Foroutani Mohammad Reza, Salamat Mohammad Reza, Bagherzadeh Sakineh, Keshtkar Mohammad, Khoshhali Mehri, Asgari Mahdi
Department of Nursing, School of Nursing, Larestan University of Medical sciences, Larestan, Iran.
Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Clin Densitom. 2025 Mar 10;28(3):101580. doi: 10.1016/j.jocd.2025.101580.
The aim of this study was to investigate the differential effects of trunk region body composition-specifically fat mass (FM) and lean mass (LM)-on lumbar spine bone mineral density (BMD) and bone mineral content (BMC), with a focus on variations by gender and menopausal status.
We identified 331 adult patients (69 men, 161 premenopausal women, and 101 postmenopausal women) who underwent dual-energy X-ray absorptiometry (DXA) to simultaneously measure trunk body composition and lumbar spine BMD (L-L). The Pearson correlation coefficient was used to assess the linear relationships between body composition components and lumbar spine BMD and BMC, stratified by gender and menopausal status. Additionally, multiple linear regression analysis with the forward stepwise elimination procedure was applied to find a reasonable subset of predictor variables.
The highest correlation coefficients between body composition and BMD were seen for men and post- and premenopausal individuals in the following areas: pelvic fat mass (r = 0.325; P < 0.01), chest lean mass (r = 0.260; P < 0.01), and total lean mass (r = 0.312; P < 0.01), respectively. Additionally, total lean mass (r = 0.477; P < 0.01), chest lean mass (r = 0.360; P < 0.01), and total lean mass (r = 0.459; P < 0.01) had the strongest correlation coefficients between body composition and BMC. Forward stepwise regression identified age, chest lean mass, and midriff fat mass as predictors of BMC in postmenopausal women; BMI and total lean mass in premenopausal women; and total lean mass in men. For BMD, chest lean mass (postmenopausal), total lean mass (premenopausal), and BMI (men) were significant predictors.
Fat mass does not affect BMD or BMC, while lean mass, strongly predicts bone health. Trunk body composition showed varying relationships with BMD and BMC, making it challenging to pinpoint how lean mass distribution in the chest and midriff specifically impacts bone health.
本研究的目的是调查躯干区域身体成分（特别是脂肪量（FM）和瘦体重（LM））对腰椎骨密度（BMD）和骨矿物质含量（BMC）的不同影响，重点关注性别和绝经状态的差异。
我们纳入了331例成年患者（69名男性、161名绝经前女性和101名绝经后女性），这些患者接受了双能X线吸收法（DXA）检查，以同时测量躯干身体成分和腰椎BMD（L-L）。采用Pearson相关系数评估按性别和绝经状态分层的身体成分组分与腰椎BMD和BMC之间的线性关系。此外，应用带有向前逐步排除程序的多元线性回归分析来寻找合理的预测变量子集。
在以下区域，男性、绝经后和绝经前个体的身体成分与BMD之间的相关系数最高：盆腔脂肪量（r = 0.325；P < 0.01）、胸部瘦体重（r = 0.260；P < 0.01）和总瘦体重（r = 0.312；P < 0.01）。此外，总瘦体重（r = 0.477；P < 0.01）、胸部瘦体重（r = 0.360；P < 0.01）和总瘦体重（r = 0.459；P < 0.01）在身体成分与BMC之间的相关系数最强。向前逐步回归确定年龄、胸部瘦体重和腹部脂肪量是绝经后女性BMC的预测因素；绝经前女性的BMI和总瘦体重；以及男性的总瘦体重。对于BMD，胸部瘦体重（绝经后）、总瘦体重（绝经前）和BMI（男性）是显著的预测因素。
脂肪量不影响BMD或BMC，而瘦体重强烈预测骨骼健康。躯干身体成分与BMD和BMC呈现出不同的关系，难以确定胸部和腹部的瘦体重分布如何具体影响骨骼健康。
