Factors associated with bone mineral density in adults: a cross-sectional population-based study

Segheto, Kátia Josiany; Juvanhol, Leidjaira Lopes; Carvalho, Cristiane Junqueira de; Silva, Danielle Cristina Guimarães da; Kakehasi, Adriana Maria; Longo, Giana Zarbato

doi:10.1590/S1980-220X2018039903572

Acessibilidade / Reportar erro

Brasil

Revista da Escola de Enfermagem da USP

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. esc. enferm. USP 54 • 2020 • https://doi.org/10.1590/S1980-220X2018039903572 copy

Factors associated with bone mineral density in adults: a cross-sectional population-based study

Fatores associados à densidade mineral óssea em adultos: um estudo transversal baseado em população

Factores asociados con la densidad mineral ósea en adultos: un estudio transversal basado en población

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

This study aimed to analyze the association between lumbar spine, femoral neck, total hip bone mineral density (biophysical bone health assessment parameter), and sociodemographic, anthropometric, behavioral, and health condition factors in Brazilian adults.

Method:

This is a cross-sectional, population-based study performed with individuals of both genders, aged between 20 and 59 (n=701). The dependent variables were evaluated by Dual Energy X-ray Absorptiometry. The independent variables were evaluated through a questionnaire, anthropometric evaluation and blood collection. The association between bone mineral density and the independent variables was evaluated by linear regression analysis. All analyses were stratified by gender.

Results:

Men presented higher bone mineral density than women. Bone mineral density was inversely associated with age range and directly associated with nutritional status in both genders and in the three bone sites analyzed. In addition, 25 Hydroxyvitamin D deficient status among men and contraceptive use among women were associated with lower bone mineral density, and a significant association was only found with lumbar spine bone mineral density in women.

Conclusion:

The factors associated with bone health among men were age, skin color, nutritional status, and vitamin D status. For women, the associated factors with bone health were age, skin color, nutritional status and contraceptive use.

Descriptors:
Bone Density; Risk Factors; Adult Health; Epidemiologic Studies

Variables	BMD-LS (g/cm²)		BMD-FN (g/cm²)		BMD-TH (g/cm²)
Variables	Mean	CI 95%	Mean	CI 95%	Mean	CI 95%
Overall	1.204(1.181-1.227)		1.094(1.075-1.113)		1.093(1.079-1.106)
Age range (years)
20-29	1.220	1.194-1.246	1.154 ^a	1.131-1.176	1.120	1.098-1.143
30-39	1.234	1.193-1.275	1.107 ^b	1.075-1.140	1.086	1.055-1.118
40-49	1.182	1.126-1.239	1.073 ^a	1.039-1.106	1.081	1.049-1.113
50-59	1.168	1.116-1.221	1.025 ^a,b	0.982-1.068	1.076	1.034-1.119
Skin Color
White	1.174	1.137-1.211	1.074	1.046-1.102	1.073	1.051-1.095
Non-white	1.226	1.197-1.255	1.109	1.083-1.136	1.107	1.083-1.130
Consumption Class
High	1.211	1.175-1.248	1.097	1.061-1.134	1.098	1.072-1.124
Intermediate	1.201	1.170-1.231	1.094	1.074-1.113	1.090	1.073-1.106
Low	1.194	1.123-1.264	1.089	1.031-1.147	1.102	1.043-1.162
Education (years)
0-4	1.195	1.170-1.220	1.041 ^a	0.998-1.085	1.095	1.064-1.126
5-8	1.171	1.103-1.239	1.072	1.023-1.121	1.077	1.037-1.118
9-11	1.230	1.181-1.279	1.127 ^a	1.089-1.165	1.127	1.093-1.161
> 12	1.207	1.172-1.242	1.107 ^a	1.086-1.128	1.083	1.064-1.102
Nutritional Status
Eutrophic	1.159 ^a	1.128-1.191	1.070 ^a	1.040-1.099	1.053 ^a	1.030-1.077
Overweight	1.246 ^a	1.209-1.283	1.102	1.068-1.137	1.111 ^a,b	1.085-1.137
Obese	1.244 ^a	1.197-1.290	1.163 ^a	1.110-1.215	1.183 ^a,b	1.142-1.225
PAL
IA	1.192	1.170-1.215	1.080	1.059-1.100	1.086	1.070-1.103
PA	1.233	1.176-1.290	1.135	1.098-1.172	1.111	1.076-1.146
Smoking
Non-smoker	1.214	1.184-1.244	1.107	1.089-1.124	1.089	1.074-1.104
Smoker	1.178	1.138-.1.219	1.084	1.041-1.128	1.096	1.054-1.138
Ex-smoker	1.192	1.150-1.235	1.068	1.032-1.105	1.101	1.073-1.128
Alcoholism (drinks/week)
0	1.200	1.160-1.240	1.072	1.023-1.121	1.079	1.043-1.115
1-7	1.203	1.170-1.235	1.104	1.080-1.128	1.088	1.065-1.111
8 or more	1.211	1.173-1.249	1.104	1.074-1.134	1.120	1.097-1.144
25(OH)D
Sufficient	1.219 ^a	1.195-1.243	1.109 ^a	1.086-1.132	1.106 ^a	1.090-1.122
Insufficient	1.205	1.163-1.247	1.090	1.050-1.130	1.095	1.061-1.128
Deficient	1.104 ^a	1.038-1.170	1.020 ^a	0.965-1.074	1.002 ^a	0.945-1.059

