Zuo Xiaoyong, Miao Zeyang, Xu Run, Shi Dan, Chang Shixin, Li Guanwu, Luo Peng
Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Geriatrics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2025 Feb 25;16:1542516. doi: 10.3389/fendo.2025.1542516. eCollection 2025.
To investigate the relationship between the Chinese visceral adiposity index (CVAI) and vertebral proton density fat fraction (PDFF).
The study included 181 postmenopausal females including 53 normal bone mineral density (BMD), 88 osteopenia, and 40 osteoporosis. Vertebral marrow PDFF was measured using Fat Analysis & Calculation Technique imaging, and BMD was assessed via dual-energy X-ray absorptiometry. Bone turnover biomarkers and lipid metabolism were evaluated. The relationship between CVAI and PDFF was assessed using multivariable linear regression models, generalized additive models, and threshold effect analysis.
The mean BMD at the lumbar spine increased, and PDFF significantly decreased as quartiles of CVAI increased ( for trends <0.05). Multivariable linear regression analysis revealed a clear negative correlation between CVAI and PDFF (regression coefficient β = -0.251, 95% CI, -0.303 to -0.200; < 0.001) after adjusting for age, time since menopause, waist circumference, body mass index, physical activity, and lipid profiles. The association with marrow PDFF remained significant (β = -0.202, 95% CI, -0.255 to -0.149, < 0.001) even after additional adjustment for BMD. Further analysis revealed an L-shaped non-linear relationship between CVAI and marrow PDFF after adjusting for age, time since menopause, waist circumference, body mass index, physical activity, lipid profiles, and BMD. An inflection point was identified at a CVAI of 128.3, below which each one-unit increase in CVAI corresponded to a more substantial decrease in marrow PDFF (β = -0.0055, 95% CI: -0.0064 to -0.0045; < 0.001). However, above this inflection point, each unit increase in CVAI was not significantly associated with a decrease in marrow PDFF.
CVAI exhibited a nonlinear negative association with marrow adiposity within a suitable range, once CVAI crossed a definite threshold, PDFF ceased to increase. This finding suggests that a moderate visceral fat accumulation may enhance skeletal integrity, while excessive visceral fat could potentially have detrimental effects.
探讨中国内脏脂肪指数（CVAI）与椎体质子密度脂肪分数（PDFF）之间的关系。
该研究纳入了181名绝经后女性，其中包括53名骨密度正常（BMD）者、88名骨量减少者和40名骨质疏松症患者。使用脂肪分析与计算技术成像测量椎体骨髓PDFF，并通过双能X线吸收法评估BMD。评估骨转换生物标志物和脂质代谢。使用多变量线性回归模型、广义相加模型和阈值效应分析评估CVAI与PDFF之间的关系。
随着CVAI四分位数的增加，腰椎的平均BMD升高，而PDFF显著降低（趋势P<0.05）。多变量线性回归分析显示，在调整年龄、绝经时间、腰围、体重指数、身体活动和血脂谱后，CVAI与PDFF之间存在明显的负相关（回归系数β=-0.251，95%CI：-0.303至-0.200；P<0.001）。即使在进一步调整BMD后，与骨髓PDFF的关联仍然显著（β=-0.202，95%CI：-0.255至-0.149，P<0.001）。进一步分析显示，在调整年龄、绝经时间、腰围、体重指数、身体活动、血脂谱和BMD后，CVAI与骨髓PDFF之间呈L形非线性关系。确定CVAI为128.3时有一个拐点，在此拐点以下，CVAI每增加一个单位，骨髓PDFF相应地有更显著的下降（β=-0.0055，95%CI：-0.0064至-0.0045；P<0.001）。然而，在该拐点以上，CVAI每增加一个单位与骨髓PDFF的下降无显著关联。
在合适范围内，CVAI与骨髓脂肪呈非线性负相关，一旦CVAI超过一定阈值，PDFF不再增加。这一发现表明，适度的内脏脂肪堆积可能增强骨骼完整性，而过多的内脏脂肪可能产生有害影响。
