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. 2023 Mar 6;18(1):171.
doi: 10.1186/s13018-023-03654-3.

The association between abdominal obesity and femoral neck bone mineral density in older adults

Jun Chen  1 , Liming Zhu  2 , Xiaocong Yao  2 , Zhongxin Zhu  3   4
Affiliations

The association between abdominal obesity and femoral neck bone mineral density in older adults

Jun Chen et al. J Orthop Surg Res. .

Abstract

Background: The relationship between obesity and osteoporosis is complex, with contradictory findings reported. Our aim was to evaluate the association between waist circumference (WC), as an easy-to-determine clinical index of abdominal obesity, and femoral neck bone mineral density (BMD) among older adults, using the National Health and Nutrition Examination Survey (NHANES) database.

Methods: Data of five NHANES cycles (2005-2010, 2013-2014, and 2017-2018), including 5801 adults aged ≥ 60 years, were used in the analysis. Weighted multiple regression analyses were performed to evaluate the association between WC and femoral neck BMD. Weighted generalized additive models and smooth curve fitting were further performed to characterize nonlinearities in the association.

Results: There was a positive association between WC and femoral neck BMD in non-adjusted models. After adjusting for body mass index (BMI), the association became negative. On subgroup analysis stratified by sex, this negative association only existed for men. An inverted U-shaped curve relationship between WC and femoral neck BMD was further identified, with an inflection point at a WC of 95 cm for both men and women.

Conclusions: Abdominal obesity is a negative predictor of bone health among older adults, independent of BMI. The association between WC and femoral neck BMD followed an inverted U-shaped curve.

Keywords: Abdominal obesity; Bone mineral density; NHANES; Older adults; Waist circumference.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Association between body mass index and waist circumference and femoral neck bone mineral density. a Association between body mass index and waist circumference. b Association between body mass index and femoral neck bone mineral density
Fig. 2
Fig. 2
Association between waist circumference and femoral neck bone mineral density. a Each black point represents a sample. b Solid rad line represents the smooth curve fit between variables. Blue bands represent the 95% of confidence interval from the fit. Age, sex, race, body mass index, education level, income-poverty ratio, moderate recreational activities, smoking, alcohol use, smoking cigarettes, blood urea nitrogen, total protein, serum uric acid, serum glucose, serum phosphorus, serum calcium, and serum 25(OH)D were adjusted
Fig. 3
Fig. 3
Association between waist circumference and femoral neck bone mineral density, stratified by sex. Age, race, body mass index, education level, income-poverty ratio, moderate recreational activities, smoking, alcohol use, smoking cigarettes, blood urea nitrogen, total protein, serum uric acid, serum glucose, serum phosphorus, serum calcium, and serum 25(OH)D were adjusted
See this image and copyright information in PMC

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