Year: 2002
Type: article
Abstract: To the Editor: Drs. Barker and Blumsohn suggest that our study in the July issue of JBMR(1) does not provide sufficient evidence to show that obese premenopausal women who lose weight do not lose bone and that those women who are supplemented with calcium during weight loss tend to gain bone. We disagree and would like to confirm why our data support our original conclusions.(1) Drs. Barker and Blumsohn suggest that −0.2% ± 2.8% change in lumbar bone mineral density (LBMD) in the placebo (Pla) group over 6 months implies that the 95% confidence limit is 3.5% (loss) over 1 year. Whereas it is not unusual to talk about bone loss in terms of an annualized rate, it is problematic to extrapolate the findings from a 6‐month weight‐loss study to a full year, because the rate of change will not necessarily remain constant. Although it is possible that the LBMD loss is as dramatic as 1.8% over 6 months (95% CI of −0.2% ± 1.6%), it is also possible that there is a gain of 1.4% bone. We used the conservative statistical approach of hypothesis testing to conclude that LBMD change in the Pla weight loss group did not differ significantly from zero. Importantly, and similar to the findings in the Pla group, there was no significant reduction in BMD in the weight maintenance group (WM; −0.8% ± 1.9% and −0.1% ± 1.3 for lumbar and whole body, respectively). However, in a different weight loss study in this laboratory that used similar methods and level of obesity but used postmenopausal women, we were able to detect a significant loss of BMD compared with the WM group.(2) Consistent with this, a recent study(3) including both pre‐ and postmenopausal obese women showed bone loss with weight loss. Furthermore, weight reduction may be associated with bone loss in nonobese premenopausal women, as shown in the well‐controlled study by Salamone et al.(4) In contrast, our population of obese premenopausal women shows no bone loss.(1)
Authors: Sue Shapses, Steven B. Heymsfield
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2014224044