Relationship between Body Mass Index and Bone Mineral Density in People with Osteoporosis: A Cross-Sectional Analytical Study
-
Seyed Mohammad Mohammadi
,
Mohammad Lotfi
,
Naser Kamyari
,
Fatemeh Shojaei Moghaddam
,
Esmat Radmanesh
Abstract
Background: Obesity and osteoporosis are prevalent global health problems. This study aims to investigate the relationship
between bone density and body mass index (BMI) in patients with osteoporosis and osteopenia.
Methods: Demographic data, BMI, bone mineral density (BMD), and T-scores of the lumbar spine (L1-L4) and neck of the left femur
were collected using the files of individuals who were referred to the Bone Density Measurement Center, Nuclear Medicine Center,
Abadan, Iran, from February 2022 to September 2023. The relationship between BMD of the lumbar spine and neck of the left femur
and BMI in individuals with osteoporosis, osteopenia, and normal BMD, with varying weight categories ranging from underweight
to obese or overweight, was investigated.
Results: In this study, 475 people were included in three groups. The mean BMI was higher than normal. In the group with
osteoporosis, the BMD of the lumbar spine of the overweight and obese group was higher than the underweight and normal weight
groups (P < 0.001). There was a direct significant correlation between BMD of the spine and BMI in the group with osteoporosis
(r = 0.389, P < 0.001). A direct and significant correlation was observed between BMI and BMD of the femur (r = 0.296) and between
BMI and BMD of the lumbar spine (r = 0.233).
Conclusion: BMI and BMD of the neck of the femur and lumbar spine were directly correlated.
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PMC4938238].
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BMI and Bone Mineral Density in Postmenopausal Women.
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[PubMed: 28144189]. [PubMed Central: PMC5239653].
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and serum osteocalcin, CatheK, PINP, β-crosslaps, TRAP, lipid
metabolism and BMI in 128 patients with postmenopausal
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36394744].
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osteoporosis in postmenopausal Sudanese women. Afr Health
Sci. 2022;22(3):399-406. doi: 10.4314/ahs.v22i3.43. [PubMed:
36910383]. [PubMed Central: PMC9993279].
Mohammadi et al.: Body Weight and Bone Density
54 J Orthop Spine Trauma. 2025; 11(2): 50-4.
https://jost.tums.ac.ir
14. Wu Y, Xing X, Ye S, Chen C, Wang J. Lipid Levels Related to
Osteoporosis in Patients with Type 2 Diabetes. Exp Clin
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[PubMed: 30235494].
15. Wu DY, Qiao D, Zhang X, Zhang HQ, Luo ZC, Wang Y, et al. Lipid
profiles as potential mediators linking body mass index to
osteoporosis among Chinese adults: the Henan Rural Cohort
Study. Osteoporos Int. 2019;30(7):1413-22. doi: 10.1007/s00198-
019-04878-y. [PubMed: 30834945].
16. Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR,
Orwig DL. Body mass index is positively associated with bone
mineral density in US older adults. Arch Osteoporos.
2014;9:175. doi: 10.1007/s11657-014-0175-2. [PubMed: 24664472].
17. Ma M, Feng Z, Liu X, Jia G, Geng B, Xia Y. The Saturation Effect of
Body Mass Index on Bone Mineral Density for People Over
50 Years Old: A Cross-Sectional Study of the US Population.
Front Nutr. 2021;8:763677. doi: 10.3389/fnut.2021.763677.
[PubMed: 34722617]. [PubMed Central: PMC8554069].
18. Zhang Y, Pu J. The Saturation Effect of Obesity on Bone Mineral
Density for Older People: The NHANES 2017-2020. Front
Endocrinol (Lausanne). 2022;13:883862. doi:
10.3389/fendo.2022.883862. [PubMed: 35651972]. [PubMed
Central: PMC9150366].
19. Ouyang Y, Quan Y, Guo C, Xie S, Liu C, Huang X, et al. Saturation
Effect of Body Mass Index on Bone Mineral Density in
Adolescents of Different Ages: A Population-Based Study. Front
Endocrinol (Lausanne). 2022;13:922903. doi:
10.3389/fendo.2022.922903. [PubMed: 35865310]. [PubMed
Central: PMC9294630].
20. Wu SF, Du XJ. Body Mass Index May Positively Correlate with
Bone Mineral Density of Lumbar Vertebra and Femoral Neck
in Postmenopausal Females. Med Sci Monit. 2016;22:145-51. doi:
10.12659/msm.895512. [PubMed: 26766815]. [PubMed Central:
PMC4716713].
