The interaction of body fat percentage and height with appendicular BMC for LBM was analyzed. Only body fat had significant negative correlation with the appendicular BMC for LBM.
For the clinical evaluation of the functional muscle-bone unit, it was proposed to evaluate the adaptation of the bone to the acting forces. A frequently used parameter for this is the total body less head bone mineral content (TBLH-BMC) determined by dual-energy X-ray absorptiometry (DXA) in relation to the total body lean body mass (LBM). Body fat percentage seemed to correlate negatively and height positively with TBLH-BMC for LBM. It was supposed that appendicular BMC for LBM is a more accurate surrogate for the functional muscle-bone unit since appendicular LBM does not incorporate the mass of internal organs. The aim of this study was to analyze the interaction of body fat percentage and height with appendicular BMC for LBM.
As part of the National Health and Nutrition Examination Survey (NHANES) study, between the years 1999 and 2004, whole-body DXA scans on randomly selected Americans from 8 years of age were carried out. From all eligible DXA scans, three major US ethnic groups were evaluated (non-Hispanic Whites, non-Hispanic Blacks, and Mexican Americans) for further statistical analysis.
For the statistical analysis, the DXA scans of 8190 non-Hispanic White children and adults (3903 female), of 4931 non-Hispanic Black children and adults (2250 female), and 5421 of Mexican American children and adults (2424 female) were eligible. Only body fat had a significant negative correlation with the appendicular BMC for LBM.
Only body fat had significant negative correlation with appendicular BMC for LBM, and thus, should be addressed when evaluating functional muscle-bone unit.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Bone mineral content
Centers for Disease Control and Prevention
Dual-energy X-ray absorptiometry
Functional muscle-bone unit
Lean body mass
Locally weighted scatterplot smoothing
National Health and Nutrition Examination Survey
Total body less head
Bikle DD, Tahimic C, Chang W, Wang Y, Philippou A, Barton ER (2015) Role of IGF-I signaling in muscle bone interactions. Bone 80:79–88. https://doi.org/10.1016/j.bone.2015.04.036
Carson JA, Manolagas SC (2015) Effects of sex steroids on bones and muscles: similarities, parallels, and putative interactions in health and disease. Bone 80:67–78. https://doi.org/10.1016/j.bone.2015.04.015
Sartori R, Sandri M (2015) BMPs and the muscle-bone connection. Bone 80:37–42. https://doi.org/10.1016/j.bone.2015.05.023
Houweling P, Kulkarni RN, Baldock PA (2015) Neuronal control of bone and muscle. Bone 80:95–100. https://doi.org/10.1016/j.bone.2015.05.006
Wolff J (2010) Das Gesetz der transformation der Knochen, 1. Aufl. Pro Business, Berlin
Frost HM (2003) Bone’s mechanostat: a 2003 update. Anat Rec A Discov Mol Cell Evol Biol 275(2):1081–1101. https://doi.org/10.1002/ar.a.10119
Schönau E, Werhahn E, Schiedermaier U et al (1996) Influence of muscle strength on bone strength during childhood and adolescence. Horm Res 45(Suppl 1):63–66
Goodman CA, Hornberger TA, Robling AG (2015) Bone and skeletal muscle: key players in mechanotransduction and potential overlapping mechanisms. Bone 80:24–36. https://doi.org/10.1016/j.bone.2015.04.014
Crabtree NJ, Högler W, Cooper MS, Shaw NJ (2013) Diagnostic evaluation of bone densitometric size adjustment techniques in children with and without low trauma fractures. Osteoporos Int 24(7):2015–2024. https://doi.org/10.1007/s00198-012-2263-8
Heymsfield SB, Smith R, Aulet M, Bensen B, Lichtman S, Wang J, Pierson RN Jr (1990) Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am J Clin Nutr 52(2):214–218
Duran I, Martakis K, Hamacher S, Stark C, Semler O, Schoenau E (2018) Are there effects of age, gender, height, and body fat on the functional muscle-bone unit in children and adults? Osteoporos Int 29(5):1069–1079. https://doi.org/10.1007/s00198-018-4401-4
