International Science Index


Associations between Metabolic Syndrome and Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Non-Vertebral Fractures


Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

[1] Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. ‘Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women’, JAMA, 301:513–521, 2009; doi: 10.1001/jama.2009.50.
[2] Dennison E.M., Syddall H.E., Aihie Sayer A., Martin H.J., Cooper C. Lipid profile, obesity and bone mineral density: the Hertfordshire Cohort Study. QJM: An International Journal of Medicine, Volume 100, Issue 5, 1 May 2007, Pages 297–303, (Accessed on 09/01/2018, open access).
[3] Didier Hans, Andrew L Goertzen, Marc-Antoine Krieg, William D Leslie. “Bone Microarchitecture Assessed by TBS Predicts Osteoporotic Fractures Independent of Bone Density: The Manitoba Study”, Journal of Bone and Mineral Research, Vol. 26, No. 11, November 2011, pp 2762–2769/ DOI: 10.1002/jbmr.499.
[4] Gonelli S., Caffarelli C., Nuti R. “Obesity and fracture risk” Clin. Cases Miner. Bone Metab., Jan; 11 (1): 9-14, 2014.
[5] Huang CY, Liao LC, Tong KM, Lai HL, Chen WK, Chen CI, Lu CY, Chen FJ. Mediating effects on health-related quality of life in adults with osteoporosis: a structural equation modeling. Osteoporos. Int. 2015; 26(3):875–883. doi: 10.1007/s00198-014-2963-3.мс.
[6] International Diabetes Federation. Worldwide definition of the metabolic syndrome. Available at: http: // Metasyndrome definition. pdf. Accessed, August 24, 2005.
[7] Kan Sun; Jianmin Liu; Nan Lu; Hanxiao Sun; Guang Ning “Association between metabolic syndrome and bone fractures: a meta-analysis of observational studies,” BMC Endocr Disord.; 14(13), 2014, Published online 2014 Feb 9. doi 10.1186/1472-6823-14-13.
[8] Maghraoui A1, Rezqi A, Mrahi S, Sadni S, Ghozlani I, Mounach A. “Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women” BMC Endocr Disord., Dec 10;14:93, 2014; doi: 10.1186/1472-6823-14-93.
[9] Von Muhlen D, Safii S, Jassal SK, Svartberg J, Barrett-Connor E. Associations between the metabolic syndrome and bone health in older men and women: The Rancho Bernardo Study. Osteoporos Int. 2007; 18:1337–1344. doi: 10.1007/s00198-007-0385-1.
[10] Official Positions of the International Society for Clinical Densitometry, Copyright ISCD, October 2007, Supersedes all prior “Official Positions” publications.
[11] Poiana C, Carsote M, Radoi V, Mihai A, Capatina C. “Prevalent osteoporotic fractures in 622 obese and non- obese menopausal women”, J Med Life, Oct-Dec; 8(4): 462–466, 2015.
[12] Sun K, Liu J, Lu N, Sun H, Ning G. Association between metabolic syndrome and bone fractures: a meta-analysis of observational studies. BMC Endocr Disord. 2014 Feb 9;14:13. doi: 10.1186/1472-6823-14-13.
[13] Susan M. Ott. “Bone strength: more just density”, Kidney International, 89; p.16-19, 2016.
[14] Taulant Muka, Katerina Trajanoska, Jessica C. Kiefte-de Jong, Ling Oei, et al. The Association between Metabolic Syndrome, Bone Mineral Density, Hip Bone Geometry and Fracture Risk: The Rotterdam Study. Published: June 12, 2015, (Accessed on 09/01/2018, open access).
[15] World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity. World Health Organization: Geneva, 2000, р.9.
[16] Yang L, Lv X, Wei D, Yue F, Guo J, Zhang T. “Metabolic syndrome and the risk of bone fractures: A Meta-analysis of prospective cohort studies”, Bone, Mar; 84:52-6, 2016; doi: 10.1016/j.bone.2015.12.008. Epub 2015 Dec 18.