Relationship of lean body mass with bone mass and bone mineral density in the general Korean population

We investigated association of lean body mass with bone mass (BM) and bone mineral density (BMD) according to gender and menopausal status in the general Korean population. Participants included 4,299 males and 5,226 females who were 20 years of age or older from the fourth and fifth Korea National Health and Nutritional Examination Surveys (2009-2010). Dual-energy X-ray absorptiometry was used for measurement of BMD and body composition. BMD was measured in the femur and lumbar spine. Appendicular skeletal muscle mass (ASM) was defined as the sum of the lean soft tissue masses for the arms and legs. Analysis was performed after categorizing participants into four groups (males <50 years, males >= 50 years, premenopausal females, and postmenopausal females). In males, the highest ASM was observed in the 20-29-year group and then showed a gradual decrease as age increased, and BM and BMD showed similar patterns of change, while in females, ASM, BMD, and BM reached the peak level in the 40-49-year group and then decreased. In multiple regression analysis, after adjusting for confounding factors, the results showed an independent association of ASM with an increase in BM and BMD (P < 0.05). After adjusting for confounding factors, total fat mass showed a significant association with BM (P < 0.05). These aforementioned relationships were commonly observed on both femur and lumbar spine in every group. Lean body mass showed an independent association with increased BM and BMD, regardless of gender, age in men, and menopausal status in women.