21. Doğan A, Nakipoğlu-Yüzer GF, Yıldızgören MT, Ozgirgin N. Is age
or the body mass index (BMI) more determinant of the bone
mineral density (BMD) in geriatric women and men? Arch
Gerontol Geriatr. 2010;51(3):338-41. doi:
10.1016/j.archger.2010.01.015. [PubMed: 20202698].
22. Li Y. Association between obesity and bone mineral density in
middle-aged adults. J Orthop Surg Res. 2022;17(1):268. doi:
10.1186/s13018-022-03161-x. [PubMed: 35568921]. [PubMed
Central: PMC9107258]
Hajivalizadeh S, Nabipour I, et al. The association between
osteoporosis and quality of life among older adults in Southern
Iran: findings from the Bushehr Elderly Health Program. BMC
Geriatr. 2024;24(1):766. doi: 10.1186/s12877-024-05348-9. [PubMed:
39289633]. [PubMed Central: PMC11409764].
2. Fahimfar N, Hesari E, Mansourzadeh MJ, Khalagi K, Sanjari M,
Hajivalizadeh S, et al. Prevalence of osteoporosis in the Iranian
population: a systematic review and meta-analysis. J Diabetes
Metab Disord. 2024;23(1):229-37. doi: 10.1007/s40200-023-01352-9.
[PubMed: 38932872]. [PubMed Central: PMC11196456].
3. Men Z, Huang C, Xu M, Ma J, Wan L, Huang J, et al. Zhuanggu
Zhitong Capsule alleviates postmenopausal osteoporosis in
ovariectomized rats by regulating autophagy through
AMPK/mTOR signaling pathway. Ann Transl Med.
2022;10(16):900. doi: 10.21037/atm-22-3724. [PubMed: 36111039].
[PubMed Central: PMC9469123].
4. López-Gómez JJ, Pérez-Castrillón JL, García de Santos I, PérezAlonso M, Izaola-Jauregui O, Primo-Martín D, et al. Influence of
Obesity on Bone Turnover Markers and Fracture Risk in
Postmenopausal Women. Nutrients. 2022;14(8). doi:
10.3390/nu14081617. [PubMed: 35458178]. [PubMed Central:
PMC9029584].
5. Colaianni G, Brunetti G, Faienza MF, Colucci S, Grano M.
Osteoporosis and obesity: Role of Wnt pathway in human and
murine models. World J Orthop. 2014;5(3):242-6. doi:
10.5312/wjo.v5.i3.242. [PubMed: 25035826]. [PubMed Central:
PMC4095016].
6. Sadie-Van Gijsen H, Crowther NJ, Hough FS, Ferris WF. The
interrelationship between bone and fat: from cellular see-saw
to endocrine reciprocity. Cell Mol Life Sci. 2013;70(13):2331-49.
doi: 10.1007/s00018-012-1211-2. [PubMed: 23178849]. [PubMed
Central: PMC11113730].
7. Gkastaris K, Goulis DG, Potoupnis M, Anastasilakis AD,
Kapetanos G. Obesity, osteoporosis and bone metabolism. J
Musculoskelet Neuronal Interact. 2020;20(3):372-81. [PubMed:
32877973]. [PubMed Central: PMC7493444].
8. Rosen CJ, Bouxsein ML. Mechanisms of disease: is osteoporosis
the obesity of bone? Nat Clin Pract Rheumatol. 2006;2(1):35-43.
doi: 10.1038/ncprheum0070. [PubMed: 16932650].
9. Cui R, Zhou L, Li Z, Li Q, Qi Z, Zhang J. Assessment risk of
osteoporosis in Chinese people: relationship among body
mass index, serum lipid profiles, blood glucose, and bone
mineral density. Clin Interv Aging. 2016;11:887-95. doi:
10.2147/cia.S103845. [PubMed: 27445467]. [PubMed Central:
PMC4938238].
10. Bijelic R, Balaban J, Milicevic S. Correlation of the Lipid Profile,
BMI and Bone Mineral Density in Postmenopausal Women.
Mater Sociomed. 2016;28(6):412-5. doi: 10.5455/msm.2016.28.412-415.
[PubMed: 28144189]. [PubMed Central: PMC5239653].
