title: Relative Importance of Lean and Fat Mass on Bone Mineral Density in Iranian Children and Adolescents.
abstract: BACKGROUND
  Body weight is made up of lean and fat mass and both are involved in growth and development. Impression of these two components in bone density accrual has been controversial.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the relationship between fat and lean mass and bone density in Iranian children and adolescents.
  
  
  METHODS
  A cross-sectional study was performed on 472 subjects (235 girls, 237 boys) aged 9-18 years old in Fars Province. The participants' weight, height, waist circumference, stage of puberty, and level of physical activity were recorded. Bone Mineral Content (BMC), Bone Mineral Density (BMD), total body fat and lean mass were measured using dual-energy X-ray absorptiometry.
  
  
  RESULTS
  Results showed that 12.2% of boys and 12.3% of girls were overweight and 5.5% of boys and 4.7% of girls were obese. Obese individuals had greater total body BMD (0.96 ± 0.11) than normal-weight ones (0.86 ± 0.11) (P < 0.001). We found the greatest correlation between total body BMD and total body lean mass (R = 0.78. P < 0.001) and the least correlation with total body fat percentage (R = 0.03, P = 0.44). Total lean mass in more active boys was 38.1 ± 10.9 and in less active boys was 32.3 ± 11.0 (P < 0.001). The results of multiple regression analysis showed that age and total body lean mass were independent factors of BMD in growing children and adolescents.
  
  
  CONCLUSIONS
  These findings suggest that lean mass was the most important predictor of BMD in both genders. Physical activity appears to positively impact on lean mass and needs to be considered in physical education and health-enhancing programs in Iranian school children.
authors.affiliation: Endocrine and Metabolism Research Center, Department of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Jeddi
authors.affiliation: Endocrine and Metabolism Research Center, Department of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dabbaghmanesh
authors.affiliation: Endocrine and Metabolism Research Center, Department of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Ranjbar Omrani
authors.affiliation: Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Sayed Mohammad Taghi
authors.initials: SM
authors.lastname: Ayatollahi
authors.affiliation: Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Bagheri
authors.affiliation: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Bakhshayeshkaram
keywords: Body Fat; Bone Density; Child; Lean Mass; Obesity