Abstract

This study investigated the relationships of fat mass (FM) and lean mass (LM) with estimated hip bone strength in Chinese men aged 50–80 years (median value: 62.0 years). A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip bone parameters were generated by dual-energy X-ray absorptiometry (DXA). The relationships of the LM index (LMI) and the FM index (FMI) with bone phenotypes were detected by generalised additive models and multiple linear regression. The associations between the FMI and the bone variables in LMI tertiles were further analysed. The FMI possessed a linear relationship with greater estimated hip bone strength after adjustment for the potential confounders (p < 0.05). Linear relationships were also observed for the LMI with most bone phenotypes, except for the cross-sectional area (p < 0.05). The contribution of the LMI (4.0%–12.8%) was greater than that of the FMI (2.0%–5.7%). The associations between the FMI and bone phenotypes became weaker after controlling for LMI. Further analyses showed that estimated bone strength ascended with FMI in the lowest LMI tertile (p < 0.05), but not in the subgroups with a higher LMI. This study suggested that LM played a critical role in bone health in middle-aged and elderly Chinese men, and that the maintenance of adequate FM could help to promote bone acquisition in relatively thin men.

Highlights

  • Osteoporosis is a common skeletal disorder in the elderly population worldwide

  • The subjects had a lower consumption of dietary calcium and an adequate dietary intake of protein compared with the recommended nutrient intake (RNI) for Chinese

  • Compared with the FMI1 subgroup, the mean values of Bone mineral density (BMD), cross sectional area (CSA), and cortical thickness (CT) were around 6.0%–7.0% higher and the mean value of buckling ratio (BR) was about 6.0% lower in the subgroup of FMI3

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Summary

Introduction

Osteoporosis is a common skeletal disorder in the elderly population worldwide. It causes a reduction in bone strength and leads to a high risk of fracture. Evidence indicates that bone geometry is another vital determinant of bone strength, and the combination of the two indices markedly improves the accuracy of predicting osteoporotic fracture risk [3,4]. Quantitative computed tomography (QCT) is considered as the golden standard for obtaining three-dimensional structural measurements of bone. The relative high costs and high radiation doses to acquire quality images of QCT limit its use in clinical practice and research [5]. The dual-energy X-ray absorptiometry (DXA) technique has been newly adopted to measure bone structure with a shorter examination time and lower radiation exposure to patients

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