Rheumatology International

, Volume 33, Issue 3, pp 607–612 | Cite as

The relationship between body composition and bone mineral density in postmenopausal Turkish women

  • Hakan Nur
  • N. Fusun Toraman
  • Zuhal Arica
  • Nur Sarier
  • Anil Samur
Original Article


In a retrospective cross-sectional study among 202 postmenopausal women aged 46–75 years, we aimed to investigate the relationship between body composition and bone mineral density (BMD) to determine whether fat mass or lean mass is a better determinant of BMD in Turkish postmenopausal women. Lumbar spine (L1–L4) and proximal femur BMD were measured by dual energy X-ray absorbsiometry. Body composition analysis was performed by bioelectric impedance method and fat mass, lean mass, and percent fat were measured. Both fat mass and lean mass were positively correlated with BMD at the lumbar spine and proximal femur, weight and body mass index. Lean mass was also positively correlated with height and negatively correlated with age and years since menopause (P < 0.01). The correlations of fat mass and lean mass with BMD at the lumbar spine and proximal femur remained significant after adjustment for age, years since menopause and height. When the lean mass was adjusted together with age, years since menopause and height, the significant relationship between the fat mass and BMD continued, however the significant correlation between the lean mass and BMD disappeared at all sites after adjustment for fat mass. In multiple regression analyses, fat mass was the significant determinant of all BMD sites. Our data suggest that fat mass is the significant determinant of BMD at the lumbar spine and proximal femur, and lean mass does not have an impact on BMD when fat mass was taken into account in Turkish postmenopausal women.


