title: Body composition assessment in the prediction of osteoporotic fractures.
abstract: To give an overview of recent research findings and insights on the role of body composition assessment in fracture risk prediction.
  
  
  
  While there is to date little doubt that bone mineral density (BMD) is a main pathogenic factor of osteoporotic fractures, recent studies have emphasized the independent contribution of body composition components, especially lean mass, to fracture risk. In this article, we address body composition changes with aging, before to focus on recent studies addressing the contribution of lean and fat mass to fracture risk, together with some hypothesized mechanisms and clinical implications.
  
  
  
  Recent compelling evidence suggest that clinicians should recognize the potential role of muscle wasting in determining fracture risk among older adults and that measures of lean mass, especially appendicular lean mass - which can be assessed simultaneously with the BMD measurement - should be considered in fracture risk assessment beyond BMD and clinical risk factors. More evidence is needed to support certain fat-related indicators in fracture risk prediction, but regional adiposity measures appear promising. Further studies in the field should help to elucidate whether interventions effective at attenuate, prevent, or ultimately reverse skeletal lean mass loss or fat accumulation, may prevent fractures.
authors.affiliation: Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Mélany
authors.initials: M
authors.lastname: Hars
authors.forename: Andrea
authors.initials: A
authors.lastname: Trombetti
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D001823:Body Composition; D015519:Bone Density; D006801:Humans; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D055948:Sarcopenia / Q000000981:diagnostic imaging / Q000453:epidemiology*