Low fat ratio is better risk factor than low body mass index for low bone mineral density

Osteoporosis is a health problem that limits quality life and may cause morbidity and mortality, unless prevented or actively treated. The objective of the study was to determine the effects of risk factors on bone mineral density. We evaluated 353 women who had undergone bone mineral density measurements for any reason in our hospital. Since a Z score less than -1 for the lumbar was considered to be an increased risk factor for fracture, subjects were divided into two groups according to lumbar Z scores of bone mineral density (BMD). Having evaluated the potential risk factors for osteoporosis in literature, we designed a questionnaire including 25 items in the following four sections: anthropometric variables, social history, reproductive history and past medical history. Logistic regression analysis used to identify the possible risk factors for low BMD. Multivariate logistic regression analysis revealed that low BMD was associated with low fat% ratio (odds ratio 3.2, [95% CI 1.93 to 5.3] p=0.0001), drinking tea (odds ratio 3.32, [95% CI, 1.19 to 4.57] p

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1. Ota M, Takahata M, Shimizu T, Kanehira Y, Kimura-Suda H, Kameda Y, Hamano H, Hiratsuka S, Sato D, Iwasaki N. Efficacy and safety of osteoporosis medications in a rat model of late-stage chronic kidney disease accompanied by secondary hyperparathyroidism and hyperphosphatemia. Osteoporos Int. Published Online: Dec 8, 2016.

2. Mandl P, Kainberger F, Friberg Hitz M. Best Pract Res Clin Rheumatol. 2016;30(4):751-65.

3. Shilbayeh S. Prevalence of osteoporosis and its reproductive risk factors among Jordanian women: a cross-sectional study. Osteoporos Int. 2003;14:929-40.

4. Baheiraei A, Pocock NA, Eisman JA, Nguyen ND, Nguyen TV. Bone mineral density, body mass index and cigarette smoking among Iranian women: implications for prevention. BMC Musculoskelet Disord. 2005;24(6):34.

5. Trijoto I, Isbagio H, Setiyohadi B, Soegondo S, Kusumawidjaja K, Ariawan I. The diagnostic value of combined risk factor analysis and radiological imaging in determining osteoporosis in post-menopausal women. Acta Med Indones. 2005;37(1):26-32.

6. Lloret A, Coiffier G, Couchouron T, Perdriger A, Guggenbuhl P. Risk factors of mortality during the first year after low energy osteoporosis fracture: a retrospective case-control study. Clinical Cases in Mineral and Bone Metabolism. 2016;13(2):123-6.

7. Raeda Al-Qutob. A health profile of midlife women afflicted with osteoporosis: Ain Al-Basha Area, Jordan. Dirasat, Medical and Biological Sciences. 2000;27:43-51.

8. Eastell R. Treatment of postmenopausal osteoporosis. N Engl J Med. 1998;338(11):736-8.

9. Compston JE, Cooper C, Kanis JA. Bone densitometry in clinical practice. BMJ. 1995;310(6993):1507-10.

10. Nevitt MC1, Johnell O, Black DM, Ensrud K, Genant HK, Cummings SR. Bone mineral density predicts non-spine fractures in very elderly women. Osteoporosis Int.1994; 4(6):325-31.

11. Romieu I, Willett WC, Stampfer MJ, Colditz GA, Sampson L, Rosner B. Energy intake and other determinants of relative weight. Am J Clin Nutr. 1988;47(3):406-12.

12. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report Series 843, Geneva. http://apps.who.int/iris/bitstream/10665/39142/1/WHO_TRS_843_en g.pdf. Access date 12.12.2016

13. Nisanoglu V, Erdil N, Aldemir M, Ozgur B, Berat Cihan H, Yologlu S, Battaloglu B. Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis. Thorac Cardiovasc Surg. 2007;55(1):32-8.

14. Kato I, Toniolo P, Zeleniuch-Jacquotte A, Shore RE, Koenig KL, Akhmedkhanov A, Riboli E. Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study. Int J Epidemiol. 2000;29(1):85-92.

