{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T21:56:05Z","timestamp":1792965365373,"version":"4.5.0"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T00:00:00Z","timestamp":1561075200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011665","name":"Deanship of Scientific Research, King Saud University","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100011665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>There are discrepancies in the reports on the association of metabolic syndrome (MetS) and its components with bone mineral density (BMD) and hence more population-based studies on this subject are needed. In this context, this observational study was aimed to investigate the association between T-scores of BMD at lumbar L1\u2013L4 and full MetS and its individual components. A total of 1587 participants (84.7% females), &gt;35 years and with risk factors associated with bone loss were recruited from February 2013 to August 2016. BMD was done at L1\u2013L4 using dual-energy X-ray absorptiometry (DXA). T-Scores were calculated. Fasting blood samples and anthropometrics were done at recruitment. Fasting lipid profile and glucose were measured. Screening for full MetS and its components was done according to the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. Logistic regression analysis revealed that the odds of having full MetS increased significantly from the lowest T-score tertile to the highest one in both sexes (OR, odd ratio (95% CI, confidence interval) of tertile 2 and 3 at 1.49 (0.8 to 2.8) and 2.46 (1.3 to 4.7), p = 0.02 in males and 1.35 (1.0 to 1.7) and 1.45 (1.1 to1.9), p &lt; 0.01 in females). The odds remained significant even after adjustments with age, body mass index (BMI), and other risk factors associated with bone loss. Among the components of MetS, only central obesity showed a significant positive association with T-score. The study suggests a significant positive association of T-score (spine) with full MetS irrespective of sex, and among the components of MetS this positive association was seen specifically with central obesity.<\/jats:p>","DOI":"10.3390\/nu11061405","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T11:54:31Z","timestamp":1561118071000},"page":"1405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Metabolic Syndrome in Arab Adults with Low Bone Mineral Density"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-6516","authenticated-orcid":false,"given":"Kaiser","family":"Wani","sequence":"first","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobhy M.","family":"Yakout","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4307-7679","authenticated-orcid":false,"given":"Mohammed Ghouse Ahmed","family":"Ansari","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Sabico","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Danish","family":"Hussain","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed S.","family":"Alokail","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Sheshah","sequence":"additional","affiliation":[{"name":"Diabetes Care Center, King Salman Bin Abdulaziz Hospital, Riyadh 12769, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naji J.","family":"Aljohani","sequence":"additional","affiliation":[{"name":"Specialized Diabetes and Endocrine Center, King Fahad Medical City, Riyadh 12231, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Al-Saleh","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"},{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"Department of Medicine, Ministry of the National Guard\u2014Health Affairs, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Reginster","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"},{"name":"Department of Public Health, Epidemiology and Health Economics, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5472-1725","authenticated-orcid":false,"given":"Nasser M.","family":"Al-Daghri","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s40618-018-0872-6","article-title":"From inflammation to sexual dysfunctions: A journey through diabetes, obesity, and metabolic syndrome","volume":"41","author":"Maiorino","year":"2018","journal-title":"J. Endocrinol. Investig."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/biof.1459","article-title":"Oxidative stress and inflammation, two features associated with a high percentage body fat, and that may lead to diabetes mellitus and metabolic syndrome","volume":"45","author":"Darroudi","year":"2018","journal-title":"BioFactors"},{"key":"ref_3","first-page":"1918","article-title":"Metabolic syndrome in saudi arabia","volume":"26","author":"Arafah","year":"2005","journal-title":"Saudi Med. J."},{"key":"ref_4","first-page":"1360","article-title":"Prevalence of metabolic syndrome in saudi adult soldiers","volume":"26","author":"Imtiaz","year":"2005","journal-title":"Saudi Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3810\/pgm.2012.01.2514","article-title":"Metabolic syndrome: Definition and therapeutic implications","volume":"124","author":"Prasad","year":"2012","journal-title":"Postgrad. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"943162","DOI":"10.1155\/2014\/943162","article-title":"A comprehensive review on metabolic syndrome","volume":"2014","author":"Kaur","year":"2014","journal-title":"Cardiol. Res. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1242\/dmm.001180","article-title":"A comprehensive definition for metabolic syndrome","volume":"2","author":"Huang","year":"2009","journal-title":"Dis. Model. Mech."