Association between body mass index and osteoporosis in women from northwestern Rio Grande do Sul☆

Mazocco, Letícia; Chagas, Patrícia

doi:10.1016/j.rbre.2016.10.002

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Original articles • Rev. Bras. Reumatol. 57 (4) • Jul-Aug 2017 • https://doi.org/10.1016/j.rbre.2016.10.002 copy

Association between body mass index and osteoporosis in women from northwestern Rio Grande do Sul^☆ ☆ Study conducted with Fundo de Incentivo à Pesquisa (FIPE), Universidade Federal de Santa Maria (UFSM) support, Santa Maria, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To investigate the association between body mass index (BMI) and bone mineral density (BMD) in postmenopausal women.

Methods:

Observational study with postmenopausal women who underwent bone densitometry in Palmeira das Missões - RS. Sociodemographic data, risk for osteoporosis and food intake were assessed through a specific form. BMI was calculated according to WHO criteria. The assessment of BMD was performed by dual-energy X-ray absorptiometry (DXA) and classified according to WHO. Statistical analysis was performed using prevalence ratios (PR) and their respective 95% confidence intervals for the factors studied. Variables associated with p < 0.20 with the different outcomes (osteopenia and osteoporosis) were included in a Poisson regression model with robust variance to adjust for potential confounding factors. A 5% significance level was considered.

Results:

393 postmenopausal women with a mean age of 59.6 ± 8.2 years participated.After the adjustments, the normal weight women had 1.2 times the prevalence of osteopenia of obese women (PR = 1.2; CI 95% 1.3-1.5). Considering osteoporosis, the PR of euthophic women was twice the PR of obese women (PR = 2; CI 95% 1.4-2.9) and was 1.7 times greater for overweight group compared to obese category (PR = 1.7; CI 95% 1.2-2.5).

Conclusion:

Obese women had lower prevalence of osteopenia compared with normal weight subjects and also with lower prevalence of osteoporosis as compared to normal- and overweight women.

Keywords:
Osteoporosis; Body mass index; Women; Bone mineral density

Variables	n	%
Marital status
With a companion	270	68.7
No companion	123	31.3

Educational level
<4 years of study	136	34.6
4-8 years of study	203	51.7
>8 years of study	54	13.7

Occupation
Unemployed	7	1.8
Employed with a formal contract	18	4.6
Employed unregistered	78	19.8
Household duties	108	27.5
Retired	182	46.3

Smoker	45	11.5
Sedentary lifestyle	230	58.5

Variables	n	%
Alcohol consumption	124	31.6
Coffee consumption	135	34.4

Milk consumption
Never	89	22.6
Up to once a week	33	8.4
2-6 times/week	48	12.2
Once a day	159	40.5
Two or more times/day	64	16.3

Yogurt consumption
Never	163	41.5
Up to once a week	99	25.2
2-6 times/week	85	21.6
Once a day	38	9.7
Two or more times/day	8	2.0

Cheese consumption
Never	47	12.0
Up to once a week	61	15.5
2-6 times/week	126	32.1
Once a day	132	33.6
Two or more times/day	27	6.9

Variable	Osteopenia (%)	Crude PR	p	Adjusted PR	p ^a a Adjusted for BMI and age.
BMI
Obesity	67.0	1		1
Eutrophia	77.8	1.2 (1.0-1.4)	0.126	1.2 (1.1-1.5)	0.048
Overweight	79.0	1.2 (1.1-1.4)	0.041	1.2 (1.0-1.3)	0.096

Age
<49 years	48.1	1		1
50-59 years	71.4	1.5 (1.0-2.2)	0.056	1.5 (1.0-2.2)	0.046
60-69 years	82.4	1.7 (1.1-2.6)	0.009	1.7 (1.2-2.5)	0.008
>70 years	86.2	1.8 (1.2-2.7)	0.006	1.8 (1.2-2.7)	0.004

Variable	Osteoporosis (%)	Crude PR	p	Adjusted PR	p ^a a Adjusted for BMI, age, marital status, smoking and alcohol.
BMI
Obesity	34.5	1		1
Eutrophia	76.9	2.2 (1.5-3.3)	<0.001	2.0 (1.4-2.9)	<0.001
Overweight	64.3	1.9 (1.3-2.8)	0.002	1.7 (1.2-2.5)	0.003

Age
<49 years	30.0	1		1
50-59 years	48.1	1.6 (0.8-3.3)	0.189	1.4 (0.7-2.6)	0.293
60-69 years	71.2	2.4 (1.2-4.7)	0.014	2.0 (1.1-3.7)	0.029
>70 years	85.2	2.8 (1.4-5.6)	0.003	2.2 (1.2-4.0)	0.015

Marital status
With a partner	49.1	1		1
Without a partner	74.2	1.5 (1.2-1.9)	0.001	1.3 (1.0-1.6)	0.028

Smoking
Stopped	51.7	1		1
Smoker	74.1	1.4 (0.9-2.2)	0.091	1.2 (0.8-1.8)	0.372
Nonsmoker	56.5	1.1 (0.7-1.6)	0.655	1.1 (0.7-1.6)	0.724

Alcohol
Yes	48.0	1		1
No	62.3	1.3 (1.0-1.8)	0.108	1.2 (0.9-1.6)	0.157

Variable	Eutrophia	Overweight	Obesity	p ^a a ANOVA.
	n = 94	n = 164	n = 135
T-score
T-score, femoral neck	-1.6 ± 1.0	-1.3 ± 0.9	-0.9 ± 1.0	<0.001
T-score, total femur	-1.4 ± 1.1	-0.8 ± 0.9	-0.3 ± 1.0	<0.001
T-score, vertebral bodies	-1.9 ± 1.4	-1.4 ± 1.3	-0.9 ± 1.4	<0.001

BMD (g/cm ² )
BMD, femoral neck	0.815 ± 0.146	0.857 ± 0.124	0.906 ± 0.140	<0.001
BMD, total femur	0.830 ± 0.138	0.899 ± 0.124	0.973 ± 0.136	<0.001
BMD, vertebral bodies	0.947 ± 0.171	1.005 ± 0.167	1.061 ± 0.188	<0.001

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[1] *Corresponding author. E-mail: patriciachagas.ufsm@hotmail.com (P. Chagas).

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Association between body mass index and osteoporosis in women from northwestern Rio Grande do Sul☆ ☆ Study conducted with Fundo de Incentivo à Pesquisa (FIPE), Universidade Federal de Santa Maria (UFSM) support, Santa Maria, RS, Brazil.

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

Association between body mass index and osteoporosis in women from northwestern Rio Grande do Sul^☆ ☆ Study conducted with Fundo de Incentivo à Pesquisa (FIPE), Universidade Federal de Santa Maria (UFSM) support, Santa Maria, RS, Brazil.