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1Department of Medical Physics and Medical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran.
2Isfahan Osteoporosis Diagnosis and Body Composition Center, Isfahan, Iran.
3Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Copyright © 2016 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.
Values are expressed as mean±SE or number (%). Age-adjusted means were calculated using general linear models. Z-scores (Z-score ≤–2.0) were used to diagnose low bone mass for premenopausal women and men <50 years and T-scores were used for postmenopausal women and men ≥50 years which were categorized as: normal if T-score ≥–1.0; osteopenia if –2.5<T-score<–1.0; osteoporosis if T-score ≤–2.5.
BMI, body mass index; BMD, bone mineral density.
aP<0.001.
Values are expressed as mean±SE or number (%). Age-adjusted means were calculated using general linear models. Z-scores (Z-score ≤–2.0) were used to diagnose low bone mass for premenopausal women and men <50 years and T-scores were used for postmenopausal women and men ≥50 years which were categorized as: normal if T-score ≥–1.0; osteopenia if –2.5<T-score<–1.0; osteoporosis if T-score ≤–2.5.
BMI, body mass index; BMD, bone mineral density.
aP<0.001; bP<0.05; cP<0.01.
CI, confidence interval.
aOdds ratios (with 95% CI) were calculated by multiple logistic regression; bP<0.01; cP<0.001; dP<0.05; eZ-scores (Z-score ≤–2.0) were used to diagnose low bone mass for premenopausal women and men <50 years and T-scores were used for postmenopausal women and men ≥50 years which were categorized as: normal if T-score ≥–1.0; osteopenia if –2.5<T-score<–1.0; osteoporosis if T-score ≤–2.5.
Variable | Men | Women | ||
---|---|---|---|---|
<50 Years | ≥50 Years | Premenopausal | Postmenopausal | |
Age, yr | 41.7±0.65 | 64.5±0.47 | 44.1±0.21 | 60.3±0.15a |
BMI, kg/m2 | 25.9±0.41 | 26.5±0.26 | 28.6±0.13 | 29.0±0.09a |
BMD, g/cm2 | ||||
L1–L4 | 1.06±0.02 | 1.03±0.01 | 1.03±0.006 | 1.03±0.004 |
Femoral neck | 0.824±0.013 | 0.838±0.008 | 0.818±0.004 | 0.796±0.002a |
Total hip | 0.886±0.013 | 0.909±0.008 | 0.875±0.004 | 0.854±0.002a |
T-score | ||||
L1–L4 | –0.733±0.121 | –0.873±0.076 | –0.819±0.034 | –0.840±0.022 |
Femur neck | –2.138±01.45 | –2.102±0.066 | –1.451±0.030 | –1.642±0.020a |
Total hip | –1.887±0.114 | –1.828±0.071 | –0.673±0.029 | –0.843±0.020a |
Z-score | ||||
L1–L4 | –0.350±0.111 | - | –0.42±0.032 | - |
Femur neck | –0.487±0.104 | –0.478±0.068 | –0.06±0.029 | –0.31±0.019a |
Total hip | –0.706±0.113 | –0.665±0.074 | 0.12±0.028 | –0.10±0.019a |
Fat mass, g | ||||
L1–L4 | 1.626±0.049 | 1.592±0.030 | 1.55±0.014 | 1.58±0.009 |
Femoral neck | 31.274±0.837 | 29.518±0.527 | 35.473±0.241 | 35.363±0.160a |
