TOPLINE:

For women in early years of menopause, body composition at baseline and its changes over 2 years were both associated with bone health outcomes. Gains in appendicular lean mass over 2 years showed strong positive effects on bone mineral density (BMD) at specific bone sites.

METHODOLOGY:

• Researchers analysed data from a randomised trial and reported how body composition and its changes over time were associated with bone characteristics among women in early menopause.
• They included 223 Swedish women (median age, 55 years; median BMI, 24.2) who stopped menstruating within the past 1-4 years and followed them for 2 years after menopause.
• Women underwent assessments for body composition, including body weight, BMI, appendicular lean mass, and fat mass.
• Bone assessments included areal BMD at the total hip, lumbar spine, and femoral neck, along with volumetric BMD and bone microarchitecture at the distal tibia.
• In a separate analysis, women were grouped into tertiles on the basis of baseline fat mass and relative changes in appendicular lean mass.

TAKEAWAY:

• Higher baseline body weight, BMI, fat mass, and appendicular lean mass were all associated with greater cortical area, cortical volumetric BMD, and total volumetric BMD (P < .05 for all). Only body weight, BMI, and fat mass were associated with total hip areal BMD (P < .05 for all), but not lumbar spine or femoral neck areal BMD.
• Changes in appendicular lean mass over 2 years showed positive associations with multiple bone outcomes, including total hip BMD (beta coefficient [β], 0.130; P < .0001), lumbar spine BMD (β, 0.091; P = .010), and cortical area (β, 0.093; P = .0003). Changes in fat mass were associated with only cortical area (β, 0.056; P = .042).
• Increases in body weight and BMI over 2 years were each significantly associated with gains in total hip BMD, total volumetric BMD, cortical volumetric BMD, and cortical area (P < .05 for all).
• Women in the highest tertiles of baseline fat mass and gain in appendicular lean mass experienced significantly lower bone loss than those in the lowest tertiles of these measures.

IN PRACTICE:

"[The study] findings underscore the dynamic and compartment-specific nature of the relationship between body composition and bone health and highlight the importance of considering both the timing and type of body composition change in evaluating skeletal outcomes," the authors of the study wrote.

"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," they added.

SOURCE:

This study was led by Marina Vilar Geraldi, University of Gothenburg, Gothenburg, Sweden. It was published online on September 11, 2025, in the Journal of Bone and Mineral Research.

LIMITATIONS:

This study included a homogeneous, predominantly Swedish cohort, which may have limited the generalisability to other racial and ethnic groups. The follow-up duration was relatively short with modest changes in variables.

DISCLOSURES:

This study received funding from BioGaia AB and the Swedish Research Council and through grants from the Sahlgrenska University Hospital. One author reported receiving lecture fees from UCB Pharma, and another author reported receiving lecture and consulting fees from several pharmaceutical companies, including Amgen, Medison Pharma, and Medac.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.