title: Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass.
abstract: To assess the relationship of total fat mass (TFM) and total lean mass (TLM) with bone mineral density (BMD) and bone mineral content (BMC), we studied 770 postmenopausal white women after total body measurements by dual-energy X-ray absorptiometry. Height-independent bone mineral density (HIBMD) was also tested. The effects of TFM and TLM on the dependent variables HIBMD, BMD, and BMC were assessed by the univariate general linear model (UGLM). Age, age at menopause, height, and bone area were entered in the models as controlling variables when appropriate. In the total population, TLM and TFM were associated with BMD, BMC, and HIBMD (P < 0.001). Taking the T-score cut-off as -2.5, women without (463) and with (307) osteoporosis were then tested separately. In nonosteoporotic women, TLM was significantly associated with BMD, BMC, and HIBMD (P < 0.001), while TFM was not. In osteoporotic women, both TLM and TFM were associated with BMD to the same extent (P < 0.05), but not with HIBMD. Women without osteoporosis were then tested according to whether their TFM/TLM fraction was less than or greater than 1. In those with TFM/TLM less than 1, both TLM (P < 0.001) and TFM (P < 0.01), tested separately, were associated with BMD and BMC, but not with HIBMD. When TLM and TFM were tested at the same time and assessed by the same UGLM, only TLM (P < 0.001) still affected these three bone parameters. In women with TFM/TLM greater than 1, testing the body components both separately and at the same time and using the UGLM showed that TFM affected both BMC and BMD (P < 0.05), while TLM did not. In conclusion, our data indicate that both TFM and TLM affect bone density, with different physiological/pathological conditions modulating this relationship.
authors: Modulo Dipartimentale di Medicina Interna, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136 Bologna, Italy. saverio.gnudi@ior.it
authors: Saverio
authors: S
authors: Gnudi
authors: Emanuela
authors: E
authors: Sitta
authors: Nicoletta
authors: N
authors: Fiumi
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*
references: Maturitas. 2004 Feb 20;47(2):99-105
references: 14757268
references: Clin Endocrinol (Oxf). 1992 Nov;37(5):426-31
references: 1486693
references: Bone. 1995 Oct;17(4 Suppl):197S-205S
references: 8579917
references: J Clin Endocrinol Metab. 1992 Sep;75(3):779-82
references: 1517366
references: Med Sci Monit. 2001 Sep-Oct;7(5):1029-33
references: 11535954
references: Metabolism. 2000 Mar;49(3):360-6
references: 10726915
references: Am J Clin Nutr. 1987 Jan;45(1 Suppl):277-82
references: 3541569
references: J Bone Miner Res. 1996 Jun;11(6):857-63
references: 8725184
references: Bone. 2002 Nov;31(5):547-55
references: 12477567
references: J Bone Miner Res. 1997 Jan;12(1):144-51
references: 9240737
references: Lancet. 2002 Jun 1;359(9321):1929-36
references: 12057569
references: J Biomech. 1984;17(12):897-905
references: 6520138
references: Exp Gerontol. 1991;26(2-3):203-14
references: 1915691
references: Calcif Tissue Int. 1992 Jan;50(1):19-23
references: 1739865
references: J Bone Miner Res. 2001 Jul;16(7):1343-52
references: 11450711
references: J Clin Endocrinol Metab. 2001 May;86(5):1884-7
references: 11344177
references: J Musculoskelet Neuronal Interact. 2001 Sep;2(1):15-24
references: 15758473
references: J Clin Endocrinol Metab. 1972 Oct;35(4):627-30
references: 5052980
references: J Clin Endocrinol Metab. 1996 Nov;81(11):3909-13
references: 8923837
references: Eur J Clin Nutr. 1994 Nov;48(11):781-94
references: 7859696
references: Am J Clin Nutr. 1995 May;61(5):1110-4
references: 7733036
references: J Bone Miner Res. 2002 Sep;17(9):1563-9
references: 12211425
references: J Bone Miner Res. 1997 Oct;12(10):1547-51
references: 9333114
references: Gerontology. 2000 Jul-Aug;46(4):189-93
references: 10859457
references: Osteoporos Int. 2000;11(12):1043-50
references: 11256896
references: Calcif Tissue Int. 1996 Dec;59(6):428-32
references: 8939766
references: Maturitas. 2001 Aug 25;39(2):133-45
references: 11514112
references: Am J Physiol. 1996 Feb;270(2 Pt 1):E320-7
references: 8779955
references: J Bone Miner Res. 1997 Oct;12(10):1539-46
references: 9333113
references: J Appl Physiol (1985). 1997 Apr;82(4):1200-9
references: 9104857
references: Bone. 2004 Sep;35(3):792-8
references: 15336618
references: J Bone Miner Res. 2001 Jun;16(6):1108-19
references: 11393788
references: Br J Radiol. 1994 Dec;67(804):1210-7
references: 7874420
references: J Clin Endocrinol Metab. 1992 Jul;75(1):45-51
references: 1619030
references: Int J Obes Relat Metab Disord. 1996 Dec;20(12 ):1111-9
references: 8968857
references: Clin Physiol Funct Imaging. 2003 May;23 (3):130-3
references: 12752553
references: Am J Physiol Endocrinol Metab. 2005 Nov;289(5):E735-45
references: 16215165
references: J Bone Miner Res. 1993 May;8(5):567-73
references: 8511983
references: Endocrinology. 1999 Apr;140(4):1630-8
references: 10098497
references: Dyn Med. 2005 Jan 04;4(1):1
references: 15631633
references: Proc Natl Acad Sci U S A. 2004 Mar 2;101(9):3258-63
references: 14978271