Skip to main content

Associations of fat mass and fat distribution with bone mineral density in pre- and postmenopausal Chinese women

Osteoporosis International volume 22, pages 113–119 (2011)Cite this article

Abstract

Summary

Fat mass (FM) is closely related to bone mineral density (BMD). However, the associations of FM and fat distribution with BMD in pre- and postmenopausal women are still poorly understood. The present study showed android fat mass accumulation after menopause had a negative association with BMD.

Introduction

FM is closely related to BMD. However, it is unknown whether FM and central fat distribution have different associations with BMD in pre- and postmenopausal women. The study aims to investigate the associations of FM and fat distribution with BMD in pre- and postmenopausal Chinese women.

Methods

Two hundred sixty premenopausal and 267 postmenopausal women aged 18 to 79 years were analyzed. Lean mass (LM), FM, percent body fat (%BF), android FM, gynoid FM, and total and regional BMD were measured using dual-energy X-ray absorptiometry. Fat distribution was assessed by android to gynoid FM ratio (AOI). Multiple regression analysis was performed to examine the associations of BMD with FM, LM, and AOI.

Results

FM, %BF, android FM, and AOI were significantly higher, whereas total and regional BMD were significantly lower in postmenopausal women (all р < 0.01). In premenopausal women, FM was positively associated with total and regional BMD (all р < 0.05). AOI had no significant association with BMD. In postmenopausal women, FM was significantly associated with total and regional BMD even additionally adjusting for LM (all р < 0.01). AOI had significantly negative association with total, head, arm, and leg BMD (all р < 0.05). The results remained unchanged when replacing FM with %BF.

Conclusions

There were different associations of FM and fat distribution with BMD in pre- and postmenopausal Chinese women. Increased central body fat had a negative association with BMD. Our findings may have significant implications in the prevention of menopause-related osteoporosis through reducing centralized fat deposition.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Bates DW, Black DM, Cummings SR (2002) Clinical use of bone densitometry: clinical applications. JAMA 288:1898–1900

    Article  PubMed  Google Scholar 

  2. NIH Consensus Development Panel on Osteoporosis Prevention Diagnosis, and Therapy (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795

    Article  Google Scholar 

  3. Krall EA, Dawson-Hughes B (1993) Heritable and life-style determinants of bone mineral density. J Bone Miner Res 8:1–9

    CAS  Article  PubMed  Google Scholar 

  4. Ho SC, Chan SG, Yip YB, Chan CS, Woo JL, Sham A (2008) Change in bone mineral density and its determinants in pre- and perimenopausal Chinese women: the Hong Kong Perimenopausal Women Osteoporosis Study. Osteoporos Int 19:1785–1796

    CAS  Article  PubMed  Google Scholar 

  5. Felson DT, Zhang Y, Hannan MT, Anderson JJ (1993) Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res 8:567–573

    CAS  Article  PubMed  Google Scholar 

  6. De Laet C, Kanis JA, Odén A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338

    Article  PubMed  Google Scholar 

  7. Wardlaw GM (1996) Putting body weight and osteoporosis into perspective. Am J Clin Nutr 63:433S–436S

    CAS  PubMed  Google Scholar 

  8. Reid IR, Ames R, Evans MC, Sharpe S, Gamble G, France JT, Lim TM, Cundy TF (1992) Determinants of total body and regional bone mineral density in normal postmenopausal women—a key role for fat mass. J Clin Endocrinol Metab 75:45–51

    CAS  Article  PubMed  Google Scholar 

  9. 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

    CAS  Article  PubMed  Google Scholar 

  10. Khosla S, Atkinson EJ, Riggs BL, Melton LJ 3rd (1996) Relationship between body composition and bone mass in women. J Bone Miner Res 11:857–863

    CAS  Article  PubMed  Google Scholar 

  11. Douchi T, Oki T, Nakamura S, Ijuin H, Yamamoto S, Nagata Y (1997) The effect of body composition on bone density in pre- and postmenopausal women. Maturitas 27:55–60

    CAS  Article  PubMed  Google Scholar 

  12. 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

    CAS  Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    CAS  PubMed  Google Scholar 

  15. Janicka A, Wren TA, Sanchez MM, Dorey F, Kim PS, Mittelman SD, Gilsanz VF (2007) Fat mass is not beneficial to bone in adolescents and young adults. J Clin Endocrinol Metab 92:143–147

    CAS  Article  PubMed  Google Scholar 

  16. Tarquini B, Navari N, Perfetto F, Piluso A, Romano S, Tarquini R (1997) Evidence for bone mass and body fat distribution relationship in postmenopausal obese women. Arch Gerontol Geriatr 24:15–21

    CAS  Article  PubMed  Google Scholar 

  17. Douchi T, Yamamoto S, Oki T, Maruta K, Kuwahata R, Nagata Y (2000) Relationship between body fat distribution and bone mineral density in premenopausal Japanese women. Obstet Gynecol 95:722–725

