title: Adipose tissue, estradiol levels, and bone health in obese men with metabolic syndrome.
abstract: OBJECTIVE
  Visceral adipose tissue (VAT) is associated with an increased risk of metabolic syndrome (MetS). Recent studies have suggested that VAT negatively affects bone. However, MetS has also been associated with higher estradiol (E2) levels, which is bone protective. We therefore investigated the impact of VAT and E2 levels on bone density, structural parameters, and strength estimates.
  
  
  METHODS
  A cross-sectional study was conducted in 72 obese men with MetS to investigate the impact of VAT and E2 levels on bone.
  
  
  METHODS
  Bone parameters were assessed by dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and high-resolution peripheral QCT (HRpQCT) at lumbar spine, proximal femur, radius, and tibia. VAT volume was measured by magnetic resonance imaging (MRI) and sexual hormones were measured in blood samples.
  
  
  RESULTS
  Men with high VAT had a lower bone density at the hip (P<0.05), lower cortical thickness, and higher buckling ratio at femoral neck (FN) (P=0.008 and P=0.02), compared with men with low VAT, despite a similar body weight and BMI. Generally, E2 levels were low (median 43 pmol/l), and men with E2 levels below median had reduced bone density at lumbar spine (P=0.04), and impaired structural parameters at radius and tibia, compared with men with E2 levels above median. At the hip, VAT volume and E2 levels affected bone density independently and additively, and 50% of men with high VAT and low E2 levels had osteopenia with significantly lower T-score at FN (P=0.004).
  
  
  CONCLUSIONS
  High VAT and low E2 negatively affect bone in obese men with MetS. VAT and E2 affect bone density at the hip independently and additively, revealing an unexpected high prevalence of osteopenia in middle-aged men with MetS.
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark marie.juul.ornstrup@clin.au.dk.
authors.forename: Marie Juul
authors.initials: MJ
authors.lastname: Ornstrup
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: Thomas Nordstrøm
authors.initials: TN
authors.lastname: Kjær
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Harsløf
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: Hans
authors.initials: H
authors.lastname: Stødkilde-Jørgensen
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: David Michael
authors.initials: DM
authors.lastname: Hougaard
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: Arieh
authors.initials: A
authors.lastname: Cohen
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: Steen Bønløkke
authors.initials: SB
authors.lastname: Pedersen
authors.affiliation: Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Department of EndocrinologyAarhus University Hospital, Tage-Hansens Gade 2, Entrance 3C, DK-8000 Aarhus C, DenmarkDepartment of Clinical MedicineAarhus University, Nordre Ringgade 1, DK-8000 Aarhus, DenmarkThe MR Research CenterAarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, DenmarkDepartment of Clinical BiochemistryImmunology and Genetics, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: Bente Lomholt
authors.initials: BL
authors.lastname: Langdahl
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D004958:Estradiol / Q000097:blood*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D004958:Estradiol