Browse > Article
http://dx.doi.org/10.9708/jksci.2021.26.08.209

The association between body composition and bone mineral density in subjects aged 50 years or older in men and postmenopausal women in Korea  

Cho, Jeong-Ran (Dept. of Health Administration, Kwangju Women's University)
Publication Information
Journal of the Korea Society of Computer and Information / v.26, no.8, 2021 , pp. 209-220 More about this Journal
Abstract
The effect of body composition such as lean mass and fat mass on bone mineral density (BMD) is complex and still controversial. In this study, we investigated the relationship between body composition and bone mineral density using nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) in 2,139 men and 2,193 postmenopausal women aged 50 years or older. Subjects with history of medication for osteoporosis or with diseases or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Fasting blood sample was obtained for blood chemistry analysis. BMD of the lumbar spine, total femur, and femoral neck, and body composition such as total lean mass (TLM), total fat mass (TFM), truncal fat mass (TrFM) were measured using dual-energy X-ray absorptiometry (DXA). There were significant positive correlations between body composition indices such as lean mass and fat mass with BMD. In multiple regression analysis, TLM was positively associated with BMD after adjusting age, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration in both men and postmenopausal women. BMD at lumbar spine and femur in lowest quartile of TLM was significantly lower than other quartiles after adjusting those confounding factors in both gender. TrFM was negatively associated with total femur BMD in male and femur neck BMD in postmenopausal women after adjusting confounding factors. In conclusion, TLM is very important factor in maintaining BMD in subjects aged 50 years or older in men and postmenopausal women.
Keywords
KNHANES; body composition; bone mineral density; lean mass; fat mass;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Y. H. Kim. "Osteoporosis or low bone mass in adults aged 50 years old and above in Republic of Korea, 2008-2011", Public Health Weekly Report, KCDC, Vol. 7, No. 42. pp. 939-942, 2014.
2 O. Johnell, J. A. Kanis. "An estimate of the worldwide prevalence and disability associated with osteoporotic fractures", Osteoporos Int, Vol. 17, No. 12. pp. 1726-1733, Dec 2006. DOI: 10.1007/s00198-006-0172-4.   DOI
3 R. L. Duckham, A. D. Baxter-Jones, J. D. Johnston, H. Vatanparast, D. Cooper, S. Kontulainen. "Does physical activity in adolescence have site-specific and sex-specific benefits on young adult bone size, content, and estimated strength?", J Bone Miner Res, Vol. 29, No. 2. pp. 479-486, Feb 2014. DOI: 10.1002/jbmr.2055.   DOI
4 J. H. Kim, H. J. Choi, M. J. Kim, C. S. Shin, N. H. Cho. "Fat mass is negatively associated with bone mineral content in Koreans", Osteoporos Int, Vol. 23, No. 7. pp. 2009-2016, Jul 2012. DOI: 10.1007/s00198-011-1808-6.   DOI
5 C. J. Kim, K. W. Oh, E. J. Rhee, K. H. Kim, S. K. Jo, C. H. Jung, J. C. Won, C. Y. Park, W. Y. Lee, S. W. Park, S. W. Kim. "Relationship between body composition and bone mineral density (BMD) in perimenopausal Korean women", Clin Endocrinol (Oxf), Vol. 71, No. 1. pp. 18-26, Jul 2009. DOI: 10.1111/j.1365-2265.2008.03452.x.   DOI