11. Jia L, Cheng M. Correlation analysis between risk factors, BMD
and serum osteocalcin, CatheK, PINP, β-crosslaps, TRAP, lipid
metabolism and BMI in 128 patients with postmenopausal
osteoporotic fractures. Eur Rev Med Pharmacol Sci.
2022;26(21):7955-9. doi: 10.26355/eurrev_202211_30147. [PubMed:
36394744].
12. Weir CB, Jan A. BMI Classification Percentile and Cut Off Points.
StatPearls. Treasure Island, FL: StatPearls Publishing; 2025.
[PubMed: 31082114].
13. Alfahal AO, Ali AE, Modawe GO, Doush WM. Association
between serum lipid profile, body mass index and
osteoporosis in postmenopausal Sudanese women. Afr Health
Sci. 2022;22(3):399-406. doi: 10.4314/ahs.v22i3.43. [PubMed:
36910383]. [PubMed Central: PMC9993279].
Mohammadi et al.: Body Weight and Bone Density
54 J Orthop Spine Trauma. 2025; 11(2): 50-4.
https://jost.tums.ac.ir
14. Wu Y, Xing X, Ye S, Chen C, Wang J. Lipid Levels Related to
Osteoporosis in Patients with Type 2 Diabetes. Exp Clin
Endocrinol Diabetes. 2019;127(7):468-72. doi: 10.1055/a-0735-9361.
[PubMed: 30235494].
15. Wu DY, Qiao D, Zhang X, Zhang HQ, Luo ZC, Wang Y, et al. Lipid
profiles as potential mediators linking body mass index to
osteoporosis among Chinese adults: the Henan Rural Cohort
Study. Osteoporos Int. 2019;30(7):1413-22. doi: 10.1007/s00198-
019-04878-y. [PubMed: 30834945].
16. Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR,
Orwig DL. Body mass index is positively associated with bone
mineral density in US older adults. Arch Osteoporos.
2014;9:175. doi: 10.1007/s11657-014-0175-2. [PubMed: 24664472].
17. Ma M, Feng Z, Liu X, Jia G, Geng B, Xia Y. The Saturation Effect of
Body Mass Index on Bone Mineral Density for People Over
50 Years Old: A Cross-Sectional Study of the US Population.
Front Nutr. 2021;8:763677. doi: 10.3389/fnut.2021.763677.
[PubMed: 34722617]. [PubMed Central: PMC8554069].
18. Zhang Y, Pu J. The Saturation Effect of Obesity on Bone Mineral
Density for Older People: The NHANES 2017-2020. Front
Endocrinol (Lausanne). 2022;13:883862. doi:
10.3389/fendo.2022.883862. [PubMed: 35651972]. [PubMed
Central: PMC9150366].
19. Ouyang Y, Quan Y, Guo C, Xie S, Liu C, Huang X, et al. Saturation
Effect of Body Mass Index on Bone Mineral Density in
Adolescents of Different Ages: A Population-Based Study. Front
Endocrinol (Lausanne). 2022;13:922903. doi:
10.3389/fendo.2022.922903. [PubMed: 35865310]. [PubMed
Central: PMC9294630].
20. Wu SF, Du XJ. Body Mass Index May Positively Correlate with
Bone Mineral Density of Lumbar Vertebra and Femoral Neck
in Postmenopausal Females. Med Sci Monit. 2016;22:145-51. doi:
10.12659/msm.895512. [PubMed: 26766815]. [PubMed Central:
PMC4716713].
21. Doğan A, Nakipoğlu-Yüzer GF, Yıldızgören MT, Ozgirgin N. Is age
or the body mass index (BMI) more determinant of the bone
mineral density (BMD) in geriatric women and men? Arch
Gerontol Geriatr. 2010;51(3):338-41. doi:
10.1016/j.archger.2010.01.015. [PubMed: 20202698].
22. Li Y. Association between obesity and bone mineral density in
middle-aged adults. J Orthop Surg Res. 2022;17(1):268. doi:
10.1186/s13018-022-03161-x. [PubMed: 35568921]. [PubMed
Central: PMC9107258]
| Files | ||
| Issue | Vol 11 No 2 (2025) | |
| Section | Research Articles | |
| Keywords | ||
| Obesity Bone density Femur Lumbar spine | ||
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How to Cite
1.
Mohammadi SM, Lotfi M, Kamyari N, Shojaei Moghaddam F, Radmanesh E. Relationship between Body Mass Index and Bone Mineral Density in People with Osteoporosis: A Cross-Sectional Analytical Study. J Orthop Spine Trauma. 2025;11(2):50-4.