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wong, S., Chin, K.-Y., Suhaimi, F., Ahmad, F., and Ima-Nirwana, S. (2016). The relationship between metabolic syndrome and osteoporosis: A review. Nutrients, 8.","DOI":"10.3390\/nu8060347"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s00198-004-1640-3","article-title":"Body mass index as a predictor of fracture risk: A meta-analysis","volume":"16","author":"Kanis","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1093\/aje\/kwm106","article-title":"Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture","volume":"166","author":"Janghorbani","year":"2007","journal-title":"Am. J. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2184","DOI":"10.1001\/jama.2011.715","article-title":"Association of bmd and frax score with risk of fracture in older adults with type 2 diabetes","volume":"305","author":"Schwartz","year":"2011","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.2337\/dc12-1188","article-title":"High bone mineral density and fracture risk in type 2 diabetes as skeletal complications of inadequate glucose control: The rotterdam study","volume":"36","author":"Oei","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sun, K., Liu, J., Lu, N., Sun, H., and Ning, G. (2014). Association between metabolic syndrome and bone fractures: A meta-analysis of observational studies. BMC Endocr. Disord., 14.","DOI":"10.1186\/1472-6823-14-13"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.bone.2009.05.003","article-title":"Associations between components of the metabolic syndrome versus bone mineral density and vertebral fractures in patients with type 2 diabetes","volume":"45","author":"Yamaguchi","year":"2009","journal-title":"Bone"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1007\/s00774-013-0446-9","article-title":"The association between bone mineral density and metabolic syndrome: A Korean population-based study","volume":"31","author":"Kim","year":"2013","journal-title":"J. Bone Miner. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"12104","DOI":"10.1038\/s41598-017-12085-0","article-title":"Serum uric acid to creatinine ratio and risk of metabolic syndrome in saudi type 2 diabetic patients","volume":"7","author":"Wani","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s00198-007-0385-1","article-title":"Associations between the metabolic syndrome and bone health in older men and women: The rancho bernardo study","volume":"18","author":"Safii","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00198-009-0990-2","article-title":"The relationship between low bone mass and metabolic syndrome in korean women","volume":"21","author":"Hwang","year":"2010","journal-title":"Osteoporos. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1507\/endocrj.K10E-297","article-title":"Association between bone mineral density and metabolic syndrome in pre- and postmenopausal women","volume":"58","author":"Jeon","year":"2011","journal-title":"Endocr. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/gme.0b013e3181e39a15","article-title":"Metabolic syndrome and bone metabolism: The camargo cohort study","volume":"17","author":"Olmos","year":"2010","journal-title":"Menopause"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"El Maghraoui, A., Rezqi, A., El Mrahi, S., Sadni, S., Ghozlani, I., and Mounach, A. (2014). Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women. BMC Endocr. Disord., 14.","DOI":"10.1186\/1472-6823-14-93"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Muka, T., Trajanoska, K., Kiefte-de Jong, J.C., Oei, L., Uitterlinden, A.G., Hofman, A., Dehghan, A., Zillikens, M.C., Franco, O.H., and Rivadeneira, F. (2015). The association between metabolic syndrome, bone mineral density, hip bone geometry and fracture risk: The Rotterdam study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0129116"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1007\/s12020-012-9684-1","article-title":"The association between metabolic syndrome and bone mineral density: A meta-analysis","volume":"42","author":"Xue","year":"2012","journal-title":"Endocrine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1093\/oxfordjournals.aje.a116842","article-title":"Relation between body size and bone mineral density in elderly men and women","volume":"138","author":"Edelstein","year":"1993","journal-title":"Am. J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1046\/j.1439-0272.2001.00469.x","article-title":"Are general obesity and visceral adiposity in men linked to reduced bone mineral content resulting from normal ageing? A population-based study","volume":"33","author":"Jankowska","year":"2001","journal-title":"Andrologia"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s12020-012-9639-6","article-title":"Association of nonalcoholic fatty liver disease with low bone mass in postmenopausal women","volume":"42","author":"Moon","year":"2012","journal-title":"Endocrine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S116","DOI":"10.1067\/mjd.2001.117432","article-title":"Estrogen production and action","volume":"45","author":"Nelson","year":"2001","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1001\/jama.292.4.490","article-title":"Clinical implications of the osteoprotegerin\/rankl\/rank system for bone and vascular diseases","volume":"292","author":"Hofbauer","year":"2004","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1007\/s12020-012-9613-3","article-title":"The role of pro\/anti-inflammatory