    CAS  Article  PubMed  Google Scholar 

  18. Stewart KJ, Deregis JR, Turner KL, Bacher AC, Sung J, Hees PS, Tayback M, Ouyang P (2002) Fitness, fatness and activity as predictors of bone mineral density in older persons. J Intern Med 252:381–388

    CAS  Article  PubMed  Google Scholar 

  19. Shen W, Chen J, Punyanitya M, Shapses S, Heshka S, Heymsfield SB (2007) MRI-measured bone marrow adipose tissue is inversely related to DXA-measured bone mineral in Caucasian women. Osteoporos Int 18:641–647

    CAS  Article  PubMed  Google Scholar 

  20. Gilsanz V, Chalfant J, Mo AO, Lee DC, Dorey FJ, Mittelman SD (2009) Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab 94:3387–3393

    CAS  Article  PubMed  Google Scholar 

  21. Kim CJ, Oh KW, Rhee EJ, Kim KH, Jo SK, Jung CH, Won JC, Park CY, Lee WY, Park SW, Kim SW (2009) Relationship between body composition and bone mineral density (BMD) in perimenopausal Korean women. Clin Endocrinol (Oxf) 71:18–26

    CAS  Article  Google Scholar 

  22. Cui LH, Shin MH, Kweon SS, Park KS, Lee YH, Chung EK, Nam HS, Choi JS (2007) Relative contribution of body composition to bone mineral density at different sites in men and women of South Korea. J Bone Miner Metab 25:165–171

    Article  PubMed  Google Scholar 

  23. Ley CJ, Lees B, Stevenson JC (1992) Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr 55:950–954

    CAS  PubMed  Google Scholar 

  24. Gambacciani M, Spinetti A, de Simone L, Cappagli B, Maffei S, Taponeco F, Fioretti P (1993) The relative contributions of menopause and aging to postmenopausal vertebral osteopenia. J Clin Endocrinol Metab 77:1148–1151

    CAS  Article  PubMed  Google Scholar 

  25. Ravn P, Cizza G, Bjarnason NH, Thompson D, Daley M, Wasnich RD, McClung M, Hosking D, Yates AJ, Christiansen C (1999) Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group. J Bone Miner Res 14:1622–1627

    CAS  Article  PubMed  Google Scholar 

  26. Park YW, Allison DB, Heymsfield SB, Gallagher D (2001) Larger amounts of visceral adipose tissue in Asian Americans. Obes Res 9:381–387

    CAS  Article  PubMed  Google Scholar 

  27. Ensrud KE, Lipschutz RC, Cauley JA, Seeley D, Nevitt MC, Scott J, Orwoll ES, Genant HK, Cummings SR (1997) Body size and hip fracture risk in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Am J Med 103:274–280

    CAS  Article  PubMed  Google Scholar 

  28. Schwartz AV (2003) Diabetes mellitus: does it affect bone? Calcif Tissue Int 73:515–519

    CAS  Article  PubMed  Google Scholar 

  29. Kontogianni MD, Dafni UG, Routsias JG, Skopouli FN (2004) Blood leptin and adiponectin as possible mediators of the relation between fat mass and BMD in perimenopausal women. J Bone Miner Res 19:546–551

    CAS  Article  PubMed  Google Scholar 

  30. Kameda T, Mano H, Yuasa T et al (1997) Estrogen inhibits bone resorption by directly inducing apoptosis of the bone-resorbing osteoclasts. J Exp Med 186:489–495

    CAS  Article  PubMed  Google Scholar 

  31. Oshima K, Nampei A, Matsuda M, Iwaki M, Fukuhara A, Hashimoto J, Yoshikawa H, Shimomura I (2005) Adiponectin increases bone mass by suppressing osteoclast and activating osteoblast. Biochem Biophys Res Commun 331:520–526

    CAS  Article  PubMed  Google Scholar 

  32. Ritland LM, Alekel DL, Matvienko OA, Hanson KB, Stewart JW, Hanson LN, Reddy MB, Van Loan MD, Genschel U (2008) Centrally located body fat is related to appetitive hormones in healthy postmenopausal women. Eur J Endocrinol 158:889–897

    CAS  Article  PubMed  Google Scholar 

  33. Ağbaht K, Gürlek A, Karakaya J, Bayraktar M (2009) Circulating adiponectin represents a biomarker of the association between adiposity and bone mineral density. Endocr 35:371–379

    Article  Google Scholar 

  34. Lee CG, Carr MC, Murdoch SJ, Mitchell E, Woods NF, Wener MH, Chandler WL, Boyko EJ, Brunzell JD (2009) Adipokines, inflammation, and visceral adiposity across the menopausal transition: a prospective study. J Clin Endocrinol Metab 94:1104–1110

