Abstract
Summary
This study was aimed to evaluate the association between body composition and bone health. High lean mass and low fat mass have protective effects on bone health in men representative of the national population.
Introduction
The aim of this study was to evaluate the association between body composition (fat mass and lean mass) and bone health in men.
Methods
Totally, 3,945 men (age ≥20 years) from the fourth Korean National Health and Nutrition Examination Survey of 2008–2009 (KNHANES IV) were included in this study. Body composition and bone mineral densities (BMDs) were measured using dual energy X-ray absorptiometry. Osteopenia or osteoporosis was identified on the basis of the World Health Organization T-score criteria.
Results
Multiple linear regression analyses showed that BMDs of the whole body, femoral neck, and lumbar spine were positively associated with lean mass and negatively associated with fat mass, after controlling for body weight and other potential confounders. Subjects with more fat mass or less lean mass, categorized according to quartiles of fat mass and lean mass, had higher odds of having osteopenia or osteoporosis, as shown by multivariable logistic regression (P for trend <0.001).
Conclusions
High lean mass and low fat mass have protective effects on bone health in a population of Korean adult men. Fat mass appears to exert a detrimental effect on BMD, in contrast with the positive weight-bearing effect. Body composition seems to be a more important determinant for bone health than simple body weight.
Similar content being viewed by others
References
Edelstein SL, Barrett-Connor E (1993) Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 138:160–169
Hannan MT, Felson DT, Anderson JJ (1992) Bone mineral density in elderly men and women: results from the Framingham osteoporosis study. J Bone Miner Res 7:547–553
Hsu YH, Venners SA, Terwedow HA et al (2006) Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. Am J Clin Nutr 83:146–154
Beck TJ, Oreskovic TL, Stone KL, Ruff CB, Ensrud K, Nevitt MC, Genant HK, Cummings SR (2001) Structural adaptation to changing skeletal load in the progression toward hip fragility: the study of osteoporotic fractures. J Bone Miner Res 16:1108–1119
Lanyon L, Skerry T (2001) Postmenopausal osteoporosis as a failure of bone's adaptation to functional loading: a hypothesis. J Bone Miner Res 16:1937–1947
Guney E, Kisakol G, Ozgen G, Yilmaz C, Yilmaz R, Kabalak T (2003) Effect of weight loss on bone metabolism: comparison of vertical banded gastroplasty and medical intervention. Obes Surg 13:383–388
Radak TL (2004) Caloric restriction and calcium's effect on bone metabolism and body composition in overweight and obese premenopausal women. Nutr Rev 62:468–481
Wardlaw GM (1996) Putting body weight and osteoporosis into perspective. Am J Clin Nutr 63:433S–436S
Pluijm SM, Visser M, Smit JH, Popp-Snijders C, Roos JC, Lips P (2001) Determinants of bone mineral density in older men and women: body composition as mediator. J Bone Miner Res 16:2142–2151
Genaro PS, Pereira GA, Pinheiro MM, Szejnfeld VL, Martini LA (2010) Influence of body composition on bone mass in postmenopausal osteoporotic women. Arch Gerontol Geriatr 51:295–298
Taaffe DR, Cauley JA, Danielson M, Nevitt MC, Lang TF, Bauer DC, Harris TB (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the Health, Aging, and Body Composition Study. J Bone Miner Res 16:1343–1352
Reid IR, Plank LD, Evans MC (1992) Fat mass is an important determinant of whole body bone density in premenopausal women but not in men. J Clin Endocrinol Metab 75:779–782
Wang MC, Bachrach LK, Van Loan M, Hudes M, Flegal KM, Crawford PB (2005) The relative contributions of lean tissue mass and fat mass to bone density in young women. Bone 37:474–481
MacInnis RJ, Cassar C, Nowson CA, Paton LM, Flicker L, Hopper JL, Larkins RG, Wark JD (2003) Determinants of bone density in 30- to 65-year-old women: a co-twin study. J Bone Miner Res 18:1650–1656
