Maintaining lean muscle mass and overall body weight was associated with reduced bone loss in women during the early years after menopause, according to study results published in the Journal of Bone and Mineral Research.
Women in the early postmenopausal period face accelerated bone loss alongside changes in body composition, including declining muscle mass and increasing fat mass. To explore how these changes influence skeletal health, investigators analyzed outcomes from a cohort of women in Sweden enrolled in a clinical trial (ELBOW II; ClinicalTrials.gov Identifier: NCT04169789).
The study followed 223 women aged between 50 and 60 years who were 1 to 4 years postmenopause. Participants were evaluated over a 2-year period. Body weight, body mass index (BMI), fat mass, and appendicular lean mass (ALM) were measured with dual-energy X-ray absorptiometry (DXA). Bone characteristics were assessed by DXA at the hip and lumbar spine, as well as by high-resolution peripheral quantitative computed tomography at the tibia.
At enrollment, participants were aged a median of 55.0 years, median BMI was 24.2 kg/m², and median body weight was 66.5 kg. The women had a mean body fat percentage of 36.3% and mean ALM of 6.58 kg. The mean duration since menopause was 2.23 years.
These findings suggest that maintaining or increasing appendicular lean mass and preserving overall body weight may help mitigate skeletal fragility during the early postmenopausal years.
At baseline, higher body weight, BMI, and fat mass were associated with stronger bone measures, including greater cortical and total volumetric bone mineral density (BMD), as well as higher total hip BMD. In contrast, baseline ALM was not linked to hip or spine BMD, and no body composition measure was associated with trabecular bone volume fraction.
Over the 2-year follow-up, however, changes in ALM emerged as the strongest predictor of skeletal benefits. Increases in ALM were associated with gains in total hip BMD (β=0.130; 95% CI, 0.069-0.191; P <.0001), lumbar spine BMD (β=0.091; 95% CI, 0.022-0.159; P =.010), total volumetric BMD (β=0.058; 95% CI, 0.023-0.094; P =.0015), trabecular bone volume fraction (β=0.048; 95% CI, 0.016-0.080; P =.0038), and cortical area (β=0.093; 95% CI, 0.043-0.144; P =.0003). Weight and BMI changes also tracked with improvements across several bone outcomes, while fat mass change was linked only to cortical area.
Exploratory comparisons highlighted the combined role of fat and muscle. Women with both lower baseline fat mass (28.1%) and greater ALM loss (-2.87 kg) experienced significantly higher rates of bone decline, with 2.4-fold greater reductions in total hip BMD and 5.2-fold greater reductions in tibia total volumetric BMD compared with women who had higher fat mass (45.0%) and ALM gains (+3.81 kg).
Study limitations include the homogeneous Swedish cohort and relatively short 2-year follow-up period.
“These findings suggest that maintaining or increasing appendicular lean mass and preserving overall body weight may help mitigate skeletal fragility during the early postmenopausal years,” the study authors concluded.
This research was supported by BioGaia AB. Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
For more articles about weight-loss, visit: https://nurobalance2.net