Association of body mass index and bone mineral density in postmenopausal women: a systematic review and meta-analysis.

BACKGROUND

This meta-analysis aims to exploring the correlation between body mass index (BMI) and bone mineral density (BMD) in postmenopausal women (PMW).

METHODS

The MEDLINE, Embase, Web of Science, Scopus and Cochrane Central database was searched in August 2025. Special medications or diseases were excluded, and the correlation coefficient values of BMI and BMD within different bone regions were extracted and pooled. Sensitivity and meta-regression analysis were further investigated. This study was pre-registered in PROSPERO (CRD42024550020).

RESULTS

Twenty nine studies from 19 countries were analyzed, involving 9,086 PMW whose mean age ranged between 53.3 and 70.2 years. Sufficient data supported a positive correlation between BMI and BMD within PMW. The pooled Pearson r for the whole-body was 0.355 (95% CI: 0.269, 0.440) with heterogeneity (I =84.3%,  < 0.001). No significant heterogeneity was found in arm (r: 0.303; 95% CI: 0.240, 0.366), calcaneal bone (r: 0.154; 95% CI: 0.059, 0.249), ward's triangle (r: 0.285; CI: 0.230,0.339) and trochanteric part (r: 0.380; CI: 0.330,0.430). The r value in lumber spine was 0.243 (95% CI: 0.217, 0.270), also without significant heterogeneity (I =49.3%,  = 0.006). There were heterogeneities in the correlations with BMI in total hip (r: 0.336; CI: 0.282, 0.390) and femoral neck (r: 0.305; CI: 0.231, 0.379).

CONCLUSION

A positive correlation between the BMD and BMI in PMW with various degrees. Trochanteric sites had the largest correlation, calcaneal sites had the lowest correlation, while other sites were moderate. Efforts to limit decreasing of BMI preventing BMD decreasing in PMW were reasonable.