{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:09:12Z","timestamp":1785506952830,"version":"3.56.0"},"reference-count":28,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brazilian National Council for Scientific and Technological Development"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The relationship between body composition, especially fat mass (FM), and bone mineral density (BMD) is still a matter of debate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to test whether FM and lean mass (LM) are predictors of osteoporosis and if the association between body composition and BMD varies by sex, age, and body mass index (BMI) status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 1316 participants from the ELSA-Brasil Cohort who underwent dual-energy X-ray absorptiometry. Osteoporosis prevalence was stratified by BMI category and sex. Multivariable regression analyses were performed with lean and FM indexes as predictors of osteoporosis and BMD at different sites according to sex, age, and BMI category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Osteoporosis was prevalent in 18.6% of postmenopausal females and 8% of males aged \u226550 years. In the fully adjusted model, LM was inversely associated with osteoporosis in the overall male population and in females with BMI \u226530\u2005kg\/m2 and positively associated with BMD in males and in postmenopausal females with BMI \u226525\u2005kg\/m2. FM was positively associated with BMD in postmenopausal females with BMI &amp;lt; 25\u2005kg\/m2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In postmenopausal women with a BMI &amp;lt; 25\u2005kg\/m2, BMD is positively associated with FM, whereas in postmenopausal females with a BMI \u226525\u2005kg\/m2, BMD is positively associated with LM. These findings support the theory that FM is an important predictor of BMD\u2014possibly due to its effect on estradiol levels through aromatization\u2014up until a certain \u201cfat threshold\u201d, after which other factors, including LM and its effect on mechanical loading, likely become more dominant factors affecting BMD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jendso\/bvag119","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:37:09Z","timestamp":1779190629000},"source":"Crossref","is-referenced-by-count":0,"title":["Fat and lean mass association with osteoporosis and bone mineral density: the ELSA-Brasil cohort"],"prefix":"10.1210","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8349-3303","authenticated-orcid":false,"given":"Thiago Bosco","family":"Mendes","sequence":"first","affiliation":[{"name":"Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almog","family":"Shalit","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo Souza","family":"Domiciano","sequence":"additional","affiliation":[{"name":"Bone Metabolism Laboratory, Division of Rheumatology, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliano","family":"Generoso","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiological Research, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 05508-000 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0315-4219","authenticated-orcid":false,"given":"Virg\u00ednia L\u00facia Naz\u00e1rio","family":"Bonoldi","sequence":"additional","affiliation":[{"name":"Bone Metabolism Laboratory, Division of Rheumatology, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9ria de Falco","family":"Caparbo","sequence":"additional","affiliation":[{"name":"Bone Metabolism Laboratory, Division of Rheumatology, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela M","family":"Bensenor","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiological Research, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 05508-000 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Andrade","family":"Lotufo","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiological Research, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 05508-000 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Sommer","family":"Bittencourt","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiological Research, University of S\u00e3o Paulo , S\u00e3o Paulo, SP 05508-000 ,","place":["Brazil"]},{"name":"Division of Cardiology, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouneh K","family":"Fazeli","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]},{"name":"Center for Human Integrative Physiology, University of Pittsburgh School of Medicine , Pittsburgh, PA 15213 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