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. 2022 May 16:13:883862.
doi: 10.3389/fendo.2022.883862. eCollection 2022.

The Saturation Effect of Obesity on Bone Mineral Density for Older People: The NHANES 2017-2020

Ya Zhang  1 , Jian Pu  2
Affiliations

The Saturation Effect of Obesity on Bone Mineral Density for Older People: The NHANES 2017-2020

Ya Zhang et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Previous studies have shown that obesity has a positive effect on bone mineral density (BMD). However, excessive obesity is harmful to health, especially in older adults. In addition, it is unclear what body mass index (BMI) and waist circumference (WC) to maintain for the most beneficial BMD in older adults.

Methods: Multivariate logistic regression models were used to investigate the association between BMI, WC, and femoral neck BMD using the most recent data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). Fitting smoothing curves and saturation effects analysis were also used to determine the association of nonlinear relationships between BMI, WC, and femoral neck BMD.

Results: The analysis included a total of 2,903 adults. We discovered that BMD and WC were positively linked to femoral neck BMD. The favorable associations of BMI and WC with femoral neck BMD were maintained in all subgroup analyses stratified by sex and race, except among Mexican Americans. Furthermore, smoothing curve fitting revealed that the link between BMI and BMD was not only a linear connection, and that there was a saturation point. The BMI saturation value in the femoral neck BMD was 24.3 (kg/m2), according to the saturation effect analysis.

Conclusions: In persons over the age of 50, our research found a positive relationship between obesity and BMD, and we also found a saturation value between BMI and BMD. According to this study, maintaining BMI at a moderate level (about 24.3 kg/m2) would result in an optimal balance between BMI and BMD in adults over 50 years of age.

Keywords: NHANES; body mass index; bone mineral density; obese; osteoporosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of participant selection. NHANES, National Health and Nutrition Examination Survey; BMD, bone mineral density; BMI, body mass index; WC, waist circumference.
Figure 2
Figure 2
The association between body mass index and femoral neck bone mineral density. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. Age, gender, race, education level, activities status, diabetes status, NAFLD status, smoking status, ALT, ALP, AST, total calcium, total cholesterol, direct HDL cholesterol, LDL cholesterol, triglyceride, and serum phosphorus were adjusted.
Figure 3
Figure 3
The association between waist circumference and femoral neck bone mineral density. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. Age, gender, race, education level, activities status, diabetes status, NAFLD status, smoking status, ALT, ALP, AST, total calcium, total cholesterol, direct HDL cholesterol, LDL cholesterol, triglyceride, and serum phosphorus were adjusted.
See this image and copyright information in PMC

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