Associations between Body Composition, Hormonal and Lifestyle Factors, Bone Turnover, and BMD
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Background: The relative importance of body composition, lifestyle factors, bone turn-over and hormonal factors in determining bone mineral density (BMD) is unknown. Westudied younger postmenopausal women to determine whether modifiable or non-modifiable risk factors for osteoporosis have stronger associations with BMD. Methods: In multivariable linear regression models, we tested associations betweennon-bone body composition measures, self-reported measures of physical activity anddietary intake, urinary N-telopeptide (NTx), sex hormone concentrations, and BMD in109 postmenopausal women aged 50 to 64 years, adjusting for current hormone thera-py use and clinical risk factors for low BMD. Lean mass, fat mass and areal BMD (aBMD)at the lumbar spine, femoral neck, total hip and distal radius were measured using dualenergy X-ray absorptiometry. Results: Higher body weight and self-reported nonwhite race were independently asso-ciated with higher aBMD at the lumbar spine, femoral neck, total hip and distal radius. Lean and fat mass were not independently associated with aBMD. Older age and higherurinary NTx were independently associated with lower aBMD at the distal radius but notat weight-bearing sites. Sensitivity analyses demonstrated lack of an independent asso-ciation between total daily protein or calorie intake and BMD. Conclusions: BMD, weight and race were the most important determinants of aBMD atall sites. Older age and higher bone turnover were independently associated with loweraBMD at the distal radius. In a limited analysis, self-reported physical activity, dietaryprotein and calorie intake were not associated with aBMD after adjustment for the othervariables.
Abstract
Background: The relative importance of body composition, lifestyle factors, bone turn-over and hormonal factors in determining bone mineral density (BMD) is unknown. Westudied younger postmenopausal women to determine whether modifiable or non-modifiable risk factors for osteoporosis have stronger associations with BMD. Methods: In multivariable linear regression models, we tested associations betweennon-bone body composition measures, self-reported measures of physical activity anddietary intake, urinary N-telopeptide (NTx), sex hormone concentrations, and BMD in109 postmenopausal women aged 50 to 64 years, adjusting for current hormone thera-py use and clinical risk factors for low BMD. Lean mass, fat mass and areal BMD (aBMD)at the lumbar spine, femoral neck, total hip and distal radius were measured using dualenergy X-ray absorptiometry. Results: Higher body weight and self-reported nonwhite race were independently asso-ciated with higher aBMD at the lumbar spine, femoral neck, total hip and distal radius. Lean and fat mass were not independently associated with aBMD. Older age and higherurinary NTx were independently associated with lower aBMD at the distal radius but notat weight-bearing sites. Sensitivity analyses demonstrated lack of an independent asso-ciation between total daily protein or calorie intake and BMD. Conclusions: BMD, weight and race were the most important determinants of aBMD atall sites. Older age and higher bone turnover were independently associated with loweraBMD at the distal radius. In a limited analysis, self-reported physical activity, dietaryprotein and calorie intake were not associated with aBMD after adjustment for the othervariables.
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