6 L. J. Zhao, H. Jiang, C. J. Papasian, D. Maulik, B. Drees, J. Hamilton, H. W. Deng. "Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis", J Bone Miner Res, Vol. 23, No. 1. pp. 17-29, Jan 2008. DOI: 10.1359/jbmr.070813.   DOI
7 Y. H. Hsu, S. A. Venners, H. A. Terwedow, Y. Feng, T. Niu, Z. Li, N. Laird, J. D. Brain, S. R. Cummings, M. L. Bouxsein, C. J. Rosen, X. Xu. "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, Vol. 83, No. 1. pp. 146-154, Jan 2006. DOI: 10.1093/ajcn/83.1.146.   DOI
8 M. W. Hamrick. "A role for myokines in muscle-bone interactions", Exerc Sport Sci Rev, Vol. 39, No. 1. pp. 43-47, Jan 2011. DOI: 10.1097/JES.0b013e318201f601.   DOI
9 J. Pfeilschifter, R. Koditz, M. Pfohl, H. Schatz. "Changes in proinflammatory cytokine activity after menopause", Endocr Rev, Vol. 23, No. 1. pp. 90-119, Feb 2002. DOI: 10.1210/edrv.23.1.0456.   DOI
10 V. A. Hughes, W. R. Frontera, G. E. Dallal, K. J. Lutz, E. C. Fisher, W. J. Evans. "Muscle strength and body composition: associations with bone density in older subjects", Med Sci Sports Exerc, Vol. 27, No. 7. pp. 967-974, Jul 1995. DOI: 10.1249/00005768-199507000-00004.   DOI
11 H. Y. Kim, H. W. Jung, H. Hong, J. H. Kim, C. H. Shin, S. W. Yang, Y. A. Lee. "The Role of Overweight and Obesity on Bone Health in Korean Adolescents with a Focus on Lean and Fat Mass", J Korean Med Sci, Vol. 32, No. 10. pp. 1633-1641, Oct 2017. DOI: 10.3346/jkms.2017.32.10.1633.   DOI
12 D. T. Felson, Y. Zhang, M. T. Hannan, J. J. Anderson. "Effects of weight and body mass index on bone mineral density in men and women: the Framingham study", J Bone Miner Res, Vol. 8, No. 5. pp. 567-573, May 1993. DOI: 10.1002/jbmr.5650080507.   DOI
13 R. P. Heaney, S. Abrams, B. Dawson-Hughes, A. Looker, R. Marcus, V. Matkovic, C. Weaver. "Peak bone mass", Osteoporos Int, Vol. 11, No. 12. pp. 985-1009, 2000. DOI: 10.1007/s001980070020.   DOI
14 I. R. Reid. "Relationships among body mass, its components, and bone", Bone, Vol. 31, No. 5. pp. 547-555, Nov 2002. DOI: 10.1016/s8756-3282(02)00864-5.   DOI
15 S. Sharma, V. R. Tandon, S. Mahajan, V. Mahajan, A. Mahajan. "Obesity: Friend or foe for osteoporosis", J Midlife Health, Vol. 5, No. 1. pp. 6-9, Jan 2014. DOI: 10.4103/0976-7800.127782.   DOI
16 E. Guney, G. Kisakol, G. Ozgen, C. Yilmaz, R. Yilmaz, T. Kabalak. "Effect of weight loss on bone metabolism: comparison of vertical banded gastroplasty and medical intervention", Obes Surg, Vol. 13, No. 3. pp. 383-388, Jun 2003. DOI: 10.1381/096089203765887705.   DOI
17 J. A. Kanis, D. Hans, C. Cooper, S. Baim, J. P. Bilezikian, N. Binkley, J. A. Cauley, J. E. Compston, B. Dawson-Hughes, G. El-Hajj Fuleihan, H. Johansson, W. D. Leslie, E. M. Lewiecki, M. Luckey, A. Oden, S. E. Papapoulos, C. Poiana, R. Rizzoli, D. A. Wahl, E. V. McCloskey, F. I. Task Force of the. "Interpretation and use of FRAX in clinical practice", Osteoporos Int, Vol. 22, No. 9. pp. 2395-2411, Sep 2011. DOI: 10.1007/s00198-011-1713-z.   DOI
18 J. Kim, H. Kwon, B. K. Heo, H. K. Joh, C. M. Lee, S. S. Hwang, D. Park, J. H. Park. "The Association between Fat Mass, Lean Mass and Bone Mineral Density in Premenopausal Women in Korea: A Cross-Sectional Study", Korean J Fam Med, Vol. 39, No. 2. pp. 74-84, Mar 2018. DOI: 10.4082/kjfm.2018.39.2.74.   DOI
19 L. J. Zhao, Y. J. Liu, P. Y. Liu, J. Hamilton, R. R. Recker, H. W. Deng. "Relationship of obesity with osteoporosis", J Clin Endocrinol Metab, Vol. 92, No. 5. pp. 1640-1646, May 2007. DOI: 10.1210/jc.2006-0572.   DOI