Zhao LJ, Liu YJ, Liu PY, Hamilton J, Recker RR, Deng HW (2007) Relationship of obesity with osteoporosis. J Clin Endocrinol Metab 92:1640–1646
Park JH, Song YM, Sung J, Lee K, Kim YS, Kim T, Cho SI (2012) The association between fat and lean mass and bone mineral density: the Healthy Twin Study. Bone 50:1006–1011
Yu Z, Zhu Z, Tang T, Dai K, Qiu S (2009) Effect of body fat stores on total and regional bone mineral density in perimenopausal Chinese women. J Bone Miner Metab 27:341–346
Verschueren S, Gielen E, O'Neill TW et al (2013) Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men. Osteoporos Int 24:87–98
Coin A, Perissinotto E, Enzi G, Zamboni M, Inelmen EM, Frigo AC, Manzato E, Busetto L, Buja A, Sergi G (2008) Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia. Eur J Clin Nutr 62:802–809
Szulc P, Beck TJ, Marchand F, Delmas PD (2005) Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study. J Bone Miner Res 20:721–729
Taes YE, Lapauw B, Vanbillemont G, Bogaert V, De Bacquer D, Zmierczak H, Goemaere S, Kaufman JM (2009) Fat mass is negatively associated with cortical bone size in young healthy male siblings. J Clin Endocrinol Metab 94:2325–2331
Kim JH, Choi HJ, Kim MJ, Shin CS, Cho NH (2012) Fat mass is negatively associated with bone mineral content in Koreans. Osteoporos Int 23:2009–2016
Lim JS, Kim KM, Rhee Y, Lim SK (2012) Gender-dependent skeletal effects of vitamin D deficiency in a younger generation. J Clin Endocrinol Metab 97:1995–2004
Min Young C (2012) Validity and reliability of Korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med 33:144–151
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419
Orimo H, Hayashi Y, Fukunaga M et al (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337
Kim KH, Lee K, Ko YJ, Kim SJ, Oh SI, Durrance DY, Yoo D, Park SM (2012) Prevalence, awareness, and treatment of osteoporosis among Korean women: the Fourth Korea National Health and Nutrition Examination Survey. Bone 50:1039–1047
Association for the Study of Obesity and the International Obesity Task Force, World Health Organization (Western Pacific Region) (2000) The Asian-Pacific perspective: redefining obesity and its treatment. Health Communications Australia Pty Limited, Sydney
Hair JF Jr, Anderson RE, Tatham RL, Black WC (1995) Multivariate data analysis, 3rd edn. Macmillan, New York
Kutner MH, Nachtsheim CJ, Neter J (2004) Applied Linear Regression Models, 4th edn. McGraw-Hill/Irwin, New York
Sheng Z, Xu K, Ou Y et al (2011) Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. Clin Endocrinol (Oxf) 74:319–324
Seeman E, Hopper JL, Young NR, Formica C, Goss P, Tsalamandris C (1996) Do genetic factors explain associations between muscle strength, lean mass, and bone density? A twin study. Am J Physiol 270:E320–E327
Lang TF (2011) The bone-muscle relationship in men and women. J Osteoporos 2011:702735
Tanaka K, Matsumoto E, Higashimaki Y, Katagiri T, Sugimoto T, Seino S, Kaji H (2012) Role of osteoglycin in the linkage between muscle and bone. J Biol Chem 287:11616–11628
Reid IR (2010) Fat and bone. Arch Biochem Biophys 503:20–27
Pfeilschifter J, Koditz R, Pfohl M, Schatz H (2002) Changes in proinflammatory cytokine activity after menopause. Endocr Rev 23:90–119
Cao JJ (2011) Effects of obesity on bone metabolism. J Orthop Surg Res 6:30
Rosen CJ, Bouxsein ML (2006) Mechanisms of disease: is osteoporosis the obesity of bone? Nat Clin Pract Rheumatol 2:35–43
Kawai M, Devlin MJ, Rosen CJ (2009) Fat targets for skeletal health. Nat Rev Rheumatol 5:365–372
de Paula FJ, Horowitz MC, Rosen CJ (2010) Novel insights into the relationship between diabetes and osteoporosis. Diabetes Metab Res Rev 26:622–630
Conflicts of interest
None
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
ESM 1
(DOC 306 kb)
Rights and permissions
About this article
Cite this article
Shin, D., Kim, S., Kim, K.H. et al. Importance of fat mass and lean mass on bone health in men: the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Osteoporos Int 25, 467–474 (2014). https://doi.org/10.1007/s00198-013-2412-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-013-2412-8