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

Analysis of body composition in individuals with high bone mass reveals a marked increase in fat mass in women but not men
Analysis of body composition in individuals with high bone mass reveals a marked increase in fat mass in women but not men
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] ?g/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.
0021-972X
818-828
Gregson, C.L.
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Paggiosi, M.A.
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Crabtree, N.
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Steel, S.A.
358d94bd-fa0d-42b2-b513-bcb0793e67d7
McCloskey, E.
5211de37-303a-42f8-b24b-00c475264f78
Duncan, E.L.
8075dd7a-c55c-4f9a-9cd6-258a73b366c1
Fan, B.
ff887a0f-1674-4530-96a9-dd759b0fee9c
Shepherd, J.A.
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Fraser, W.D.
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Smith, G.D.
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Tobias, J.H.
de2ae2cb-8547-475a-98e0-9d5169b8deb7
Gregson, C.L.
fc84c2dd-c427-486f-a212-3e3549cb5cdf
Paggiosi, M.A.
d2e54fb6-9e62-42e6-b3e7-2c742d4dc911
Crabtree, N.
b7c1f191-bda3-410b-afd5-d5631a8176aa
Steel, S.A.
358d94bd-fa0d-42b2-b513-bcb0793e67d7
McCloskey, E.
5211de37-303a-42f8-b24b-00c475264f78
Duncan, E.L.
8075dd7a-c55c-4f9a-9cd6-258a73b366c1
Fan, B.
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Shepherd, J.A.
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Fraser, W.D.
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Smith, G.D.
c7e35f45-1a12-4c5b-a767-f5184de4f2e4
Tobias, J.H.
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Gregson, C.L., Paggiosi, M.A., Crabtree, N., Steel, S.A., McCloskey, E., Duncan, E.L., Fan, B., Shepherd, J.A., Fraser, W.D., Smith, G.D. and Tobias, J.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 & Metabolism, 98 (2), 818-828. (doi:10.1210/jc.2012-3342). (PMID:23337721)

Record type: Article

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] ?g/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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Published date: 1 February 2013
Organisations: Faculty of Medicine

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Local EPrints ID: 352666
URI: http://eprints.soton.ac.uk/id/eprint/352666
ISSN: 0021-972X
PURE UUID: 8d7fdbbb-78c4-41f7-8b7d-1b26b1b2d818

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Date deposited: 16 May 2013 14:23
Last modified: 16 Jul 2019 21:33

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Contributors

Author: C.L. Gregson
Author: M.A. Paggiosi
Author: N. Crabtree
Author: S.A. Steel
Author: E. McCloskey
Author: E.L. Duncan
Author: B. Fan
Author: J.A. Shepherd
Author: W.D. Fraser
Author: G.D. Smith
Author: J.H. Tobias

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