In this cross-sectional study of 217 Chinese children with DMD, body fat percentage rather than obesity was linked to low muscle mass, glucocorticoid exposure and higher body fat were linked to low bone mineral density, and gut microbiota composition was associated with BMD, body fat percentage, age, GC exposure, and P1NP, suggesting that treatments targeting gut microbiota may alleviate glucocorticoid-induced low BMD in DMD.
Children with DMD who had obesity or high body fat percentage had higher caloric intake and lower bone mineral density and osteocalcin levels.
Older age increased the risk of low muscle mass in children with DMD.
Overweight, obesity, low body fat percentage, and a high level of calories from protein were protective factors for low muscle mass.
Glucocorticoid exposure increased the risk of low BMD, whereas low body fat percentage decreased it.
Gut microbiota composition was closely associated with BMD Z-score, body fat percentage, age, GC exposure, and P1NP.
DMD children with low BMD had a higher abundance of Bacteroides vulgatus and a lower abundance of Prevotella copri.
Body fat percentage, rather than obesity, was the risk factor for low muscle mass in DMD, and skeletal muscle index (SMI) may assess muscle mass more accurately than skeletal muscle mass (SMM).
The authors suggest a high level of calories from protein may benefit SMI and that targeting gut microbiota may alleviate glucocorticoid-induced low BMD in DMD.
This study looked at 217 Chinese children with Duchenne muscular dystrophy (DMD), a muscle-wasting disease. Researchers measured body composition, blood markers, diet (using three days of recalled meals), and gut bacteria to see how nutrition, gut microbes, and muscle and bone health relate to one another. Children with obesity or a high percentage of body fat ate more calories and had weaker bones and lower levels of a bone-related marker (osteocalcin). Older age raised the chance of low muscle mass, while a higher share of calories from protein appeared linked to better muscle index. Long-term glucocorticoid (steroid) use was linked to a higher chance of low bone density. Children with low bone density also had different gut bacteria, with more Bacteroides vulgatus and less Prevotella copri. This research suggests that body fat percentage, rather than body weight category alone, may be the more useful nutritional marker in DMD, and that gut bacteria may play a role in steroid-related bone loss. Because this was a cross-sectional study, it shows associations at one point in time and cannot prove cause and effect. Further studies would be needed to test whether dietary changes or treatments targeting gut microbes can improve muscle and bone health in these children.
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Upload Your LabsLi S, Cheng R, He M, Hu Q, Xu H, Wu X, et al.. (2026). Exploring the relationship among nutrition, gut microbiota and musculoskeletal health in children with Duchenne muscular dystrophy: a cross-sectional study.. European journal of nutrition. https://doi.org/10.1007/s00394-026-04135-z