The menopausal transition stage brings physiological changes associated with the development of metabolic syndrome (MetS), which can affect bone mineral density (BMD), and may be more evident in the postmenopausal stage. The aim of this study was assessing the association between low BMD and MetS and its components among reproductive/menopausal transition and postmenopausal women in the northeast region of Mexico. A descriptive cross-sectional study was carried out (2015-2016) in 40-60-year-old women (n = 376) who were residents in the metropolitan area of Monterrey, in Nuevo Leon State, Mexico. Anthropometric measurements, blood pressure, a dual-energy X-ray absorptiometry (DXA) evaluation of BMD of two anatomical sites (lumbar spine and dual femur), and a biochemical analysis were obtained. The prevalence of MetS was 57.2%. In participants without MetS, the prevalence of osteopenia was 27.3% in the lumbar spine and 18.6% in the dual femur, while in participants with MetS, the prevalence of osteopenia was 35.8% in the lumbar spine and 14.4% in the dual femur. Osteoporosis in participants without MetS was present in 6.8% in the lumbar spine and in 1.8% in the dual femur, while in women with MetS, its prevalence was 4.7% in the lumbar spine and 0.5% in the dual femur. An association between low BMD at the lumbar spine and dual femur and components of MetS diseases was identified in Mexican women as follows: waist circumference ≥ 88 cm showed an increase risk for low BMD at femoral site in both reproductive/menopausal transition (OR 7.638; 95% CI: 1.607-36.298; p = 0.011) and postmenopausal women (OR 2.600; 95% CI: 1.023-6.609; p = 0.045); HDL < 50 mg/dL was associated with low BMD in both the femur (OR 3.639; 95% CI: 1.039-12.743; p = 0.043) and lumbar spine (OR 2.654; 95% CI: 1.092-6.447; p = 0.031); hypertension in postmenopausal women increased the risk for low BMD in the femur (OR 2.634; 95% CI: 1.150-6.035; p = 0.022). In conclusion, we found that components of the MetS were associated with low BMD, thus indicating that MetS increases the risk for developing osteopenia or osteoporosis. Furthermore, age was found to be an independent risk factor for low BMD.

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