Association between lean body mass to visceral fat mass ratio and bone mineral density in United States population: a cross-sectional study

Abstract

Background Studies have explored the correlation between body composition and bone mineral density (BMD), but there has yet to be a consensus. Thus, the present study aims to comprehensively investigate the association between lean body mass, adipose tissue, and BMD. Methods We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) (2011–2018) with 11,227 subjects. Multiple linear regression, smoothed curve fitting, threshold, and saturation effect analysis were used to explore the association between lean body mass, visceral fat mass, and BMD. Also, we used the lean body mass to visceral fat mass ratio (Log LM/VFM) as a proxy variable to analyze its association with BMD alone. Results After adjusting for potential confounding factors, the results showed a positive correlation between lean mass and total BMD (for continuous: β = 0.078, P < 0.001; for quartile: β = 0.138, P < 0.001), while visceral fat mass was negatively correlated (for continuous: β = -0.027, P < 0.001; for quartile: β = -0.065, P < 0.001). A positive correlation was observed when the alternative variable Log LM/VFM was analyzed separately for its association with BMD (for continuous: β = 0.034, P < 0.001; for quartile: β = 0.084, P < 0.001). In addition, subgroup analyses for gender, age, body mass index, hypertension, and diabetes showed that all subgroups except the diabetes subgroup showed a substantial degree of robustness (P < 0.05). The smoothed curve fitting showed a nonlinear relationship between Log LM/VFM and BMD, and there was a threshold effect with a critical value of 2.60. Conclusion Maintaining a proper ratio of lean body mass and visceral fat mass is beneficial for increasing BMD.

The Association between Obesity and Reduced Weight-Adjusted Bone Mineral Content in Older Adults: A New Paradigm That Contrasts with the Obesity Paradox

“…The distribution of body composition may also impact bone mass status, particularly the ratio between lean mass and visceral fat mass [44], and this is in line with our third finding, in which an increased trunk fat/ALM ratio was associated with lower w-BMC%, with the trunk fat representing the central fat deposition. Another important component included in this ratio is the ALM, which expresses the muscle mass of the extremities, whose impact on bone mass is not yet fully understood [45].…”

L-shaped association between lean body mass to visceral fat mass ratio with hyperuricemia: a cross-sectional study

“…Diminished lean body mass and elevated visceral fat both are strongly linked to an elevated risk of metabolic diseases. When the two are present together, there is likely a synergistic effect on metabolic health [ 18 , 19 , 56 ]. Based on the Chinese National Health Survey, He et al [ 57 ] found that total body fat to muscle ratio was positively correlated with hyperuricemia and that the higher the ratio, the higher the SUA.…”

“…Contemporary investigations have further revealed that maintaining an optimal proportion of lean body mass to adipose tissue yields advantageous outcomes in mitigating metabolic risk [ 17 ]. We are dedicated to researching the relationship between body composition and metabolic health [ 18 , 19 ]. However, the existing evidence is inadequate to establish a correlation between the proportion of lean body mass to visceral fat and hyperuricemia.…”