Department of Endocrinology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China.
Department of Obstetrics and Gynecology, The Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road No. 9, Suzhou, 215000, Jiangsu, China.
BMC Musculoskelet Disord. 2023 Sep 8;24(1):715. doi: 10.1186/s12891-023-06844-6.
The relationship between abdominal adipose tissue and osteoporosis is poorly understood. The purpose of this study was to examine the associations of abdominal adipose tissue with bone mineral density (BMD) among a nationally representative sample of US middle-aged adults.
This study included 1498 participants from the National Health and Nutrition Examination Survey 2013-2014 and 2017-2018. Dual-energy x-ray absorptiometry was used to measure BMD at the lumbar spine and femoral neck, as well as to assess abdominal adipose mass by categorizing total adipose tissue (TAT) into visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Linear regression was used to assess the relationship between abdominal adipose tissue and BMD, and logistic regression and generalized additive model were used to assess the associations of abdominal adipose tissue with the development of low BMD.
In our study, men accounted for 51.3%, and the mean age and body mass index for men and women were 49.3 and 49.6 years, and 23.9 and 28.3 kg/m, respectively. In the univariate model, we found that abdominal adipose mass was positively associated with BMD at femoral neck and spine in both genders. In the multivariate model, among men, a negative correlation was observed between TAT and SAT and BMD at the femoral neck. Additionally, higher masses of TAT, SAT, and VAT were found to significantly increase the risk of low BMD at both the femoral neck and lumbar spine. In contrast, there was no significant association between abdominal adipose mass and BMD in middle-aged women, regardless of menopausal status.
Our finding suggested that abdominal adipose tissue, regardless of its location (SAT or VAT), may have a negative impact on BMD in middle-aged men independently of body weight, but this relationship was not observed in women. Further research is needed to confirm these findings and investigate potential mechanisms underlying these associations.
腹部脂肪组织与骨质疏松症之间的关系尚未得到充分理解。本研究旨在检查美国中年成年人的代表性样本中腹部脂肪组织与骨密度（BMD）之间的关联。
本研究包括来自 2013-2014 年和 2017-2018 年全国健康和营养检查调查的 1498 名参与者。双能 X 射线吸收法用于测量腰椎和股骨颈的 BMD，并通过将总脂肪组织（TAT）分类为内脏脂肪组织（VAT）和皮下脂肪组织（SAT）来评估腹部脂肪质量。线性回归用于评估腹部脂肪组织与 BMD 之间的关系，逻辑回归和广义加性模型用于评估腹部脂肪组织与低 BMD 发生的关联。
在我们的研究中，男性占 51.3％，男性和女性的平均年龄和体重指数分别为 49.3 和 49.6 岁，23.9 和 28.3kg/m。在单变量模型中，我们发现腹部脂肪质量与两性的股骨颈和脊柱的 BMD 呈正相关。在多变量模型中，男性中 TAT 和 SAT 与股骨颈 BMD 呈负相关。此外，TAT、SAT 和 VAT 的质量较高，被发现显著增加了股骨颈和腰椎低 BMD 的风险。相比之下，无论绝经状态如何，腹部脂肪质量与中年女性的 BMD 均无显著相关性。
我们的研究结果表明，腹部脂肪组织，无论其位置（SAT 或 VAT）如何，可能对独立于体重的中年男性的 BMD 产生负面影响，但在女性中未观察到这种关系。需要进一步研究来证实这些发现，并研究这些关联的潜在机制。
