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Appendicular fat mass is positively associated with femoral neck bone mineral density in older women

Marques, Elisa A. MSc1; Moreira, Pedro PhD1,2; Wanderley, Flávia MSc1; Pizarro, Andreia N. MSc1; Leão-Rosas, José P. MD1; Mota, Jorge PhD1; Carvalho, Joana PhD1

Menopause: The Journal of The North American Menopause Society: March 2012 - Volume 19 - Issue 3 - p 311–318
doi: 10.1097/gme.0b013e31822a8d51
Original Articles
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Objective In this study, we examined the relationships between body fat accumulation and distribution and bone mineral density (BMD) in older women.

Methods A total of 100 healthy white women (mean ± SD age, 68.7 ± 5.5 y) free of medications known to affect bone were enrolled. Lean mass, fat mass (FM), percentage body fat, android FM, gynoid FM, appendicular FM (AFM), appendicular lean mass, and femoral neck BMD were measured by dual-energy x-ray absorptiometry. Dietary intake was assessed by 4-day dietary record, and potential renal acid load was also calculated. Performance measures included knee extension and flexion strength measured on an isokinetic dynamometer. Physical activity was assessed using accelerometers and a questionnaire. Lactase nonpersistence was defined by the C/T-13910 genotype. Sociodemographic information, lifestyle behaviors, and clinical status were also examined. Stepwise multiple linear regression analysis showed that AFM was the most significant positive predictor of femoral neck BMD.

Results After adjustment for confounders (age, height, age at menopause, potential renal acid load, physical activity, and knee muscle strength), AFM had strong and independent associations with femoral neck BMD (26.4% of variance).

Conclusions These data highlight that in older women, localization of FM is more important for bone mass than obesity per se or lean mass. AFM (subcutaneous adiposity) seems to exhibit an independent protective effect on BMD.

Appendicular fat mass is more important than total fat mass or abdominal fat for femoral neck bone mineral density in older women. The positive association between appendicular fat mass and femoral neck BMD remained significant after adjusting for age, height, age at menopause, potential renal acid load, physical activity, and knee muscle strength.

From the 1Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, and 2Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.

Received May 10, 2011; revised and accepted June 22, 2011.

Funding/support: This research was funded by the Portuguese Foundation of Science and Technology, grant FCOMP-01-0124-FEDER-009587-PTDC/DES/102094/2008. E.A.M., F.W., and J.M. are supported by grants from the Portuguese Foundation of Science and Technology (SFRH/BD/36319/2007, SFRH/BD/33124/2007, and SFRH/BSAB/1025/2010, respectively).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Elisa A. Marques, MSc, Research Centre in Physical Activity, Health and Leisure, University of Porto, Rua Dr Plácido Costa 91, 4200-450 Porto, Portugal. E-mail: emarques@fade.up.pt

©2012The North American Menopause Society