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. 2013 Feb;98(2):818-28.
doi: 10.1210/jc.2012-3342. Epub 2013 Jan 21.

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

Celia L Gregson  1 , Margaret A Paggiosi, Nicola Crabtree, Sue A Steel, Eugene McCloskey, Emma L Duncan, Bo Fan, John A Shepherd, William D Fraser, George Davey Smith, Jon H Tobias
Affiliations

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

Celia L Gregson et al. J Clin Endocrinol Metab. 2013 Feb.

Abstract

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. A total 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: Among women, 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 were less 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.

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Figures

Figure 1.
Figure 1.
Differences in TB BMC and FM with increasing age in HBM cases and controls, stratified by gender. Gray triangles, HBM cases; black circles, controls. B coefficients are standardized and adjusted for height only with 95% CI shown.
See this image and copyright information in PMC

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