Determinants of Bone Mineral Density and Metabolic Syndrome in South Asian Indian Men

There is a rising minority population in the United States and South Asians make up the
largest growing sub population. Health concerns in the minority population are several of
which metabolic syndrome (MetS) and low bone mineral density (BMD) are important.
Interestingly research in the past decade is beginning to suggest an interplay between bone
and energy metabolism. Hormones, bone proteins and cytokines that play an important role in
bone metabolism are also altered in metabolic syndrome, suggesting that both these

conditions may share a common etiology. Hence the primary question in this study would be to
assess whether bone is altered in the South Asian population in the United States and whether
hormones or other proteins regulating bone influence metabolic syndrome outcomes in the South
Asians, specifically the South Asian Indian population. There is also an altered body
composition in the South Asian Indian population with a greater visceral adiposity. Greater
visceral adipose tissue (VAT) is associated in both the pathogenesis of metabolic syndrome
and low BMD, possibly due to release of pro inflammatory cytokines. Interestingly several
factors that are involved in the etiology of low BMD such as a greater visceral adiposity,
high serum pro inflammatory cytokines, altered hormonal milieu such as low 25 hydroxy vitamin
D (25OHD) and high parathyroid hormone (PTH), low osteocalcin levels, low calcium and high
carbohydrate diet may share a relationship with MetS outcomes. The South Asian population has
all the above-mentioned biochemical and metabolic alterations and it would be interesting to
examine this in an immigrant Asian population residing in the USA. The investigators propose
to examine 30 South Asian Indians between the ages of 30-50 years, using 30 resident
Caucasian men as controls. Bone measures such as BMD and bone mineral content will be
measured at radius, trochanter, hip and tibia and body composition including lean mass, fat
mass, android fat and gynoid fat will be assessed using the Dual X ray energy absorptiometry
(DXA). Biochemical measures including a complete metabolic panel, PTH, 25OHD, osteocalcin and
other bone markers, and pro inflammatory cytokines will be measured in the serum.
Investigators hypothesize that South Asian Indian men will have a lower BMD and higher MetS
risk factors compared to age and BMI matched Caucasian men. Investigators further propose
that common biochemical and metabolic alterations will underlie both low BMD and MetS
outcomes in SAI population, but not in the Caucasian population. Identification of common
determinants will help design a single future interventional trial that will target both MetS
and bone health in the SA population

Specific Aim 1 To determine whether Bone Mineral Density (BMD) at weight-bearing and non
weight-bearing sites is lower in age- and weight-matched SAI compared to white men.

It is hypothesized that SAI men will have lower BMD at weight-bearing sites compared to age
and BMI-matched white men.

Specific Aim 2 To determine whether body composition influences Bone Mineral Density in SAI
men.

It is hypothesized that greater abdominal adiposity, specifically visceral fat, influences
BMD in SAI men compared to age- and BMI-matched white men.

Specific Aim 3 To examine the hormonal, inflammatory, and dietary determinants of Bone
Mineral Density and MetS in SAI compared to white men.

It is hypothesized that the hormonal, inflammatory, and dietary determinants of both MetS and
low BMD will be similar in the SAI men but not in the white men.

This study will involve one single visit. The following will be conducted during this visit:

- This visit will last for about 2 hours

- Blood draw- Four 5 ml tubes of blood will be collected via venipuncture

- Spot urine sample collection

- Measurement of height, weight, blood pressure, waist circumference

- Completion of study questionnaires

- DXA scan

Inclusion Criteria:

- South Asian Indian and Caucasian males

- 20 and 50 years of age

- BMI range 23 - 35 kg/m2

Exclusion Criteria:

- An individual is unwilling to sign the informed consent document.

- A physician states that a participant is not able to participate in the study.

- Individuals with the presence of any acute illness in the past month.

- Individuals with preexisting chronic medical conditions such as diabetes (type I and
II), cancer, other metabolic disorders.

- Individuals who are using medications known to influence bone, blood glucose,
lipids,and blood pressure.

- Individuals who had a history of major diseases, such as cardiac, diabetes, renal, or
evidence of cancer, in the past year.