Endocrine Abstracts

Introduction: Despite available evidence for a relationship between bone health and obesity, the results of clinical trials remain conflicting. Thus, we conducted a cross-sectional study to analyze possible associations between waist circumference (WC), body mass index (BMI) and body weight (BW) with bone health in postmenopausal women.

Materials and Methods: The study included 84 women from Northeastern Bulgaria. Their mean age was 60.54±7.07 years, and their mean duration of menopause was 11.45±6.62 years. Bone health was assessed by dual-energy X-ray absorptiometry (DEXA), analysis of bone metabolic markers and fracture risk calculation.

Results: According to BMI 31% of the subjects were with normal weight, 50% were overweight and 20% were obese. In 82% of the women WC was over 80 cm. Significant positive correlations of bone mineral density (BMD) with WC (L1-L4 r=0.264; P=0.015, Femoral Neck r=0.338; P=0.002, Total Neck r=0.393; P < 0.001), BMI (L1-L4 r=0.295; P=0.006, Femoral Neck r=0.223; P=0.042, Total Neck r=0.330; P=0.002) and BW (L1-L4 r=0.446; P 0.001, Femoral Neck r=0.409; P 0.001, Total Neck r=0.457; P 0.001) were found. However, after BW adjustment the correlations of BMD with WC and BMI became insignificant. Moreover, a negative association was found between Femoral Neck BMD and BMI after BW adjustment (r=-0.260; P=0.018). On the other hand, the positive relationship between BMD and BW remained significant after WC and BMI adjustment. In addition, WC was inversely related to osteocalcin (r=-0.217; P=0.048) and Beta CrossLaps (r=-0.226; P=0.039). Nevertheless, a positive relationship was found between WC and pyrilinks D/creatinuria ratio (r=0.277; P=0.011), but it was associated with higher eGFR in obesity. Furthermore, higher BW was noted as a significant negative predictor of the 10-year risk of major osteoporotic fracture (MOF) (β=-0.730, P0.001) and hip fracture (HF) (β=-0.730, P0.001), but positive associations were found between BMI and the both fracture risks (for MOF β=0.532, P=0.009; for HF (β=0.441, P=0.026).

Conclusion: We assumed that obesity might be detrimental to postmenopausal bone health, as it was associated with lower BMD, lower bone turnover and higher fracture risks.