Association between Obesity and Bone Mineral Density by Gender and Menopausal Status.
BACKGROUND
We investigated whether there were gender differences in the effect of obesity on bone mineral density (BMD) based on menopausal status.


METHODS
We assessed 5,892 consecutive patients 20 to 91 years old who were referred for dual-energy X-ray absorptiometry (DXA) scans. All subjects underwent a standard BMD scan of the hip (total hip and femoral neck) and lumbar spine (L1 to L4) using a DXA scan and body size assessment. Body mass index was used to categorize the subjects as normal weight, overweight, and obese.


RESULTS
BMD was higher in obese and overweight versus normal weight men, premenopausal women, and postmenopausal women. Compared to men ≥50 years and postmenopausal women with normal weight, the age-adjusted odds ratio of osteopenia was 0.19 (95% confidence interval [CI], 0.07 to 0.56) and 0.38 (95% CI, 0.29 to 0.51) for obese men ≥50 years and postmenopausal women. Corresponding summaries for osteoporosis were 0.26 (95% CI, 0.11 to 0.64) and 0.15 (95% CI, 0.11 to 0.20), respectively. Compared to men <50 years and premenopausal women with normal weight, the age-adjusted odds ratio of low bone mass was 0.22 (95% CI, 0.11 to 0.45) and 0.16 (95% CI, 0.10 to 0.26) for obese men <50 years and premenopausal women, respectively.


CONCLUSIONS
Obesity is associated with BMD of the hip and lumbar spine and overweight and obese individuals have similar degrees of osteoporosis. This result was not significantly different based on gender and menopausal status, which could be an important issue for further investigation.
Department of Medical Physics and Medical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Reza
MR
Salamat
Isfahan Osteoporosis Diagnosis and Body Composition Center, Isfahan, Iran.
Amir Hossein
AH
Salamat
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. janghorbani@hlth.mui.ac.ir.
Mohsen
http://orcid.org/0000-0003-3024-3380
M
Janghorbani
Body mass index; Bone density; Gender identity; Menopause; Obesity paradox