quality in Healthy Premenopausal Women: A Transiliac Bone Biopsy Study

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