Associations between body mass index,lean and fat body mass and bone mineral density in middle-aged Australians: The Busselton Healthy Ageing Study |
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| Affiliation: | 1. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;2. School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia;3. Busselton Population Medical Research Institute, Busselton, Western Australia, Australia;4. School of Population Health, University of Western Australia, Crawley, Western Australia, Australia;5. Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;6. Department of Clinical Biochemistry, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia;1. Department of Rehabilitation, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province 110001, PR China;2. Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, IN 46202, USA;3. Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Harbin Medical University, Daqing, Heilongjiang Province 163316, PR China;1. Internal Medicine, Hospital of Piombino, Livorno, Italy;2. FADOI Foundation, Research Department, Milan, Italy;3. Department of Locomotor System, Division of Rheumatology, ASL3-Azienda Sanitaria Genovese, Genoa, Italy;4. Section of Osteoporosis and Musculoskeletal Diseases, Department of Radiological, Oncological and Anatomical–Pathological Sciences, University “La Sapienza”, Rome, Italy;5. Rheumatology, “G. Pini” Institute, Milan, Italy;6. Department of Medical, Surgical and Neurological Sciences, University of Siena, Italy;7. Internal Medicine, Hospital of Ceva, Cuneo, Italy;8. Internal Medicine, Hospital Pugliese-Ciaccio, Catanzaro, Italy;9. Internal Medicine, Azienda Ospedaliero-Universitaria “S. Anna”, Ferrara, Italy;10. QBGroup SpA, Padova, Italy;11. Department of Internal Medicine I, Arcispedale S. Maria Nuova, Reggio Emilia, Italy;12. Medical Department, “Civile” Hospital, Legnano, Italy;13. Department of Internal Medicine, Hospital “Maggiore della Carità”, Novara, Italy;1. Department of Orthodontics, Field of Developmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan;2. Department of Oral Biochemistry, Field of Developmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan;1. MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK;2. MRC International Nutrition Group at London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT UK and MRC Unit, The Gambia;3. MRC Keneba, Keneba, The Gambia |
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| Abstract: | Low BMI is a risk factor for osteoporosis, but it is not clear if relationships between BMI, lean mass (LM), fat mass (FM) and BMD are consistent across different levels of BMI. We studied 1929 Caucasian participants (1014 females) aged 45–66 years in the Busselton Healthy Ageing Study in Western Australia. Body composition and BMD of total body, lumbar spine, total hip and femoral neck were measured using DXA. From generalized additive models, the positive relationships between BMI and BMD were weaker at high BMI, particularly at the spine and in males. In the entire cohort, adjusting for relevant covariates, LM and FM were significant predictors of all BMD measures in both genders. In men, analysis by tertiles of BMI showed that LM and FM (in kg) were positively associated with BMD (in mg/cm2) in tertile 1 except for LM and spine BMD (LM β: 5.18–6.80, FM β: 3.38–9.24, all P < 0.05), but not in the middle or upper tertiles (LM β: − 3.12–3.07, FM β: − 4.75–1.82, P > 0.05). In women, LM was positively associated with BMD in each tertile of BMI, except for spine BMD in the upper tertile, with regression coefficients lower in the upper tertile (β: 5.16–9.95, 5.76–9.56 and 2.80–5.78, respectively, all P < 0.05). FM was positively associated with total body, spine and total hip BMD in women in BMI tertile 1 (β: 2.86–6.68, P < 0.05); these associations were weaker or absent in the middle and upper tertiles. In conclusion, in middle-aged adults the positive relationships between lean or fat mass with BMD among those with higher BMI are absent in males and weaker in females. |
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