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ORIGINAL ARTICLE
Year : 2016  |  Volume : 43  |  Issue : 2  |  Page : 67-69

Effect of obesity on osteoporosis: A DEXA scan-based report in urban population of Belagavi


Department of Orthopaedics, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre and Charitable Hospital, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India

Date of Web Publication18-May-2016

Correspondence Address:
Saumya Agarwal
Department of Orthopaedics, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre and Charitable Hospital, Jawaharlal Nehru Medical College, Belagavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-5009.182596

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  Abstract 

Introduction: Obesity and osteoporosis are two major emerging challenges. Body mass index (BMI) is widely used as an index of the degree of obesity. Osteoporosis is a skeletal disease characterized by excessive skeletal fragility and susceptibility to low-trauma fracture among the elderly, it is typically defined in an individual with a bone mineral density (BMD) T-score, that is, 2.5 or more and standard deviations (SD) below normal (T-score ≤ -2.5). Aims and Objectives: To examine association between BMI and BMD among the urban population of Belagavi, Karnataka, India. Materials and Methods: 500 patients, 25 years of age and above, who underwent Dual-Energy X-ray Absorptiometry (DEXA) scan from the period of June 2013 to May 2015 in KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India, were divided according to BMI (kg/m 2 ) and age groups: 25-39 years, 40-59 years, and 60 and above. Results: (1) Overweight people are less osteopenic and less osteoporotic than normal people. (2) Older people have low BMI. (3) Older people have low BMD. (4) Females have high BMI. (5) Females have low BMD. Conclusion: BMD was found to be significantly higher in overweight patients as compared to the BMD of the normal weight category. In addition, significant negative correlation between age and BMI was observed. Age and BMD correlated negatively as well. Females were found to be more obese and osteoporotic than males, signaling toward the culprit - Estrogen. Further studies are required to investigate the effect of other factors such as exposure to sunlight, calcium intake, and other habits like smoking and diet.

Keywords: Dual-Energy X-ray Absorptiometry (DEXA), obesity, osteopenia, osteoporosis


How to cite this article:
Agarwal S, Uppin RB. Effect of obesity on osteoporosis: A DEXA scan-based report in urban population of Belagavi. J Sci Soc 2016;43:67-9

How to cite this URL:
Agarwal S, Uppin RB. Effect of obesity on osteoporosis: A DEXA scan-based report in urban population of Belagavi. J Sci Soc [serial online] 2016 [cited 2020 Aug 9];43:67-9. Available from: http://www.jscisociety.com/text.asp?2016/43/2/67/182596


  Introduction Top


Obesity and osteoporosis are two major emerging challenges in medical practice. Obesity is a condition of excessive body fat that causes or exacerbates several public health problems. Body mass index (BMI) is widely used as an index of the degree of obesity. Osteoporosis is a skeletal disease [Figure 1] characterized by excessive skeletal fragility and susceptibility to low-trauma fracture among the elderly; it is typically defined in an individual with a bone mineral density (BMD) T-score, that is, 2.5 or more and standard deviations (SD) below normal (T-score ≤ −2.5) [Figure 2]. [1] Body fat mass, a component of body weight, is one of the most important indices of obesity, and a substantial body of evidence indicates that fat mass may have beneficial effects on bone. [2] Greater fat mass imposes a greater mechanical stress on bone, and in response, bone mass increases to accommodate the greater load. This has been well accepted that the most powerful, measurable determinant of fracture risk is the amount of bone in the skeleton, as measured by BMD.
Figure 1: Showing T-Score interpretation

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Figure 2: Showing Normal Bone Matrix and Osteoporotic Bone

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  Aims and objectives Top


To examine the association between BMI and BMD among the urban population of Belagavi, Karnataka, India as well as to see if this relationship differs by age and sex.


  Materials and methods Top


500 patients, 25 years of age and above, who underwent Dual-Energy X-ray Absorptiometry (DEXA) scan from the period of June 2013 to May 2015 in KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India, were divided into normal weight (18.5 < BMI, 25.0 kg/m), overweight (25.0 < BMI, 30.0 kg/m), and obese (BMI > 30.0 kg/m). BMI (kg/m 2 ) was calculated as weight (kg) divided by height square (m 2 ). They were then divided in three age groups such as 25-39 years, 40-59 years, and 60 and above.


  Results Top


  1. Overweight people are less osteopenic and less osteoporotic than normal people [Graph 1]
  2. Older people have low BMI [Graph 2]
  3. Older people have low BMD [Graph 3]
  4. Females have high BMI [Graph 4]
  5. Females have low BMD [Graph 5]













  Discussion Top


In this study, BMD was found to be significantly higher in overweight patients as compared to the BMD of normal weight category. Additionally, significant negative correlation between age and BMI in the normal weight, overweight, and obese patients was observed. Age and BMD correlated negatively with each other in all the groups and the correlation was significant that suggests that advancing age is associated with low BMD. Adipocytes (the cell for storing energy) and osteoblasts (the bone formation cells) derive from a common progenitor - The mesenchymal stem cell. Secondary causes of osteoporosis, including diabetes mellitus, glucocorticoids, and immobility, are associated with bone-marrow adiposity. [3] Females were found to be more obese and osteoporotic than males, signaling toward the culprit - Estrogen. Women, more than men, are at risk for osteoporosis-related fractures, especially in the wrists, lumbar spine, and hips. [4] Menopause has been associated with increased bone loss, increased fat mass, and decreased lean mass. This study is an attempt to address one of the important public health problems which can be controlled if preventive measures are taken at an early stage.


  Conclusion Top


Extensive data have shown that high body weight or BMI is correlated with high BMD, and that a decrease in body weight leads to bone loss. These correlations are seen in both men and women, across the entire adult age range, and throughout the skeleton. The results of this study suggest that advancing age and lower BMI are important risk factors for the occurrence of low BMD and that any grade of obesity might have a positive influence on the BMD. Further studies are required to investigate the effect of other factors such as exposure to sunlight, calcium intake, and other habits like smoking and diet.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kanis JA, Melton LJ 3 rd , Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res 1994;9:1137-41.   Back to cited text no. 1
    
2.
Zhao LJ, Jiang H, Papasian CJ, Maulik D, Drees B, Hamilton J, et al. Correlation of obesity and osteoporosis: Effect of fat mass on the determination of osteoporosis. J Bone Miner Res 2008;23:17-29.  Back to cited text no. 2
    
3.
Rosen CJ, Bouxsein ML. Mechanisms of disease: Is osteoporosis the obesity of bone? Nat Clin Pract Rheumatol 2006;2:35-43.  Back to cited text no. 3
    
4.
Wardlaw GM. Putting body weight and osteoporosis into perspective. Am J Clin Nutr 1996;63(Suppl):433-6S.  Back to cited text no. 4
    


    Figures

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  In this article
Abstract
Introduction
Aims and objectives
Materials and me...
Results
Discussion
Conclusion
References
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