Predicting osteoporosis with body compositions in postmenopausal women: a non-invasive method

Wei-Hsiu Hsu, Wei-Bin Hsu, Chun-Hao Fan, Robert Wen-Wei Hsu, Wei-Hsiu Hsu, Wei-Bin Hsu, Chun-Hao Fan, Robert Wen-Wei Hsu

Abstract

Background: The prevalence of osteoporosis is rising steadily as the aging population increases. Bone mineral density (BMD) assessment is a golden standard to establish the diagnosis of osteoporosis. However, the accessibility and radiation exposure limited its role in community screening. A more convenient approach for screening is suggested.

Methods: A total of 363 postmenopausal women over the age of 50 were included in this study and assessed with the body composition [including fat-free mass (FFM), fat mass (FM), and basal metabolic rate (BMR)] and BMD. Normal distributions and correlation coefficients among variables were calculated using the Shapiro-Wilk test and Pearson's correlation analysis, respectively. A receiver operating characteristic (ROC) curve was plotted, and the area under ROC curves (AUC) was determined to obtain the optimal cutoff values of the body composition variables for osteoporosis prediction.

Results: The correlation coefficient of FFM, FM, FM ratio, and BMR with femur neck T-score was 0.373, 0.266, 0.165, and 0.369, respectively, while with spine T-score was 0.350, 0.251, 0.166, and 0.352, respectively (p < 0.01 for all). FFM, FM, and BMR showed an optimal cutoff value of 37.9 kg, 18.6 kg, and 1187.5 kcal, respectively, for detecting osteoporosis.

Conclusions: The present study provided a model to predict osteoporosis in postmenopausal women, and the optimal cutoff value of FFM, FM, and BMR could be calculated in the Asian population. Among these factors, BMR seemed a better predictor than others. The BMR could be a target for exercise intervention in postmenopausal women for maintaining or improving BMD.

Trial registration: ClinicalTrials.gov , NCT02936336 . Retrospectively registered on13 October 2016.

Keywords: Basal metabolic rate; Fat mass; Fat-free mass; Osteoporosis; Postmenopausal women.

Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The example of BMD measurement of the a femoral neck and b lumbar spine L2–L4 by DXA in female aged 69
Fig. 2
Fig. 2
ROC analysis to identify the optimal cutoff value of FFM, FM, FM ratio, and BMR to osteoporosis. Relationship between sensitivity and specificity at different cutoff scores in various variables

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