Table 2.
Effects of each component of MetS on bone health in human studies.
| Researcher (Year) | Types of Study | Findings |
|---|---|---|
| Obesity | ||
| Edelstein & Barrett-Connor 1993 [54] | Rancho Bernardo Study (1492 ambulatory white adults, 55–84 years) | Body size, waist and hip ratio, BMI, and waist circumference were positively related with high BMD. |
| Jankowska et al. 2001 [12] | Polish men (272 men, 20–60 years) | Visceral adiposity (assessed by waist/hip ratio) contributed to reduced bone mass in men. |
| De Laet et al. 2005 [13] | 60,000 men and women from 12 cohorts Rotterdam, EVOS/EPOS, CaMos, Rochester, Sheffield, Dubbo, EPIDOS, OFELY, Kuopio, Hiroshima, and two cohorts from Gothenburg | Low BMI was associated with higher risk for all fractures. |
| Pesonen et al. 2005 [55] | Kuopio Osteoporosis Risk Factor and Prevention Study (1873 women, 48.0–59.6 years) | Premenopausal women had higher BMD, menopausal women had lower BMD. |
| Yamaguchi et al. 2009 [56] | 187 men (28–83 years) and 125 postmenopausal women (46–82 years) with type 2 diabetes | Visceral fat (men) and hyperinsulinemia (women) increased FN-BMD in diabetic, protecting against vertebral fracture. |
| Zhao et al. 2007 [57] | Chinese (878 pre-menopausal women, 1110 men; 19.6–45.1 years); Caucasian (2667 females, 1822 males; 19.1–90.1 years) | Increased fat mass did not have a beneficial effect on bone mass. |
| Greco et al. 2010 [58] | 398 obese patients (291 women, 107 men; age = 44.1 + 14.2 years) | Obese individuals had low lumbar BMD. |
| Dyslipidemia | ||
| Yamaguchi et al. 2002 [16] | 214 Japanese postmenopausal women (47–86 years) | High LDL and low HDL cholesterol levels caused low bone mass; high triglycerides levels caused low incidence of vertebral fractures in postmenopausal women. |
| Adami et al. 2004 [15] | 2 cohorts: 236 pre- or post-menopausal (35–81 years old); 265 men and 481 women (68–75 years) | The worse the lipid profile (lower HDL cholesterol and higher LDL cholesterol or triglycerides), the higher the bone mass. |
| Hyperglycemia | ||
| Barrett-Connor & Kritz-Silverstein 1996 [17] | Rancho Bernardo Heart and Chronic Disease Study (411 men and 559 women, 50–89 years) | Hyperinsulinemia only increased BMD in women, but not in men. |
| Schwartz et al. 2001 [59] | Osteoporotic Fractures Study (9654 women, ≥65 years) | Diabetic had increased risk of hip, proximal humerus, and foot fractures. |
| Hanley et al. 2003 [19] | Canadian Multicenter Osteoporosis Study (5566 women and 2187 men, ≥50 years) | Type II diabetes was associated with higher BMD in both men and women. |
| Bonds et al. 2006 [60] | Women’s Health Initiative Observational Cohort (93,676 postmenopausal women) | Women with type 2 diabetes were at increased risk for fractures. |
| Janghorbani et al. 2007 [61] | 836,941 participants from 16 eligible studies (two case-control studies and 14 cohort studies) | Type 1 and type 2 diabetes increased risk of hip fracture in men and women. |
| Yaturu et al. 2009 [48] | 3458 non-diabetic and 735 diabetic male veterans (50–76 years) | Diabetes lowered BMD resulted in increased incidence of hip fractures in men and higher osteoporosis. |
| Hypertension | ||
| Cappuccio et al. 1999 [62] | 3676 white women (66–91years) | Hypertension increased calcium losses which might contribute to hip fractures. |
| Hanley et al. 2003 [19] | Canadian Multicenter Osteoporosis Study (5566 women and 2187 men, ≥50 years) | Hypertension and type II diabetes were associated with higher BMD in both men and women. |
| Gotoh et al. 2005 [63] | 68 non-diabetic women with or without hypertension | Hypertension: ↓ BMD, ↑ calcium/sodium excretion ratio, ↑ PTH, ↑ 1,25(OH)2D. |
Abbreviation: 1,25(OH)2D = 1,25-dihydroxyvitamin D; BMD = bone mineral density; BMI = body mass index; FN-BMD = femoral neck bone mineral density; HDL = high density lipoprotein; LDL = low density lipoprotein; PTH = parathyroid hormone.