Abstract

BackgroundBone mineral density (BMD) loss is a major complication of menopause, and this loss is closely associated with Fat mass (FM). The relationship between FM, fat distribution (FD), and BMD in postmenopausal women, however, remains incompletely understood. The present study was thus developed to explore these associations between body fat accumulation, FD, and BMD among non-obese postmenopausal women over the age of 60.MethodsThis was a cross-sectional analysis of 357 healthy postmenopausal women between the ages of 60.2 and 86.7 years. Dual-energy X-ray absorptiometry (DXA) was utilized to measure total and regional BMD as well as fat-related parameters including total FM, android and gynoid fat, body fat percentage (BF%), and total lean mass (LM) for all subjects. The android-to-gynoid fat ratio (AOI) was used to assess FD. Pearson’s correlation testing and multiple regression analyses were used to explore relationships among AOI, LM, FM, and BMD.ResultsBoth LM and FM were positively correlated with total and regional BMD in univariate analysis (all P < 0.01), whereas BMD was not significantly associated with AOI in any analyzed site other than the head. Multivariate linear regression models corrected for age, height, and years post-menopause, revealed a sustained independent positive relationship between FM and BMD (standard β range: 0.141 – 0.343, P < 0.01). The relationship between FM and BMD was unaffected by adjustment for LM (standard β range: 0.132 – 0.258, P < 0.01), whereas AOI had an adverse impact on BMD at most analyzed skeletal sites (total body, hip, femoral neck, arm, leg, and head) (standard β range: −0.093 to −0.232, P < 0.05). These findings were unaffected by using BF% in place of FM (standard β range: −0.100 to −0.232, P < 0.05).ConclusionsIn this cohort of non-obese postmenopausal women over the age of 60 from China, total FM was positively associated with BMD, while AOI was negatively correlated with BMD. As such, a combination of proper weight gain and the control of central obesity may benefit the overall bone health of women after menopause.

Highlights

  • Osteoporosis is a prevalent and often asymptomatic condition that commonly develops in women after menopause, contributing to significant reductions in quality of life over time

  • The diagnosis of osteoporosis is primarily made through measurements of bone mineral density (BMD) [1], which is in turn closely tied to body composition-related parameters including lean mass (LM) and fat mass (FM) [2]

  • 357 healthy, non-obese (BMI: 18.5 – 30) postmenopausal women were enrolled in the present study

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Summary

Introduction

Osteoporosis is a prevalent and often asymptomatic condition that commonly develops in women after menopause, contributing to significant reductions in quality of life over time. The android-to-gynoid fat ratio (AOI) has been reported to be a valuable indicator of central (visceral) fat accumulation that is correlated with BMD, but studies have yielded inconsistent findings regarding such a relationship [16–20]. For example, found central fat accumulation to be negatively correlated with BMD [18], whereas Kapus et al observed the opposite relationship [19]. These contrasting results underscore the complex interplay between FM, fat distribution (FD), and BMD in postmenopausal women. The present study was developed to explore these associations between body fat accumulation, FD, and BMD among non-obese postmenopausal women over the age of 60

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