20 M. C. Wang, L. K. Bachrach, M. Van Loan, M. Hudes, K. M. Flegal, P. B. Crawford. "The relative contributions of lean tissue mass and fat mass to bone density in young women", Bone, Vol. 37, No. 4. pp. 474-481, Oct 2005. DOI: 10.1016/j.bone.2005.04.038.   DOI
21 C. De Laet, J. A. Kanis, A. Oden, H. Johanson, O. Johnell, P. Delmas, J. A. Eisman, H. Kroger, S. Fujiwara, P. Garnero, E. V. McCloskey, D. Mellstrom, L. J. Melton, 3rd, P. J. Meunier, H. A. Pols, J. Reeve, A. Silman, A. Tenenhouse. "Body mass index as a predictor of fracture risk: a meta-analysis", Osteoporos Int, Vol. 16, No. 11. pp. 1330-1338, Nov 2005. DOI: 10.1007/s00198-005-1863-y.   DOI
22 Y. M. Kim, S. H. Kim, S. Kim, J. S. Yoo, E. Y. Choe, Y. J. Won. "Variations in fat mass contribution to bone mineral density by gender, age, and body mass index: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011", Osteoporos Int, Vol. 27, No. 8. pp. 2543-2554, Aug 2016. DOI: 10.1007/s00198-016-3566-y.   DOI
23 M. B. Leonard, J. Shults, B. A. Wilson, A. M. Tershakovec, B. S. Zemel. "Obesity during childhood and adolescence augments bone mass and bone dimensions", Am J Clin Nutr, Vol. 80, No. 2. pp. 514-523, Aug 2004. DOI: 10.1093/ajcn/80.2.514.   DOI
24 A. Kim, S. Baek, S. Park, J. Shin. "Bone Mineral Density of Femur and Lumbar and the Relation between Fat Mass and Lean Mass of Adolescents: Based on Korea National Health and Nutrition Examination Survey (KNHNES) from 2008 to 2011", Int J Environ Res Public Health, Vol. 17, No. 12Jun 22 2020. DOI: 10.3390/ijerph17124471.   DOI
25 I. R. Reid. "Fat and bone", Arch Biochem Biophys, Vol. 503, No. 1. pp. 20-27, Nov 1 2010. DOI: 10.1016/j.abb.2010.06.027.   DOI
26 X. Fu, X. Ma, H. Lu, W. He, Z. Wang, S. Zhu. "Associations of fat mass and fat distribution with bone mineral density in pre- and postmenopausal Chinese women", Osteoporos Int, Vol. 22, No. 1. pp. 113-119, Jan 2011. DOI: 10.1007/s00198-010-1210-9.   DOI
27 "The guideline of 4th (2007-2009) Korea National Health and Nutrition Survey (KNHANES IV)", Korea Centers for Disease Control and Prevention. pp. 1-227, 2008.
28 "The guideline of 5th (2010-2012) Korea National Health and Nutrition Survey (KNHANES V)", Korea Centers for Disease Control and Prevention. pp. 1-291, 2012.
29 S. M. Pluijm, M. Visser, J. H. Smit, C. Popp-Snijders, J. C. Roos, P. Lips. "Determinants of bone mineral density in older men and women: body composition as mediator", J Bone Miner Res, Vol. 16, No. 11. pp. 2142-2151, Nov 2001. DOI: 10.1359/jbmr.2001.16.11.2142.   DOI
30 O. F. Sotunde, H. S. Kruger, H. H. Wright, L. Havemann-Nel, I. M. Kruger, E. Wentzel-Viljoen, A. Kruger, M. Tieland. "Lean Mass Appears to Be More Strongly Associated with Bone Health than Fat Mass in Urban Black South African Women", J Nutr Health Aging, Vol. 19, No. 6. pp. 628-636, Jun 2015. DOI: 10.1007/s12603-015-0492-1.   DOI
31 H. A. Weiler, L. Janzen, K. Green, J. Grabowski, M. M. Seshia, K. C. Yuen. "Percent body fat and bone mass in healthy Canadian females 10 to 19 years of age", Bone, Vol. 27, No. 2. pp. 203-207, Aug 2000. DOI: 10.1016/s8756-3282(00)00314-8.   DOI
32 E. Lazcano-Ponce, J. Tamayo, A. Cruz-Valdez, R. Diaz, B. Hernandez, R. Del Cueto, M. Hernandez-Avila. "Peak bone mineral area density and determinants among females aged 9 to 24 years in Mexico", Osteoporos Int, Vol. 14, No. 7. pp. 539-547, Jul 2003. DOI: 10.1007/s00198-002-1363-2.   DOI