Body composition Bone mineral density Postmenopausal women Fat mass Lean mass 


  1. 1.
    Sambrook P, Cooper C (2006) Osteoporosis. Lancet 367:2010–2018CrossRefGoogle Scholar
  2. 2.
    Heaney RP (2003) Advances in therapy for osteoporosis. Clin Med Res 1:93–97PubMedCrossRefGoogle Scholar
  3. 3.
    Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedCrossRefGoogle Scholar
  4. 4.
    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 8:567–573PubMedCrossRefGoogle Scholar
  5. 5.
    Reid IR (2002) Relationship among body mass, its components, and bone. Bone 31:547–555PubMedCrossRefGoogle Scholar
  6. 6.
    Abernathy RP, Black DR (1996) Healthy body weights: an alternative perspective. Am J Clin Nutr 63:448–451Google Scholar
  7. 7.
    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 75:45–51PubMedCrossRefGoogle Scholar
  8. 8.
    Reid IR, Evans MC, Ames RW (1994) Volumetric bone density of the lumbar spine is related to fat mass but not lean mass in normal postmenopausal women. Osteoporos Int 4:362–367PubMedCrossRefGoogle 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 a mediator. J Bone Miner Res 16:2142–2151PubMedCrossRefGoogle Scholar
  10. 10.
    Li S, Wagner R, Holm K, Lehotsky J, Zinaman MJ (2004) Relationship between soft tissue body composition and bone mass in perimenopausal women. Maturitas 47:99–105PubMedCrossRefGoogle Scholar
  11. 11.
    Salamone LM, Glynn N, Black D, Epstein RS, Palermo L, Meilahn E, Kuller LH, Cauley JA (1995) Body composition and bone mineral density in premenopausal and early perimenopausal women. J Bone Miner Res 10:1762–1768PubMedCrossRefGoogle Scholar
  12. 12.
    Sheng Z, Xu K, Ou Y, Dai R, Luo X, Liu S, Su X, Wu X, Xie H, Yuan L, Liao E (2011) Relationship of body composition with prevalance of osteoporosis in central South Chinese postmenopausal women. Clin Endoc 74:319–324CrossRefGoogle Scholar
  13. 13.
    Ho-Pham LT, Nguyen ND, Lai TQ, Nguyen TV (2010) Contributions of lean mass and fat mass to bone mineral density: a study in postmenopausal women. BMC Muskuloskeletal Disorders 11:59CrossRefGoogle Scholar
  14. 14.
    Douchi T, Yamamoto S, Oki T, Maruta K, Kuwahata R, Yamasaki H, Nagata Y (2000) Difference in the effect of adiposity on bone density between pre- and postmenopausal women. Maturitas 34:261–266PubMedCrossRefGoogle Scholar
  15. 15.
    Ijuin M, Douchi T, Matsuo T, Yamamoto S, Uto H, Nagata Y (2002) Difference in the effects of body composition on bone mineral density between pre and postmenopausal women. Maturitas 43:239–244PubMedCrossRefGoogle Scholar
  16. 16.
    Wu F, Ames R, Clearwater J, Evans MC, Gamble G, Reid IR (2002) Prospective 10-year study of the determinants of bone density and bone loss in normal postmenopausal women, including the effect of hormone replacement therapy. Clin Endocrinol (Oxf) 56:703–711CrossRefGoogle Scholar
  17. 17.
    Zhao LJ, Liu YJ, Liu PY, Hamilton J, Recker RR, Deng HW (2007) Relationship of obesity with osteoporosis. J Clin Endocrinol Metab 92:1640–1646PubMedCrossRefGoogle Scholar
  18. 18.
    Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu T, Li Z, Laird N, Brain JD, Cummings SR, Bouxsein ML, Rosen CJ, Xu X (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
  19. 19.
    Reid IR (2008) Relationships between fat and bone. Osteoporos Int 19:595–606PubMedCrossRefGoogle Scholar
  20. 20.
    Reid IR, Legge M, Stapleton JP, Evans MC, Grey AB (1995) Regular exercise dissociates fat mass and bone density in premenopausal women. J Clin Endocrinol Metab 80:1764–1768PubMedCrossRefGoogle Scholar
  21. 21.
    Douchi T, Matsuo T, Uto H, Kuwahata T, Oki T, Nagata Y (2003) Lean body mass and bone mineral density in physically exercising postmenopausal women. Maturitas 45:185–190PubMedCrossRefGoogle Scholar
  22. 22.
    Leslie WD, Weiler HA, Nyomba BL (2007) Ethnic differences in adiposity and body composition: the First Nations bone health study. Appl Physiol Nutr Metab 32:1065–1072PubMedCrossRefGoogle Scholar
  23. 23.
    Care AD, Abbas SK, Pell J, Seitz PK, Cooper CW (1998) Stimulatory effect of insulin on calcitonin secretion. Horm Metab Res 30:200–205PubMedCrossRefGoogle Scholar
  24. 24.
    Clowes JA, Robinson RT, Heller SR, Eastell R, Blumsohn A (2002) Acute changes of bone turnover and PTH induced by insulin and glucose: euglycemic and hypoglycemic hyperinsulinemic clamp studies. J Clin Endocrinol Metab 87:3324–3329PubMedCrossRefGoogle Scholar
  25. 25.
    Zhao LJ, Jiang H, Papasian CJ, Maulik D, Drees B, Hamilton J, Deng HW (2008) Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis. J Bone Miner Res 23:17–29PubMedCrossRefGoogle Scholar
  26. 26.
    Cornish J, Callon KE, Bava U, Lin C, Naot D, Hill BL, Grey AB, Broom N, Myers DE, Nicholson GC, Reid IR (2002) Leptin directly regulates bone cell function in vitro and reduces bone fragility in vivo. J Endocrinol 175:405–415PubMedCrossRefGoogle Scholar
  27. 27.
    Thomas T (2004) The complex effects of leptin on bone metabolism through multiple pathways. Curr Opin Pharmacol 4:295–300PubMedCrossRefGoogle Scholar
  28. 28.
    Roux C, Arabi A, Porcher R, Garnero P (2003) Serum leptin as a determinant of bone resorption in healthy postmenopausal women. Bone 33:847–852PubMedCrossRefGoogle Scholar
  29. 29.
    Weiss LA, Barrett-Connor E, von Muhlen D, Clark P (2006) Leptin predicts BMD and bone resorption in older women but not older men: the Rancho Bernardo study. J Bone Mineral Res 21:758–764CrossRefGoogle Scholar
  30. 30.
    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 33:646–651PubMedCrossRefGoogle Scholar
  31. 31.
    Thommesen L, Stunes AK, Monjo M, Grosvik K, Tamburstuen MV, Kjobli E, Lyngstadaas SP, Reseland JE, Syversen U (2006) Expression and regulation of resistin in osteoblasts and osteoclasts indicate a role in bone metabolism. J Cell Biochem 99:824–834PubMedCrossRefGoogle Scholar
  32. 32.
    Reid IR, Evans MC, Cooper GJS, Ames RW, Stapleton J (1993) Circulating insulin levels are related to bone density in normal postmenopausal women. Am J Physiol 265:655–659Google Scholar
  33. 33.
    Stolk RP, Vandaele PLA, Pols HAP, Burger H, Hofman A, Birkenhager JC, Lamberts SWJ, Grobbee DE (1996) Hyperinsulinemia and bone mineral density in an elderly population—the Rotterdam study. Bone 18:545–549PubMedCrossRefGoogle Scholar
  34. 34.
    Cornish J, Naot D (2002) Amylin and adrenomedullin: novel regulators of bone growth. Curr Pharm Des 8:2009–2021PubMedCrossRefGoogle Scholar
  35. 35.
    Cornish J, Callon KE, Bava U, Watson M, Xu X, Lin JM, Chan VA, Grey AB, Naot D, Buchanan CM, Cooper GJ, Reid IR (2007) Preptin, another peptide product fo the pancreatic beta-cell, is osteogenic in vitro and in vivo. Am J Physiol Endocrinol Metab 292:117–122CrossRefGoogle Scholar
  36. 36.
    Svendsen OL, Haarbo J, Heitmann JL, Gotfredsen A, Christiansen C (1991) Measurement of body fat in the elderly subjects by dual energy X-ray absorbsiometry, bioelectrical impedance, and antropometry. Am J of Clin Nutr 53:1117–1123Google Scholar
  37. 37.
    Sahin G, Polat G, Bagis S, Milcan A, Bagdatoglu O, Erdogan C, Camdeviren H (2003) Body composition, bone mineral density, and circulating leptin levels in postmenopausal Turkish women. Rheumatol Int 23:87–91PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Hakan Nur
    • 1
  • N. Fusun Toraman
    • 1
  • Zuhal Arica
    • 1
  • Nur Sarier
    • 1
  • Anil Samur
    • 2
  1. 1.Department of Physical Medicine and RehabilitationAntalya Education and Research HospitalAntalyaTurkey
  2. 2.Department of Biostatistics and Medical Informatics, Faculty of MedicineAkdeniz UniversityAntalyaTurkey

Personalised recommendations