title: Body composition predictors of skeletal integrity in obesity.
abstract: OBJECTIVE
  To determine body composition predictors of skeletal integrity in overweight/obese subjects using dual energy X-ray absorptiometry (DXA). We hypothesized that visceral adiposity would be negatively, and lean mass positively, associated with DXA measures of skeletal integrity in obesity.
  
  
  METHODS
  Our study was institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant and written informed consent was obtained. We studied 82 overweight or obese, but otherwise healthy premenopausal women and men of similar age who were part of a clinical trial (mean age: 37 ± 10 years, mean BMI: 34 ± 7 kg/m(2)). All subjects underwent DXA of the spine and hip for assessment of bone mineral density (BMD), trabecular bone score (TBS), and hip structural analysis (HSA), and of the whole body for the assessment of body composition, including estimated visceral adipose tissue (VAT).
  
  
  RESULTS
  Sixty-three subjects (77 %) had normal BMD and 19 subjects (23 %) had osteopenia. There were strong age-, sex-, and BMD-independent positive associations between lean mass and HSA parameters (r = 0.50 to r = 0.81, p < 0.0001), whereas there was no association with TBS. There were strong age-, sex- and BMD-independent inverse associations between total fat and VAT mass and TBS (r = -0.60 and r = -0.72, p < 0.0001 for both correlations), whereas there were no associations with HSA parameters.
  
  
  CONCLUSIONS
  Lean mass is a positive predictor of hip geometry, whereas fat and VAT mass are negative predictors of trabecular microarchitecture in overweight/obese subjects.
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Bulfinch 457B, 55 Fruit Street, Boston, MA, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Schorr
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Bulfinch 457B, 55 Fruit Street, Boston, MA, USA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Dichtel
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Bulfinch 457B, 55 Fruit Street, Boston, MA, USA.
authors.forename: Anu V
authors.initials: AV
authors.lastname: Gerweck
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Torriani
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Bulfinch 457B, 55 Fruit Street, Boston, MA, USA.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Miller
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA. mbredella@mgh.harvard.edu.
authors.forename: Miriam A
authors.initials: MA
authors.lastname: Bredella
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D001823:Body Composition; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D001900:Boston / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology*; D017697:Premenopause; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: DXA; Hip structural analysis; Lean mass; Obesity; Trabecular bone score; Visceral adipose tissue