Influence of adipose tissue mass on bone mass in an overweight or obese population: systematic review and meta-analysis

Context The scientific literature shows conflicting evidence about the relationship between adiposity and bone mass in overweight and obese populations. Objective The aim of this review was to quantify the correlation between adipose mass (absolute and relative) and bone mineral density (BMD) in overweight and obese populations. Data Sources Three databases were searched electronically. In addition, reference lists of relevant articles were screened. Study Selection A total of 16 studies, comprising 2587 participants and 75 correlation coefficients were selected for inclusion in the review. Data Extraction Data were extracted from each study using a standardized form. Results Multilevel modeling indicated opposing relationships between BMD and adiposity: absolute adiposity correlated positively, and relative adiposity negatively, with BMD. Sex and age were the primary moderators of these relationships. Strong evidence supported a negative relationship between relative adipose mass and BMD in men (R = −0.37; 95%CI, −0.57 to −0.12) and in those aged less than 25 years (R = −0.28; 95%CI, −0.45 to −0.08). Conclusion To prevent bone loss in overweight and obese populations, nutrition- and exercise-based interventions that focus on a controlled reduction of adipose mass with concomitant preservation of lean mass are recommended. Systematic Review Registration: PROSPERO no. CRD42015024313