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Association between metabolic syndrome and bone loss at various skeletal sites in postmenopausal women: a 3-year retrospective longitudinal study

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Abstract

Summary

Although the presence of metabolic syndrome (MetS) and increasing numbers of MetS components were associated with attenuated bone loss at various skeletal sites in postmenopausal women, this beneficial effect of MetS on bone mass can be mainly explained by higher mechanical loading in the affected subjects.

Introduction

Previous cross-sectional epidemiological studies reported the inconsistent results regarding the combined effects of MetS on bone mass. In our present report, we performed a large, longitudinal study to evaluate MetS in relation to annualized bone mineral density (BMD) changes in postmenopausal Korean women.

Methods

The study cohort consisted of 1,218 postmenopausal women who had undergone comprehensive routine health examinations with an average follow-up interval of 3 years. The BMD at the lumbar spine and proximal femur sites was measured with dual-energy X-ray absorptiometry using the same equipment at baseline and at follow-up.

Results

Following adjustment for age, baseline BMD, and lifestyle factors, the women with MetS had 21.7, 17.0, 26.7, and 31.1 % less bone loss at the total femur, femur neck, trochanter, and lumbar spine, respectively, compared with MetS-free women (P = 0.004 to 0.041). Consistently, the rates of bone loss at all skeletal sites were linearly attenuated with increasing numbers of MetS components (P = 0.004 to <0.001). Importantly, when weight and height were added as confounding factors, the differences and trends of annualized BMD changes according to the MetS status disappeared.

Conclusion

Our current results indicate that the beneficial effects of MetS on bone mass can be mainly explained by higher mechanical loading in the affected subjects. Consequently, MetS per se may not be a meaningful concept for predicting future bone loss and for explaining associations between osteoporosis and cardiovascular diseases.

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Acknowledgments

This study was supported by grants from the Korea Health Technology R&D Project and the National Project for Personalized Genomic Medicine, Ministry of Health & Welfare, Republic of Korea (project numbers A110536 and A111218-GM03, respectively).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-Dong, Songpa-Gu, 138-736, Seoul, Korea

    B.-J. Kim, S. H. Ahn, S. H. Lee, J.-M. Koh & G. S. Kim

  2. Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, 138-736, Seoul, Korea

    S. J. Bae, E. H. Kim, H.-K. Kim & J. W. Choe

  3. Skeletal Diseases Genome Research Center, Kyungpook National University Hospital, 700-412, Daegu, Korea

    T.-H. Kim & S.-Y. Kim

  4. Department of Orthopedic Surgery, Kyungpook National University School of Medicine, 700-412, Daegu, Korea

    S.-Y. Kim

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  1. B.-J. Kim
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  2. S. H. Ahn
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  4. E. H. Kim
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Corresponding author

Correspondence to J.-M. Koh.

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Supplementary Figure 1

Annualized serum total ALP changes according to the MetS status. Multivariate-adjusted least-square mean (± standard error) annualized serum total ALP changes were generated by analysis of covariance (ANCOVA) after adjustment for confounders. The multivariable adjustment model included age, smoking and drinking habits, exercise habits, and dairy consumption. The final adjustment model included weight and height, as well as factors from the multivariable adjustment model. MetS, metabolic syndrome; ALP, alkaline phosphatase; Wt, weight; Ht, height. (JPEG 24 kb)

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Kim, BJ., Ahn, S.H., Bae, S.J. et al. Association between metabolic syndrome and bone loss at various skeletal sites in postmenopausal women: a 3-year retrospective longitudinal study. Osteoporos Int 24, 2243–2252 (2013). https://doi.org/10.1007/s00198-013-2292-y

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  • DOI: https://doi.org/10.1007/s00198-013-2292-y

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