Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Arch Osteoporos. 2023 Mar 22;18(1):44. doi: 10.1007/s11657-023-01233-x.
The effect of fat deficit on bone metabolism is understudied. This study showed that low body fat percent (adipopenia) in non-underweight community adults was associated with elevated odds of osteoporosis independent of low lean mass, highlighting potential clinical importance of adipopenia as an osteoporosis risk factor particularly in older adults.
Although underweight is risk factor for osteoporosis, the association of low body fat percent (adipopenia) with osteoporosis in non-underweight adults remains unclear.
Among individuals aged ≥ 50 years with body mass index ≥ 18.5 kg/m in the Korean National Health and Nutrition Examination Survey 2008-2011, appendicular lean mass (ALM) and body fat percent (BFP) were measured using dual-energy x-ray absorptiometry. Low lean mass was defined as ALM/height < 7.0 kg/m and < 5.4 kg/m in men and women, respectively. Osteoporosis was defined as a bone mineral density (BMD) T-score ≤ -2.5 at the lumbar spine, femoral neck, or total hip. Participants were grouped into adipopenia (BFP < 17% in men; < 30%, in women; 1 standard deviation below the mean), normal, and obesity (BFP > 30% in men; > 40% in women) groups.
Of the 5,830 participants (women 50.2%, mean age 63.9 years), 793 had adipopenia. The adipopenia group had a higher prevalence of osteoporosis (31%) than the normal (21%) or obesity groups (27%; p < 0.001). The presence of adipopenia was associated with 61% elevated odds of prevalent osteoporosis (p < 0.001) independent of low lean mass and covariates, which remained robust using different thresholds for adipopenia. Individuals with adipopenia and low lean mass had 3.5-fold elevated odds of osteoporosis compared to those with normal lean mass and fat percent. The association between adipopenia and osteoporosis was stronger in older women compared to middle-aged women (OR 1.93 vs. 0.99, P for interaction = 0.023).
Adipopenia was associated with osteoporosis in non-underweight adults, independent of low lean mass and covariates.
脂肪不足对骨骼代谢的影响研究较少。本研究表明，非体重不足的社区成年人体脂百分比较低（脂肪减少）与骨质疏松症的几率增加独立相关，而与低瘦体重无关，这突出了脂肪减少作为骨质疏松症危险因素的潜在临床重要性，特别是在老年人中。
尽管体重不足是骨质疏松症的危险因素，但体脂百分比较低（脂肪减少）与非体重不足成年人的骨质疏松症的关系仍不清楚。
在 2008-2011 年韩国国家健康和营养检查调查中，年龄在 50 岁及以上、体重指数≥18.5kg/m2的个体中，使用双能 X 射线吸收法测量四肢瘦体重（ALM）和体脂肪百分比（BFP）。低瘦体重定义为男性 ALM/身高<7.0kg/m 和女性 ALM/身高<5.4kg/m。骨质疏松症定义为腰椎、股骨颈或总髋部的骨密度（BMD）T 评分≤-2.5。参与者分为脂肪减少组（男性 BFP<17%；女性 BFP<30%，低于平均值 1 个标准差）、正常组和肥胖组（男性 BFP>30%；女性 BFP>40%）。
在 5830 名参与者中（女性占 50.2%，平均年龄 63.9 岁），793 名参与者有脂肪减少。脂肪减少组的骨质疏松症患病率（31%）高于正常组（21%）或肥胖组（27%；p<0.001）。存在脂肪减少与骨质疏松症的患病率增加 61%相关（p<0.001），独立于低瘦体重和协变量，使用不同的脂肪减少阈值时结果仍然稳健。与正常瘦体重和脂肪百分比的个体相比，脂肪减少和低瘦体重的个体骨质疏松症的几率增加了 3.5 倍。与中年女性相比，老年女性的脂肪减少与骨质疏松症之间的关联更强（OR 1.93 比 0.99，P 交互=0.023）。
在非体重不足的成年人中，脂肪减少与骨质疏松症相关，独立于低瘦体重和协变量。