33 K. J. Ellis, R. J. Shypailo, W. W. Wong, S. A. Abrams. "Bone mineral mass in overweight and obese children: diminished or enhanced?", Acta Diabetol, Vol. 40 Suppl 1. pp. S274-277, Oct 2003. DOI: 10.1007/s00592-003-0085-z.   DOI
34 K. Zhu, M. Hunter, A. James, E. M. Lim, B. R. Cooke, J. P. Walsh. "Discordance between fat mass index and body mass index is associated with reduced bone mineral density in women but not in men: the Busselton Healthy Ageing Study", Osteoporos Int, Vol. 28, No. 1. pp. 259-268, Jan 2017. DOI: 10.1007/s00198-016-3710-8.   DOI
35 M. A. Bredella, M. Torriani, R. H. Ghomi, B. J. Thomas, D. J. Brick, A. V. Gerweck, L. M. Harrington, A. Breggia, C. J. Rosen, K. K. Miller. "Determinants of bone mineral density in obese premenopausal women", Bone, Vol. 48, No. 4. pp. 748-754, Apr 1 2011. DOI: 10.1016/j.bone.2010.12.011.   DOI
36 L. T. Ho-Pham, U. D. Nguyen, T. V. Nguyen. "Association between lean mass, fat mass, and bone mineral density: a meta-analysis", J Clin Endocrinol Metab, Vol. 99, No. 1. pp. 30-38, Jan 2014. DOI: 10.1210/jc.2013-319010.1210/jc.2014-v99i12-30A.   DOI
37 P. Dimitri, N. Bishop, J. S. Walsh, R. Eastell. "Obesity is a risk factor for fracture in children but is protective against fracture in adults: a paradox", Bone, Vol. 50, No. 2. pp. 457-466, Feb 2012. DOI: 10.1016/j.bone.2011.05.011.   DOI
38 D. R. Taaffe, J. A. Cauley, M. Danielson, M. C. Nevitt, T. F. Lang, D. C. Bauer, T. B. Harris. "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, Vol. 16, No. 7. pp. 1343-1352, Jul 2001. DOI: 10.1359/jbmr.2001.16.7.1343.   DOI
39 S. Gnudi, E. Sitta, N. Fiumi. "Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass", J Bone Miner Metab, Vol. 25, No. 5. pp. 326-332, 2007. DOI: 10.1007/s00774-007-0758-8.   DOI
40 S. H. Ahn, S. H. Lee, H. Kim, B. J. Kim, J. M. Koh. "Different relationships between body compositions and bone mineral density according to gender and age in Korean populations (KNHANES 2008-2010)", J Clin Endocrinol Metab, Vol. 99, No. 10. pp. 3811-3820, Oct 2014. DOI: 10.1210/jc.2014-1564.   DOI
41 I. R. Reid, L. D. Plank, M. C. Evans. "Fat mass is an important determinant of whole body bone density in premenopausal women but not in men", J Clin Endocrinol Metab, Vol. 75, No. 3. pp. 779-782, Sep 1992. DOI: 10.1210/jcem.75.3.1517366.   DOI
42 W. D. Leslie, J. T. Schousboe, S. N. Morin, P. Martineau, L. M. Lix, H. Johansson, E. V. McCloskey, N. C. Harvey, J. A. Kanis. "Loss in DXA-estimated total body lean mass but not fat mass predicts incident major osteoporotic fracture and hip fracture independently from FRAX: a registry-based cohort study", Arch Osteoporos, Vol. 15, No. 1. pp. 96, Jun 25 2020. DOI: 10.1007/s11657-020-00773-w.   DOI
43 R. Rizzoli, J. P. Bonjour, S. L. Ferrari. "Osteoporosis, genetics and hormones", J Mol Endocrinol, Vol. 26, No. 2. pp. 79-94, Apr 2001. DOI: 10.1677/jme.0.0260079.   DOI
44 "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group", World Health Organ Tech Rep Ser, Vol. 843. pp. 1-129, 1994.
45 J. Makovey, V. Naganathan, P. Sambrook. "Gender differences in relationships between body composition components, their distribution and bone mineral density: a cross-sectional opposite sex twin study", Osteoporos Int, Vol. 16, No. 12. pp. 1495-1505, Dec 2005. DOI: 10.1007/s00198-005-1841-4.   DOI