Total hip | 253.473±7.094 | 247.471±4.463 | 299.505±2.113 | 300.222±1.403a |
L1–L4 | ||||
Normal | - | 192 (49.1) | - | 1,732 (49.9) |
Osteopenia | - | 169 (43.2) | - | 1,498 (43.2) |
Osteoporosis | - | 30 (7.7) | - | 238 (6.9) |
Femoral neck | ||||
Normal | - | 44 (11.3) | - | 737 (21.3)a |
Osteopenia | - | 164 (41.9) | - | 1,748 (50.4)a |
Osteoporosis | - | 183 (46.8) | - | 984 (28.4)a |
Total hip | ||||
Normal | - | 75 (19.2) | - | 1,684 (48.7)a |
Osteopenia | - | 186 (46.0) | - | 1,493 (43.2)a |
Osteoporosis | - | 136 (34.8) | - | 282 (8.2)a |
Z-score <–2.0 | ||||
L1–L4 | 12 (6.6) | - | 89 (5.5) | - |
Femoral neck | 20 (10.0) | - | 45 (2.5) | - |
Total hip | 39 (19.5) | - | 17 (0.9) | - |
BMI, kg/m2 | ||||
<18.5 | 8 (4.0) | 7 (1.8) | 14 (0.8) | 23 (0.7)a |
18.5–24.9 | 75 (37.3) | 142 (36.4) | 429 (23.5) | 625 (18.0)a |
25–29.9 | 82 (40.8) | 160 (41.0) | 752 (41.2) | 1,371 (39.6) |
30–39.9 | 36 (17.9) | 81 (20.8) | 610 (33.4) | 1,394 (40.2)a |
≥40 | 0 | 0 | 22 (1.2) | 53 (1.5)a |
Variable | Men | Women | ||
---|---|---|---|---|
<50 Years | ≥50 Years | Premenopausal | Postmenopausal | |
Normal weight | ||||
Age, yr | 40±1.07 | 64.7±0.74 | 41.2±0.44 | 60.7±0.37a |
BMI, kg/m2 | 21.9±0.23 | 23.3±0.17 | 22.7±0.11 | 22.7±0.09a |
BMD, g/cm2 | ||||
L1–L4 | 1.02±0.03 | 1.02±0.018 | 1.02±0.012 | 1.02±0.009 |
Femoral neck | 0.79±0.015 | 0.83±0.010 | 0.77±0.007 | 0.75±0.005a |
Total hip | 0.82±0.014 | 0.89±0.010 | 0.81±0.007 | 0.75±0.005a |
T-score | ||||
L1–L4 | –0.94±0.15 | –0.93±0.11 | –0.90±0.07 | –0.87±0.05 |
Femoral neck | –2.49±0.12 | –2.22±0.09 | –1.85±0.06 | –2.06±0.05a |
Total hip | –2.45±0.12 | –2.07±0.08 | –1.17±0.06 | –1.38±0.04a |
L1–L4 | ||||
Normal | - | 67 (42.7) | - | 325 (50.2) |
Osteoporosis | - | 15 (9.6) | - | 53 (8.2) |
Osteopenia | - | 75 (47.8) | - | 270 (41.7) |
Femoral neck | ||||
Normal | - | 12 (7.6) | - | 68 (10.5)a |
Osteoporosis | - | 92 (58.6) | - | 287 (44.3)a |
Osteopenia | - | 53 (33.8) | - | 293 (45.2)a |
Total hip | ||||
Normal | - | 14 (8.9) | - | 178 (27.8)a |
Osteoporosis | - | 79 (50.3) | - | 125 (19.5)a |
Osteopenia | - | 64 (40.8) | - | 338 (52.7)a |
Z-score <–2.0 | ||||
L1–L4 | 4 (5.9) | - | 22 (5.6) | - |
Femoral neck | 13 (17.6) | - | 25 (5.7)b | - |
Total hip | 25 (33.8) | - | 11 (2.5)a | - |
Overweight | ||||
Age, yr | 41.0±0.97 | 64.4±0.64 | 44.5±0.30 | 60.6±0.23a |
BMI, kg/m2 | 27.3±0.17 | 27.3±0.11 | 27.6±0.06 | 27.6±0.04b |
BMD, g/cm2 | ||||
L1–L4 | 1.04±0.02 | 1.05±0.016 | 1.03±0.009 | 1.03±0.006 |
Femoral neck | 0.83±0.015 | 0.86±0.010 | 0.81±0.005 | 0.79±0.004a |
Total hip | 0.88±0.014 | 0.94±0.009 | 0.86±0.005 | 0.85±0.003a |
T-score | ||||
L1–L4 | –0.79±0.14 | –0.78±0.10 | –0.84±0.05 | –0.85±0.04 |
Femoral neck | –2.18±0.12 | –1.88±0.08 | –1.54±0.05 | –1.67±0.03a |
