Differential contributions of lean and fat mass on bone mineral density in Asian women of reproductive age: the Singapore Preconception Study of Long-Term Maternal and Child Outcomes study
Differential contributions of lean and fat mass on bone mineral density in Asian women of reproductive age: the Singapore Preconception Study of Long-Term Maternal and Child Outcomes study
The relationships between fat mass (FM), lean mass (LM), and bone mass are complex with significant implications for obesity, sarcopenia, and osteoporosis later in life. While greater LM is associated with higher BMD, the association between FM and BMD is less clear. Such relationships warrant further investigation, especially in Asians, who have a higher risk of metabolic diseases and osteoporotic fractures compared to Western populations. This study investigated the associations of LM, FM, and modifiable risk factors with BMD in Asian women aged 18-45 yr. A total of 191 women from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) cohort study underwent DXA scanning at the first study visit for BMD and body composition measurements. LM, FM, and four body composition phenotypes derived from dichotomizing LM and FM were related to cohort-specific Z-scores of BMD at FN (BMDFN), LS (BMDLS), and whole body (BMDWB). Adjusting for covariates, LM showed positive associations with Z-BMDFN, [β (95%CI)], [0.38 (0.22, 0.55)], Z-BMDLS [0.43 (0.25, 0.62)], and Z-BMDWB, [0.63 (0.44, 0.81)]. Fat mass by contrast showed an inverse association only with Z-BMDWB, [-0.39 (-0.58, -0.20)]. Compared to women with healthy body composition (higher LM-lower FM), women with lower LM-higher FM had similar BMI, mean (SD) 20.9 (1.5) kg/m2 but disproportionately higher percent fat, 38.4 (2.2%), and lower Z-BMDFN [-0.58 (-0.97, -0.18)], Z-BMDLS [-0.41 (-0.81, 0.00)], and Z-BMDWB [-0.66 (-1.06, -0.25)]. Chinese women had lower BMD than Malay women. Physical activity and education attainment were positively, while the age of menarche was negatively associated with BMD. These findings in young women underscore the importance of early interventions recognizing ethnic differences in BMD to improve lifecourse musculoskeletal health. Most importantly, intervention strategies for Asian women should focus on healthy body composition beyond BMI, with a goal to preserve or increase LM.
Asian women, general population studies, human association studies, lean mass, osteoporosis, sarcopenia
Tint, Mya Thway
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Cremaschi, Andrea
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Leow, Melvin Khee Shing
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Padmapriya, Natarajan
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Ang, Seng Bin
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Lai, Jun Shi
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Chan, Jerry Kok Yen
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Bernard, Jonathan Y.
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Gluckman, Peter D.
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Chong, Yap-Seng
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Godfrey, Keith M.
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Müller-Riemenschneider, Falk
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Zhang, Cuilin
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Harvey, Nicholas C.
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De Iorio, Maria
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Eriksson, Johan G.
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19 May 2025
Tint, Mya Thway
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Cremaschi, Andrea
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Leow, Melvin Khee Shing
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Padmapriya, Natarajan
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Ang, Seng Bin
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Lai, Jun Shi
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Chan, Jerry Kok Yen
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Bernard, Jonathan Y.
c831fc27-9e1a-46ca-b335-859e14c5083b
Gluckman, Peter D.
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Chong, Yap-Seng
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Godfrey, Keith M.
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Müller-Riemenschneider, Falk
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Zhang, Cuilin
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Harvey, Nicholas C.
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De Iorio, Maria
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Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Tint, Mya Thway, Cremaschi, Andrea, Leow, Melvin Khee Shing, Padmapriya, Natarajan, Ang, Seng Bin, Lai, Jun Shi, Chan, Jerry Kok Yen, Bernard, Jonathan Y., Gluckman, Peter D., Chong, Yap-Seng, Godfrey, Keith M., Müller-Riemenschneider, Falk, Zhang, Cuilin, Harvey, Nicholas C., De Iorio, Maria and Eriksson, Johan G.
(2025)
Differential contributions of lean and fat mass on bone mineral density in Asian women of reproductive age: the Singapore Preconception Study of Long-Term Maternal and Child Outcomes study.
JBMR Plus, 9 (6), [ziaf054].
(doi:10.1093/jbmrpl/ziaf054).
Abstract
The relationships between fat mass (FM), lean mass (LM), and bone mass are complex with significant implications for obesity, sarcopenia, and osteoporosis later in life. While greater LM is associated with higher BMD, the association between FM and BMD is less clear. Such relationships warrant further investigation, especially in Asians, who have a higher risk of metabolic diseases and osteoporotic fractures compared to Western populations. This study investigated the associations of LM, FM, and modifiable risk factors with BMD in Asian women aged 18-45 yr. A total of 191 women from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) cohort study underwent DXA scanning at the first study visit for BMD and body composition measurements. LM, FM, and four body composition phenotypes derived from dichotomizing LM and FM were related to cohort-specific Z-scores of BMD at FN (BMDFN), LS (BMDLS), and whole body (BMDWB). Adjusting for covariates, LM showed positive associations with Z-BMDFN, [β (95%CI)], [0.38 (0.22, 0.55)], Z-BMDLS [0.43 (0.25, 0.62)], and Z-BMDWB, [0.63 (0.44, 0.81)]. Fat mass by contrast showed an inverse association only with Z-BMDWB, [-0.39 (-0.58, -0.20)]. Compared to women with healthy body composition (higher LM-lower FM), women with lower LM-higher FM had similar BMI, mean (SD) 20.9 (1.5) kg/m2 but disproportionately higher percent fat, 38.4 (2.2%), and lower Z-BMDFN [-0.58 (-0.97, -0.18)], Z-BMDLS [-0.41 (-0.81, 0.00)], and Z-BMDWB [-0.66 (-1.06, -0.25)]. Chinese women had lower BMD than Malay women. Physical activity and education attainment were positively, while the age of menarche was negatively associated with BMD. These findings in young women underscore the importance of early interventions recognizing ethnic differences in BMD to improve lifecourse musculoskeletal health. Most importantly, intervention strategies for Asian women should focus on healthy body composition beyond BMI, with a goal to preserve or increase LM.
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ziaf054
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Accepted/In Press date: 26 March 2025
e-pub ahead of print date: 9 April 2025
Published date: 19 May 2025
Keywords:
Asian women, general population studies, human association studies, lean mass, osteoporosis, sarcopenia
Identifiers
Local EPrints ID: 502526
URI: http://eprints.soton.ac.uk/id/eprint/502526
ISSN: 2473-4039
PURE UUID: 88f279e1-776a-48c8-b14b-b7efe85b6890
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Date deposited: 30 Jun 2025 17:06
Last modified: 22 Aug 2025 01:52
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Contributors
Author:
Mya Thway Tint
Author:
Andrea Cremaschi
Author:
Melvin Khee Shing Leow
Author:
Natarajan Padmapriya
Author:
Seng Bin Ang
Author:
Jun Shi Lai
Author:
Jerry Kok Yen Chan
Author:
Jonathan Y. Bernard
Author:
Peter D. Gluckman
Author:
Yap-Seng Chong
Author:
Falk Müller-Riemenschneider
Author:
Cuilin Zhang
Author:
Maria De Iorio
Author:
Johan G. Eriksson
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