Association of central adiposity and metabolic markers with osteopenia and osteoporosis in Chinese adults: a QCT-based cross-sectional study.

The prevalences of osteopenia and osteoporosis in the study population were 35.14% and 14.05%, respectively.

• Cross-sectional study conducted among 10,142 Chinese adults aged ≥45 years
• Bone mineral density assessed via quantitative computed tomography (QCT) for lumbar spine
• Participants were categorized as normal, osteopenia, and osteoporosis

WWI demonstrated the strongest predictive value for osteoporosis among all anthropometric and metabolic indices examined.

• WWI achieved an area under the curve (AUC) of 0.726 for osteoporosis prediction
• WWI outperformed all other indices including RFM and ABSI, which followed in predictive performance
• ROC curve analyses were used to evaluate predictive capabilities

Weight-adjusted waist index (WWI), relative fat mass (RFM), a body shape index (ABSI), triglyceride-glucose (TyG) index, and glycated hemoglobin (HbA1c) were independently associated with both osteopenia and osteoporosis.

• Associations were identified after adjusting for confounders using multivariable logistic regression
• All five indices showed statistically significant independent associations with low BMD conditions
• These indices capture central adiposity and/or metabolic dysfunction

BMI and the visceral adiposity index (VAI) showed no significant associations with low bone mineral density.

• Neither BMI nor VAI was significantly associated with osteopenia or osteoporosis after adjusting for confounders
• This contrasts with WWI, RFM, and ABSI, which were all significantly associated with low BMD
• Findings suggest that global adiposity measures like BMI may be insufficient for osteoporosis risk assessment

Central adiposity indices outperformed general adiposity and visceral adiposity indices in predicting osteoporosis risk.

• WWI, RFM, and ABSI — all measures of central adiposity — were independently associated with osteopenia and osteoporosis
• BMI, a measure of overall adiposity, showed no significant association
• VAI, a measure of visceral adiposity, also showed no significant association
• Authors conclude that 'indices associated with central adiposity and metabolic dysfunction, especially WWI, may provide more precise prediction of osteoporosis risk'

Incorporating central adiposity and metabolic indices into early risk stratification for osteoporosis among older Chinese adults may have potential clinical utility.

• Study population was middle-aged and older Chinese adults aged ≥45 years
• Authors suggest these indices could improve early identification of individuals at risk for osteoporosis
• The study design was cross-sectional, limiting causal inference