Endocrine Abstracts

Introduction: Traditionally, obesity is thought to exert a positive impact on bone mineral density (BMD). However, the effect of adipose tissue on bone health is under investigation. Trabecular bone score (TBS) is a measure of bone texture, providing information on bone quality and microarchitecture, independently of BMD. Lower values of TBS indicate a worsening in bone quality and amplify fracture risk. Herein, we aimed to investigate the association of body composition and bone quality as evaluated by lumbar spine TBS.

Methods: We included 83 subjects (69 women and 14 men) with a mean age of 62.38years ± 10.48. There was no history of secondary osteoporosis, neither received anti-osteoporotic drugs. Body composition and lumbar spine TBS were evaluated by dual-energy X-ray absorptiometry (DXA). To determine the associations among the variables of interest linear regression analysis was performed (Stata Corp (2017)).

Results: Our analysis demonstrated that total fat mass is negatively associated with TBS (P<0.01). Moreover, total lean mass is positively correlated with TBS. Extending our analysis to examine the association of visceral adipose tissue (VAT) mass and arm fat mass with TBS, we demonstrated that VAT mass is negatively associated with TBS (P<0.05). Furthermore, we found that right and left arm fat mass, each one or combined, associated negatively with TBS (P<0.05), even after adjustment for age and weight. Each right and left arm lean mass or combined were positively associated with TBS reaching statistical significance (P<0.1).

Conclusions: Our study provide evidence that total fat and in specific VAT negatively impacts bone quality as it is estimated by TBS. It is known that VAT is the main source of proinflammatory adipocytokines provoking low grade inflammation that has potentially a negative impact on bone quality. We also showed for the first time that the body composition of the arms is correlated with the bone quality of lumbar spine, possibly underscoring the importance of the physical exercise of the upper part of the body in the bone quality of vertebrae.

References: 1. Paik J.M et al. BMI, Waist Circumference, and Risk of Incident Vertebral Fracture in Women. Obesity 2019, 27, 1513–1519. 2. Seaton MP, et al. Associations of Lean Mass, Muscular Strength, and Physical Function with Trabecular Bone Score in Older Adults. J Clin Densitom. 2023;26(3):101370. 3. Kirk B, et al. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep. 2020;18(4):388–400.