Korean Journal of Family Medicine

"Fat Mass"

Original Article

The Association between Fat Mass, Lean Mass and Bone Mineral Density in Premenopausal Women in Korea: A Cross-Sectional Study: Jeehyun Kim, Hyuktae Kwon, Bo-Kyoung Heo, Hee-Kyung Joh, Cheol Min Lee, Seung-Sik Hwang, Danbee Park, Jae-Hong Park; Korean J Fam Med 2018;39(2):74-84. Published online March 22, 2018; DOI: https://doi.org/10.4082/kjfm.2018.39.2.74

Abstract
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Background

We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea.

Methods

A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008–2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed.

Results

In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11–18.01) and truncal FM (OR, 5.48; 95% CI, 1.75–17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women.

Conclusion

Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.

Citations

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Review

Weight and Bone Mineral Density: The Summary of Epidemiological Evidence.: Hyun Ah Park, Hye Jin Kim, Tae Jun Kim, Jin Joo Park, Jin Kyun Park; Korean J Fam Med 2009;30(3):167-174. Published online March 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.3.167

Abstract
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Not only bone mineral density (BMD) is strongly associated with body weight, but also weight change infl uences BMD change. The weight change related bone change is more marked in women especially after menopause, in the elderly, in the underweight and in persons who have the history of weight cycling. Because of the health impacts of obesity, weight reduction has been often recommended in practices. Therefore various intervention methods have been tried to reduce the weight change related bone change such as hormone therapy, raloxifene, exercise, and calcium supplementation. This review summarizes the epidemiological evidences of the weight change related bone change and the associated factors.

Citations

Citations to this article as recorded by

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Original Articles

Age Associated Changes in Body Mass Index and Body Fat Distribution.: Jung Ho Lee, Chan Hee Song, Keun Sang Yum, Kyung Soo Kim, Soon Woo Nam, Jun Yeol Han, Gyu Won Jeong, Hei Sik Sun; J Korean Acad Fam Med 2003;24(11):1010-1016. Published online November 10, 2003

Abstract
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Background
: Body mass index is currently applied as the diagnostic standard of overweight and obesity, regardless of age. Percentage body fat ratio applies separate standards among different sex, but does not have separate standards for different age groups. Since body mass index and percentage body fat may differ according to age, we conducted this study to see if a separate standard for overweight and obesity is indeed necessary for different age groups.

Methods : We selected 2,190 subjects, who were the 10 percent picked randomly by computer, among 21,921 clients who had visited the St. Mary's Hospital's health promotion center in Seoul. Those diagnosed with diabetes, thyroid disease, renal failure, and tuberculosis were excluded, leaving 1,939 over the age of 20, as final subjects. Anthropometric measurements were done using electronic scales and height meters, while body composition was measured with a multi-frequency bioelectric impedance analysis (Inbody 3.0 Biospace, Seoul). The results of this study were shown in mean and standard deviation, and mean values according to ages were compared by Ancova test.

Results : In the case of adult men, percentage body fat increased with age. This was observed especially with subjects over 30 compared to subjects in their 20s, although not proven to be statistically significant. A decrease in fat free mass rather than increase in body fat mass was noted with aging. With adult women, percentage body fat increased markedly with subjects over 50, mainly due to increased body fat mass rather than decreased fat free mass. Subjects exceeding a body mass index of 25, which is the standard limit of body mass index for obesity, was 60th percentile for adult men, and 70∼80th percentile for adult women. Percentage body fat in this case was 22.54% for men and 31.99∼33.46% for women.

Conclusion : Our study indicates that both men and women show changes in body mass index and fat free mass with aging. Hence, there are limitations to applying a universal standard for body mass Index, regardless of age. We suggest that further studies on standards for adult obesity should be conducted based on specific Korean epidemiologic data.

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The Relationship among Testosterone, IGF- 1 and Fat Mass.: Ki Young Kim, In Sun Kang, Young Gon Kang, So Lim Kim, Kyung Kyun Sin, Moon Jong Kim, Young Jin Lee, Chul Young Bae; J Korean Acad Fam Med 2003;24(3):245-253. Published online March 10, 2003

Abstract
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Background
: The age-related increase in fat mass seems related to decrease in hormone level. Few studies have been done in Korea concerning the association between testosterone, GH (growth hormone) and fat mass. This study was undertaken to evaluate the relationship among testosterone, IGF-1 and fat mass.

Methods : The study was performed from February to October 2001 in the Health Screening Center of Pundang CHA Hospital with 243 men as subjects. Fat intake was measured through interview with diet therapist and other data were obtained by self-questionnaire. Fat mass was measured using Inbody 3.0 and the level of total testosterone, SHBG and IGF-1 in serum were measured.

Results : Smoking was negatively correlated with fat mass and WHR (waist to hip ratio) (P＜0.05) and fat intake was positively correlated with fat mass (P＜0.05). Fat mass was negatively correlated with total testosterone, calculated free testosterone, and SHBG (r=-0.26; P＜0.01, r=-0.15; P＜0.05, r=-0.31; P＜0.01). WHR was positively correlated with age (r=0.26; P＜0.01) and negatively correlated with total testosterone, calculated free testosterone, and IGF-1 (r=-0.24; P＜0.01, r=-0.20; P＜0.01, r=-0.16; P＜0.05). After adjustment for age, body mass index, smoking, and fat intake, the calculated free testosterone and IGF-1 were independently negatively correlated with fat mass (β=-0.072; P＜0.01, β=-0.0035; P＜0.05) and WHR (β=-6.9E-04; P＜0.05, β=-4.0E-05; P＜0.05) but, total testosterone and SHBG were not independently correlated with fat mass and WHR.

Conclusion : The results indicate that the calculated free testosterone and IGF-1 can be independent determinants of fat mass and WHR in middle-aged men.