Association of Body Compositions and Bone Mineral Density in Chinese Children and Adolescents: Compositional Data Analysis

Weight-adjusted waist index as a new predictor of osteoporosis in postmenopausal patients with T2DM

This study aimed to investigate the predictive value of the weight-adjusted waist index (WWI) for osteoporosis in postmenopausal patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 229 postmenopausal patients with T2DM (mean age 64.53 ± 7.4 years). Collect anthropometric data. Bone mineral density (BMD) of the lumbar spine and femoral necks was measured using dual-energy X-ray absorptiometry. Calculate WWI and Osteoporosis Self-Assessment Tool for Asians (OSTA). Use SPSS 25.0 to analyze data employing binary logistic regression and the receiver operating characteristic (ROC) curve. WWI in osteoporosis group was significantly higher than that in non-osteoporosis group (11.54 ± 0.82 vs. 11.07 ± 0.73, P = 0.000), while the OSTA was significantly lower in osteoporosis group compared to non-osteoporosis group (- 1.40 (- 2.8, 0.40) vs. 0.10 (- 1.45,1.80), P = 0.000). Binary logistic regression analysis indicated that the risk of osteoporosis in WWI ≥ 11.55 group was 3.158 times higher than that in WWI < 11.55 group (95% CI 1.714-5.820, P = 0.000). The risk in OSTA ≤ - 1 group was 3.935 times higher than that in OSTA > - 1 group (95% CI 2.168-7.141, P = 0.000). The area under the ROC curve for OSTA and WWI in predicting the risk of osteoporosis in postmenopausal patients with T2DM aged over 70 was 0.761 and 0.808, respectively, with sensitivities of 0.429 and 0.714. In postmenopausal patients with T2DM, WWI is closely associated with osteoporosis and negatively correlates with BMD. Among postmenopausal T2DM patients aged over 70, WWI may be superior to OSTA in predicting osteoporosis.

Do cardiometabolic risk factors mediate the relationship between body composition and bone mineral content in South Indian children aged 5 to 16 years?

BACKGROUND/OBJECTIVE

The complex interplay between adiposity, bone health and cardiometabolic risk (CMR) factors is unclear in Indian children. We aimed to investigate the mediating role of number of CMR factors on the relationship between fat % and bone mineral content (BMC) % in South Indian children aged 5-16 years.

SUBJECTS AND METHODS

Healthy children (n = 317), from India, underwent anthropometric, blood biochemistry, blood pressure, along with body composition and BMC assessments using Dual-energy X-ray absorptiometry. Based on the number of CMR factors, children were categorised into three groups: 0, 1 and ≥ 2. Analysis of variance was used to compare the parameters between the CMR groups and mediation analysis was performed to examine if the number of CMR factors mediated the relationship between fat % and BMC %.

RESULTS

The prevalence of 0, 1 and ≥ 2 CMR factors was 42.3%, 33.9% and 23.9% respectively; mean BMC % was lowest in ≥ 2 CMR group. In the whole group, BMC % had significant negative correlation with fat % (r = -0.68, p < 0.0001) and positive correlation with lean % (r = 0.64, p < 0.0001). Adjusted for age and sex, results suggested significant mediating effect of number of CMR factors on the relationship between fat % and BMC % (Average Causal Mediation Effects =-0.002, bootstrapped 95% CI: -0.0039, -0.0001, p < 0.01), but losing significance when adjusted for co-variates.

CONCLUSION

Number of CMR factors mediates the relationship between fat % and BMC % in Indian children. Further studies are needed to confirm these findings, understand mechanisms and plan appropriate strategies.

The association between body roundness index and osteoporosis in American adults: analysis from NHANES dataset

Background

An innovative way to quantify obesity that appropriately captures levels of visceral and body fat is the Body Roundness Index (BRI). The purpose of this study is to look at the relationship between BRI and osteoporosis (OP) in adult Americans.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2018. NHANES is a research program designed to assess the health and nutritional status of adults and children in the United States. It conducts surveys focusing on various populations and health-related topics. Logistic regression analysis was employed to investigate the relationship between BRI and OP, adjusting for various covariates. BRI was categorized into four levels to further explore the association trends between different BRI levels and OP, enhancing the robustness of the results. Using restricted cubic spline (RCS) analysis, the dose-response relationship between BRI and OP was illustrated. Subgroup analyses were also carried out to evaluate the consistency and robustness of the findings.

Results

This study included 8,899 participants aged 50 years and older, among whom 763 had OP. BRI and the prevalence of OP were inversely correlated in the fully adjusted model (OR = 0.79, 95% CI: 0.69-0.86). The prevalence of OP considerably reduced with higher BRI levels when BRI was converted from a continuous to a categorical variable in comparison to the lowest BRI quartile. RCS analysis revealed an L-shaped negative correlation between BRI and OP prevalence, with a threshold effect analysis identifying a breakpoint at BRI = 5.29. Each unit increase in BRI to the left of this breakpoint was linked to a 36% decrease in the probability of OP (OR = 0.64, 95% CI: 0.57-0.72). Based on stratified factor subgroup analyses, it was shown that the negative correlation between BRI and OP persisted.

