Skip to main content
SpringerLink
Log in

Examining effects of habitual physical activity and body composition on bone structure in early post-menopausal women: a pQCT analysis

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

After menopause, bones decline in structure and can break more easily. Physical activity can strengthen bones. This study investigated how activity and body composition can impact bone structure in post-menopausal women. Higher levels of physical activity were positively associated with bone structure at the lower leg.

Purpose

The menopausal transition is characterized by dramatic bone loss, leading to an increased risk of fracture. Few studies have examined how modifiable risk factors influence bone structure. Thus, the objective of this cross-sectional study was to examine the relationship between habitual physical activity (PA), body composition, and bone structure in post-menopausal women with low bone mass.

Methods

Data was analyzed from 276 post-menopausal women with low bone mass enrolled in the Heartland Osteoporosis Prevention Study. Body composition and bone structure measures were collected using dual X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) at the tibia. Habitual PA was collected using the Human Activity Profile questionnaire. Multiple regression analysis was used to determine the relative impact of habitual PA and body composition on bone structure measures (density, area, and strength). Direct and/or indirect effects of PA on bone outcomes were assessed by path analysis.

Results

Mean (± SD) age of participants was 54.5 (± 3.2) years and average BMI was 25.7 (± 4.7). Mean T-score of the total lumber spine and hip were − 1.5 (± .6) and − 0.8 (± .59), respectively, with all women classified with low bone mass. Habitual PA had a significant positive effect on bone area and strength measures at the 66% site, and trend effects at the 4% site. Lean mass had a significant positive effect on area and strength at the 66% site and 4% site. Fat mass showed no effect at the 66% site, with a positive effect on density and strength at the 4% site.

Conclusion

Increased habitual activity was related to improved bone structure of the tibia. Our results in post-menopausal women emphasize that PA and lean mass preservation are important for maintaining bone structure in the years following menopause.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The dataset used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Foundation NO (2020) Osteoporosis fast facts. [cited 2020 June 9 2020]; Available from: https://cdn.nof.org/wp-content/uploads/2015/12/Osteoporosis-Fast-Facts.pdf. Accessed 6/1/2021

  2. Blake GM, Fogelman I (2007) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J 83(982):509–517

    Article  Google Scholar 

  3. Wainwright SA et al (2005) Hip fracture in women without osteoporosis. J Clin Endocrinol Metab 90(5):2787–2793

    Article  CAS  Google Scholar 

  4. Lespessailles E et al (2017) Low-trauma fractures without osteoporosis. Osteoporos Int 28(6):1771–1778

    Article  CAS  Google Scholar 

  5. Stagi S et al (2016) Peripheral quantitative computed tomography (pQCT) for the assessment of bone strength in most of bone affecting conditions in developmental age: a review. Ital J Pediatr 42(1):88

    Article  Google Scholar 

  6. Burt LA et al (2018) Lower Bone density, impaired microarchitecture, and strength predict future fragility fracture in postmenopausal women: 5-year follow-up of the Calgary CaMos Cohort. J Bone Miner Res 33(4):589–597

    Article  Google Scholar 

  7. Varela A, Jolette J (2018) Bone toolbox: biomarkers, imaging tools, biomechanics, and histomorphometry. Toxicol Pathol 46(5):511–529

    Article  CAS  Google Scholar 

  8. Kemmler W, Häberle L, von Stengel S (2013) Effects of exercise on fracture reduction in older adults: a systematic review and meta-analysis. Osteoporos Int 24(7):1937–1950

    Article  CAS  Google Scholar 

  9. Shedd KM et al (2007) Quantifying leisure physical activity and its relation to bone density and strength. Med Sci Sports Exerc 39(12):2189–2198

    Article  Google Scholar 

  10. Hannam K et al (2017) Habitual levels of higher, but not medium or low, impact physical activity are positively related to lower limb bone strength in older women: findings from a population-based study using accelerometers to classify impact magnitude. Osteoporos Int 28(10):2813–2822

    Article  CAS  Google Scholar 

  11. Shojaa M et al (2020) Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters. Osteoporos Int 31(8):1427–1444. https://doi.org/10.1007/s00198-020-05441-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Hamilton CJ, Thomas SG, Jamal SA (2010) Associations between leisure physical activity participation and cortical bone mass and geometry at the radius and tibia in a Canadian cohort of postmenopausal women. Bone 46(3):774–779

    Article  Google Scholar 

  13. Polidoulis I, Beyene J, Cheung AM (2012) The effect of exercise on pQCT parameters of bone structure and strength in postmenopausal women–a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 23(1):39–51

    Article  CAS  Google Scholar 

  14. Campbell OB et al (2000) Comparative evaluation of hypofractionated radiotherapy and conventional fractionated radiotherapy in the management of carcinoma of the cervix in Ibadan, Nigeria. Afr J Med Med Sci 29(3–4):253–258

    CAS  PubMed  Google Scholar 

  15. Daly RM et al (2020) Effects of a 12-month supervised, community-based, multimodal exercise program followed by a 6-month research-to-practice transition on bone mineral density, trabecular microarchitecture, and physical function in older adults: a randomized controlled trial. J Bone Miner Res 35(3):419–429

    Article  Google Scholar 

  16. Bilek LD et al (2016) Protocol for a randomized controlled trial to compare bone-loading exercises with risedronate for preventing bone loss in osteopenic postmenopausal women. BMC Womens Health 16(1):59