Total hip | –1.97±0.12 | –1.57±0.08 | –0.80±0.04 | –0.89±0.03a |
L1–L4 | ||||
Normal | - | 87 (51.8) | - | 670 (48.9) |
Osteoporosis | - | 12 (7.1) | - | 92 (6.7) |
Osteopenia | - | 69 (41.1) | - | 609 (44.4) |
Femoral neck | ||||
Normal | - | 19 (11.3) | - | 250 (18.2)a |
Osteoporosis | - | 74 (44.0) | - | 416 (30.3)a |
Osteopenia | - | 75 (44.6) | - | 705 (51.4)a |
Total hip | ||||
Normal | - | 34 (20.2) | - | 624 (45.6)a |
Osteoporosis | - | 52 (31.0) | - | 109 (8.0)a |
Osteopenia | - | 82 (48.8) | - | 636 (46.5)a |
Z-score <–2.0 | ||||
L1–L4 | 6 (8.7) | - | 37 (5.6) | - |
Femoral neck | 4 (5.4) | - | 14 (1.9)b | - |
Total hip | 9 (12.2) | - | 5 (0.7)a | - |
Obese | ||||
Age, yr | 42.7±1.27 | 61.4±0.81 | 45.7±0.29 | 59.9±0.20a |
BMI, kg/m2 | 32.2±0.49 | 32.5±0.31 | 33.5±0.14 | 33.4±0.08c |
BMD, g/cm2 | ||||
L1–L4 | 1.06±0.04 | 1.07±0.023 | 1.04±0.010 | 1.03±0.006 |
Femoral neck | 0.92±0.023 | 0.89±0.014 | 0.85±0.006 | 0.82±0.004a |
Total hip | 0.99±0.022 | 0.98±0.013 | 0.92±0.006 | 0.89±0.004a |
T-score | ||||
L1–L4 | –0.78±0.21 | –0.63±0.13 | –0.76±0.06 | –0.81±0.03 |
Femoral neck | –1.41±0.19 | –1.66±0.12 | –1.15±0.05 | –1.41±0.03a |
Total hip | –0.98±0.18 | –1.17±0.11 | –0.29±0.05 | –0.52±0.03a |
L1–L4 | ||||
Normal | - | 47 (56.6) | - | 736 (50.9) |
Osteoporosis | - | 3 (3.6) | - | 93 (6.4) |
Osteopenia | - | 33 (39.8) | - | 618 (42.7) |
Femoral neck | ||||
Normal | - | 15 (18.1) | - | 419 (29.0)a |
Osteoporosis | - 25 (30.1) | - | 280 (19.4)a | |
Osteopenia | - | 43 (51.8) | - | 748 (51.7)a |
Total hip | ||||
Normal | - | 30 (36.1) | - | 881 (60.9)a |
Osteoporosis | - | 9 (10.8) | - | 48 (3.3)a |
Osteopenia | - | 44 (53.0) | - | 518 (35.8)a |
Z-score <–2.0 | ||||
L1–L4 | 2 (6.5) | - | 30 (5.3) | - |
Femoral neck | 1 (2.9) | - | 6 (0.9)c | - |
Total hip | 0 | - | 1 (0.2) | - |
Variable | Prevalence, % (95% CI) | Age-adjusted odds ratio (95% CI)a | ||||||
---|---|---|---|---|---|---|---|---|
Men <50 Years | Men ≥50 Years | Premenopausal women | Postmenopausal women | Men <50 Years | Men ≥50 Years | Premenopausal women | Postmenopausal women | |
Femoral neck osteopenia | - | 41.8 (36.9–46.7) | - | 50.4 (48.7–52.0) | - | - | - | - |
Normal weight | - | 32.2 (24.7–39.7) | - | 45.2 (41.4–49.0) | - | 1.00 | - | 1.00 |
Overweight | - | 45.0 (37.3–52.7) | - | 51.4 (48.8–54.1) | - | 0.59 (0.25–1.39) | - | 0.62 (0.46–0.84)b |
Obese | - | 53.1 (41.7–64.3) | - | 51.7 (49.1–54.3) | - | 0.19 (0.07–0.56)b | - | 0.38 (0.29–0.51)c |
Femoral neck osteoporosise | 9.9 (6.0–15.2) | 46.9 (42.0–51.9) | 2.5 (1.8–3.3) | 28.4 (26.9–29.9) | - | - | - | - |
Normal weight | 17.6 (9.7–28.2) | 59.7 (51.9–67.6) | 5.7 (3.7–8.3) | 44.3 (40.5–48.1) | 1.00 | 1.00 | 1.00 | 1.00 |