adipokines on bone metabolism in nafld obese adolescents: Effects of long-term interdisciplinary therapy","volume":"42","author":"Campos","year":"2012","journal-title":"Endocrine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1749-799X-6-30","article-title":"Effects of obesity on bone metabolism","volume":"6","author":"Cao","year":"2011","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4161","DOI":"10.1210\/jc.2007-0757","article-title":"Bone mineral density in adults with the metabolic syndrome: Analysis in a population-based US sample","volume":"92","author":"Kinjo","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1210\/jc.2007-0843","article-title":"The association between hyperglycemia and fracture risk in middle age. A prospective, population-based study of 22,444 men and 10,902 women","volume":"93","author":"Holmberg","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"E735","DOI":"10.1152\/ajpendo.00159.2005","article-title":"Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues","volume":"289","author":"Thrailkill","year":"2005","journal-title":"Am. J. Physiol. -Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.2337\/diacare.24.7.1198","article-title":"Diabetes and risk of fracture: The blue mountains eye study","volume":"24","author":"Ivers","year":"2001","journal-title":"Diabetes Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4221","DOI":"10.1529\/biophysj.105.075804","article-title":"Beneath the minerals, a layer of round lipid particles was identified to mediate collagen calcification in compact bone formation","volume":"91","author":"Xu","year":"2006","journal-title":"Biophys. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1359\/jbmr.2003.18.4.784","article-title":"Associations among disease conditions, bone mineral density, and prevalent vertebral deformities in men and women 50 years of age and older: Cross-sectional results from the canadian multicentre osteoporosis study","volume":"18","author":"Hanley","year":"2003","journal-title":"J. Bone Miner. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.annepidem.2005.06.051","article-title":"Bone mineral density and hypertension prevalence in postmenopausal women: Results from the third national health and nutrition examination survey","volume":"16","author":"Mussolino","year":"2006","journal-title":"Ann. Epidemiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"M61","DOI":"10.1093\/gerona\/52A.2.M61","article-title":"Bone mineral density and biochemical markers of bone turnover in healthy elderly men and women","volume":"52","author":"Krall","year":"1997","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S1056-8727(02)00190-3","article-title":"The impact of ethnicity on type 2 diabetes","volume":"17","author":"Abate","year":"2003","journal-title":"J. Diabetes Complicat."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1359\/jbmr.1997.12.12.2113","article-title":"A comparison of longitudinal measurements in the spine and proximal femur using lunar and hologic instruments","volume":"12","author":"Pocock","year":"1997","journal-title":"J. Bone Miner. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1007\/s00774-013-0445-x","article-title":"Triglyceride metabolism in bone tissue is associated with osteoblast and osteoclast differentiation: a gene expression study","volume":"31","author":"Zupan","year":"2013","journal-title":"J. Bone Miner. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/1759720X16687480","article-title":"Diabetes and bone health: Latest evidence and clinical implications","volume":"9","author":"Sundararaghavan","year":"2017","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Komorita, Y., Iwase, M., Idewaki, Y., Fujii, H., Ohkuma, T., Ide, H., Jodai, K.T., Yoshinari, M., Murao, K.A., and Oku, Y. (2019). Impact of hip fracture on all-cause mortality in Japanese patients with type 2 diabetes mellitus: The Fukuoka Diabetes Registry. J. Diabetes Investig.","DOI":"10.1111\/jdi.13076"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1016\/j.celrep.2019.04.066","article-title":"Obesity-Associated Hypermetabolism and Accelerated Senescence of Bone Marrow Stromal Stem Cells Suggest a Potential Mechanism for Bone Fragility","volume":"27","author":"Tencerova","year":"2019","journal-title":"Cell Rep."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Guh, D.P., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C.L., and Anis, A.H. (2009). The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health, 9.","DOI":"10.1186\/1471-2458-9-88"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"547","DOI":"10.3803\/EnM.2016.31.4.547","article-title":"Association between obesity and bone mineral density by gender and menopausal status","volume":"31","author":"Salamat","year":"2016","journal-title":"Endocrinol. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.bone.2005.09.008","article-title":"Systemic bone loss and induction of coronary vessel disease in a rat model of chronic inflammation","volume":"38","author":"Smith","year":"2006","journal-title":"Bone"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/6\/1405\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:00:21Z","timestamp":1760187621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/6\/1405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,21]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6]]}},"alternative-id":["nu11061405"],"URL":"https:\/\/doi.org\/10.3390\/nu11061405","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,21]]}}}