    Article  Google Scholar 

  17. Kanis JA et al (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22(9):2395–2411

    Article  CAS  Google Scholar 

  18. Harris PA et al (2009) Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381

    Article  Google Scholar 

  19. Kanis JA et al (2017) FRAX update. J Clin Densitom 20(3):360–367

    Article  Google Scholar 

  20. Lexicomp (2018) Acetaminophen. Available from: https://online-lexi-com.library1.unmc.edu/lco/action/doc/retrieve/docid/patch_f/6264-f_adverse-reactions

  21. VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA (1990) Height-normalized indices of the body’s fat-free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr 52(6):953–959. https://doi.org/10.1093/ajcn/52.6.953

    Article  CAS  PubMed  Google Scholar 

  22. Davidson Megan, de Morton Natalie (2007) A systematic review of the Human Activity Profile. Clin Rehabil 21(2):151–162. https://doi.org/10.1177/0269215506069475

    Article  PubMed  Google Scholar 

  23. Cheng P et al (2015) Clinical Effect of endoscopic pneumatic dilation for achalasia. Medicine 94(28):e1193

    Article  Google Scholar 

  24. Bilek LD et al (2008) Use of the Human Activity Profile for estimating fitness in persons with arthritis. Arthritis Rheum 59(5):659–664

    Article  Google Scholar 

  25. Wetzsteon RJ et al (2011) Mechanical loads and cortical bone geometry in healthy children and young adults. Bone 48(5):1103–1108

    Article  Google Scholar 

  26. Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891

    Article  Google Scholar 

  27. Lam FM, Pang MY (2016) Correlation between tibial measurements using peripheral quantitative computed tomography and hip areal bone density measurements in ambulatory chronic stroke patients. Brain Inj 30(2):199–207

    Article  Google Scholar 

  28. Liu XS et al (2010) Bone density, geometry, microstructure, and stiffness: relationships between peripheral and central skeletal sites assessed by DXA, HR-pQCT, and cQCT in premenopausal women. J Bone Miner Res 25(10):2229–2238

    Article  Google Scholar 

  29. Benedetti MG et al (2018) The effectiveness of physical exercise on bone density in osteoporotic patients. Biomed Res Int 2018:4840531–4840531

    Article  Google Scholar 

  30. Stattin K et al (2017) Leisure-time physical activity and risk of fracture: a cohort study of 66,940 men and women. J Bone Miner Res 32(8):1599–1606

    Article  Google Scholar 

  31. Nilsson M et al (2017) Current physical activity is independently associated with cortical bone size and bone strength in elderly Swedish women. J Bone Miner Res 32(3):473–485

    Article  CAS  Google Scholar 

  32. Uusi-Rasi K et al (2002) Associations of calcium intake and physical activity with bone density and size in premenopausal and postmenopausal women: a peripheral quantitative computed tomography study. J Bone Miner Res 17(3):544–552

    Article  CAS  Google Scholar 

  33. Baker JF et al (2013) Associations between body composition and bone density and structure in men and women across the adult age spectrum. Bone 53(1):34–41

    Article  Google Scholar 

  34. Gibbs JC et al (2017) Appendicular and whole body lean mass outcomes are associated with finite element analysis-derived bone strength at the distal radius and tibia in adults aged 40years and older. Bone 103:47–54

    Article  Google Scholar 

  35. Edwards MH et al (2015) Lean mass and fat mass have differing associations with bone microarchitecture assessed by high resolution peripheral quantitative computed tomography in men and women from the Hertfordshire Cohort Study. Bone 81:145–151

    Article  Google Scholar 

  36. Ahlborg HG et al (2003) Bone loss and bone size after menopause. N Engl J Med 349(4):327–334

    Article  Google Scholar 

  37. Dupuit M et al (2020) Moderate-intensity continuous training or high-intensity interval training with or without resistance training for altering body composition in postmenopausal women. Med Sci Sports Exerc 52(3):736–745

    Article  Google Scholar 

  38. Xu L et al (2010) Fat mass accumulation compromises bone adaptation to load in Finnish women: a cross-sectional study spanning three generations. J Bone Miner Res 25(11):2341–2349

    Article  Google Scholar 

Download references

Funding

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under award number R01NR015029.

Author information

Authors and Affiliations

  1. College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA

    L. E. Flores, S. Nelson & L. D. Bilek

  2. Lincoln Division, University of Nebraska Medical Center College of Nursing, Lincoln, NE, USA

    N. Waltman

  3. Center for Nursing Science, University of Nebraska Medical Center, Omaha, NE, USA

    K. Kupzyk

  4. Creighton Osteoporosis Research Center, Omaha, NE, USA

    J. Lappe

  5. Diabetes, Endocrinology, & Metabolism, Nebraska Medicine, Omaha, NE, USA

    L. Mack

Authors
  1. L. E. Flores
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Waltman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Kupzyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Lappe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Mack
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. D. Bilek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. E. Flores.

Ethics declarations

Ethics approval

The parent study from which this study draws data was approved by the Institutional Review Boards at both the University of Nebraska Medical Center and the Creighton University Medical Center in Omaha, NE.

Consent to participate/for publication

Written consent for participation and publication of data was obtained from participants at the time of screening and again at the time of enrollment using two separate documents.

Conflict of interest

None.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 113 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Flores, L.E., Nelson, S., Waltman, N. et al. Examining effects of habitual physical activity and body composition on bone structure in early post-menopausal women: a pQCT analysis. Osteoporos Int 33, 425–433 (2022). https://doi.org/10.1007/s00198-021-06146-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-021-06146-4

Keywords

Search

Navigation