Niu He-Gang, Hu Gao-Kai, Li Tong, Guo Zhao, Hu Yang, Gong Yu-Kang, Ye Gao-Qi, Chen De-Jin, An Ji-Long, Gao Wen-Shan
Department of Orthopaedic Surgery, Affiliated Hospital of Hebei University, 212 Yuhua East Road, Baoding, 071000, Hebei Province, China.
Calcif Tissue Int. 2025 May 25;116(1):76. doi: 10.1007/s00223-025-01386-6.
Obesity significantly impacts bone health. The ABSI is an innovative metric for assessing obesity, offering greater accuracy than traditional measures such as body mass index and waist circumference in reflecting visceral fat accumulation. This study aims to investigate the relationship between ABSI and BMD as well as its association with osteoporosis among U.S. adults, utilizing data from the NHANES. This cross-sectional study analyzed data from adults aged 18 years and older, collected during the 2005-2006, 2013-2014, and 2017-2018 cycles of the NHANES. Multivariate linear regression models were used to evaluate the association between ABSI and BMD. Multivariate logistic regression models were applied to assess the relationship between ABSI and osteoporosis. Restricted cubic spline models were employed to evaluate potential nonlinear associations between ABSI and BMD as well as osteoporosis. Additionally, subgroup analyses and sensitivity analyses were conducted to ensure the robustness of the findings. A total of 5487 participants were included in the analysis, with a mean age of 47.04 years. ABSI was found to be negatively associated with BMD at the femoral neck, total femur, and lumbar spine. Participants in the highest ABSI quartile exhibited a significantly higher prevalence of osteoporosis compared to those in the lowest quartile (OR = 1.95; 95% CI 1.61-2.26). Nonlinear relationships were observed between ABSI and BMD at the femoral neck, total femur, lumbar spine, and osteoporosis, with inflection points at 8.84, 8.56, 9.23, and 8.14, respectively. Sensitivity analyses confirmed the robustness of these associations. Subgroup analyses revealed significant interactions between ABSI and BMD in smokers (P < 0.05). This study identifies a significant negative association between ABSI and BMD and a positive association with osteoporosis. The nonlinear relationship observed between ABSI and both BMD and osteoporosis underscores the importance of maintaining an optimal ABSI to promote bone health. These findings support the utility of ABSI as a valuable marker for early identification and prevention of osteoporosis, offering actionable insights for clinical and public health strategies. Future longitudinal research is warranted to validate these results and further elucidate the underlying mechanisms.
肥胖对骨骼健康有显著影响。ABSI是一种用于评估肥胖的创新指标，在反映内脏脂肪堆积方面比体重指数和腰围等传统测量方法更准确。本研究旨在利用美国国家健康与营养检查调查（NHANES）的数据，调查美国成年人中ABSI与骨密度（BMD）之间的关系及其与骨质疏松症的关联。这项横断面研究分析了在NHANES的2005 - 2006年、2013 - 2014年和2017 - 2018年周期中收集的18岁及以上成年人的数据。使用多元线性回归模型评估ABSI与BMD之间的关联。应用多元逻辑回归模型评估ABSI与骨质疏松症之间的关系。采用受限立方样条模型评估ABSI与BMD以及骨质疏松症之间潜在的非线性关联。此外，进行了亚组分析和敏感性分析以确保研究结果的稳健性。共有5487名参与者纳入分析，平均年龄为47.04岁。研究发现ABSI与股骨颈、全股骨和腰椎的骨密度呈负相关。与最低四分位数的参与者相比，ABSI最高四分位数的参与者骨质疏松症患病率显著更高（比值比=1.95；95%置信区间1.61 - 2.26）。在股骨颈、全股骨、腰椎的ABSI与骨密度以及ABSI与骨质疏松症之间观察到非线性关系，拐点分别为8.84、8.56、9.23和8.14。敏感性分析证实了这些关联的稳健性。亚组分析显示吸烟者中ABSI与骨密度之间存在显著交互作用（P＜0.05）。本研究确定了ABSI与骨密度之间存在显著负相关以及与骨质疏松症存在正相关。在ABSI与骨密度和骨质疏松症之间观察到的非线性关系强调了维持最佳ABSI以促进骨骼健康的重要性。这些发现支持了ABSI作为早期识别和预防骨质疏松症的有价值标志物的实用性，为临床和公共卫生策略提供了可操作的见解。未来有必要进行纵向研究以验证这些结果并进一步阐明潜在机制。
