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Relationship between body composition and bone mass in women
S Khosla1, E J Atkinson, B L Riggs
1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Summary
Lean body mass (LBM) and fat body mass (FBM) both influence bone mineral content (BMC). However, adjusting BMC for body size can obscure LBM
Area of Science:
- Bone Densitometry
- Body Composition Analysis
- Skeletal Health Research
Background:
- Increasing body weight is linked to higher bone mass and reduced bone loss.
- The specific roles of lean body mass (LBM) and fat body mass (FBM) in mediating these effects are unclear due to conflicting study conclusions.
- Discrepancies arise from varied measurements of bone mass, particularly the use of corrected parameters like bone mineral density (BMD) which may bias results.
Purpose of the Study:
- To clarify the independent contributions of LBM and FBM to bone mineral content (BMC) across different skeletal sites.
- To investigate how different bone mass parameters (BMC, BMD, BMAD, BMD/height) influence the observed relationships between body composition and bone.
- To resolve contradictory findings regarding the impact of body composition on skeletal mass.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to measure BMC at total body, lumbar spine, proximal femur, and forearm in 138 premenopausal and 213 postmenopausal women.
- LBM and FBM were determined from whole-body DXA scans.
- Multivariate analyses, controlling for age and height, assessed the predictive power of LBM and FBM on BMC, and also examined corrected bone mass parameters (BMD, BMAD, BMD/height).
Main Results:
- Both LBM and FBM significantly predicted total body BMC in both premenopausal and postmenopausal women.
- LBM was a dominant predictor of spine and forearm BMC, and hip BMC in premenopausal women.
- When BMC was adjusted for bone or body size (using BMD, BMAD, or BMD/height), FBM appeared more important, partly because these correction factors are highly correlated with LBM.
Conclusions:
- The relationship between body composition and bone mass is highly dependent on the specific bone mass parameter used in the analysis.
- Both LBM and FBM play significant roles in determining bone mass.
- The relative importance of LBM versus FBM is influenced by the skeletal site measured and menopausal status, and can be obscured by size-correction methods.