15. McTiernan A, Wactawski-Wende J, Wu L, Rodabough RJ, Watts NB, Tylavsky F, Freeman R, Hendrix S, Jackson R; Women's Health Initiative Investigators. Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women’s Health Initiative Dietary Modification Trial. The Am J Clin Nutr. 2009;89(6):1864-76.

16. Bultink IE, Lems WF, Kostense PJ, Dijkmans BA, Voskuyl AE. Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Arthritis Rheum. 2005;52(7):2044-50.

17. Taylor BC, Schreiner PJ, Stone KL, Fink HA, Cummings SR, Nevitt MC, Bowman PJ, Ensrud KE. Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc. 2004;52(9):1479-86.

18. Varenna M, Binelli L, Zucchi F, Rossi V, Sinigaglia L. Prevalence of osteoporosis and fractures in a migrant population from southern to northern Italy: a cross-sectional, comparative study. Osteoporos Int. 2003;14(9):734-40.

19. Adami S, Giannini S, Giorgino R, Isaia G, Maggi S, Sinigaglia L, Filipponi P, Crepaldi G, Di Munno O. The effect of age, weight, and lifestyle factors on calcaneal quantitative ultrasound: the ESOPO study. Osteoporos Int. 2003;14(3):198-207.

20. van Der Voort DJ, van Der Weijer PH, Barentsen R. Early menopause: increased fracture risk at older age. Osteoporos Int. 2003;14(6):525-30.

21. Al-Qutob RJ, Mawajdeh SM, Khalil AA, Schmidt AB, Hannak AO, Masri BK. The magnitude of osteoporosis in middle aged women. Saudi Med J. 2001;22(12):1109-17.

22. Mariconda M, Pavia M, Colonna A, Angelillo IF, Marsico O, Sanzo F, Mancuso C, Milano C. Appendicular bone density, biochemical markers of bone turnover and lifestyle factors in female teachers of Southern Italy. Eur J Epidemiol. 1997;13(8):909-17.

23. Huuskonen J, Vaisanen SB, Kroger H, Jurvelin C, Bouchard C, Alhava E, Rauramaa R. Determinants of bone mineral density in middle aged men: a population-based study. Osteoporos Int. 2000;11(8):702-8.

24. Kim CH, Kim YI, Choi CS, Park JY, Lee MS, Lee SI, Kim GS. Prevalence and risk factors of low quantitative ultrasound values of calcaneus in Korean elderly women. Ultrasound Med Biol. 2000;26(1):35-40.

25. Hegarty VM, May HM, Khaw KT. Tea drinking and bone mineral density in older women. Am J Clin Nutr. 2000;71(4):1003-7.

26. Hamdi Kara I, Aydin S, Gemalmaz A, Aktürk Z, Yaman H, Bozdemir N, Kurdak H, Sitmapinar K, Devran Sencar I, Başak O, Akdeniz M, Işildar H, Burgut E, Ozcan S, Akça U, Dağdeviren N, Ungan M. Habitual tea drinking and bone mineral density in postmenopausal Turkish women: investigation of prevalence of postmenopausal osteoporosis in Turkey (IPPOT Study).Int J Vitam Nutr Res. 2007;77(6):389-97.

27. Kanis J, Johnell O, Gullberg B, Allander E, Elffors L, Ranstam J, Dequeker J, Dilsen G, Gennari C, Vaz AL, Lyritis G, Mazzuoli G, Miravet L, Passeri M, Perez Cano R, Rapado A, Ribot C. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos Int. 1999;9(1):45-54.

28. Furukawa M, Kiyohara C, Horiuchi T, Tsukamoto H, Mitoma H, Kimoto Y, Uchino A, Nakagawa M, Oryoji K, Shimoda T, Harada M, Akashi K. Prevalence and risk factors of vertebral fracture in female Japanese patients with systemic lupus erythematosus. Mod Rheumatol. 2013;23(4):765-73.

29. Frost HM. The mechanostat: A proposed pathogenic mechanism of osteoporoses and the bone mass effects of mechanical and nonmechanical agents. Bone Miner 1987;2(2):73–85.