    CAS  Article  PubMed  Google Scholar 

  35. Ozkurt B, Ozkurt ZN, Altay M, Aktekin CN, Cağlayan O, Tabak Y (2009) The relationship between serum adiponectin level and anthropometry, bone mass, osteoporotic fracture risk in postmenopausal women. Eklem Hastalik Cerrahisi 20:78–84

    PubMed  Google Scholar 

  36. Lenchik L, Register TC, Hsu FC, Lohman K, Nicklas BJ, Freedman BI, Langefeld CD, Carr JJ, Bowden DW (2003) Adiponectin as a novel determinant of bone mineral density and visceral fat. Bone 33:646–651

    CAS  Article  PubMed  Google Scholar 

  37. Ganesan K, Teklehaimanot S, Tran TH, Asuncion M, Norris K (2005) Relationship of C-reactive protein and bone mineral density in community-dwelling elderly females. J Natl Med Assoc 97:329–333

    PubMed  Google Scholar 

  38. Oelzner P, Franke S, Müller A, Hein G, Stein G (1999) Relationship between soluble markers of immune activation and bone turnover in post-menopausal women with rheumatoid arthritis. Rheumatology (Oxford) 38:841–847

    CAS  Article  Google Scholar 

  39. Gjesdal CG, Halse JI, Eide GE, Brun JG, Tell GS (2008) Impact of lean mass and fat mass on bone mineral density: the Hordaland Health Study. Maturitas 59:191–200

    Article  PubMed  Google Scholar 

  40. Li S, Wagner R, Holm K, Lehotsky J, Zinaman MJ (2004) Relationship between soft tissue body composition and bone mass in perimenopausal women. Maturitas 47:99–105

    Article  PubMed  Google Scholar 

  41. Petit MA, Beck TJ, Shults J, Zemel BS, Foster BJ, Leonard MB (2005) Proximal femur bone geometry is appropriately adapted to lean mass in overweight children and adolescents. Bone 36:568–576

    Article  PubMed  Google Scholar 

  42. Kuwahata A, Kawamura Y, Yonehara Y, Matsuo T, Iwamoto I, Douchi T (2008) Non-weight-bearing effect of trunk and peripheral fat mass on bone mineral density in pre- and post-menopausal women. Maturitas 60:244–247

    Article  PubMed  Google Scholar 

  43. Lee K, Lee S, Kim YJ, Kim YJ (2008) Waist circumference, dual-energy X-ray absortiometrically measured abdominal adiposity, and computed tomographically derived intra-abdominal fat area on detecting metabolic risk factors in obese women. Nutrition 24:625–631

    Article  PubMed  Google Scholar 

  44. Matsuo T, Douchi T, Nakae M, Uto H, Oki T, Nagata Y (2003) Relationship of upper body fat distribution to higher regional lean mass and bone mineral density. J Bone Miner Metab 21:179–183

    Article  PubMed  Google Scholar 

  45. Douchi T, Iemura A, Matsuo T, Kuwahata T, Oki T, Yoshimitsu N, Nagata Y (2003) Relationship of head lean mass to regional bone mineral density in elderly postmenopausal women. Maturitas 46:225–230

    Article  PubMed  Google Scholar 

  46. Bagur A, Vega E, Mautalen CD (1995) Discrimination of total body bone mineral density measured by dexa in vertebral osteoporosis. Calcif Tissue Int 56:263–267

    CAS  Article  PubMed  Google Scholar 

  47. Revilla RM, Hernández ER, Villa LF, Seco C, Sanchez-Atrio A, Rico H (1997) Total body bone measurements in spinal osteoporosis by dual-energy X-ray absorptiometry. Calcif Tissue Int 61:44–47

    CAS  Article  PubMed  Google Scholar 

  48. Nordin BE, Chatterton BE, Schultz CG, Need AG, Horowitz M (1996) Regional bone mineral density interrelationships in normal and osteoporotic postmenopausal women. J Bone Miner Res 11:849–856

    CAS  Article  PubMed  Google Scholar 

  49. Waters DL, Hale L, Grant AM, Herbison P, Goulding A (2009) Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders. Osteoporos Int 21:351–357

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Affiliations

  1. Obesity and Body Composition Research Center, School of Public Health, Zhejiang University, 388 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China

    X. Fu, H. Lu, W. He, Z. Wang & S. Zhu

  2. Injury Research Center, Medical College of Wisconsin, Milwaukee, WI, USA

    X. Ma

  3. Obesity Research Center, St. Luke’s-Roosevelt Hospital, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Z. Wang

Authors
  1. X. Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. X. Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. He
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Zhu.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Fu, X., Ma, X., Lu, H. et al. Associations of fat mass and fat distribution with bone mineral density in pre- and postmenopausal Chinese women. Osteoporos Int 22, 113–119 (2011). https://doi.org/10.1007/s00198-010-1210-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-010-1210-9

Keywords

  • Bone mineral density
  • Fat distribution
  • Fat mass
  • Menopausal status