Variables	BMD-LS (g/cm²)		BMD-FN (g/cm²)		BMD-TH (g/cm²)
Variables	Mean	CI 95%	Mean	CI 95%	Mean	CI 95%
Overall	1.151 (1.131-1.171)		0.991 (0.974-1.007)		0.999 (0.981-1.017)
Age range (years)
20-29	1.186^a	1.161-1.210	1.032 ^a	1.009-1.054	1.019	0.996-1.042
30-39	1.200 ^b	1.159-1.241	1.031 ^b	0.996-1.065	1.010	0.970-1.051
40-49	1.184 ^c	1.156-1.212	0.987	0.958-1.016	1.007	0.973-1.040
50-59	1.055 ^a,b,c	1.005-1.104	0.926 ^a,b	0.889-0.963	0.967	0.934-1.001
Skin Color
White	1.115	1.085-1.144	0.965	0.939-0.992	0.975	0.952-0.998
Non-white	1.170	1.142-1.197	1.004	0.982-1.026	1.013	0.986-1.039
Consumption Class
High	1.156	1.120-1.191	0.980	0.955-1.006	0.980	0.945-1.014
Intermediate	1.155	1.131-1.179	0.993	0.971-1.015	1.003	0.982-1.023
Low	1.121	1.046-1.195	0.997	0.942-1.053	1.019	0.957-1.081
Education (years)
0-4	1.116	1.047-1.186	0.963	0.920-1.006	0.995	0.951-1.039
5-8	1.159	1.111-1.207	1.018	0.977-1.059	1.028	0.990-1.066
9-11	1.145	1.109-1.182	0.991	0.961-1.022	0.992	0.958-1.025
> 12	1.172	1.151-1.194	0.994	0.971-1.017	0.993	0.971-1.016
Nutritional Status
Eutrophic	1.136	1.113-1.160	0.972 ^a	0.949-0.994	0.966 ^a	0.942-0.990
Overweight	1.157	1.120-1.193	0.983 ^b	0.957-1.010	0.999 ^b	0.973-1.025
Obese	1.181	1.145-1.217	1.050 ^a,b	1.012-1.089	1.087 ^a,b	1.060-1.114
PAL
IA	1.148	1.121-1.175	0.998	0.976-1.019	1.001	0.979-1.024
PA	1.158	1.126-1.190	0.972	0.942-1.003	0.994	0.964-1.024
Smoking
Non-smoker	1.163	1.136-1.190	1.000	0.977-1.022	1.003	0.982-1.024
Smoker	1.115	1.058-1.172	0.968	0.929-1.007	0.979	0.942-1.015
Ex-smoker	1.130	1.096-1.163	0.972	0.938-1.006	0.997	0.958-1.036
Alcoholism (drinks/week)
0	1.141	1.117-1.165	0.985	0.964-1.006	1.000	0.982-1.018
1-7	1.162	1.125-1.200	0.993	0.967-1.019	0.990	0.959-1.020
8 or more	1.206	1.160-1.252	1.053	0.989-1.116	1.065	1.016-1.115
Menopause
No	1.189 ^a	1.163-1.215	1.016	0.955-1.037	1.011	0.987-1.035
Yes	1.081 ^a	1.034-1.128	0.942	0.909-0.975	0.976	0.945-1.008
Hormone Replacement Therapy
No	1.152	1.132-1.171	0.992	0.975-1.010	1.000	0.981-1.019
Yes	1.130	1.028-1.233	0.943	0.887-0.998	0.982	0.924-1.041
Contraceptive
No	1.189	1.164-1.214	1.033 ^a	1.005-1.060	1.020	0.991-1.048
Yes	1.140	1.111-1.168	0.976 ^a	0.954-0.998	0.966	0.974-1.017
25(OH)D
Sufficient	1.168	1.138-1.198 ^a	0.991 ^a	0.969-1.013	0.989	0.961-1.017
Insufficient	1.136	1.101-1.171	0.976	0.951-1.000	0.966	0.970-1.021
Deficient	1.145	1.098-1.193 ^a	1.022 ^a	0.974-1.069	1.032	0.993-1.071

