Influence of Body Composition on Quantitative Ultrasound Parameters of the Os Calcis in a Population-based Sample of Pre- and Postmenopausal Women

Body mass is known to be related to measures of bone mineral density (BMD) as well as to parameters of quantitative ultrasound (US). To examine the effect of the body compartment's fat mass and lean body mass on quantitative ultrasonic bone parameters, data from a sample of 3241 German women were analyzed. Anthropometric measures, including skinfold thickness, were obtained from standardized measurements, and fat and lean body mass were derived from classical regression formulas based on skinfold measurements. Ultrasonic bone measurements were performed on the right os calcis, and speed of sound (SOS) and broadband ultrasound attenuation (BUA) were determined. Women were grouped into pre- and postmenopausal status; postmenopausal women were further stratified into ever and never hormone-replacement user. Correlation analysis indicated lean body mass to be stronger correlated with BUA than fat mass in both pre- (r = 0.23; P = 0.0001) and postmenopausal women with (r = 0.19; P = 0.0001) and without hormone replacement therapy (HRT) (r = 0.26; p = 0.0001). SOS demonstrated very small or no associations with body mass or its components. Multiple linear regression models were used to describe the relationship among body weight, fat mass, and lean body mass on BUA after adjustment for confounding variables. Both in pre- and postmenopausal women lean body mass was more strongly related to BUA than fat mass. However, body mass measures explained only small amounts of the overall variance in BUA (R(2) = 1-3% in premenopausal women; R(2) = 1% postmenopausal with HRT; R(2) = 4-5% in postmenopausal women without HRT). In conclusion, the strong influence of body mass and its components previously reported for BMD was not observed for quantitative ultrasonic bone parameters.