Kim J, Wang Z, Heymsfield SB, Baumgartner RN, Gallagher D (2002) Total-body skeletal muscle mass: estimation by a new dual-energy X-ray absorptiometry method. Am J Clin Nutr 76(2):378–383. https://doi.org/10.1093/ajcn/76.2.378
Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147(8):755–763
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M, European Working Group on Sarcopenia in Older People (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39(4):412–423. https://doi.org/10.1093/ageing/afq034
Schoenau E, Neu CM, Beck B, Manz F, Rauch F (2002) Bone mineral content per muscle cross-sectional area as an index of the functional muscle-bone unit. J Bone Miner Res 17(6):1095–1101. https://doi.org/10.1359/jbmr.2002.17.6.1095
Ashby RL, Adams JE, Roberts SA, Mughal MZ, Ward KA (2011) The muscle-bone unit of peripheral and central skeletal sites in children and young adults. Osteoporos Int 22(1):121–132. https://doi.org/10.1007/s00198-010-1216-3
Choukair D, Kneppo C, Feneberg R, Schönau E, Lindner M, Kölker S, Hoffmann GF, Tönshoff B (2017) Analysis of the functional muscle-bone unit of the forearm in patients with phenylketonuria by peripheral quantitative computed tomography. J Inherit Metab Dis 40(2):219–226. https://doi.org/10.1007/s10545-016-0002-6
CDC National Health and Nutrition Examination Survey. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed 30 Jan 2019
Curtin LR, Mohadjer LK, Dohrmann SM et al (2012) The National Health and Nutrition examination survey: sample design, 1999-2006. Vital Health Stat 2(155):1–39
Crabtree NJ, Arabi A, Bachrach LK, Fewtrell M, el-Hajj Fuleihan G, Kecskemethy HH, Jaworski M, Gordon CM (2014) Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom 17(2):225–242. https://doi.org/10.1016/j.jocd.2014.01.003
Schoeller DA, Tylavsky FA, Baer DJ, Chumlea WC, Earthman CP, Fuerst T, Harris TB, Heymsfield SB, Horlick M, Lohman TG, Lukaski HC, Shepherd J, Siervogel RM, Borrud LG (2005) QDR 4500A dual-energy X-ray absorptiometer underestimates fat mass in comparison with criterion methods in adults. Am J Clin Nutr 81(5):1018–1025
Kuczmarski RJ (2002) 2000 CDC growth charts for the United States: methods and development. Vital and health statistics. Series 11, data from the National Health Survey, no. 246. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Md
Cole TJ, Green PJ (1992) Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 11(10):1305–1319
Royston P, Wright EM (2000) Goodness-of-fit statistics for age-specific reference intervals. Stat Med 19(21):2943–2962. https://doi.org/10.1002/1097-0258(20001115)19:21<2943:AID-SIM559>3.0.CO;2-5
van Buuren S, Fredriks M (2001) Worm plot: a simple diagnostic device for modelling growth reference curves. Stat Med 20(8):1259–1277. https://doi.org/10.1002/sim.746
Rigby RA, Stasinopoulos DM (2005) Generalized additive models for location, scale and shape (with discussion). J Royal Statistical Soc C 54(3):507–554. https://doi.org/10.1111/j.1467-9876.2005.00510.x
Ferretti JL, Capozza RF, Cointry GR, García SL, Plotkin H, Alvarez Filgueira ML, Zanchetta JR (1998) Gender-related differences in the relationship between densitometric values of whole-body bone mineral content and lean body mass in humans between 2 and 87 years of age. Bone 22(6):683–690. https://doi.org/10.1016/S8756-3282(98)00046-5
Cure-Cure C, Capozza RF, Cointry GR, Meta M, Cure-Ramírez P, Ferretti JL (2005) Reference charts for the relationships between dual-energy X-ray absorptiometry-assessed bone mineral content and lean mass in 3,063 healthy men and premenopausal and postmenopausal women. Osteoporos Int 16(12):2095–2106. https://doi.org/10.1007/s00198-005-2007-0
Capozza RF, Cointry GR, Cure-Ramírez P et al (2004) A DXA study of muscle-bone relationships in the whole body and limbs of 2512 normal men and pre- and post-menopausal women. Bone 35(1):283–295. https://doi.org/10.1016/j.bone.2004.03.010