Variables	BMD-LS (g/cm²)				BMD-FN (g/cm²)				BMD-TH (g/cm²)
Variables	ß	CI 95%	ßAj	CI 95%	ß	CI 95%	ßAj	CI 95%	ß	CI 95%	ßAj	CI 95%
Age Range (years)
20-29	0.00	---	0.00	---	0.00	---	0.00	---	0.00	---	---	---
30-39	0.14	-0.03;0.06	0.06	-0.03;0.05	-0.04	-0.08;-0.09	-0.05	-0.08;-0.02	0.03	-0.06;0.01	-0.04	-0.07;-0.01
40-49	-0.03	-0.09;0.02	-0.07	-0.11;-0.02	-0.08	-0.12;-0.03	-0.10	-0.14;-0.06	-0.04	-0.09;0.02	-0.10	-0.09;-0.06
50-59	-0.05	-0.10;-0.06	-0.07	-0.12;-0.02	-0.12	-0.17;-0.07	-0.15	-0.19;-0.11	-0.04	-0.09;0.04	-0.15	-0.14;-0.11
Skin Color
White	0.00	---	0.00	---	0.00	---	0.00	---	---
Non-White	0.05	0.04;0.09	0.03	0.02;0.07	0.03	-0.04;0.07	0.03	0.00;0.06	---
Nutritional Status
Eutrophic	0.00	---	0.00	---	0.00	---	0.00	---	0.00	---	---	---
Overweight	0.08	0.03;0.13	0.10	0.05;0.14	0.03	-0.01;0.08	0.05	0.07;0.10	0.05	0.01;0.09	0.06	0.01;0.10
Obese	0.08	0.03;0.13	0.10	0.05;0.14	0.09	0.03;0.15	0.12	0.07;0.18	0.13	0.08;0.17	0.13	0.07;0.19
25(OH)D
Sufficient	0.00	---	0.00	---	0.00	---	0.00	---	0.00	---	---	---
Insufficient	-0.01	-0.06;0.03	-0.02	-0.06;0.02	-0.01	-0.06;0.02	-0.01	-0.05;0.18	-0.01	-0.04;0.02	-0.01	-0.04;0.02
Deficient	-0.11	-0.18;-0.04	-0.09	-0.16;-0.05	-0.08	-0.14;-0.03	-0.08	-0.01;-0.03	-0.01	-0.06;-0.04	-0.08	-0.13;-0.04

Variable	BMD-LS (g/cm²)				BMD-FN (g/cm²)				BMD-TH (g/cm²)
Variable	ß	CI 95%	ßAj	CI 95%	ß	CI 95%	ßAj	CI 95%	ß	CI 95%	ßAj	CI 95%
Age Range (years)
20-29	0.00	--	0.00	---	0.00	---	0.00	---	0.00	---	0.00	---
30-39	0.14	-0.03;0.06	0.01	-0.05;0.07	-0.01	-0.03;0.03	-0.01	-0.05;0.01	-0.08	-0.04; 0.02	-0.02	-0.06;0.08
40-49	-0.01	-0.04;0.03	-0.03	-0.08;0.02	-0.04	-0.08;-0.03	-0.07	-0.11; -0.03	-0.01	-0.05; 0.03	-0.04	-0.08;-0.03
50-59	-0.13	-0.19;-0.07	-0.16	-0.23;-0.10	-0.10	-0.14;-0.06	-0.13	-0.17; -0.09	-0.05	-0.08;-0.01	-0.09	-0.13;-0.05
Skin Color
White	0.00	---	0.00	---	0.00	---	0.00	---	---
Non-White	0.05	0.01;0.09	0.04	0.09;0.08	0.03	0.04;0.07	0.02	-0.01;0.05	---
Contraceptive
No	0.00	---	0.00	---	---
Yes	0.04	0.06;0.09	-0.01	-0.06;0.02	---
Nutritional Status
Eutrophic	0.00	---	0.00	---	---	---	---	---	0.00	---	0.00	---
Overweight	0.02	-0.02;0.06	0.02	-0.01;0.06	0.01	-0.02;0.04	0.03	0.03;0.06	0.03	-0.09;0.06	0.04	0.01;0.08
Obese	0.04	-0.06;0.08	0.04	0.01;0.07	0.07	0.03;0.12	0.10	0.07;0.14	0.12	0.08;0.15	0.14	0.10;0.17

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author:
Kátia Josiany Segheto Universidade Federal de Viçosa, Departamento de Nutrição e Saúde. Avenida PH Rolfs, s/n CEP 36571-000 - Viçosa, Minas Gerais, Brazil. kaseghetto@gmail.com