Relationships among body weight, lipids and bone mass in elderly individuals with fractures: A case-control study

Abstract

Background: The prevalence of osteoporosis and low bone mass is steadily rising each year. Low body weight is commonly linked to diminished bone mass and serves as a robust predictor of osteoporosis. Nonetheless, the connection between body mass index (BMI), bone mineral density, and lipid profiles among the elderly remains elusive.

Aim: To examine the association between BMI and bone mass, explore the correlation between lipid profiles and bone mass, and delve into the interplay between lipid metabolism and bone health.

Methods: The study included 520 patients aged ≥ 65 years (178 men and 342 women). Age, sex, weight, and height were recorded. Femoral neck bone mineral density and T scores were determined using a dual-energy X-ray absorptiometry scanner. Blood calcium (Ca), phosphorus (P), albumin (ALB), alkaline phosphatase (ALP), aspartate aminotransferase, alanine aminotransferase, triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were measured. Patients were classified by sex (male and female), age (65-79 years and ≥ 80 years), and T score (normal bone mineral density, osteopenia and osteoporosis).

Results: Age, sex, BMI, and ALP and TG levels were independent risk factors for osteoporosis. For the 65-79- and ≥ 80-year-old groups, females presented lower T scores than males. Ca, P, ALB, ALP, TC, HDL and LDL levels were significantly different between men and women in the 65-79-year-old group. In addition, BMI and TG levels were significantly decreased in osteoporotic patients compared with patients with normal bone mass. TC levels declined in 65- to 79-year-old male and female osteoporosis patients. In the group of women aged ≥ 80 years, osteoporotic patients showed significantly increased ALP levels. Furthermore, we found positive correlations between BMI and TG levels in the male and female patient groups. However, we found no significant differences in ALB, Ca, P, HDL and LDL levels in osteoporotic patients compared to patients with normal bone mass.

Conclusion: Osteoporotic patients showed significantly decreased BMI and TG levels compared with those with normal bone mass. BMI showed positive correlations with TG levels in male and female patients. These results indicate correlations between BMI and bone mass and between lipid profiles and bone mass.

Keywords: Body mass index; Elderly patients; Lipid profiles; Osteoporosis; Weight loss.

Figure 1

The differences of age, body mass index, calcium, phosphorus, albumin, alkaline phosphatase, aspartate aminotransferase, alanine transaminase, triglyceride, total cholesterol, high-density lipoprotein, and low-density lipoprotein in male patients. A: Presented the group of 65-79 years old man; N(N) = 35, N(OPA) = 50, N(OP) = 21; B: Presented the group of ≥ 80 years old man; N(N) = 13, N(OPA) = 31, N(OP) = 28. ^aP < 0.05, ^bP < 0.01 and ^cP < 0.001 as different significance levels. BMI: Body mass index; Ca: Calcium; P: Phosphorus; ALB: Albumin; ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; ALT: Alanine transaminase; TG: Triglyceride; TC: Total cholesterol; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; N: Normal bone mass; OPA: Osteopenia; OP: Osteoporosis.

Figure 2

The differences of age, body mass index, calcium, phosphorus, albumin, alkaline phosphatase, aspartate aminotransferase, alanine transaminase, triglyceride, total cholesterol, high-density lipoprotein, and low-density lipoprotein in female patients. A: Presented the group of 65-79 years old female; N(N) = 19, N(OPA) = 65, N(OP) = 104; B: Presented the group of ≥ 80 years old female; N(N) = 17, N(OPA) = 38, N(OP) = 99. ^aP < 0.05, ^bP < 0.01 and ^dP < 0.0001 as different significance levels. BMI: Body mass index; Ca: Calcium; P: Phosphorus; ALB: Albumin; ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; ALT: Alanine transaminase; TG: Triglyceride; TC: Total cholesterol; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; N: Normal bone mass; OPA: Osteopenia; OP: Osteoporosis.

Figure 3

The correlation between body mass index and triglyceride in male and female patients. A: Presented the group of 65-79 years old male patients; n = 106; B: Presented the group of ≥ 80 years old male patients; n = 72; C: Presented the group of 65-79 years old female patients; n = 188; D: Presented the group of ≥ 80 years old female patients; n = 154. P < 0.05 as a different significance level. BMI: Body mass index; TG: Triglyceride.