Schiessl H, Frost HM, Jee WSS (1998) Estrogen and bone-muscle strength and mass relationships. Bone 22(1):1–6. https://doi.org/10.1016/S8756-3282(97)00223-8
Galea GL, Price JS, Lanyon LE (2013) Estrogen receptors’ roles in the control of mechanically adaptive bone (re)modeling. Bonekey Rep 2:413. https://doi.org/10.1038/bonekey.2013.147
Mueller SM, Herter-Aeberli I, Cepeda-Lopez AC, Flück M, Jung HH, Toigo M (2017) The effect of body composition and serum inflammatory markers on the functional muscle-bone unit in premenopausal women. Int J Obes 41(8):1203–1206. https://doi.org/10.1038/ijo.2017.100
Kawai M, de Paula FJA, Rosen CJ (2012) New insights into osteoporosis: the bone-fat connection. J Intern Med 272(4):317–329. https://doi.org/10.1111/j.1365-2796.2012.02564.x
Reid IR (2008) Relationships between fat and bone. Osteoporos Int 19(5):595–606. https://doi.org/10.1007/s00198-007-0492-z
Hetherington-Rauth M, Bea JW, Blew RM, Funk JL, Hingle MD, Lee VR, Roe DJ, Wheeler MD, Lohman TG, Going SB (2018) Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls. Bone 113:144–150. https://doi.org/10.1016/j.bone.2018.05.023
Gibbs JC, Giangregorio LM, Wong AKO, Josse RG, Cheung AM (2017) Appendicular and whole body lean mass outcomes are associated with finite element analysis-derived bone strength at the distal radius and tibia in adults aged 40years and older. Bone 103:47–54. https://doi.org/10.1016/j.bone.2017.06.006
Aloia JF, Vaswani A, Ma R, Flaster E (1995) To what extent is bone mass determined by fat-free or fat mass? Am J Clin Nutr 61(5):1110–1114
Ho-Pham LT, Nguyen UDT, Nguyen TV (2014) Association between lean mass, fat mass, and bone mineral density: a meta-analysis. J Clin Endocrinol Metab 99(1):30–38. https://doi.org/10.1210/jc.2014-v99i12-30A
Winther A, Jørgensen L, Ahmed LA, Christoffersen T, Furberg AS, Grimnes G, Jorde R, Nilsen OA, Dennison E, Emaus N (2018) Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromsø Study, Fit Futures. BMC Musculoskelet Disord 19(1):21. https://doi.org/10.1186/s12891-018-1933-x
Hannam K, Deere KC, Hartley A, al-Sari UA, Clark EM, Fraser WD, Tobias JH (2016) Habitual levels of higher, but not medium or low, impact physical activity are positively related to lower limb bone strength in older women: findings from a population-based study using accelerometers to classify impact magnitude. Osteoporos Int 28:2813–2822. https://doi.org/10.1007/s00198-016-3863-5
Bjørnerem Å, Bui QM, Ghasem-Zadeh A, Hopper JL, Zebaze R, Seeman E (2013) Fracture risk and height: an association partly accounted for by cortical porosity of relatively thinner cortices. J Bone Miner Res 28(9):2017–2026. https://doi.org/10.1002/jbmr.1934
Heaney RP (1995) Bone mass, the mechanostat, and ethnic differences. J Clin Endocrinol Metab 80(8):2289–2290. https://doi.org/10.1210/jcem.80.8.7629221
Fricke O, Schoenau E (2007) The ‘Functional muscle-bone Unit’: probing the relevance of mechanical signals for bone development in children and adolescents. Growth Hormon IGF Res 17(1):1–9. https://doi.org/10.1016/j.ghir.2006.10.004
Duran I, Schütz F, Hamacher S, Semler O, Stark C, Schulze J, Rittweger J, Schoenau E (2017) The functional muscle-bone unit in children with cerebral palsy. Osteoporos Int 28(7):2081–2093. https://doi.org/10.1007/s00198-017-4023-2
Shepherd JA, Lu Y, Wilson K, Fuerst T, Genant H, Hangartner TN, Wilson C, Hans D, Leib ES, International Society for Clinical Densitometry Committee on Standards of Bone Measurement (2006) Cross-calibration and minimum precision standards for dual-energy X-ray absorptiometry: the 2005 ISCD official positions. J Clin Densitom 9(1):31–36. https://doi.org/10.1016/j.jocd.2006.05.005
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Duran, I., Martakis, K., Bossier, C. et al. Interaction of body fat percentage and height with appendicular functional muscle-bone unit. Arch Osteoporos 14, 65 (2019). https://doi.org/10.1007/s11657-019-0610-5
- Appendicular functional muscle-bone unit
- Bone mineral content
- Body fat percentage