ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 921

Association Between Metabolic Syndrome and Bone Mineral Density in a Community-Dwelling Older Women: The São Paulo Ageing & Health Study (SPAH)

Luana G. Machado1, Diogo S. Domiciano2, Jaqueline B. Lopes1, Camille P. Figueiredo1, Valéria Caparbo3, Liliam Takayama1 and Rosa M.R. Pereira3, 1Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 2Rheumatology, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil, 3Rheumatology, University of São Paulo, São Paulo, Brazil

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Epidemiology and Health Services Research: Epidemiology and Outcomes of Rheumatic Disease II

Session Type: Abstract Submissions (ACR)

Background/Purpose: Recent studies have shown a link between metabolic syndrome (MS) and bone mass. However, these results are uncertain about the positive/negative effect of the components of MS on bone mineral density (BMD) and risk of fragility fractures. Furthermore, the higher prevalence of MS among subjects with higher body mass index (BMI) is a confounding factor, since previous findings have demonstrated that obesity could be a protective factor against bone loss.  In this way, the aim of this study was to evaluate the prevalence of MS in a community-dwelling older women with high frequency of overweight/obesity and its association with bone parameters.

Methods:

343 community-dwelling older women were evaluated by specific questionnaire (including history of clinical fractures and cardiovascular risk factors). Lumbar spine, femoral neck and total hip BMD were evaluated by DXA. Laboratory tests, including calcium, phosphorus, creatinine, lipid profile, insulin, glucose and uric acid were also performed. Thoracolumbar spine X-rays were assessed to identify vertebral fractures. National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria were used to define MS. Logistic regression models were used to analyze the relationship between MS and bone parameters.

Results:

The prevalence of MS was high (62.1%). Women with MS had higher BMI (30.7±4.9 vs. 27.2±4.9kg/m2, P<0.001), body fat percentage(37.7±5.0 vs. 34.9±6.5%, P<0.001), serum levels of creatinine (0.9±0.2 vs. 0.8±0.2mg/dl, P=0.003), insulin (12.7±10.7vs. 8.7±14.2U/mL, P=0.004), uric acid (5.6±1.5 vs. 5.1±1.3mg/dl, P=0.001), lumbar spine BMD (0.881±0.171 vs. 0.837±0.178g/cm2, P=0.025), femoral neck BMD (0.684±0.120 vs. 0.629±0.121g/cm2, P<0.001) and total hip BMD (0.814±0.131 vs. 0.743±0.140g/cm2, P<0.001) compared to women without MS. After adjustments for BMI, logistic regression analyses demonstrated that hip BMD remained as an independent factor associated with MS (OR:10.73 95% CI:1.33-86.55, P=0.026).  No significant difference concerning the prevalence of vertebral or nonvertebral fractures was observed between the women with and without MS.

Conclusion:

A positive association between total hip BMD and MS was found in our community-dwelling older women, even after adjustment for BMI. Nevertheless, the frequency of vertebral and nonvertebral fractures was similar in women with and without MS. Taken together, these results suggest that higher BMI per se does not explain the positive association between higher BMD and MS and does not protect against osteoporotic fractures. Further studies are necessary to elucidate the effect of MS on bone mass and fracture risk, possibly related to bone quality.

Disclosure:

L. G. Machado,
None;

D. S. Domiciano,
None;

J. B. Lopes,
None;

C. P. Figueiredo,
None;

V. Caparbo,
None;

L. Takayama,
None;

R. M. R. Pereira,
None.

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