Osteoporosis International

, Volume 25, Issue 5, pp 1563–1570 | Cite as

Gender differences in the relationships between lean body mass, fat mass and peak bone mass in young adults

  • K. Zhu
  • K. Briffa
  • A. Smith
  • J. Mountain
  • A. M. Briggs
  • S. Lye
  • C. Pennell
  • L. Straker
  • J. P. Walsh
Original Article



The relationships between fat mass and bone mass in young adults are unclear. In 1,183 young Australians, lean body mass had a strong positive relationship with total body bone mass in both genders. Fat mass was a positive predictor of total body bone mass in females, with weaker association in males.


Body weight and lean body mass are established as major determinants of bone mass, but the relationships between fat mass (including visceral fat) and peak bone mass in young adults are unclear. The aim of this study was to evaluate the associations between bone mass in young adults and three body composition measurements: lean body mass, fat mass and trunk-to-limb fat mass ratio (a surrogate measure of visceral fat).


Study participants were 574 women and 609 men aged 19–22 years from the Raine study. Body composition, total body bone mineral content (TBBMC), bone area and areal bone mineral density (TBBMD) were measured using DXA.


In multivariate linear regression models with height, lean body mass, fat mass and trunk-to-limb fat mass ratio as predictor variables, lean mass was uniquely associated with the largest proportion of variance of TBBMC and TBBMD in males (semi-partial R2 0.275 and 0.345, respectively) and TBBMC in females (semi-partial R2 0.183). Fat mass was a more important predictor of TBBMC and TBBMD in females (semi-partial R2 0.126 and 0.039, respectively) than males (semi-partial R2 0.006 and 0.018, respectively). Trunk-to-limb fat mass ratio had a weak, negative association with TBBMC and bone area in both genders (semi-partial R2 0.004 to 0.034).


Lean body mass has strong positive relationship with total body bone mass in both genders. Fat mass may play a positive role in peak bone mass attainment in women but the association was weaker in men; different fat compartments may have different effects.


Fat mass Lean body mass Peak bone mass Raine Study Trunk-to-limb fat mass ratio Young adults 


