Study Finds Connection Between Gut Microbiome and Bone Density

Could Lead to New Strategies to Improve Bone Strength in Older Americans

BOSTON  – There is growing evidence that a relative abundance of certain gut microbes may be related to skeletal health, according to a new study published in Frontiers in Endocrinology. If confirmed by additional research, the findings could provide the opportunity to alter gut microbiomes to achieve better bone health, as scientists learn more about “osteomicrobiology,” a new term recently used to characterize this relationship.

Due to the lack of large-scale human studies of the gut microbiome and skeletal health, researchers led by Paul C. Okoro, data scientist II at Hebrew SeniorLife and the Hinda and Arthur Marcus Institute for Aging Research, and principal investigator Douglas P. Kiel, M.D., MPH, senior scientist at the Marcus Institute, conducted an observational study based on the Framingham Third Generation Study of men and women, and the Osteoporotic fractures in Men (MrOS) study of older men to determine whether they could find a potentially modifiable factor contributing to skeletal health. The study used high-resolution imaging of the arm and leg.

This is significant because low bone density increases the risk of developing osteoporosis, affecting more than 10 million Americans over the age of 50, and can increase the risk of fractures.

Entitled “A Two-Cohort Study on the Association between the Gut Microbiota and Bone Density, Microarchitecture, and Strength,” the study found that bacteria called Akkermansia, which has been associated with obesity, and Clostridiales bacterium DTU089, had negative associations with bone health for older adults. DTU089, a bacterium from the class Clostridia, has been described to be more abundant in people with lower physical activity, and lower protein intake, and could be significant because prior studies have found protein intake and physical activity have a definite connection to skeletal health. 

“We found patterns in which greater abundance of microbiota were associated with worse measures of bone density and microarchitecture. In fact, some bacteria were associated with differences in the bone cross sectional area, suggesting the possibility that certain microbes could influence how the bone changes size with aging,” said Dr. Kiel. “It is premature to know if the bacterial organisms themselves may have effects on skeletal health. With additional studies we might be able to gain insights regarding associations between specific bacterial species in the intestine and skeletal integrity. We also hope to identify specific functional pathways influenced by the bacteria that could influence the skeleton. For example, some bacteria can lead to low levels of inflammation that may affect bone health. Ultimately, if findings like this are confirmed, we may be able to target the gut microbiome to influence skeletal health.”

Harvard T.H. Chan School of Public Health, Oregon Health and Sciences University, BIDMC, Minneapolis and Palo Alto VA Health Care System, University of Minnesota, University of Pittsburgh, Stanford University, Emory University collaborated in this retrospective cohort study.

Co-authors of the study include Eric S. Orwoll, M.D., professor of medicine, Department of Medicine, Oregon Health & Sciences University; Curtis Huttenhower, PhD, professor of computational biology and bioinformatics, Department of Biostatistics, Harvard T.H. Chan School of Public Health; Xochitl Morgan, PhD, senior research scientist and director of microbiome analysis core, Department of Biostatistics, Harvard T.H. Chan School of Public Health, Thomas M. Kuntz, PhD, research associate, Department of Biostatistics, Harvard T.H. Chan School of Public Health; Lauren J. McIver, associate director of engineering, Department of Biostatistics, Harvard T.H. Chan School of Public Health; Alyssa B. Dufour, PhD, assistant scientist iI, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife; Mary L. Bouxsein, PhD, professor, orthopedic surgery, Endocrine Unit, Massachusetts General Hospital, Harvard Medical School; Lisa Langsetmo, PhD, MSc, associate professor, Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System; Samaneh Farsijani, PhD, R.D., assistant professor of epidemiology, Department of Epidemiology and Center for Aging and Population Health University of Pittsburgh; Deborah M. Kado, M.D., M.S., professor of medicine, Department of Medicine, Stanford University, and director of the Geriatric Research Education and Clinical Center (GRECC), VA Health System Palo Alto, CA; Roberto Pacifici, M.D., director, Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Shivani Sahni, PhD, associate scientist, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife; Douglas P. Kiel, M.D., MPH, senior scientist, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife.

Funding came from grants from NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases – NIAMS).

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across six campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; and Jack Satter House, Revere. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $85 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 1,000 geriatric care providers each year. For more information about Hebrew SeniorLife, visit our website or follow us on our blog, Facebook, Instagram, Twitter, and LinkedIn.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.