Centrally located body fat is associated with lower bone mineral density in older Puerto Rican adults123

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Background: Fat mass is thought to be protective against osteoporosis, primarily because of its weight-bearing effect. Few studies have evaluated the association between abdominal fat mass (AFM) and bone health beyond its weight-bearing effect.

Objective: We tested the hypothesis that higher body weight–adjusted AFM is associated with poor bone health.

Design: A cross-sectional study was conducted in 629 Puerto Rican adults aged 47–79 y. Bone mineral density (BMD) of the femoral neck, trochanter, total femur, and lumbar spine (L2-L4) were measured by using dual-energy X-ray absorptiometry (DXA). AFM and total fat mass (TFM) were assessed by using body-composition software from whole-body DXA scans. Osteoporosis and osteopenia were defined as T-scores ≤ −2.5 and −1.0 to −2.5 SD, respectively, at the respective bone site.

Results: After confounders were controlled for, body weight–adjusted AFM was inversely associated with BMD at all 4 bone sites in women and at the femoral neck in men. For TFM, small inverse associations were seen at the trochanter and total femur in women. In men, similar associations were seen at the 3 femur sites. In both sexes, the odds for osteoporosis or osteopenia at each of the femoral sites increased by 10−16% for every 100-g increase in body weight–adjusted AFM.

Conclusions: Higher AFM was associated with poor bone health in this Puerto Rican sample. Efforts to reduce abdominal obesity will not only reduce the risk of chronic disease but may also improve bone health. This trial is registered at ttp://www.clinicaltrials.gov as NCT01231958.

Abbreviations:

AFM
abdominal fat mass
BMD
bone mineral density
DXA
dual-energy X-ray absorptiometry
GED
General Education Development
TFM
total fat mass

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1

From the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (SNB and AHL); the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA (SNB, BD-H, AHL, and KLT); the School of Medicine, Tufts University, Boston, MA (BD-H); the Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA (MTH); and the Department of Health Sciences, Northeastern University, Boston, MA (KLT).

2

Supported by grants from the NIH (P01 AG023394, P50 HL105185, and R01 AG027087-01A1).

3

Address correspondence to KL Tucker, 316 Robinson Hall, Department of Health Sciences, Northeastern University, Boston, MA 02115. E-mail:[email protected].