内脏脂肪代谢评分与骨密度及骨质疏松症的关联：一项美国国家健康与营养检查调查横断面研究

Association of visceral fat metabolic score with bone mineral density and osteoporosis: a NHANES cross-sectional study.

作者信息

Gu Peng, Shi Bowen, Zhang Zheng, Du Ying, Jia Yanqing, Zhu Guowei, Wen Tianlin, Jia Zhiwei, Wu Yaohong, Zhao Xiyan

机构信息

Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.

Clinical Medical School, Qinghai University, Xining, 810001, China.

出版信息

J Health Popul Nutr. 2025 May 14;44(1):156. doi: 10.1186/s41043-025-00914-2.

DOI:10.1186/s41043-025-00914-2

PMID:40369619

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12079861/

Abstract

BACKGROUND

Metabolic Score for Visceral Fat (METS-VF) is commonly used as an indicator for assessing visceral fat metabolism. However, the relationship between METS-VF, Bone Mineral Density (BMD), and osteoporosis remains unclear in the American population.

METHODS

This study utilized cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), including participants aged 20 years and older, from the survey cycles conducted between 2005 and 2010, 2013-2014, and 2017-2018. Multivariable weighted linear regression and logistic regression analyses were first applied to investigate the associations between the METS-VF, femoral BMD, and osteoporosis. In addition, subgroup interaction analyses were performed to evaluate the robustness of these associations. To address potential non-linear relationships, restricted cubic spline regression was employed. All statistical analyses were conducted using R software version 4.3.3. P values were two-tailed, with P < 0.05 considered statistically significant.

RESULTS

After adjusting for all covariates, the positive correlations between METS-VF and BMD measurements at all sites remained statistically significant (p < 0.001 & p for trend < 0.001). Multivariable logistic regression analysis indicated that, after adjusting for covariates related to osteoporosis, each one-unit increase in METS-VF was associated with a 63.1% reduction in the risk of developing osteoporosis. Moreover, the direction of the associations between METS-VF and both BMD and osteoporosis remained consistent across all subgroups, while restricted cubic spline (RCS) analyses suggested nonlinear relationships. The 5.82-7.35 METS-VF range yielded a mean 51.9% osteoporosis risk reduction (sustained ≥ 30% peak efficacy in 66.7% of participants).

CONCLUSIONS

METS-VF demonstrated a nonlinear positive association with BMD and a nonlinear inverse relationship with osteoporosis risk. Future studies should establish optimal biological thresholds of METS-VF for skeletal health.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

内脏脂肪代谢评分（METS-VF）通常用作评估内脏脂肪代谢的指标。然而，在美国人群中，METS-VF、骨密度（BMD）和骨质疏松症之间的关系仍不清楚。

方法

本研究利用了美国国家健康与营养检查调查（NHANES）的横断面数据，包括2005年至2010年、2013年至2014年以及2017年至2018年调查周期中20岁及以上的参与者。首先应用多变量加权线性回归和逻辑回归分析来研究METS-VF、股骨骨密度和骨质疏松症之间的关联。此外，进行亚组交互分析以评估这些关联的稳健性。为了处理潜在的非线性关系，采用了受限立方样条回归。所有统计分析均使用R软件版本4.3.3进行。P值为双侧，P < 0.05被认为具有统计学意义。

结果

在调整所有协变量后，METS-VF与所有部位骨密度测量值之间的正相关性仍具有统计学意义（p < 0.001，趋势p < 0.001）。多变量逻辑回归分析表明，在调整与骨质疏松症相关的协变量后，METS-VF每增加一个单位，患骨质疏松症的风险降低63.1%。此外，METS-VF与骨密度和骨质疏松症之间关联的方向在所有亚组中保持一致，而受限立方样条（RCS）分析表明存在非线性关系。METS-VF范围在5.82至7.35之间时，骨质疏松症风险平均降低51.9%（66.7%的参与者峰值疗效持续≥30%）。