Analysis of body composition in individuals with high bone mass reveals a marked increase in fat mass in women but not men

Gregson, Celia L., Paggiosi, Margaret A., Crabtree, Nicola, Steel, Sue A., McCloskey, Eugene, Duncan, Emma L., Fan, Bo, Shepherd, JJohn A., Fraser, William D., Smith, George Davey, & Tobias, John H. (2013) Analysis of body composition in individuals with high bone mass reveals a marked increase in fat mass in women but not men. Journal of Clinical Endocrinology and Metabolism, 98(2), pp. 818-828.

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Context: High bone mass (HBM), detected in 0.2% of dual-energy x-ray absorptiometry (DXA) scans, is characterized by raised body mass index, the basis for which is unclear. Objective: To investigate why body mass index is elevated in individuals with HBM, we characterized body composition and examined whether differences could be explained by bone phenotypes, eg, bone mass and/or bone turnover. Design, Setting, and Participants: We conducted a case-control study of 153 cases with unexplained HBM recruited from 4 UK centers by screening 219 088 DXA scans. Atotal of 138 first-degree relatives (of whom 51 had HBM) and 39 spouses were also recruited. Unaffected individuals served as controls. Main Outcome Measures: We measured fat mass, by DXA, and bone turnover markers. Results: Amongwomen, fat mass was inversely related to age in controls (P<.01), but not in HBM cases (P<.96) in whom mean fat mass was 8.9 [95% CI 4.7, 13.0] kg higher compared with controls (fully adjusted mean difference, P<.001). Increased fat mass in male HBM cases was less marked (gender interaction P = .03). Compared with controls, lean mass was also increased in female HBM cases (by 3.3 [1.2, 5.4] kg; P<.002); however, lean mass increases wereless marked than fat mass increases, resulting in 4.5% lower percentage lean mass in HBM cases (P<.001). Osteocalcin was also lower in female HBM cases compared with controls (by 2.8 [0.1, 5.5]μg/L; P = .04). Differences in fat mass were fully attenuated after hip bone mineral density (BMD) adjustment (P = .52) but unchanged after adjustment for bone turnover (P < .001), whereas the greater hip BMD in female HBM cases was minimally attenuated by fat mass adjustment (P<.001). Conclusions: HBM is characterized by a marked increase in fat mass in females, statistically explained by their greater BMD, but not by markers of bone turnover. Copyright © 2013 by The Endocrine Society.

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ID Code: 94181
Item Type: Journal Article
Refereed: Yes
Additional Information: Cited By :9
Export Date: 14 March 2016
Correspondence Address: Gregson, C.L.; Avon Orthopaedic Centre, University of Bristol, Southmead Hospital, Bristol BS10 5NB, United Kingdom; email:
Chemicals/CAS: adiponectin, 283182-39-8; osteocalcin, 136461-80-8; Osteocalcin, 104982-03-8
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Keywords: adiponectin, osteocalcin, adult, age distribution, aged, article, body composition, bone density, bone mass, bone turnover, case control study, controlled study, dual energy X ray absorptiometry, fat mass, female, hip, human, lean body weight, major clinical study, male, phenotype, physical activity, priority journal, sex difference, Adipose Tissue, Age Factors, Aged, 80 and over, Body Mass Index, Bone and Bones, Case-Control Studies, Humans, Middle Aged, Sex Factors
DOI: 10.1210/jc.2012-3342
ISSN: 1945-7197
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: The Endocrine Society 2013
Deposited On: 29 Mar 2016 01:47
Last Modified: 30 Mar 2016 00:50

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