Overweight | 5.4 (1.5–13.3) | 44.4 (36.7–52.1) | 1.9 (1.0–3.1) | 30.3 (27.9–32.8) | 0.28 (0.09–0.094)d | 0.52 (0.23–1.16) | 0.34 (0.17–0.68)b | 0.36 (0.26–0.50)c |
Obese | 2.9 (0.08–15.3) | 28.4 (18.9–39.5) | 0.9 (0.3–2.1) | 19.4 (17.3–21.4) | 0.17 (0.02–1.40) | 0.26 (0.11–0.64)b | 0.18 (0.07–0.45)c | 0.15 (0.11–0.20)c |
L1–L4 osteopenia | - | 43.1 (38.2–48.0) | - | 43.2 (41.5–44.8) | - | - | - | - |
Normal weight | - | 46.3 (38.3–54.3) | - | 41.7 (37.9–45.5) | - | 1.00 | - | 1.00 |
Overweight | - | 41.2 (33.6–48.9) | - | 44.4 (41.8–47.1) | - | 0.72 (0.45–1.13) | - | 1.09 (0.90–1.33) |
Obese | - | 40.7 (29.9–52.2) | - | 42.7 (40.2–45.3) | - | 0.66 (0.38–1.15) | - | 1.01 (0.83–1.23) |
L1–L4 osteoporosise | 7.1 (3.7–12.1) | 7.7 (5.3–10.8) | 5.5 (4.4–6.7) | 6.9 (6.1–7.8) | - | - | - | - |
Normal weight | 5.9 (1.6–14.4) | 10.1 (5.2–14.0) | 5.6 (3.6–8.4) | 8.2 (6.2–10.6) | 1.00 | 1.00 | 1.00 | 1.00 |
Overweight | 8.7 (3.3–18.0) | 7.5 (3.9–12.7) | 5.6 (4.0–7.8) | 6.7 (5.4–8.2) | 1.68 (0.44–6.38) | 0.62 (0.27–1.40) | 1.00 (0.57–1.73) | 0.8 4 (0.58–1.21) |
Obese | 6.5 (0.6–21.4) | 3.7 (0.8–10.4) | 5.3 (3.6–7.5) | 6.4 (5.2–7.8) | 1.31 (0.22–7.79) | 0.29 (0.08–1.02) | 0.94 (0.53–1.69) | 0.79 (0.55–1.14) |
Total hip osteopenia | - | 46.2 (41.2–51.1) | - | 43.2 (41.5–44.8) | - | - | - | - |
Normal weight | - | 40.3 (32.4–48.1) | - | 52.7 (48.9–56.6) | - | 1.00 | - | 1.00 |
Overweight | - | 48.8 (41.0–56.5) | - | 46.5 (43.8–49.1) | - | 0.53 (0.97–1.03) | - | 0.50 (0.40–0.62)c |
Obese | - | 51.9 (40.5–63.1) | - | 35.8 (33.3–38.3) | - | 0.32 (0.15–0.67)b | - | 0.28 (0.23–0.35)c |
Total hip osteoporosise | 18.7 (13.0–24.3) | 34.6 (29.9–39.3) | 0.9 (0.5–1.5) | 8.2 (7.3–9.1) | - | - | - | - |
Normal weight | 33.8 (23.2–45.7) | 50.3 (42.3–58.4) | 2.5 (1.3–4.5) | 19.5 (16.4–22.6) | 1.00 | 1.00 | 1.00 | 1.00 |
Overweight | 12.2 (5.7–21.8) | 31.9 (24.7–39.1) | 0.7 (0.2–1.5) | 8.0 (6.7–9.5) | 0.27 (0.12–0.65)b | 0.27 (0.13–0.55)c | 0.29 (0.10–0.86)d | 0.19 (0.13–0.28)c |
Obese | 0.0 (0.0–10.3) | 11.1 (5.2–20.1) | 0.2 (0.006–0.9) | 3.3 (2.5–4.4) | 0.04 (0.02–0.09)c | 0.05 (0.02–0.14)c | 0.07 (0.009–0.56)d | 0.06 (0.04–0.10)c |
Variable | Age | BMI | ||||
---|---|---|---|---|---|---|
Men | Premenopausal women | Postmenopausal women | Men | Premenopausal women | Postmenopausal women | |
L1–L4 BMD, g/cm2 | −0.013 | −0.005 | −0.041a | 0.114a | 0.059b | 0.036b |
Femoral neck BMD, g/cm2 | −0.362c | −0.159c | −0.360c | 0.225c | 0.240c | 0.232c |
Total hip BMD, g/cm2 | −0.219c | −0.088c | −0.358c | 0.322c | 0.356c | 0.308c |
Body composition | BMD, g/cm2 | ||
---|---|---|---|
L1–L4 | Femoral neck | Total hip | |
Men | |||
Fat mass, g | |||
Femoral neck | −0.005 | −0.170a | −0.249a |
L1–L4 | 0.138b | 0.076 | 0.030 |
Total hip | 0.048 | −0.131b | −0.226a |
