Role of visceral adipose tissue in osteoporosis: A longitudinal analysis in a Southern Taiwan medical Center's health management center.

PURPOSE: The relationship between visceral adipose tissue (VAT) and bone mineral density (BMD) remains controversial. To further elucidate this association, a longitudinal cohort study to examine the association between VAT and BMD was conducted at a medical center in Southern Taiwan.

METHODS

We conducted a retrospective analysis of 3535 health checkup participants aged at least 50 years who initially underwent bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). Subsequently, these participants underwent follow-up DXA after a minimum of one year, from January 2017 to December 2022. The participants were stratified into two cohorts (osteoporosis and nonosteoporosis). Hazard ratios (HRs) for osteoporosis were compared using the Cox regression model in two distinct cohorts.

RESULTS

Out of 3535 participants, 201 (5.7 %) developed osteoporosis while remaining 3334 (94.3 %) did not develop the disease. After adjusting for demographic, behavioral, and clinical variables, the VAT mass (HR: 0.79, 95 % confidence intervals (CI):0.59-0.87, P < 0.05) demonstrated a significant association with osteoporosis development. Age (HR: 1.07, 95 % CI: 1.05-1.09, P < 0.001), diabetes mellitus (HR: 0.32, 95 % CI: 0.14-0.66, P < 0.01), and muscle mass (HR: 0.95, 95 % CI: 0.91-0.97, P < 0.01) also demonstrated significant associations. Furthermore, a generalized additive model (GAM) illustrated a nonlinear relationship between VAT and the likelihood of osteoporosis.

CONCLUSION

The study demonstrates that lower levels of VAT are correlated with an increased incidence of osteoporosis, especially in individuals with reduced VAT. These findings highlight the potential need for BMD screening among people with reduced VAT.