  1. 1.
    Khosla S, Atkinson EJ, Riggs BL, Melton LJ 3rd (1996) Relationship between body composition and bone mass in women. J Bone Miner Res 11:857–863PubMedCrossRefGoogle Scholar
  2. 2.
    Bogl LH, Latvala A, Kaprio J, Sovijarvi O, Rissanen A, Pietilainen KH (2011) An investigation into the relationship between soft tissue body composition and bone mineral density in a young adult twin sample. J Bone Miner Res 26:79–87PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    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
  4. 4.
    Sayers A, Tobias JH (2010) Fat mass exerts a greater effect on cortical bone mass in girls than boys. J Clin Endocrinol Metab 95:699–706PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Janicka A, Wren TA, Sanchez MM, Dorey F, Kim PS, Mittelman SD, Gilsanz V (2007) Fat mass is not beneficial to bone in adolescents and young adults. J Clin Endocrinol Metab 92:143–147PubMedCrossRefGoogle Scholar
  6. 6.
    Baxter-Jones AD, Eisenmann JC, Mirwald RL, Faulkner RA, Bailey DA (2008) The influence of physical activity on lean mass accrual during adolescence: a longitudinal analysis. J Appl Physiol 105:734–741PubMedCrossRefGoogle Scholar
  7. 7.
    Lu H, Fu X, Ma X, Wu Z, He W, Wang Z, Allison DB, Heymsfield SB, Zhu S (2011) Relationships of percent body fat and percent trunk fat with bone mineral density among Chinese, black, and white subjects. Osteoporos Int 22:3029–3035PubMedCrossRefGoogle Scholar
  8. 8.
    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
  9. 9.
    Baker JF, Davis M, Alexander R, Zemel BS, Mostoufi-Moab S, Shults J, Sulik M, Schiferl DJ, Leonard MB (2013) Associations between body composition and bone density and structure in men and women across the adult age spectrum. Bone 53:34–41PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Hamrick MW, Ferrari SL (2008) Leptin and the sympathetic connection of fat to bone. Osteoporos Int 19:905–912PubMedCrossRefGoogle Scholar
  11. 11.
    Reid IR (2010) Fat and bone. Arch Biochem Biophys 503:20–27PubMedCrossRefGoogle Scholar
  12. 12.
    Braun T, Schett G (2012) Pathways for bone loss in inflammatory disease. Curr Osteoporos Rep 10:101–108PubMedCrossRefGoogle Scholar
  13. 13.
    Heaney RP, Abrams S, Dawson-Hughes B, Looker A, Marcus R, Matkovic V, Weaver C (2000) Peak bone mass. Osteoporos Int 11:985–1009PubMedCrossRefGoogle Scholar
  14. 14.
    WHO (March 2011) Obesity and overweight. Fact sheet N°311. World Health OrganizationGoogle Scholar
  15. 15.
    Zagarins SE, Ronnenberg AG, Gehlbach SH, Lin R, Bertone-Johnson ER (2010) The association of lean mass and fat mass with peak bone mass in young premenopausal women. J Clin Densitom 13:392–398PubMedCrossRefGoogle Scholar
  16. 16.
    Kirchengast S (2010) Gender differences in body composition from childhood to old age: an evolutionary point of view. Journal of Life Science 2:1–10Google Scholar
  17. 17.
    Makovey J, Naganathan V, Sambrook P (2005) Gender differences in relationships between body composition components, their distribution and bone mineral density: a cross-sectional opposite sex twin study. Osteoporos Int 16:1495–1505PubMedCrossRefGoogle Scholar
  18. 18.
    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
  19. 19.
    Russell M, Mendes N, Miller KK, Rosen CJ, Lee H, Klibanski A, Misra M (2010) Visceral fat is a negative predictor of bone density measures in obese adolescent girls. J Clin Endocrinol Metab 95:1247–1255PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Ackerman KE, Davis B, Jacoby L, Misra M (2011) DXA surrogates for visceral fat are inversely associated with bone density measures in adolescent athletes with menstrual dysfunction. J Pediatr Endocrinol Metab 24:497–504PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    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 94:3387–3393PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Baxter-Jones AD, Faulkner RA, Forwood MR, Mirwald RL, Bailey DA (2011) Bone mineral accrual from 8 to 30 years of age: an estimation of peak bone mass. J Bone Miner Res 26:1729–1739PubMedCrossRefGoogle Scholar
  23. 23.
    Newnham JP, Evans SF, Michael CA, Stanley FJ, Landau LI (1993) Effects of frequent ultrasound during pregnancy: a randomised controlled trial. Lancet 342:887–891PubMedCrossRefGoogle Scholar
  24. 24.
    Robinson M, Oddy WH, McLean NJ, Jacoby P, Pennell CE, de Klerk NH, Zubrick SR, Stanley FJ, Newnham JP (2010) Low-moderate prenatal alcohol exposure and risk to child behavioural development: a prospective cohort study. BJOG 117:1139–1150PubMedCrossRefGoogle Scholar
  25. 25.
    Savgan-Gurol E, Bredella M, Russell M, Mendes N, Klibanski A, Misra M (2010) Waist to hip ratio and trunk to extremity fat (DXA) are better surrogates for IMCL and for visceral fat respectively than for subcutaneous fat in adolescent girls. Nutr Metab (Lond) 7:86CrossRefGoogle Scholar
  26. 26.
    Kleinbaum DG, Kupper LL, Muller KE, Nizam A (1998) Applied regression analysis and other multivariable methods. Duxbury Press, Pacific GroveGoogle Scholar
  27. 27.
    De Laet C, Kanis JA, Oden A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338PubMedCrossRefGoogle Scholar
  28. 28.
    Choi HS, Kim KJ, Kim KM, Hur NW, Rhee Y, Han DS, Lee EJ, Lim SK (2010) Relationship between visceral adiposity and bone mineral density in Korean adults. Calcif Tissue Int 87:218–225PubMedCrossRefGoogle Scholar
  29. 29.
    Bouxsein M (2011) Biomechanics of age-related fractures. In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis, 2nd edn. Academic, San Diego, pp 509–534Google Scholar
  30. 30.
    Pou KM, Massaro JM, Hoffmann U et al (2007) Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress: the Framingham heart study. Circulation 116:1234–1241PubMedCrossRefGoogle Scholar
  31. 31.
    Cartier A, Lemieux I, Almeras N, Tremblay A, Bergeron J, Despres JP (2008) Visceral obesity and plasma glucose-insulin homeostasis: contributions of interleukin-6 and tumor necrosis factor-alpha in men. J Clin Endocrinol Metab 93:1931–1938PubMedCrossRefGoogle Scholar
  32. 32.
    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
  33. 33.
    Dimitri P, Bishop N, Walsh JS, Eastell R (2012) Obesity is a risk factor for fracture in children but is protective against fracture in adults: a paradox. Bone 50:457–466PubMedCrossRefGoogle Scholar
  34. 34.
    Schott AM, Cormier C, Hans D et al (1998) How hip and whole-body bone mineral density predict hip fracture in elderly women: the EPIDOS prospective study. Osteoporos Int 8:247–254PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2014

Authors and Affiliations

  • K. Zhu
    • 1
    • 2
  • K. Briffa
    • 3
  • A. Smith
    • 3
  • J. Mountain
    • 4
  • A. M. Briggs
    • 5
  • S. Lye
    • 6
  • C. Pennell
    • 7
  • L. Straker
    • 3
  • J. P. Walsh
    • 1
    • 2
  1. 1.Department of Endocrinology and DiabetesSir Charles Gairdner HospitalNedlandsAustralia
  2. 2.School of Medicine and PharmacologyUniversity of Western AustraliaCrawleyAustralia
  3. 3.School of PhysiotherapyCurtin UniversityPerthAustralia
  4. 4.Telethon Institute for Child Health Research, Centre for Child Health ResearchUniversity of Western AustraliaPerthAustralia
  5. 5.Curtin Health Innovation Research InstituteCurtin UniversityPerthAustralia
  6. 6.Samuel Lunenfeld Research Institute, Mount Sinai HospitalTorontoCanada
  7. 7.School of Women’s and Infants’ HealthUniversity of Western AustraliaCrawleyAustralia

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