DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20194881

Relationship of body mass index with bone mineral density in postmenopausal women: an Indian perspective

Avani Goyal, Veena Ganju Malla

Abstract


Background: Osteoporosis is a common health problem that affects postmenopausal females, leading to increased susceptibility to fractures. Body mass index (BMI) has been shown to be an important predictor of bone mineral density (BMD) with increased body weight correlating with positive influence on bone metabolism. Low BMI predisposes postmenopausal females to rapid bone loss and low bone mass, crucial in the pathogenesis of osteoporosis. However, a specific BMI value chart to accurately predict osteoporosis remains to be fully established. The present study aimed to investigate the relationship of BMI and BMD in postmenopausal Indian females.

Methods: 90 healthy postmenopausal females with 1-5 years of menopause were enrolled in the study. Subjects were categorized according to their BMI into normal, overweight and obese. BMD was assessed using dual energy X-ray absorptiometry (DEXA) scan at L1-L4 vertebrae and femoral neck and expressed as T-scores. Quantitative variables were compared using ANOVA/Kruskal Wallis Test.

Results: Bone mineral density was significantly higher in the obese group as compared to normal BMI group at both lumbar spine (p=0.001) and femoral neck (p=0.001). BMD at lumbar spine was lower than that at femoral neck across all the three groups of BMI.

Conclusions: BMI and body weight are important factors affecting BMD. Postmenopausal females with low BMI are more likely to have osteopenia and osteoporosis and are thus at an increased risk of pathological fractures. Routine BMD monitoring in postmenopausal females with low BMI may be necessary to initiate early clinical interventions for osteoporosis.


Keywords


Body mass Index, Dual Energy X-ray absorptiometry, Menopause, Oseoporosis

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References


Menopausal terminology. International Menopause Society, 2015. Available at: http://www.imsociety.org/menopause_terminology.php. Accessed on 8th May 2018.

Pal A, Hande D, Khatri S. Assessment of menopausal symptoms in perimenopause and postmenopause women above 40 years in rural area. Int J Healthcare Biomed Res. 2013;1(3):166-74.

Unni J. Third consensus meeting of Indian Menopause Society (2008): A summary. J Mid-life Health. 2010;1(1):43-7.

Shatrugna V, Kulkarni B, Kumar P, Rani K, Balakrishna N. Bone status of Indian women from a low-income group and its relationship to the nutritional status. Osteoporosis Int. 2005;16(12):1827-35.

Nohara T, Kamei T, Ohta A. Accelerated decrease in bone mineral density in women aged 52-57 years. Tohoku J Exp Med. 2006;210(4):341-7.

Fritz M, Speroff L. Clinical Gynecologic Endocrinology and Infertility. 8th ed. New Delhi: Wolters kluwer; 2011:714-720.

Krassas G, Papadopoulou P. Oestrogen action on bone cells. J Musculoskel Neuron Interact. 2001;2(2):143-51

Padubiri VG, Daftary SN. Perimenopause, menopause, premature menopause and postmenopausal bleeding. Howkins and Bourne Shaw’s textbook of Gynecology. 15th ed. New Delhi: Elsevier India pvt. Ltd.; 2011:1233-47.

Hensye G, Silva V, Mendonca L, Conceicao F, Zahar S, Farias M. Influence of obesity on bone density in postmenopausal women. Arq Bras Endocrinol Metab. 2007;51(6):943-9.

Ravn P, Cizza G, Bjarnason N, Thompson D, Daley M, Wasnich R, et al. Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. J Bone Mineral Res. 1999;14(9):1622-7.

Méndez J, Rojano-Mejía D, Pedraza J, Coral-Vázquez R, Soriano R, García-García E, et al. Bone mineral density in postmenopausal Mexican-Mestizo women with normal body mass index, overweight, or obesity. Menopause: The J North American Menopause Society. 2012;20(5):568-72.

Wu S, Du X. Body mass index may positively correlate with bone mineral density oflumbar vertebra and femoral neck in postmenopausal females. Med Sci Monitor. 2016;22:145-51.

Asomaning K, Bertone JE, Nasca P, Hooven F, Pekow P. The association between body mass index and osteoporosis in patients referred for a bone mineral density examination. J Women's Health. 2006;15(9):1028-34.

Jain V. Prediction of bone mineral density by age, body mass index and menopausalstatus in middle socioeconomic status women of urban Kolar region of Bhopal. IOSR J Dent Med Sci. 2013;12(3):17-21.

Tariq S, Tariq S, Khalid PL. Relationship of anthropometric measures with bonemineral density in postmenopausal non-osteoporotic, osteopenic and osteoporotic women. J Pakistan Med Asso. 2017;67(4):590-4.

Bansal S, Bansal A. Relation between obesity and osteoporosis in Women. Int J Med Dent Sci. 2017;6(1):1382-5.

Compston J, Watts N, Chapurlat R, Cooper C, Boonen S, Greenspan S, et al. Obesity is not protective against fracture in postmenopausal women: GLOW. The Am J Med. 2011;124(11):1043-50.