Association of visceral and subcutaneous fat with bone mineral density in US adults: a cross-sectional study

Abstract

The relationship between the accumulation of fat in visceral or subcutaneous tissue and bone mineral density (BMD) remains unclear. Our primary objective in this study was to illuminate this relationship by conducting an investigation on a vast scale, encompassing a nationally representative population in the United States. A weighted multiple linear regression model was established to evaluate the relationship between visceral fat, subcutaneous fat, and BMD. Additionally, the exploration of the potential nonlinear relationship was conducted employing the methodology of smooth curve fitting. In order to determine potential inflection points, a two-stage linear regression model was utilized. A total of 10,455 participants between the ages of 20 and 59 were included in this study. Various weighted multiple linear regression models revealed a negative correlation between lumbar BMD and visceral mass index (VMI) and subcutaneous mass index (SMI). However, the association between VMI and lumbar BMD displayed a U-shaped pattern upon employing the smooth curve fitting, and the inflection point of 0.304 kg/m2was determined using a two-stage linear regression model. Our findings indicated a negative association between subcutaneous fat and BMD. A U-shaped relationship was observed between visceral fat and BMD.

Bone health following paediatric and adolescent bariatric surgery: a systematic review and meta-analysis

“…Increased fat mass up to a healthy range has traditionally been considered as ‘bone-protective’ since mechanical loading is associated with higher BMD through proliferation of osteoblasts and reduction of bone apoptosis. 54 , 55 Healthy bones respond to mechanical stress up to a reasonable limit by remodelling, and a decrease in mechanical loading through weight loss may lead to bone loss. 56 , 57 This effect may be pronounced in weight-bearing bones such as the lumbar region that was evaluated in this study and may explain our findings as the procedures that generate the most weight loss have lower BMD and Z scores.…”

Links among Obesity, Type 2 Diabetes Mellitus, and Osteoporosis: Bone as a Target

“…According to Ng et al [25], the relationship between visceral and subcutaneous fat depots and bone health is more complex and is specific for age, gender, menopausal status, bone compartment, and adipose depot. Lin et al [18] revealed a negative association between subcutaneous fat and lumbar spine BMD. On the other hand, a non-linear (U-shaped) relationship between visceral fat and BMD was determined.…”

“…In general, adipose tissue is made up of adipocytes distributed in the organism, especially in the subcutaneous and visceral fat. The function of adipose tissue varies from organs as energy storage sites to endocrine organs secreting various factors that can influence different organ systems and regulate energy metabolism [3,18]. In the context of obesity and T2DM, intramuscular fat and bone marrow adipose tissue also play a significant role in skeletal homeostasis and bone fragility [4,9].…”

Impaired Remodeling of White Adipose Tissue in Obesity and Aging: From Defective Adipogenesis to Adipose Organ Dysfunction

“…On the other hand, increased mechanical loading resulting from elevated BMI has been linked to higher BMD and improved microstructure, thus positively impacting both cortical and trabecular bone health [244]. To reconcile conflicting results, a U-shaped correlation between visceral WAT and BMD has been proposed [245], thus further increasing the level of complexity.…”