Associations of Bone Mineral Density with Lean Mass, Fat Mass, and Dietary Patterns in Postmenopausal Chinese Women: A 2-Year Prospective Study.
OBJECTIVE
To assess factors associated with bone mineral density (BMD) in postmenopausal women in a longitudinal study, and to examine the relative contribution of lean mass, fat mass, dietary patterns, and years since menopause to BMD.


METHODS
Two hundred and eighty-two postmenopausal women were randomly selected from Hongqi Community Health Center, in Harbin City, China. All participants were followed up from 2009 to 2011. Dietary data were collected using a Food Frequency Questionnaire. BMD of the left hip, the lumbar spine, and the total body, and the body composition were measured by dual-energy X-ray absorptiometry at baseline and follow-up.


RESULTS
Lean mass and fat mass were positively associated with BMD of the spine, hip, and the total body at both baseline and follow-up. The association between fat mass and BMD at the spine at baseline (P = 0.210) and at the spine (P = 0.116) and hip (P = 0.073) in the second year was not statistically significant when height was adjusted. Six dietary patterns were identified but only cereal grains-fruits pattern (P = 0.001 in the spine, P = 0.037 in hip) and milk-root vegetables pattern (P = 0.010 in hip) were associated with BMD of the spine and hip. The linear mixed model of follow-up data showed that lean mass, years since menopause, and age of menophania were the significant determinants of BMD of all sites. Moreover, lean mass was the best determinant of BMD (VIP = 1.936).


CONCLUSIONS
Lean mass, years since menopause, age of menophania and dietary patterns are the important determinants of BMD of the spine, hip, and the total body. Lean mass is the best determinant of BMD.
Department of Biostatistics, Public Health College, Harbin Medical University, Harbin City, Heilongjiang Province, China.
Yongjie
Y
Chen
Department of Biostatistics, Public Health College, Harbin Medical University, Harbin City, Heilongjiang Province, China.
Jing
J
Xiang
School of Medicine, University of Queensland, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia.
Zhiqiang
Z
Wang
Department of Biostatistics, Public Health College, Harbin Medical University, Harbin City, Heilongjiang Province, China.
Yaming
Y
Xiao
The First People's Hospital of Tengzhou, Zaozhuang City, Shandong Province, China.
Dongmei
D
Zhang
Department of Epidemiology and Evidence-based Medicine, Public Health College, Changsha Medical University, Changsha City, Hunan Province, China.
Xia
X
Chen
The Harbin Institute of Technology Hospital, Harbin City, Heilongjiang Province, China.
Huiting
H
Li
Department of Biostatistics, Public Health College, Harbin Medical University, Harbin City, Heilongjiang Province, China.
Meina
M
Liu
Department of Biostatistics, Public Health College, Harbin Medical University, Harbin City, Heilongjiang Province, China.
Qiuju
Q
Zhang
D050154:Adiposity; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001823:Body Composition; D015992:Body Mass Index; D015519:Bone Density; D002681:China; D003430:Cross-Sectional Studies; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000208:ethnology*; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D049629:Waist-Hip Ratio