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

K. Zhu, M. Hunter, A. James, E. M. Lim, B. R. Cooke, J. P. Walsh

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Abstract

Summary: The obesity-BMD relationship is complex. In 3045 middle-aged adults, we found that in women (but not men) with discordant fat mass index (FMI)/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone. Introduction: The relationship between obesity and BMD is complex. FMI (fat mass (kg) / height (m)2) is a more accurate measure of fatness than BMI, and depending on body composition, some individuals have discordant BMI/FMI categories. We examined associations between FMI, BMI and BMD in participants in the Busselton Healthy Ageing Study. Methods: Body composition and BMD of the hip, spine and total body were measured using DXA in 3045 participants (1644 females) aged 45–67 years. Using standard BMI/FMI categories, the participants were classified as underweight/fat deficit, normal, overweight/excess fat, obese I and obese II–III. Results: BMI and FMI categories were concordant in 77.3 % of females and 71.2 % of males. There were 12.9 % females and 13.2 % males in a higher FMI than BMI category (high body fat for BMI), whereas 9.8 % females and 15.6 % males were in a lower category (low body fat for BMI). Females with high body fat for BMI had significantly lower covariate-adjusted BMD at the femoral neck, total hip and total body (differences of 3.8, 5.1 and 2.6 %, respectively, all P < 0.05) than females with low body fat for BMI and lower total body BMD than women with concordant FMI/BMI (by 1.4 %, P = 0.04). In males, BMD did not differ significantly between those who were concordant or discordant for FMI/BMI categories. Conclusion: In women (but not men) with discordant FMI/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone.

Original languageEnglish
Pages (from-to)259-268
Number of pages10
JournalOsteoporosis International
Volume28
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

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Bone Density
Body Mass Index
Fats
Adipose Tissue
Body Composition
Hip
Obesity
Bone and Bones
Thinness
Femur Neck
Spine

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@article{587f8aa8a1184add833544bd8c2b7a6b,
title = "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",
abstract = "Summary: The obesity-BMD relationship is complex. In 3045 middle-aged adults, we found that in women (but not men) with discordant fat mass index (FMI)/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone. Introduction: The relationship between obesity and BMD is complex. FMI (fat mass (kg) / height (m)2) is a more accurate measure of fatness than BMI, and depending on body composition, some individuals have discordant BMI/FMI categories. We examined associations between FMI, BMI and BMD in participants in the Busselton Healthy Ageing Study. Methods: Body composition and BMD of the hip, spine and total body were measured using DXA in 3045 participants (1644 females) aged 45–67 years. Using standard BMI/FMI categories, the participants were classified as underweight/fat deficit, normal, overweight/excess fat, obese I and obese II–III. Results: BMI and FMI categories were concordant in 77.3 {\%} of females and 71.2 {\%} of males. There were 12.9 {\%} females and 13.2 {\%} males in a higher FMI than BMI category (high body fat for BMI), whereas 9.8 {\%} females and 15.6 {\%} males were in a lower category (low body fat for BMI). Females with high body fat for BMI had significantly lower covariate-adjusted BMD at the femoral neck, total hip and total body (differences of 3.8, 5.1 and 2.6 {\%}, respectively, all P < 0.05) than females with low body fat for BMI and lower total body BMD than women with concordant FMI/BMI (by 1.4 {\%}, P = 0.04). In males, BMD did not differ significantly between those who were concordant or discordant for FMI/BMI categories. Conclusion: In women (but not men) with discordant FMI/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone.",
keywords = "Baby boomers, Body mass index, Bone mineral density, Busselton Healthy Ageing Study, Fat mass index, Middle-aged adults",
author = "K. Zhu and M. Hunter and A. James and Lim, {E. M.} and Cooke, {B. R.} and Walsh, {J. P.}",
year = "2017",
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T1 - Discordance between fat mass index and body mass index is associated with reduced bone mineral density in women but not in men

T2 - the Busselton Healthy Ageing Study

AU - Zhu, K.

AU - Hunter, M.

AU - James, A.

AU - Lim, E. M.

AU - Cooke, B. R.

AU - Walsh, J. P.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Summary: The obesity-BMD relationship is complex. In 3045 middle-aged adults, we found that in women (but not men) with discordant fat mass index (FMI)/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone. Introduction: The relationship between obesity and BMD is complex. FMI (fat mass (kg) / height (m)2) is a more accurate measure of fatness than BMI, and depending on body composition, some individuals have discordant BMI/FMI categories. We examined associations between FMI, BMI and BMD in participants in the Busselton Healthy Ageing Study. Methods: Body composition and BMD of the hip, spine and total body were measured using DXA in 3045 participants (1644 females) aged 45–67 years. Using standard BMI/FMI categories, the participants were classified as underweight/fat deficit, normal, overweight/excess fat, obese I and obese II–III. Results: BMI and FMI categories were concordant in 77.3 % of females and 71.2 % of males. There were 12.9 % females and 13.2 % males in a higher FMI than BMI category (high body fat for BMI), whereas 9.8 % females and 15.6 % males were in a lower category (low body fat for BMI). Females with high body fat for BMI had significantly lower covariate-adjusted BMD at the femoral neck, total hip and total body (differences of 3.8, 5.1 and 2.6 %, respectively, all P < 0.05) than females with low body fat for BMI and lower total body BMD than women with concordant FMI/BMI (by 1.4 %, P = 0.04). In males, BMD did not differ significantly between those who were concordant or discordant for FMI/BMI categories. Conclusion: In women (but not men) with discordant FMI/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone.

AB - Summary: The obesity-BMD relationship is complex. In 3045 middle-aged adults, we found that in women (but not men) with discordant fat mass index (FMI)/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone. Introduction: The relationship between obesity and BMD is complex. FMI (fat mass (kg) / height (m)2) is a more accurate measure of fatness than BMI, and depending on body composition, some individuals have discordant BMI/FMI categories. We examined associations between FMI, BMI and BMD in participants in the Busselton Healthy Ageing Study. Methods: Body composition and BMD of the hip, spine and total body were measured using DXA in 3045 participants (1644 females) aged 45–67 years. Using standard BMI/FMI categories, the participants were classified as underweight/fat deficit, normal, overweight/excess fat, obese I and obese II–III. Results: BMI and FMI categories were concordant in 77.3 % of females and 71.2 % of males. There were 12.9 % females and 13.2 % males in a higher FMI than BMI category (high body fat for BMI), whereas 9.8 % females and 15.6 % males were in a lower category (low body fat for BMI). Females with high body fat for BMI had significantly lower covariate-adjusted BMD at the femoral neck, total hip and total body (differences of 3.8, 5.1 and 2.6 %, respectively, all P < 0.05) than females with low body fat for BMI and lower total body BMD than women with concordant FMI/BMI (by 1.4 %, P = 0.04). In males, BMD did not differ significantly between those who were concordant or discordant for FMI/BMI categories. Conclusion: In women (but not men) with discordant FMI/BMI categories, higher body fat for BMI was associated with lower BMD, suggesting that increased fat mass without an accompanying increase in lean mass may be deleterious to bone.

KW - Baby boomers

KW - Body mass index

KW - Bone mineral density

KW - Busselton Healthy Ageing Study

KW - Fat mass index

KW - Middle-aged adults

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U2 - 10.1007/s00198-016-3710-8

DO - 10.1007/s00198-016-3710-8

M3 - Article

VL - 28

SP - 259

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JO - Osteoporosis International: with other metabolic bone diseases

JF - Osteoporosis International: with other metabolic bone diseases

SN - 0937-941X

IS - 1

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