title: Low fatness, reduced fat intake and adequate plasmatic concentrations of LDL-cholesterol are associated with high bone mineral density in women: a cross-sectional study with control group.
abstract: BACKGROUND
  Several parameters are associated with high bone mineral density (BMD), such as overweight, black background, intense physical activity (PA), greater calcium intake and some medications. The objectives are to evaluate the prevalence and the main aspects associated with high BMD in healthy women.
  
  
  METHODS
  After reviewing the database of approximately 21,500 BMD scans performed in the metropolitan area of São Paulo, Brazil, from June 2005 to October 2010, high BMD (over 1400 g/cm² at lumbar spine and/or above 1200 g/cm² at femoral neck) was found in 421 exams. Exclusion criteria were age below 30 or above 60 years, black ethnicity, pregnant or obese women, disease and/or medications known to interfere with bone metabolism. A total of 40 women with high BMD were included and matched with 40 healthy women with normal BMD, paired to weight, age, skin color and menopausal status. Medical history, food intake and PA were assessed through validated questionnaires. Body composition was evaluated through a GE-Lunar DPX MD + bone densitometer. Radiography of the thoracic and lumbar spine was carried out to exclude degenerative alterations or fractures. Biochemical parameters included both lipid and hormonal profiles, along with mineral and bone metabolism. Statistical analysis included parametric and nonparametric tests and linear regression models. P < 0.05 was considered significant.
  
  
  RESULTS
  The mean age was 50.9 (8.3) years. There was no significant difference between groups in relation to PA, smoking, intake of calcium and vitamin D, as well as laboratory tests, except serum C-telopeptide of type I collagen (s-CTX), which was lower in the high BMD group (p = 0.04). In the final model of multivariate regression, a lower fat intake and body fatness as well a better profile of LDL-cholesterol predicted almost 35% of high BMD in women. (adjusted R2 = 0.347; p < 0.001). In addition, greater amounts of lean mass and higher IGF-1 serum concentrations played a protective role, regardless age and weight.
  
  
  CONCLUSIONS
  Our results demonstrate the potential deleterious effect of lipid metabolism-related components, including fat intake and body fatness and worse lipid profile, on bone mass and metabolism in healthy women.
authors.affiliation: Nutrition Department, School of Public Health, Sao Paulo University, Av. Dr. Arnaldo, 715, São Paulo-SP, Brazil CEP-01246-904.
authors.forename: Karin S
authors.initials: KS
authors.lastname: Sarkis
authors.forename: Lígia A
authors.initials: LA
authors.lastname: Martini
authors.forename: Vera L
authors.initials: VL
authors.lastname: Szejnfeld
authors.forename: Marcelo M
authors.initials: MM
authors.lastname: Pinheiro
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D018752:Diet, Fat-Restricted; D005260:Female; D005272:Femur Neck / Q000033:anatomy & histology; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL