Adiposity and bone health in Spanish adolescents. The HELENA study Gracia Marco, Luis Andrés Ortega Porcel, Francisco Bartolomé Jiménez Pavón, David Gerardo, Rodríguez Castillo, Manuel J Vicente-Rodríguez, German Moreno, Luis A While the association of lean mass (LM) with bone mass is well understood, the association of fat mass (FM) with bone mass is controversial. Our results support that adolescents with higher levels of adiposity have greater bone mass, but this association is fully explained by their higher levels of LM. Introduction: We aimed (1) to study the independent association of FM and LM with bone mass and (2) to study the differences in bone mass by weight status in adolescents, after controlling for relevant confounders, such as physical activity (PA), calcium intake, and LM. Methods: Participants were 330 adolescents (167 boys, 12.5-17.5 years) from the HELENA study. The relationships of FM (DXA, n = 330; BodPod, n = 282) and LM (DXA, n = 330) with different bone variables (whole body, total hip, lumbar spine, and femoral neck) were analyzed by linear regression, and differences between weight status were analyzed by ANCOVA. Results: Fat mass (DXA) was positively associated with bone variables in both sexes, after adjustment for height, calcium intake, and sexual maturation. Additional adjustment by PA slightly increases the associations. However, adjustment for LM inverted these associations. Similar results were obtained using BodPod instead of DXA for assessing FM. Overweight/obese adolescents had higher BMC than their non-overweight peers in most of regions studied. Additional adjustment for PA slightly increased the differences between weight status groups, while adjusting for LM inverted the associations. LM was strong and positively associated with all bone variables in both sexes. Additional adjustment for PA or FM did not change the results. Conclusions: Adolescents with higher levels of adiposity have greater bone mass, but this association is explained by their higher levels of LM. 2025-04-08T12:11:17Z 2025-04-08T12:11:17Z 2012 journal article Gracia-Marco, L., Ortega, F. B., Jimenez-Pavon, D., Rodriguez, G., Castillo, M. J., Vicente-Rodriguez, G., & Moreno, L. A. (2012). Adiposity and bone health in Spanish adolescents. The HELENA study. Osteoporosis International, 23, 937-947. https://hdl.handle.net/10481/103526 10.1007/s00198-011-1649-3 eng http://creativecommons.org/licenses/by-nc-nd/4.0/ embargoed access Attribution-NonCommercial-NoDerivatives 4.0 Internacional