Conclusion

In a large, representative sample of American adults, this study identified a significant negative correlation between BRI and the prevalence of OP. Specifically, as BRI increases, the prevalence of osteoporosis decreases. Maintaining an appropriate and healthy BRI level may play a critical role in the prevention of osteoporosis. Therefore, regular monitoring of BRI and the adoption of appropriate health measures are essential for reducing the risk of osteoporosis.

Cross-sectional study of characteristics of body composition of 24,845 children and adolescents aged 3-17 years in Suzhou

BACKGROUND

We aimed to analyze the characteristics of the body composition of children and adolescents aged 3-17 in Suzhou, China.

METHODS

A cross-sectional study between January 2020 and June 2022 using bioelectrical impedance was conducted to determine the fat mass (FM), fat-free mass (FFM), skeletal muscle mass, and protein and mineral contents of 24,845 children aged 3-17 who attended the Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, China. Measurement data was presented in tables as mean ± SD, and groups were compared using the independent samples t-test.

RESULTS

FM and fat-free mass increased with age in both boys and girls. The fat-free mass of girls aged 14-15 decreased after reaching a peak, and that of boys in the same age group was higher than that of the girls (p < 0.05). There were no significant differences in FM between boys and girls younger than 9- and 10-years old. The percentage body fat (PBF) and FM index of girls increased rapidly between 11 and 15 years of age (p < 0.05), and those of boys aged 11-14 were significantly lower (p < 0.05), suggesting that the increase in body mass index (BMI) was mainly contributed by muscle mass (MM) in boys.

CONCLUSIONS

The body composition of children and adolescents varies according to their age and sex. A misdiagnosis of obesity made on the basis of BMI alone can be avoided if BMI is used in combination with FM index, percentage body fat, and other indexes.

The association between weight-adjusted-waist index and total bone mineral density in adolescents: NHANES 2011-2018

Introduction

The weight-adjusted waist index (WWI) serves as an innovative obesity measure, seemingly surpassing body mass index (BMI) and waist circumference (WC) in evaluating lean and fat mass. This study aimed to explore the relationship between WWI and total bone mineral density (BMD) in US adolescents.

Methods

This population-based study investigated adolescents aged 8-19 years with comprehensive WWI and total BMD data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. WWI was computed by dividing WC by the square root of body weight. Weighted multivariate linear regression and smoothed curve fitting were employed to examine linear and non-linear associations. Threshold effects were determined using a two-part linear regression model. Additionally, subgroup analyses and interaction tests were conducted.

Results

Multivariate linear regression analysis revealed a significant negative association between WWI and total BMD in 6,923 US adolescents aged 8-19 years [β = -0.03, 95% CI: (-0.03, -0.03)]. This negative correlation remained consistent across all subcategories, with the exception of age, encompassing gender,ethnicity, and diabetes status subgroups. Furthermore, a non-linear relationship and saturation effect between WWI and total BMD were identified, with an inflection point at 9.88 cm/√kg.

Conclusions

Our research demonstrated a notable negative relationship and saturation effect between WWI and total BMD among US adolescents.

Effect of obesity status on adolescent bone mineral density and saturation effect: A cross-sectional study

BACKGROUND

The effect of obesity status on bone mineral density (BMD) in adolescents and whether there is a saturation effect is still insufficient. A cross-sectional study of adolescents aged 12-19 was conducted to investigate them.

METHODS

Weighted multivariate linear regression models were used to assess the relationship between obesity status and BMD via datasets from the National Health and Nutrition Examination Survey 2011-2018. The nonlinear relationships and saturation values were ascertained by fitting smooth curves and analyzing saturation effects. At the same time, the subgroup stratified analysis was also performed.

RESULTS

4056 adolescents were included in this study. We found that body mass index (BMI) and waist circumference (WC) were significantly associated with total BMD, which remained significant in subgroups stratified by age, gender, standing height, and ethnicity. We also noticed an inverse correlation between left leg fat/lean mass and left leg BMD, which was only significant in males and other races. Fitting smooth curve and saturation effect analysis showed that BMI, WC, left leg fat/lean mass, and BMD had a specific saturation effect. There was a saturation effect on bone mineral density in adolescents with a BMI of 22 kg/m², a WC of 70.5 cm, or a left leg fat/lean mass of 0.2994.

CONCLUSIONS

We found a positive saturation effect of BMI and WC with BMD and a negative saturation effect of left leg fat/lean mass with BMD. Appropriate obesity status allows adolescents to have better bone mass development but not excessive obesity.