Bone mineral density and trabecular bone tissue quality in obese men

V.V. Povoroznyuk, A.S. Musiienko


Obesity and osteoporosis are the two metabolic dise­ases with increased prevalence over last decades and a strong impact on the global morbidity and mortality have gained a status of major health threats worldwide. There is evidence that the higher body mass index (BMI) values are associated with greater bone mineral density (BMD) resulting in a site-specific protective effect for fragility fractures. On the other hand, higher BMI values increases incidence of falls and is associated with worse fractures consolidation. However, trabecular bone score (TBS) indirectly explores bone quali­ty, independently of BMD. The aim of the study was to determine the connection between the BMD and TBS parameters in Ukrainian men suffering from obesity. Methods. We examined 396 men aged 40–89 years, by the BMI all the subjects were divided into 2 groups: Group A — with obesity and BMI ≥ 30 kg/m2 (n = 129) and Group B — without obesity and BMI < 30 kg/m2 (n = 267). The BMD of total body, lumbar spine at the site L1–L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1–L4 was assessed by means of TBS iNsight (Med-Imaps, Pessac, France). Results. In general, obese men had a significantly higher BMD of lumbar spine, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L1–L4 was significantly lower in obese men compared to non-obese men (p < 0.001). The significant positive correlation between the fat mass and the BMD at different sites was observed. The correlation between the fat mass and TBS of L1–L4 was also significant, but negative. Conclusions. Obesity negatively affects the quality of trabecular bone, while bone mineral density was significantly higher.


trabecular bone score; bone mineral density; men; obesity


Bermeo S, Gunaratnam K, Duque G. Fat and bone interactions. Curr Osteoporos Rep. 2014;12(2):235-42.

Cao JJ. Effects of obesity on bone metabolism. J Orthop Surg Res. 2011;15(6):30.

Compston J. Obesity and bone. Curr Osteoporos Rep. 2013;11(1):30-35.

Faje A, Klibanski A. Body composition and skeletal health: too heavy? Too thin? Curr Osteoporos Rep. 2012;10(3):208-16.

Gonçalves MJ, Rodrigues AM, Canhão H, Fonseca JE. Osteoporosis: from bone biology to individual treatment decision. Acta Med Port. 2013;26(4):445-55.

Gonnelli S, Caffarelli C, Nuti R. Obesity and fracture risk. Clin Cases Miner Bone Metab. 2014;11(1):9-14.

Gower BA, Casazza K. Divergente ffects of obesity on bone health. J Clin Densitom. 2013;16(4):450-454.

Leonard MB, Zemel BS, Wrotniak BH et al. Tibia and radius bone geometry and volumetric density in obese compared to non-obese adolescents. Bone. 2015;73:69-76.

Naot D, Cornish J. Cytokines and Hormones That Contribute to the Positive Association between Fat and Bone. Front Endocrinol (Lausanne). 2014;9(5):70.

Nielson CM, Srikanth P, Orwoll ES. Obesity and fracture in men and women: an epidemiologic perspective. J Bone Miner Res. 2012;27(1):1-10.

Rosen CJ, Bouxsein ML. Mechanisms of disease: is osteoporosis the obesity of bone? Nature clinical practice. 2006;2(1):35-43.

Sharma S, Randon TV, Mahajan S et al. Obesity: Friend or foe for osteoporosis. J Midlife Health. 2014;5(1):6-9.

De Laet C, Kanis JA, Oden A et al. Body mass index as a predictor of fracture risk: a meta‐analysis. Osteoporos Int. 2005;16:1330-1338.

Nielson CM, Marshall LM, Adams AL, LeBlanc ES, Cawthon PM, Ensrud K, Stefanick ML, Barrett‐Connor E, Orwoll ES. Osteoporotic Fractures in Men Study Research Group. BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). J Bone Miner Res. 2011;26(3):496-502.

Leslie WD, Orwoll ES, Nielson CM, Morin SN, Majumdar SR, Johansson H, Odén A, McCloskey EV, Kanis JA. Estimated Lean Mass and Fat Mass Differentially Affect Femoral Bone Density and Strength Index but Are Not FRAX Independent Risk Factors for Fracture. J Bone Miner Res. 2014;29(11):2511-2519.

Premaor MO, Compston JE, Avilés FF, Pagès‐Castellà A, Nogués X, Díez‐Pérez A, Prieto‐Alhambra D. The Association Between Fracture Site and Obesity in Men: A Population‐Based Cohort Study. J Bone Miner Res. 2013;28(8):1771-1777.

Lv S, Zhang A, Di W, Sheng Y, Cheng P, Qi H, Liu J, Yu J, Ding G, Cai J, Lai B. Assessment of Fat distribution and Bone quality with Trabecular Bone Score (TBS) in Healthy Chinese Men. Scientific Reports. 2016;26:1-8.

Weisberg SP, McCann D, Desai M et al. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003;112(12):1796-1808.

Mazzetti G, Berger C, Leslie WD, Hans D, Langsetmo L, Hanley DA, Kovacs CS, Prior JC, Kaiser SM, Davison KS, Josse R, Papaioannou A, Adachi JR, Goltzman D, Morin SN. Densitometer-Specific Differences in the Correlation Between Body Mass Index and Lumbar Spine Trabecular Bone Score. J Clin Densitom. 2016 Dec 26. pii: S1094-6950(16)30185-8. doi: 10.1016/j.jocd.2016.11.003. [Epub ahead of print]

Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu T, Li Z, Laird N, Brain JD, Cummings SR, Bouxsein ML, Rosen CJ, Xu X. Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. Am J Clin Nutr. 2006;83:146-154.

Salamat MR, Salamat AH, Janghorbani M. Association between Obesity and Bone Mineral Density by Gender and Menopausal Status. Endocrinol Metab. 2016;31:547-558.

Evans AL, Paggiosi MA, Eastell R, Walsh JS. Bone Density, Microstructure and Strength in Obese and Normal Weight Men and Women in Younger and Older Adulthood. J Bone Miner Res. 2015;30(5):920-928.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© "Publishing House "Zaslavsky", 1997-2017


 Яндекс.МетрикаSeo анализ сайта Рейтинг