Abstract—Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site- specific. This study is aimed at determining the connection between the bone mineral density (BMD) and trabecular bone score (TBS) parameters in Ukrainian women suffering from obesity. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group A included 360 women with obesity whose BMI was ≥30 kg/m 2 , and Group B – 665 women with no obesity and BMI of <30 kg/m 2 . The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non- obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50- 59, 60-69 and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non- obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%. Keywords—Bone mineral density, trabecular bone score, obesity, women. I. INTRODUCTION HE combined effect of osteoporosis and obesity on the morbidity and mortality of the population worldwide is addressed by the numerous recent studies [1], [3], [5], [6], Vladyslav Povoroznyuk, Nataliia Dzerovych, and Tetyana Kovtun are with D.F. Chebotarev Institute of gerontology NAMS Ukraine, Kyiv, Ukraine (e- mail: okfpodac@ukr.net, zeronat@ukr.net, t.kovtun@mail.ru). Larysa Martynyuk is with I. Horbachevsky Ternopil State Medical University, Ternopil, Ukraine (e-mail: l_martynyuk@yahoo.com). [12]. It has also been reported that age and female gender increase the risk of developing both obesity and osteoporosis [6]. Body weight is generally considered a strong predictor of bone mass in both males and females [6], which positively correlate with bone mineral density and negatively - with fracture risk, according to the results of numerous laboratory and clinical studies [8]. Many researchers have reported that in healthy premenopausal and postmenopausal women the total body fat is positively related to the bone mineral density, which is commonly considered the most important measurable determinant of fracture risk, and that the decreased body weight leads to bone loss [6]. Obesity undermines the healthy bone metabolism through the following set of mechanisms. Because both adipocytes and osteoblasts are derived from a common multipotential mesenchymal stem cell, obesity may increase adipocyte differentiation and fat accumulation while decreasing osteoblast differentiation and bone formation. Obesity is associated with a chronic inflammation. Increase in the rate of circulating and tissue proinflammatory cytokines is likely to promote osteoclast activity and bone resorption through modification of the receptor activator of NF-B (RANK)/ RANK ligand/osteoprotegerin pathway. Furthermore, the excessive secretion of leptin and/or decreased production of adiponectin by adipocytes in obesity may either directly affect bone formation or indirectly affect bone resorption through up-regulated pro-inflammatory cytokine production. Finally, the high fat intake may interfere with the intestinal calcium absorption and therefore decrease calcium availability for the bone formation [2]-[4], [7], [9], [12]. There is further evidence that the relationship between weight and fracture risk is site-specific [6], [8], [10], [12]. The results of a meta-analysis of 60,000 men and women from 12 prospective, population based cohorts show that total fractures, osteoporotic fractures and hip fractures are all inversely correlated to the body mass index (BMI) in both men and women [6]. Several recent studies demonstrate that the obesity protects human body against fractures and at the same time that the obesity is a risk factor for certain types of fracture. Namely, the study by Hsu, carried out in a large cohort of Chinese men and women, shows that the frequency of nonspine fractures is significantly higher in the subjects with a higher percentage of body fat, independent of their body weight. The Global Longitudinal study of Osteoporosis in Women, a prospective cohort study involving 723 physician practices in 10 countries, has reported that fractures in obese women accounted for 23% Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity T World Academy of Science, Engineering and Technology International Journal of Medical and Health Sciences Vol:9, No:5, 2015 452 International Scholarly and Scientific Research & Innovation 9(5) 2015 scholar.waset.org/1307-6892/10001795 International Science Index, Medical and Health Sciences Vol:9, No:5, 2015 waset.org/Publication/10001795