Abstract
Objectives
To study the independent association of fat mass (FM) and lean mass (LM) with bone
mass and to study the differences in bone mass by weight and fat status in 223 seniors
(aged 65–89 years) from the city of Zaragoza (Spain), after controlling for age, height,
physical activity (PA) and LM.
Study design
Cross-sectional study.
Main outcome measures
LM, FM, bone mineral content (BMC) and density (BMD) were measured with dual energy
X-ray absortiometry. The relationships of FM and LM with bone-related variables (subtotal
body, hip, femoral neck and lumbar spine) were analyzed by linear regression and differences
between weight and fat status were analyzed by one-way analysis of covariance.
Results
In men, there were no significant associations between FM and BMC or BMD. In women
FM was positively associated with bone-related variables after adjustment for age,
height and PA, whereas adjustment for LM removed all these significant associations.
Overweight/obese elderly women had higher BMC and BMD than their non-overweight peers
in all regions studied. Additional adjustment for PA did not change the differences
between weight status groups, while adjusting for LM removed some of the associations.
Overfat/obese men and women did not show higher levels of bone mass than their non-overfat
peers. LM was positively associated with bone variables in both sexes. Additional
adjustment for PA and FM did not alter the results.
Conclusion
The association between fat mass and bone mass of elderly women is mediated by the
independent association between lean mass and bone mass.
Abbreviations:
LM (lean mass), FM (fat mass), BMC (bone mineral content), BMD (bone mineral density), BMI (body mass index), PA (physical activity), DXA (dual energy X-ray absortiometry)Keywords
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References
- Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis.Am J Med. 1993; 94: 646-650
- The worldwide problem of osteoporosis: insights afforded by epidemiology.Bone. 1995; 17: 505S-511S
- Mortality after all major types of osteoporotic fracture in men and women: an observational study.Lancet. 1999; 353: 878-882
- Eight genes are highly associated with BMD variation in postmenopausal Caucasian women.Bone. 2010; 46: 604-612
- Factors associated with 5-year risk of hip fracture in postmenopausal women.JAMA. 2007; 298: 2389-2398
- Modifiable predictors of bone loss in older men: a prospective study.Am J Prev Med. 2004; 26: 436-442
- Influence of muscle strength, physical activity and weight on bone mass in a population-based sample of 1004 elderly women.Osteoporos Int. 2003; 14: 768-772
- Impact of lean mass and fat mass on bone mineral density: the Hordaland Health Study.Maturitas. 2008; 59: 191-200
- Fat or lean tissue mass: which one is the major determinant of bone mineral mass in healthy postmenopausal women?.J Bone Miner Res. 1997; 12: 144-151
- Relationship of obesity with osteoporosis.J Clin Endocrinol Metab. 2007; 92: 1640-1646
- Effects of lean and fat mass on bone mineral density and arterial stiffness in elderly men.Osteoporos Int. 2009; 20: 1385-1391
- Muscle mass is more strongly related to hip bone mineral density than is quadriceps strength or lower activity level in adults over age 50 year.J Clin Densitom. 2008; 11: 503-510
- Muscular development and physical activity as major determinants of femoral bone mass acquisition during growth.Br J Sports Med. 2005; 39: 611-616
- Adiposity and bone health in Spanish adolescents. The HELENA study.Osteoporos Int. 2012; 23: 937-947
- Relationship between body composition and bone mineral content in young and elderly women.Ann Hum Biol. 2002; 29: 559-565
- Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group.J Bone Miner Res. 1999; 14: 1622-1627
- Longitudinal change in the heights of men and women: consequential effects on body mass index.Epidemiol Rev. 1999; 21: 247-260
- Prevalence of overweight and obesity in non-institutionalized people aged 65 or over from Spain: the elderly EXERNET multi-centre study.Obes Rev. 2011; 42: 301-325
- Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index.Am J Clin Nutr. 2000; 72: 694-701
World Health Organization. Expert Committee on Physical Status: The use and interpretation of anthropometric physical status; 2005.
World Health Organization. Assessment of osteoporosis at the primary health care level; 2007.
- Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass.J Bone Miner Metab. 2007; 25: 326-332
- Postmenopausal bone mineral density: relationship to calcium intake, calcium absorption, residual estrogen, body composition, and physical activity.Canadian Journal of Physiology and Pharmacology. 1996; 74: 911-917
- Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis.J Bone Miner Res. 2008; 23: 17-29
- Relationship between body composition and bone mass in women.J Bone Miner Res. 1996; 11: 857-863
- The role of serum concentrations of sex steroids and bone turnover in the development and occurrence of postmenopausal osteoporosis.Calcif Tissue Int. 1986; 38: 318-322
- Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study.Int J Obes (Lond). 2009; 33: 885-892
- The relationship between body composition and bone mineral content: threshold effects in a racially and ethnically diverse group of men.Osteoporos Int. 2008; 19: 29-38
- Obesity in the elderly.Obes Res. 2001; 9: 244S-248S
- Reducing falls and resulting hip fractures among older women.MMWR Recomm Rep. 2000; 49: 3-12
- Effect of protein intake on bone and muscle mass in the elderly.Nutr Rev. 2010; 68: 616-623
Article info
Publication history
Published online: October 16, 2012
Accepted:
September 18,
2012
Received in revised form:
September 6,
2012
Received:
April 24,
2012
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
