Advertisement

Osteoporosis International

, Volume 25, Issue 2, pp 467–474 | Cite as

Importance of fat mass and lean mass on bone health in men: the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV)

  • D. Shin
  • S. Kim
  • K. H. Kim
  • S. M. ParkEmail author
Original Article

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.

Keywords

Body composition Bone health Bone mineral density Fat mass Lean mass Osteoporosis 

Notes

Conflicts of interest

None

Supplementary material

198_2013_2412_MOESM1_ESM.doc (308 kb)
ESM 1 (DOC 306 kb)

References

  1. 1.
    Edelstein SL, Barrett-Connor E (1993) Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 138:160–169PubMedGoogle Scholar
  2. 2.
    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 7:547–553PubMedCrossRefGoogle Scholar
  3. 3.
    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 83:146–154PubMedGoogle Scholar
  4. 4.
    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 16:1108–1119PubMedCrossRefGoogle Scholar
  5. 5.
    Lanyon L, Skerry T (2001) Postmenopausal osteoporosis as a failure of bone's adaptation to functional loading: a hypothesis. J Bone Miner Res 16:1937–1947PubMedCrossRefGoogle Scholar
  6. 6.
    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 13:383–388PubMedCrossRefGoogle Scholar
  7. 7.
    Radak TL (2004) Caloric restriction and calcium's effect on bone metabolism and body composition in overweight and obese premenopausal women. Nutr Rev 62:468–481PubMedCrossRefGoogle Scholar
  8. 8.
    Wardlaw GM (1996) Putting body weight and osteoporosis into perspective. Am J Clin Nutr 63:433S–436SPubMedGoogle Scholar
  9. 9.
    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 16:2142–2151PubMedCrossRefGoogle Scholar
  10. 10.
    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 51:295–298PubMedCrossRefGoogle Scholar
  11. 11.
    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 16:1343–1352PubMedCrossRefGoogle Scholar
  12. 12.
    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 75:779–782PubMedGoogle Scholar
  13. 13.
    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 37:474–481PubMedCrossRefGoogle Scholar
  14. 14.
    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 18:1650–1656PubMedCrossRefGoogle Scholar
  15. 15.
    Zhao LJ, Liu YJ, Liu PY, Hamilton J, Recker RR, Deng HW (2007) Relationship of obesity with osteoporosis. J Clin Endocrinol Metab 92:1640–1646PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    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 50:1006–1011PubMedCrossRefGoogle Scholar
  17. 17.
    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 27:341–346PubMedCrossRefGoogle Scholar
  18. 18.
    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 24:87–98PubMedCrossRefGoogle Scholar
  19. 19.
    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 62:802–809PubMedCrossRefGoogle Scholar
  20. 20.
    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 20:721–729PubMedCrossRefGoogle Scholar
  21. 21.
    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 94:2325–2331PubMedCrossRefGoogle Scholar
  22. 22.
    Kim JH, Choi HJ, Kim MJ, Shin CS, Cho NH (2012) Fat mass is negatively associated with bone mineral content in Koreans. Osteoporos Int 23:2009–2016PubMedCrossRefGoogle Scholar
  23. 23.
    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 97:1995–2004PubMedCrossRefGoogle Scholar
  24. 24.
    Min Young C (2012) Validity and reliability of Korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med 33:144–151CrossRefGoogle Scholar
  25. 25.
    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 28:412–419PubMedCrossRefGoogle Scholar
  26. 26.
    Orimo H, Hayashi Y, Fukunaga M et al (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337PubMedCrossRefGoogle Scholar
  27. 27.
    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 50:1039–1047PubMedCrossRefGoogle Scholar
  28. 28.
    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, SydneyGoogle Scholar
  29. 29.
    Hair JF Jr, Anderson RE, Tatham RL, Black WC (1995) Multivariate data analysis, 3rd edn. Macmillan, New YorkGoogle Scholar
  30. 30.
    Kutner MH, Nachtsheim CJ, Neter J (2004) Applied Linear Regression Models, 4th edn. McGraw-Hill/Irwin, New YorkGoogle Scholar
  31. 31.
    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) 74:319–324CrossRefGoogle Scholar
  32. 32.
    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–E327PubMedGoogle Scholar
  33. 33.
    Lang TF (2011) The bone-muscle relationship in men and women. J Osteoporos 2011:702735PubMedCentralPubMedCrossRefGoogle Scholar
  34. 34.
    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 287:11616–11628PubMedCrossRefGoogle Scholar
  35. 35.
    Reid IR (2010) Fat and bone. Arch Biochem Biophys 503:20–27PubMedCrossRefGoogle Scholar
  36. 36.
    Pfeilschifter J, Koditz R, Pfohl M, Schatz H (2002) Changes in proinflammatory cytokine activity after menopause. Endocr Rev 23:90–119PubMedGoogle Scholar
  37. 37.
    Cao JJ (2011) Effects of obesity on bone metabolism. J Orthop Surg Res 6:30PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Rosen CJ, Bouxsein ML (2006) Mechanisms of disease: is osteoporosis the obesity of bone? Nat Clin Pract Rheumatol 2:35–43PubMedCrossRefGoogle Scholar
  39. 39.
    Kawai M, Devlin MJ, Rosen CJ (2009) Fat targets for skeletal health. Nat Rev Rheumatol 5:365–372PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    de Paula FJ, Horowitz MC, Rosen CJ (2010) Novel insights into the relationship between diabetes and osteoporosis. Diabetes Metab Res Rev 26:622–630PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  1. 1.Jangseong Public Health CenterJangseongSouth Korea
  2. 2.Department of Family MedicineKorea Cancer Center HospitalSeoulSouth Korea
  3. 3.Department of Family Medicine, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea

Personalised recommendations