30. Frost HM, Schönau E. The "muscle-bone unit" in children and adolescents: a 2000 overview. J Pediatr Endocrinol Metab. 2000;13(6):571-90.

31. Korpelainen R, Korpelainen J, Heikkinen J, Vaananen K, KeinanenKiukaanniemi S. Lifestyle factors are associated with osteoporosis in lean women but not in normal and overweight women: a populationbased cohort study of 1222 women. Osteoporos Int. 2003;14(1):34- 43.

32. Strotmeyer ES, Cauley JA, Schwartz AV, Nevitt MC, Resnick HE, Bauer DC, Tylavsky FA, de Rekeneire N, Harris TB, Newman AB. Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study. Arch Intern Med. 2005;165(14):1612-7.

33. Magnus JH, Broussard DL. Relationship between bone mineral density and myocardial infarction in US adults. Osteoporos Int. 2005;16(12):2053-62.

34. Nash D, Magder LS, Sherwin R, Rubin RJ, Silbergeld EK. Bone density-related predictors of blood lead level among peri- and postmenopausal women in the United States: The Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol. 2004;160(9):901-11.

35. Izumotani K, Hagiwara S, Izumotani T, Miki T, Morii H, Nishizawa Y. Risk factors for osteoporosis in men. J Bone Miner Metab. 2003;21(2):86-90.

36. Lunt M, Masaryk P, Scheidt-Nave C, Nijs J, Poor G, Pols H, Falch JA, Hammermeister G, Reid DM, Benevolenskaya L, Weber K, Cannata J, O'Neill TW, Felsenberg D, Silman AJ, Reeve J. The effects of lifestyle, dietary dairy intake and diabetes on bone density and vertebral deformity prevalence: the EVOS study. Osteoporos Int. 2001;12(8):688-98.

37. Grainge MJ, Coupland CA, Cliffe SJ, Chilvers CE, Hosking DJ. Cigarette smoking, alcohol and caffeine consumption, and bone mineral density in postmenopausal women. The Nottingham EPIC Study Group. Osteoporos Int. 1998;8(4):355-63.

38. Baron JA, Farahmand BY, Weiderpass E, Michaelsson K, Alberts A, Persson I, Ljunghall S. Cigarette smoking, alcohol consumption, and risk of hip fracture in women. Arch Intern Med. 2002;162(1):101-2.

39. Brot C, Jensen LB, Sorensen OH. Bone mass and risk factors for bone loss in perimenopausal Danish women. J Intern Med. 1997;242(6):505-11.

40. Franceschi S, Schinella D, Bidoli E, Dal Maso L, La Vecchia C, Parazzini F, Zecchin R. The influence of body size, smoking, and diet on bone density in pre- and postmenopausal women. Epidemiology. 1996;7(4):411-4.

41. Yoshimura N, Suzuki T, Hosoi T, Orimo H. Epidemiology of hip fracture in Japan: incidence and risk factors. J Bone Miner Metab. 2005;23 Suppl:78-80.

42. Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr. 2001;74(5):694- 700.

43. Portakal M, Altay ZE, Baysal O, Aykol G, Oner T. Postmenopozal osteoporozda farkli tedavi protokollerinin Karsilastirilmasi. Osteoporoz Dunyasindan. 2005;11(1):33-5.

44. Tekin GO, Kekilli E, Yagmur J, Uckan A, Yagmur C, Aksoy Y, Turhan H, Yetkin E. Int J Cardiol. 2008;131(1):66-9.

45. Saadi HF, Reed RL, Carter AO, Qazaq HS, Al-Suhaili AR. Bone density estimates and risk factors for osteoporosis in young women. East Mediterr Health J. 2001;7(4-5):730-7.

46. Alekel DL, Mortillaro E, Hussain EA, West B, Ahmed N, Peterson CT, Werner RK, Arjmandi BH, Kukreja SC. Lifestyle and biologic contributors to proximal femur bone mineral density and hip axis length in two distinct ethnic groups of premenopausal women. Osteoporos Int. 1999;9(4):327-38.