Changes in bone mineral density over time by body mass index in the health ABC study

J. T. Lloyd, D. E. Alley, M. C. Hochberg, S. R. Waldstein, T. B. Harris, S. B. Kritchevsky, A. V. Schwartz, E. S. Strotmeyer, Catherine Womack, D. L. Orwig

Research output: Contribution to journalArticle

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Abstract

Summary: Obesity appears protective against osteoporosis in cross-sectional studies. However, results from this longitudinal study found that obesity was associated with bone loss over time. Findings underscore the importance of looking at the longitudinal relationship, particularly given the increasing prevalence and duration of obesity among older adults. Introduction: Cross-sectional studies have found a positive association between body mass index (BMI) and bone mineral density (BMD), but little is known about the longitudinal relationship in US older adults. Methods: We examined average annual rate of change in BMD by baseline BMI in the Health, Aging, and Body Composition Study. Repeated measurement of BMD was performed with dual-energy X-ray absorptiometry (DXA) at baseline and years 3, 5, 6, 8, and 10. Multivariate generalized estimating equations were used to predict mean BMD (femoral neck, total hip, and whole body) by baseline BMI (excluding underweight), adjusting for covariates. Results: In the sample (n = 2570), 43 % were overweight and 24 % were obese with a mean baseline femoral neck BMD of 0.743 g/cm 2 , hip BMD of 0.888 g/cm 2 , and whole-body BMD of 1.09 g/cm 2 . Change in total hip or whole-body BMD over time did not vary by BMI groups. However, obese older adults lost 0.003 g/cm 2 of femoral neck BMD per year more compared with normal weight older adults (p < 0.001). Femoral neck BMD change over time did not differ between the overweight and normal weight BMI groups (p = 0.74). In year 10, adjusted femoral neck BMD ranged from 0.696 g/cm 2 among obese, 0.709 g/cm 2 among normal weight, and 0.719 g/cm 2 among overweight older adults. Conclusions: Findings underscore the importance of looking at the longitudinal relationship between body composition and bone mineral density among older adults, indicating that high body mass may not be protective for bone loss over time.

Original languageEnglish (US)
Pages (from-to)2109-2116
Number of pages8
JournalOsteoporosis International
Volume27
Issue number6
DOIs
StatePublished - Jun 1 2016

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Bone Density
Body Mass Index
Health
Femur Neck
Obesity
Body Composition
Weights and Measures
Hip
Cross-Sectional Studies
Pelvic Bones
Bone and Bones
Thinness
Photon Absorptiometry
Osteoporosis
Longitudinal Studies

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

Lloyd, J. T., Alley, D. E., Hochberg, M. C., Waldstein, S. R., Harris, T. B., Kritchevsky, S. B., ... Orwig, D. L. (2016). Changes in bone mineral density over time by body mass index in the health ABC study. Osteoporosis International, 27(6), 2109-2116. https://doi.org/10.1007/s00198-016-3506-x

Changes in bone mineral density over time by body mass index in the health ABC study. / Lloyd, J. T.; Alley, D. E.; Hochberg, M. C.; Waldstein, S. R.; Harris, T. B.; Kritchevsky, S. B.; Schwartz, A. V.; Strotmeyer, E. S.; Womack, Catherine; Orwig, D. L.

In: Osteoporosis International, Vol. 27, No. 6, 01.06.2016, p. 2109-2116.

Research output: Contribution to journalArticle

Lloyd, JT, Alley, DE, Hochberg, MC, Waldstein, SR, Harris, TB, Kritchevsky, SB, Schwartz, AV, Strotmeyer, ES, Womack, C & Orwig, DL 2016, 'Changes in bone mineral density over time by body mass index in the health ABC study', Osteoporosis International, vol. 27, no. 6, pp. 2109-2116. https://doi.org/10.1007/s00198-016-3506-x
Lloyd JT, Alley DE, Hochberg MC, Waldstein SR, Harris TB, Kritchevsky SB et al. Changes in bone mineral density over time by body mass index in the health ABC study. Osteoporosis International. 2016 Jun 1;27(6):2109-2116. https://doi.org/10.1007/s00198-016-3506-x
Lloyd, J. T. ; Alley, D. E. ; Hochberg, M. C. ; Waldstein, S. R. ; Harris, T. B. ; Kritchevsky, S. B. ; Schwartz, A. V. ; Strotmeyer, E. S. ; Womack, Catherine ; Orwig, D. L. / Changes in bone mineral density over time by body mass index in the health ABC study. In: Osteoporosis International. 2016 ; Vol. 27, No. 6. pp. 2109-2116.
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abstract = "Summary: Obesity appears protective against osteoporosis in cross-sectional studies. However, results from this longitudinal study found that obesity was associated with bone loss over time. Findings underscore the importance of looking at the longitudinal relationship, particularly given the increasing prevalence and duration of obesity among older adults. Introduction: Cross-sectional studies have found a positive association between body mass index (BMI) and bone mineral density (BMD), but little is known about the longitudinal relationship in US older adults. Methods: We examined average annual rate of change in BMD by baseline BMI in the Health, Aging, and Body Composition Study. Repeated measurement of BMD was performed with dual-energy X-ray absorptiometry (DXA) at baseline and years 3, 5, 6, 8, and 10. Multivariate generalized estimating equations were used to predict mean BMD (femoral neck, total hip, and whole body) by baseline BMI (excluding underweight), adjusting for covariates. Results: In the sample (n = 2570), 43 {\%} were overweight and 24 {\%} were obese with a mean baseline femoral neck BMD of 0.743 g/cm 2 , hip BMD of 0.888 g/cm 2 , and whole-body BMD of 1.09 g/cm 2 . Change in total hip or whole-body BMD over time did not vary by BMI groups. However, obese older adults lost 0.003 g/cm 2 of femoral neck BMD per year more compared with normal weight older adults (p < 0.001). Femoral neck BMD change over time did not differ between the overweight and normal weight BMI groups (p = 0.74). In year 10, adjusted femoral neck BMD ranged from 0.696 g/cm 2 among obese, 0.709 g/cm 2 among normal weight, and 0.719 g/cm 2 among overweight older adults. Conclusions: Findings underscore the importance of looking at the longitudinal relationship between body composition and bone mineral density among older adults, indicating that high body mass may not be protective for bone loss over time.",
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AU - Waldstein, S. R.

AU - Harris, T. B.

AU - Kritchevsky, S. B.

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