The association between body fat distribution and osteosarcopenia in older adults: evidence from the PoCOsteo study.

Total fat mass was significantly and inversely associated with osteosarcopenia in older adults.

• Cross-sectional data from the PoCOsteo study involving 1,897 participants were analyzed.
• OR for osteosarcopenia with total fat = 0.946 (95% CI: 0.918–0.975).
• Body fat distribution was assessed using Dual X-ray absorptiometry (DXA).
• Models were adjusted for age, gender, marital status, tobacco use, income, education, occupation, and hypertension.

Android fat mass was inversely associated with osteosarcopenia.

• OR for osteosarcopenia with android fat = 0.932 (95% CI: 0.911–0.953).
• Android fat was among the strongest fat depot associations observed with osteosarcopenia.
• The association remained significant after adjustment for multiple covariates.

Trunk fat mass was inversely associated with osteosarcopenia.

• OR for osteosarcopenia with trunk fat = 0.927 (95% CI: 0.903–0.952).
• Trunk fat showed one of the stronger inverse associations among the fat depots examined.
• Trunk fat was also negatively associated with both osteoporosis and sarcopenia individually.

BMI was inversely associated with osteosarcopenia and showed the strongest association among the measures examined.

• OR for osteosarcopenia with BMI = 0.738 (95% CI: 0.703–0.775).
• BMI showed the largest magnitude of inverse association compared to specific fat depot measures.
• The association was significant after adjustment for age, gender, marital status, tobacco use, income, education, occupation, and hypertension.

Multiple fat deposits including gynoid, arm, and trunk fat, as well as the trunk-to-limb fat mass ratio, were negatively associated with both osteoporosis and sarcopenia individually.

• Regression models revealed negative associations between total, gynoid, trunk, arm, and android fat deposits and both osteoporosis and sarcopenia.
• The trunk-to-limb fat mass ratio was also negatively associated with both conditions.
• Osteopenia/osteoporosis was defined using T-score.
• Sarcopenia was identified based on skeletal muscle mass index (SMI), handgrip strength measurements, and/or walking speed.

The study used a cross-sectional design with a sample of 1,897 older adult participants from the PoCOsteo study.

• Osteosarcopenia is defined as the simultaneous occurrence of osteopenia and sarcopenia.
• Body fat distribution was assessed using Dual X-ray absorptiometry (DXA).
• Covariates included age, gender, marital status, tobacco use, income, education, occupation, and hypertension.
• The cross-sectional design limits causal inference.