Lean mass, g | |||
Femoral neck | 0.030 | 0.136b | 0.154a |
L1–L4 | 0.265a | 0.028 | 0.018 |
Total hip | 0.119b | 0.253a | 0.245a |
Premenopausal women | |||
Fat mass, g | |||
Femoral neck | 0.028 | −0.045 | −0.126a |
L1–L4 | 0.075b | 0.040 | 0.016 |
Total hip | 0.027 | 0.005 | −0.084b |
Lean mass, g | |||
Femoral neck | 0.026 | −0.036 | 0.009 |
L1–L4 | 0.253a | −0.042 | −0.009 |
Total hip | 0.020 | 0.040 | 0.077b |
Postmenopausal women | |||
Fat mass, g | |||
Femoral neck | 0.029 | −0.176a | −0.232a |
L1–L4 | 0.102a | −0.008 | −0.032 |
Total hip | 0.035c | −0.103a | −0.163a |
Lean mass, g | |||
Femoral neck | −0.008 | 0.082a | 0.125a |
L1–L4 | 0.201b | 0.060b | 0.092a |
Total hip | −0.003 | 0.199a | 0.243a |
Variable | Men | ||
---|---|---|---|
L1–L4 | Femoral neck | Total hip | |
Normal weight | |||
Fat mass, g | |||
Femoral neck | 0.036 | −0.158a | −0.235a |
L1–L4 | 0.078b | 0.045 | 0.031 |
Total hip | 0.041 | −0.112a | −0.182a |
Lean mass, g | |||
Femoral neck | 0.018 | 0.194a | 0.210a |
L1–L4 | 0.225a | 0.023 | 0.026 |
Total hip | 0.019 | 0.264a | 0.290a |
Overweight | |||
Fat mass, g | |||
Femoral neck | 0.008 | −0.154a | −0.226a |
L1–L4 | 0.077a | 0.009 | −0.027 |
Total hip | 0.010 | 0.121a | −0.194a |
Lean mass, g | |||
Femoral neck | 0.015 | −0.157a | 0.202a |
L1–L4 | 0.225a | −0.037 | 0.064 |
Total hip | 0.038 | 0.216a | 0.267a |
Obese | |||
Fat mass, g | |||
Femoral neck | 0.042 | −0.129a | −0.184a |
L1–L4 | 0.131a | 0.013 | −0.007 |
Total hip | 0.045c | −0.44c | −0.118a |
Lean mass, g | |||
Femoral neck | 0.029 | 0.074b | 0.156a |
L1–L4 | 0.228a | 0.38 | 0.082a |
Total hip | 0.032 | 0.182a | 0.241a |
Values are expressed as mean±SE or number (%). Age-adjusted means were calculated using general linear models. Z-scores (Z-score ≤–2.0) were used to diagnose low bone mass for premenopausal women and men <50 years and T-scores were used for postmenopausal women and men ≥50 years which were categorized as: normal if T-score ≥–1.0; osteopenia if –2.5<T-score<–1.0; osteoporosis if T-score ≤–2.5. BMI, body mass index; BMD, bone mineral density. a
Values are expressed as mean±SE or number (%). Age-adjusted means were calculated using general linear models. Z-scores (Z-score ≤–2.0) were used to diagnose low bone mass for premenopausal women and men <50 years and T-scores were used for postmenopausal women and men ≥50 years which were categorized as: normal if T-score ≥–1.0; osteopenia if –2.5<T-score<–1.0; osteoporosis if T-score ≤–2.5. BMI, body mass index; BMD, bone mineral density. a
CI, confidence interval. aOdds ratios (with 95% CI) were calculated by multiple logistic regression; b
BMI, body mass index; BMD, bone mineral density. a
BMD, bone mineral density. a
BMD, bone mineral density. a