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Sarcopenic obesity defined by visceral adiposity was associated with osteoporotic vertebral fracture

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Abstract

Background

Previous studies have reported that the fracture risk related to sarcopenic obesity (SO) may be influenced by the distribution of fat mass. Therefore, it is useful to explore a body component suitable for defining obesity when predicting fracture risk. This study was an attempt to explore the contribution of SO defined by visceral adiposity on the incidence of osteoporotic fracture.

Methods

We enrolled 736 Chinese patients aged > 60 years in this prospective study. Sarcopenia was defined as low skeletal muscle index (SMI) with muscle strength or low SMI with low physical performance. Obesity was categorized as follows: (1) android to gynoid ratio (A/G ratio, men > 0.82, women > 0.65) as an indicator of visceral adiposity; (2) body fat percentage (men > 27.8%; women > 34.5%); and (3) body mass index (≥ 25 kg/m2). A Cox proportional hazard model was used to determine the association between SO and the risk of osteoporotic fracture.

Results

The incidence of SO was 8.7%; 9.0% in females and 8.1% in males. Of 223 (30.2%) patients with self-reported fractures. SO classified by A/G was associated with an increased risk of osteoporotic vertebral fracture (HR: 1.71, 95% CI: 1.07–2.72). High SMI was associated with a reduced risk of osteoporotic vertebral fracture (HR: 0.82, 95% CI: 0.72–0.93), higher BMI was associated with a higher risk vertebral fracture (HR: 1.12, 95% CI: 0.94–1.63), and higher A/G ratio was associated with a higher risk of any fracture (HR: 1.28, 95% CI: 1.14–1.43) and osteoporotic vertebral fracture (HR: 1.19, 95% CI: 1.05–1.36).

Conclusions

Our findings suggest that SO, defined by visceral adiposity, was associated with the risk of osteoporotic vertebral fracture. Moreover, low SMI, low muscle strength and visceral adiposity were independently associated with osteoporotic fracture.

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Funding

This work was funded by the Aging and Health of Women and Children Research Project of Shanghai Municipal Health Commission (2020YJZX0116), Science and Technology project of Jiangxi Provincial Health Commission (202140997).

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Authors and Affiliations

  1. Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China

    Hao Chen, Yu-Yang Yi, Shu-Bao Zhang, Hao-Wei Xu, Xin-Yue Fang,  Tao-Hu, De-Sheng Wu & Shan-Jin Wang

  2. Department of orthopedic, East Hospital, Ji’an Hospital, Jinggangshan University, Jiangxi, China

    Shan-Jin Wang

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  1. Hao Chen
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Contributions

SJW and DSW initiated the idea, did the data analysis; HC YYY and ZSB wrote the assay. YYY supervised and reviewed the manuscript. XHW, XYF, and TH gathered the data and helped with the data analysis. All authors read and approved the final manuscript.

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Correspondence to Shan-Jin Wang.

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Hao Chen and Yu-Yang Yi are co-first authors.

Supplementary information

Figure S1.

Hazard ratios for osteoporotic vertebral fracture incidence according to A/G ratio, using restrictive cubic spline analysis (PNG 224 kb)

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(DOCX 21 kb)

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Chen, H., Yi, YY., Zhang, SB. et al. Sarcopenic obesity defined by visceral adiposity was associated with osteoporotic vertebral fracture. Arch Osteoporos 17, 41 (2022). https://doi.org/10.1007/s11657-022-01087-9

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