title: Association of Hip Bone Mineral Density and Body Composition in a Rural Indian Population: The Andhra Pradesh Children and Parents Study (APCAPS).
abstract: Fat mass is variably associated with bone mass, possibly due to differential mechanical and biological effects of fat mass. We examined the association of fat mass with bone mass in a lean population.
  
  
  
  To investigate association between hip bone mineral density and fat and lean mass in a cross-sectional study from southern India.
  
  
  
  The Andhra Pradesh Children and Parents Study is a prospective cohort study in Hyderabad, India. In 2009-2012, the study collected data on anthropometric measures, bone mineral density (BMD), fat mass, and lean mass measured by dual-energy x-ray absorptiometry, and socioeconomic data of the adult participants (n = 1760; mean age = 34.9 years old for women; 2130 and 32.3 for men).
  
  
  
  The median BMI (kg/m2) was 20.1 kg/m2. Women had relatively higher fat mass as compared to men. In models adjusted for lean mass, there was an association between hip bone mineral density and fat mass in women (β (95% confidence interval): premenopausal 0.025 (0.006 to 0.045); postmenopausal 0.045 (0.014 to 0.076)) but not in men (0.001 (-0.012 to 0.0014)). The association between hip BMD and fat mass was stronger in postmenopausal than premenopausal women. Hip BMD was consistently associated with lean mass, in both men and women.
  
  
  
  In this relatively lean population, lean mass was more consistently associated with hip BMD than fat mass. Weight gain through lean mass improvement may be a more reliable public health strategy for strengthening bone health in transitional settings.
authors.affiliation: Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Mika
authors.initials: M
authors.lastname: Matsuzaki
authors.affiliation: National Institute of Nutrition, Indian Council of Medical Research Tarnaka, Jamai-Osmania, Hyderabad, India.
authors.forename: Bharati
authors.initials: B
authors.lastname: Kulkarni
authors.affiliation: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Kuper
authors.affiliation: Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Wells
authors.affiliation: Department of Population Health and Statistics Centre for Longitudinal Studies, Institute of Education, University of London, London, United Kingdom.
authors.forename: George B
authors.initials: GB
authors.lastname: Ploubidis
authors.affiliation: Public Health Foundation of India, Gurgaon, Haryana, India.
authors.forename: Poornima
authors.initials: P
authors.lastname: Prabhakaran
authors.affiliation: Department of Anthropology, University of Delhi, Delhi, India.
authors.forename: Vipin
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Public Health Foundation of India, Gurgaon, Haryana, India.
authors.forename: Gagandeep Kaur
authors.initials: GK
authors.lastname: Walia
authors.affiliation: Public Health Foundation of India, Gurgaon, Haryana, India.
authors.forename: Aastha
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Centre for Chronic Disease Control, Gurgaon, Haryana, India.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Davey Smith
authors.affiliation: National Institute of Nutrition, Indian Council of Medical Research Tarnaka, Jamai-Osmania, Hyderabad, India.
authors.forename: Kankipati Vijaya
authors.initials: KV
authors.lastname: Radhakrishna
authors.affiliation: MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.affiliation: Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kinra
mesh_terms: D000328:Adult; D001823:Body Composition; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D010384:Pelvic Bones / Q000000981:diagnostic imaging*; D062486:Public Health Surveillance; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult