绝经后女性的体成分与年龄和绝经的关系及其对不同部位骨密度的影响

目的 调查绝经后女性的体成分与年龄、绝经年龄、绝经年限和腰椎、髋部BMD之间的关系.方法 用双能X线骨密度仪测量919例绝经后女性的体成分、正位腰椎和髋部BMD.结果 下身脂肪量、全身脂肪量和全身瘦组织量与年龄、绝经年龄和绝经年限都相关(P＜0.05～0.01),但只有绝经年限进入体成分的多元逐步回归方程,采用复合或三次回归模型拟合优度最佳.体成分随绝经年限的延长有下降趋势.绝经10年以上女性的下身脂肪量和全身瘦组织量显著减少,分别较绝经年限5年以内女性下降8.6%和3.1%.所有部位的体成分与所测区域的BMD 均呈正相关(P＜0.05～0.01),控制体重变量后,仅有全身脂肪量与腰椎BMD 呈正相关(P＜0.05),而全身瘦组织量与髋部BMD 呈正相关(P＜0.05).多元逐步回归分析发现体成分是影响腰椎和髋部BMD的一个重要因素,但对腰椎BMD影响最大的是全身脂肪量,而对髋部BMD影响最大的是全身瘦组织量.BMD 越低者,全身脂肪量和全身瘦组织量也越低,组间比较有显著性差异.结论 绝经后女性的体成分与年龄、绝经年龄、绝经年限和腰椎、髋部BMD相关,其中,绝经年限对体成分的影响最大,体成分组分对BMD的影响存在部位差异.     

2型糖尿病患者血清骨钙素与骨骼肌指数的相关性研究

目的 探讨2型糖尿病患者血清骨钙素(OC)水平与骨骼肌指数(SMI)的相关性。方法 选取2型糖尿病患者550例,收集一般资料、实验指标,使用双能X线吸收法(DXA)测量人体成分：四肢骨骼肌质量、骨密度和全身脂肪百分比。根据SMI分为SMI正常组、SMI减少组,分析SMI的影响因素。结果 SMI减少组的男性患者比例、吸烟史、饮酒史、合并骨质疏松症患者比例均高于SMI正常组,BMI、白蛋白、TG、PTH、腰椎BMD、股骨颈BMD、髋部BMD、SMI、全身脂肪百分比低于SMI正常组(P<0.05)。男性的SMI、腰椎BMD、股骨颈BMD、髋部BMD均高于女性,而OC、全身脂肪百分比均低于女性(P<0.01)。纳入年龄、性别、BMI、全身脂肪百分比、HbAlc、白蛋白、UA、25(OH)D等因素,OC与SMI呈正相关(P<0.01)。结论 2型糖尿病患者血清骨钙素水平和骨骼肌指数呈正相关。血清骨钙素水平可能影响骨骼肌质量,是骨骼肌指数的影响因素之一。     

成人无功能性垂体腺瘤患者术后垂体功能减退对骨密度和身体成分的影响

目的横断面调查成人无功能性垂体腺瘤(non-functional pituitary adenoma,NFPA)术后垂体功能减退患者骨密度(bone mineral density,BMD)及身体成分的改变,进一步分析BMD与身体成分的关系。方法收集2018年11月至2020年1月就诊于中南大学湘雅医院的成人NFPA术后垂体功能减退患者43例,并收集年龄、性别比、体质量指数(body mass index,BMI)匹配的健康对照组56例,测量所有研究对象BMI、腰围、腰臀比,采用双能X线骨密度仪(DEXA)评估腰椎及髋关节的BMD并分析骨骼肌质量及体脂含量。结果(1)垂体功能减退组腰椎L_1~4、股骨颈的BMD及Z值,全身总和骨矿含量均显著低于对照组(P<0.05)。(2)在男性,垂体功能减退患者的腰臀比、腰围身高比、躯干及全身脂肪百分比、脂肪指数显著高于对照组;在女性,垂体功能减退患者的腰围、腰臀比、躯干及全身脂肪百分比、A/G比率、躯干脂肪比/腿部脂肪比均显著高于对照组(P<0.05)。(3)Pearson相关性分析显示,四肢骨骼肌质量(ASM)、骨骼肌质量指数(SMI)与男性患者各部位的BMD呈显著正相关,躯干及全身脂肪百分比与女性患者髋部BMD呈显著负相关(P<0.05)。多元线性回归分析示,SMI是男性患者腰椎L_1~4 BMD、股骨颈BMD、全髋关节BMD、全身骨矿含量的独立保护因素(P<0.05)。结论(1)成人无功能性垂体腺瘤术后发生垂体功能减退的患者出现骨密度减低及腹部脂肪沉积的风险增加。(2)骨骼肌质量及体脂对骨密度有重要影响,SMI是男性垂体功能减退患者腰椎与髋部骨密度、全身骨矿含量的独立保护因素。     

人体脂肪组织对骨密度的影响

目的探讨人体脂肪对骨密度的影响。方法将160例采用双能X线骨密度吸收仪(dual-energy X-ray absorptiometry,DXA)进行骨密度和身体成分分析的患者作为研究对象,根据脂肪指数将女性和男性患者平分为高脂肪指数组和低脂肪指数组,比较两组的股骨颈、全髋和腰椎骨密度。结果 54例高脂肪指数组女性的脂肪指数为(10.0198±1.6811)kg/m~2,身体脂肪百分比为(36.71±3.06)%;54例低脂肪指数组女性的脂肪指数为(6.7167±1.0130)kg/m~2,身体脂肪百分比为(30.05±3.76)%。26例高脂肪指数组男性的脂肪指数为(6.9240±0.9090)kg/m~2,身体脂肪百分比为(25.72±3.17)%;26例低脂肪指数组男性的脂肪指数为(4.8085±0.7368)kg/m~2;身体脂肪百分比为(21.55±2.39)%。女性高脂肪指数组的股骨颈、全髋和腰椎骨密度均显著高于低脂肪指数组(P0.05);男性高脂肪指数组与低脂肪指数组的各部位骨密度差异无统计学意义(P0.05)。结论女性脂肪量对股骨颈、全髋和腰椎骨密度有正面影响。     

广州地区骨质疏松症合并髋部骨折骨密度阈值的研讨

目的 了解广州地区骨质疏松髋部骨折的骨密度阈值为预防髋部骨折提供有用的数据和措施。方法 调查和分析133例年龄在65岁以上，受伤后两周内入院治疗的男女性不同类型的髋部骨折患者的骨密度情况，分析及提出髋部骨折的骨密度阈值。结果 无论何种类型的股骨颈骨折男性的骨密度均比女性高，差异有显著性，虽然男性股骨颈骨折平均BMD≥-2.31SD；但其中73％病例有1个部位骨密度≤-2.5SD。女性股骨颈骨折和男，女性粗隆间骨折髋部骨量损失相近似，都明显低于男性股骨颈骨折。结论 股骨颈骨折的类型以及粗隆间骨折Garden分型与骨量无关；外伤后女性发生股骨颈骨折或粗隆间骨折与骨量无关。男性发生粗隆间骨折与骨量丢失更多有关。男女性骨质疏松髋部骨折都可以用骨密度减低2．5SD作为骨折的阈值。     

人体瘦组织对骨密度的影响

目的探讨人体瘦组织对骨密度的影响。方法将160例进行DXA(Dual-energy x-ray absorptiometry双能X线骨密度吸收仪)骨密度和身体成分分析的患者作为研究对象,根据瘦组织指数将女性和男性患者平分为高瘦组织指数组和低瘦组织指数组,比较二组的股骨颈、全髋和腰椎骨密度。结果 54例高瘦组织指数组女性瘦组织指数为16.9942±1.2634 kg/m~2,54例低瘦组织指数组女性瘦组织指数为14.2981±0.7956 kg/m~2;26例高瘦组织指数组男性瘦组织指数为19.5200±1.0863 kg/m~2,26例低瘦组织指数组男性瘦组织指数为16.0654±1.4077 kg/m~2。男女高瘦组织指数组的股骨颈、全髋和腰椎骨密度均显著高于低瘦组织指数组(P0.05)。结论高瘦组织指数女性和男性患者均具有较高的股骨颈、全髋和腰椎骨密度。     

女性骨质疏松性髋部骨折的骨密度和髋部结构强度变化

目的观察女性骨质疏松性髋部骨折的骨密度和髋部结构强度变化。方法对95例骨质疏松性髋部骨折女性患者进 行双能X线骨密度检测和髋关节结构分析,年龄：76. 60 ±9. 36岁,体重指数：20. 88 ±3. 72 kg/m2 ;将63例年龄>50岁骨密度 正常的女性作为对照组。对照组女性年龄57. 24 ±5. 65岁,体重指数：26. 56 ±4. 82 kg/m2,比较二组股骨颈骨密度和结构强 度参数(包括骨横截面积、皮质厚度和屈曲应力比）。结果髋部骨折患者的股骨颈骨密度、股骨颈和转子间的骨横截面积和 皮质厚度均非常显著低于对照组;屈曲应力比非常显著高于对照组,87. 4%髋部骨折患者的股骨颈和转子间屈曲应力比均> 10;而84. 1%正常骨密度组患者的股骨颈和转子间屈曲应力比均< 10。结论髋部骨折患者的股骨颈骨密度及髋关节结构 强度均发生非常显著改变,骨强度降低,HSA提供的结构强度参数有助于预测髋部骨折风险。     

DXA在糖耐量低减的老年男性脂肪含量测量中的应用

目的 探讨应用双能X线吸收法(DXA)进行人体脂肪含量测量的可行性,并研究糖耐量低减的老年男性患者中脂肪含量与骨密度的相关性.方法 选取171例糖耐量低减的老年男性行腰椎、股骨及全身的DXA检查,收集测量的骨密度、脂肪含量百分比、组织厚度及体重指数(BMI)等数据进行相关性统计分析.结果 腰椎骨密度与腹部脂肪含量(fat%腹部)呈正相关,相关系数r=0.263(P<0.001);股骨颈骨密度与臀部脂肪含量(fat%臀部)呈负相关,r=-0.284(P<0.001).fat%腹部、fat%臀部与BMI高度相关,r=0.561,0.377(P<0.001);腹部、臀部组织厚度与BMI高度相关,r分别为0.854,0.850(P<0.001).结论 DXA测量所得的脂肪含量百分比及组织厚度可作为肥胖检测的定量指标,更多应用于临床;脂肪成分对骨密度具有双重影响,其机制尚待进一步研究.     

北京南郊地区成年人桡骨远端骨密度及FRAX骨折风险评分与BMI的相关分析和探索研究

目的探讨北京南郊地区不同性别成年人非优势手臂桡骨远端骨密度及骨折风险预测工具FRAX计算出的全身骨折风险与身体质量指数(body mass index,BMI)及年龄之间的关系。方法回顾性分析2015年1月至2017年6月期间在我院接受双能X线骨密度检测(DEXA)的体检人群2 680名作为研究对象,其中男性944名,女性1 736名,收集相关临床指标,计算BMI值,检测受检者非优势手臂的桡骨远端骨密度,登录网站计算FRAX骨折风险评分。按年龄及BMI分组,采用方差分析的方法分别研究桡骨远端骨密度及FRAX骨折风险评分与BMI及年龄之间的关系。采用最小显著性差异法(least significant difference,LSD)分别比较BMI各组及各年龄组桡骨远端骨密度和FRAX骨折风险评分的组间差异。结果 (1)北京南郊地区成年人非优势手臂桡骨远端骨密度(bone mineral density,BMD)随年龄增高而降低,FRAX骨折风险评分即10年内发生全身骨质疏松性骨折的概率(probability of a major osteoporotic fracture,PMOF)随年龄增高而增高,差异均有统计学意义(P0.05),且各年龄组骨密度BMD值男性均高于女性,PMOF男性均低于女性,差异有统计学意义(P0.05)。(2)北京南郊地区成年人非优势手臂桡骨远端骨密度BMD随BMI的升高呈而增高,且差异有统计学意义(P0.05)。不论性别,PMOF在BMI为24~27.9(超重组)达高峰,正常体重组及肥胖组均低于超重组。(3)BMI各组中男性BMD值均高于女性,PMOF各BMI组中男性均低于女性,差异有统计学意义(P0.05)。结论桡骨远端骨密度BMD及PMOF与受检者性别、年龄、BMI均相关,其中同等年龄及BMI情况下,女性的骨折风险均高于男性;随着年龄增长,骨密度降低,骨折风险增加;随着BMI的增高,骨密度BMD逐渐增高,但此时骨折风险不随BMD的增高而降低,而表现为超重人群骨折风险最高,正常体重人群骨折风险最低,故超重亦是使骨折风险增加的危险因素。通过利用FRAX软件,测量桡骨远端骨密度的高低并充分考虑性别、年龄、BMI等因素可有效评估患者的骨折风险。     

老年女性髋部骨折与DXA骨强度参数的相关性研究

目的探讨髋部骨强度参数对老年女性髋部骨折的影响。方法对2014年10月-2017年2月至南京市中医院骨伤科就诊体检、年龄大于60岁的受试者进行双能X线测定,并收集受试者髋部骨折病史等临床资料进行回顾性分析。共纳入93名受试者,按骨折史分为髋部骨折组33人,胸腰椎骨折组32人,正常组28人,对骨密度、髋部几何参数及髋部力学参数进行统计学分析。结果股骨颈BMD(g/cm~2)、全髋BMD(g/cm2)、股骨颈皮质比率(%)、股骨颈最小宽度(mm)、d3(mm)、y(mm)等参数与老年女性髋部骨折具有显著相关性。结论本项研究基于双能X线测定法,发现部分髋部几何力学参数与老年女性髋部骨折相关,具有重要的临床指导意义,同时改变了单一的"低骨量—高骨折风险"预测模式,形成"骨密度+髋部几何力学分析"多元化模式,可有效提高老年女性髋部骨折风险的预测能力。     

Effects of lean and fat mass on bone mineral density and arterial stiffness in elderly men

Summary  The role of body composition on arterial stiffness and osteoporosis remains unclear, especially in the elderly male population. Our results indicate that elderly men with high lean mass and low fat mass exhibit the best arterial and bone profile with the lowest arterial stiffness and the highest bone mineral density. Introduction  The aim of this study was to evaluate the influence of fat and lean mass on both arterial stiffness and bone mass density (BMD) in elderly men. Methods  This study was performed in 169 French males over 60 years old. Aortic stiffness was assessed by carotid/femoral pulse wave velocity (PWV). BMD and body composition were determined with a dual-energy X-ray absorptiometry device in the lumbar spine L1–L4, femoral neck, and total body. Results  Lean mass was positively correlated with the three T scores accounting for 11.6%, 26.6%, and 12.2% of the variability in the lumbar spine L1–L4, femoral neck, and total body BMD T scores, respectively. Fat mass had no effect on BMD. However, fat mass was positively correlated with aortic PWV, accounting for 9.8% of its variability. Lean mass was not a determinant of PWV. Hypertension, diabetes, and dyslipidemia were associated with higher PWV but had no effect on BMD. Conclusions  In males from a general population over 60 years of age, bone and arterial aging are differently influenced by lean and fat mass. Our results indicate that elderly men with high lean mass and low fat mass exhibit the best arterial and bone profile with the lowest arterial stiffness and the highest BMD.     

Body composition and vertebral fracture risk in female patients treated with glucocorticoid

Introduction Glucocorticoid (GC) causes bone loss and an increase in bone fragility. However, fracture risk was found to be only partly explained by bone mineral density in GC-treated patients (GC patients). Although GC causes a change in the distribution of fat in the body, the relationship between body composition and fracture risk in GC patients remains unknown. Methods The present study examined the relationship between the presence or absence of vertebral fractures and various indices, including body composition, in 92 premenopausal GC patients, 122 postmenopausal GC patients and 122 postmenopausal age-matched control subjects. Dual-energy X-ray absorptiometry was employed to analyze body composition. Results Percentage lean body mass (LBM), % fat and % trunk fat were not significantly different between postmenopausal GC patients and the control women. When groups with and without vertebral fractures were compared, % LBM and % fat were significantly higher and lower in groups with vertebral fractures, respectively, in postmenopausal GC patients, but not in the postmenopausal control women, although % trunk fat was not significantly different between groups with and without vertebral fractures. Femoral neck BMD was negatively correlated with % LBM and positively correlated with % fat. In premenopausal GC patients, % trunk fat was significantly higher in the fracture group, although % LBM and % fat were not significantly different between groups with and without vertebral fractures. Conclusion The present study revealed that body composition is related to vertebral fracture risk in GC-treated patients. Lower % fat can be included in the determination of vertebral fractures in postmenopausal GC-treated patients. The influence of body composition on vertebral fracture risk may be different between the pre- and postmenopausal state in GC patients.     

Body composition and bone density reference data for Korean children,adolescents, and young adults according to age and sex: results of the 2009–2010 Korean National Health and Nutrition Examination Survey (KNHANES)

We established the timing of peak bone mass acquisition and body composition maturation and provide an age- and sex-specific body composition and bone density reference database using dual-energy X-ray absorptiometry in Korean subjects 10–25 years of age. Reference percentiles and curves were developed for bone mineral content (BMC), bone mineral density (BMD) of the whole body, the lumbar spine, and the femoral neck, and for fat mass (FM) and lean mass (LM) of 1969 healthy participants (982 males) who participated in the 2009–2010 Korean National Health and Nutrition Examination Survey. Additionally, bone mineral apparent density (BMAD), FM index, and LM index were calculated to adjust for body size. BMC and BMD at all skeletal sites as well as LM increased with age, reaching plateaus at 17–20 years of age in females and 20–23 years of age in males. The femoral neck was the first to reach a bone mass plateau, followed by the lumbar spine and then the whole body. Spine BMAD increased with age in both sexes, but femoral and whole-body BMAD remained the same over time. Females displayed a dramatic increase in FM during puberty, but the FM of males decreased until mid-puberty. These findings indicate that bone health and body composition should be monitored using a normal reference database until the late second to early third decade of life, when statural growth and somatic maturation are completed.     

中老年人群骨密度与人体测量指标及体成分相关性的研究

目的 了解北京市中老年人群骨密度和体成分检测情况,并探讨骨密度与人体测量指标及体成分之间的关系。方法 采用SPT(磷化存储高精度数字成像技术）骨密度分析仪（MetriScan）测定255例40岁以上中老年人的骨密度,利用体成分分析仪测定体脂肪、肌肉量等,并进行人体测量获得身高、体重、握力等数据。结果 (1)每10岁作为一个年龄段,共4个年龄段（70岁以上为1个年龄段）,随着年龄增加骨密度逐渐下降,尤其是女性60～69岁年龄段骨密度值与前一个年龄段测定值相比,差异有统计学意义,60岁以上同年龄段受试者的骨密度在不同性别之间差异有统计学意义(P<0.05),女性骨骼健康状况与男性相比明显较差;(2)骨密度与身高、体重、左右手握力、肌肉量、去脂体重、蛋白质和无机盐均呈正相关,而与体脂肪率呈显著负相关（P<0.01）。结论 身高、体重、左右手握力、体脂肪率、肌肉量、去脂体重、蛋白质和无机盐水平均与骨密度密切相关,也可以作为评价骨骼健康状况的间接参考指标,去脂体重和肌肉量是骨密度主要的决定因素。     

Loss of Bone Density and Lean Body Mass after Hip Fracture

Few studies of bone loss have assessed the amount of loss directly after a hip fracture. The present prospective study was conducted to determine changes in bone mineral density (BMD) and muscle mass shortly after fracture and through 1 year to assess short-term loss and related factors. The setting was two acute care teaching hospitals in Baltimore, Maryland, and subjects were 205 community-dwelling women with a new fracture of the proximal femur between 1992 and 1995. Bone density of the nonfractured hip and whole-body and body composition were measured by dual-energy X-ray absorptiometry at 3 and 10 days and 2, 6 and 12 months after admission. Mean BMD of the femoral neck was 0.546 ± 0.007 g/cm² at baseline. Average loss of femoral neck BMD from baseline was 2.1% at 2 months, 2.5% at 6 months and 4.6% at 12 months. The average loss of BMD in the intertrochanteric region was 2.1% at 12 months. Total lean body mass decreased by 6% while fat mass increased by 3.6% by 1 year after the fracture. These findings indicate that significant loss in BMD and lean body mass occur shortly after hip fracture while body fat increases. Continued loss was evident throughout the 1 year of follow-up. This loss of both bone density and muscle mass may lead to new fractures. Received: 1 February 1999 / Accepted: 20 May 1999     

Estimated Lean Mass and Fat Mass Differentially Affect Femoral Bone Density and Strength Index but Are Not FRAX Independent Risk Factors for Fracture

Although increasing body weight has been regarded as protective against osteoporosis and fractures, there is accumulating evidence that fat mass adversely affects skeletal health compared with lean mass. We examined skeletal health as a function of estimated total body lean and fat mass in 40,050 women and 3600 men age ≥50 years at the time of baseline dual‐energy X‐ray absorptiometry (DXA) testing from a clinical registry from Manitoba, Canada. Femoral neck bone mineral density (BMD), strength index (SI), cross‐sectional area (CSA), and cross‐sectional moment of inertia (CSMI) were derived from DXA. Multivariable models showed that increasing lean mass was associated with near‐linear increases in femoral BMD, CSA, and CSMI in both women and men, whereas increasing fat mass showed a small initial increase in these measurements followed by a plateau. In contrast, femoral SI was relatively unaffected by increasing lean mass but was associated with a continuous linear decline with increasing fat mass, which should predict higher fracture risk. During mean 5‐year follow‐up, incident major osteoporosis fractures and hip fractures were observed in 2505 women and 180 men (626 and 45 hip fractures, respectively). After adjustment for fracture risk assessment tool (FRAX) scores (with or without BMD), we found no evidence that lean mass, fat mass, or femoral SI affected prediction of major osteoporosis fractures or hip fractures. Findings were similar in men and women, without significant interactions with sex or obesity. In conclusion, skeletal adaptation to increasing lean mass was positively associated with BMD but had no effect on femoral SI, whereas increasing fat mass had no effect on BMD but adversely affected femoral SI. Greater fat mass was not independently associated with a greater risk of fractures over 5‐year follow‐up. FRAX robustly predicts fractures and was not affected by variations in body composition. © 2014 American Society for Bone and Mineral Research.     

北京市中老年女性月经及身体成分与骨密度的相关性研究

目的调查北京市中老年女性年龄、月经和身体成分特征,分析其与骨密度的关系以及对骨密度的影响。方法招募45～80岁女性384名,调查受试者月经状况,包括初潮年龄、绝经年龄和绝经年限;测试受试者腰椎、左股骨颈、左髋以及全身骨密度,并测试全身脂肪和肌肉含量,由此计算脂肪含量指数(fat mass index,FMI)、肌肉含量指数(lean mass index,LMI)和四肢骨骼质量指数(appendicular skeletal muscle mass index,ASMI)。采用Pearson相关和多元逐步回归模型分析各因素与骨密度的关系。结果相关性结果显示,年龄、绝经年限、初潮年龄与骨密度呈显著负相关,绝经年龄、LMI、FMI和ASMI与骨密度呈显著正相关。多元逐步回归分析结果显示,绝经年限与各部位骨密度均呈显著负相关,ASMI与各部位骨密度均呈显著正相关,FMI仅与全髋和全身骨密度具有显著相关性,初潮年龄和绝经年龄仅与腰椎和全身骨密度具有显著相关性。结论绝经年限是中老年女性骨密度的独立危险因素,而ASMI则为独立保护因素,绝经年龄、初潮年龄以及FMI对中老年女性骨密度的影响存在部位差异性。     

百色壮族中老年人骨密度和体成分的特点及其相关性分析

目的测量并探讨百色壮族中老年人群的骨密度、身体成分的特点以及随年龄变化的规律,为改善少数民族地区老龄人口健康状况提供科学依据。方法随机抽取620名(男性248名,女性372名)百色壮族健康中老年人作为研究对象。测量受试者的右足跟骨密度,以及身高、体重、和身体成分(身体质量指数、腰臀比、去脂体重、肌肉量、脂肪量、体脂肪率)。运用SPSS17.0软件进行统计学处理。结果百色壮族中老年骨密度与身高、体重、腰臀比、去脂体重、肌肉量均随年龄增长逐渐降低,而脂肪量、体脂肪率在各年龄组间之间无显著差异。同年龄组男性的骨密度和身高、体重、去脂体重、肌肉量均明显高于女性,而女性的脂肪量、体脂肪率则明显高于男性。结论百色壮族中老年人的骨密度与年龄呈负相关线性关系,与体重、身高、脂肪量、体脂肪率、去脂体重、肌肉量均呈正相关线性关系。     

Bone mass and body composition in normal women.

The interrelationships between measurements of bone mass and total-body bone mineral were examined in a cross-sectional study of normal healthy women aged 17-82 years. In addition we evaluated the relationship between measures of body composition, estimated by four independent techniques, and bone mass in the same population. Considering the group as a whole, bone mass at all sites correlated with each other and with total-body bone mineral (TBBM). Cancellous and cortical sites could predict TBBM equally well. As expected, all measurements of bone mass were significantly lower in postmenopausal women in comparison to premenopausal women. Declines in bone mass were only seen in premenopausal women in the femoral neck and Ward's triangle, not in lumbar spine, radius, or skeleton as a whole. In postmenopausal women bone mass correlated negatively with age and years from menopause equally at all sites. TBBM was significantly related to height and weight in both premenopausal and postmenopausal women. In premenopausal and postmenopausal women TBBM also correlated with fat mass, but TBBM was much better correlated with percentage body fat in premenopausal than postmenopausal women. TBBM was a constant proportion of lean body mass in premenopausal women, but the fraction of lean mass occupied by the skeleton declined with age in postmenopausal women. Correction of TBBM for lean mass did not change the relationship between TBBM and percentage fat in premenopausal women but eliminated the relationship in postmenopausal women. Regional measurements, which are at least partially corrected for body size by dividing mass by area, correlated less well with height and weight and with any index of obesity, especially in postmenopausal women.