Role of visceral adipose tissue in osteoporosis: A longitudinal analysis in a Southern Taiwan medical Center's health management center

Wei-Chin Huang; I-Shu Chen; Hsien-Chung Yu; Chi-Shen Chen; Chiao-Lin Hsu; Pin-Chieh Wu

doi:10.1016/j.jfma.2025.05.031

Role of visceral adipose tissue in osteoporosis: A longitudinal analysis in a Southern Taiwan medical Center's health management center

J Formos Med Assoc. 2025 May 30:S0929-6646(25)00261-X. doi: 10.1016/j.jfma.2025.05.031. Online ahead of print.

Authors

Wei-Chin Huang¹, I-Shu Chen², Hsien-Chung Yu³, Chi-Shen Chen⁴, Chiao-Lin Hsu⁵, Pin-Chieh Wu⁶

Affiliations

¹ Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
² Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.
³ Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Nursing, Meiho Institute of Technology, Ping-Tung, Taiwan.
⁴ Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Institute of Health Care Management, Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Pharmacy, Chia Nan University of Pharmacy & Science, Tainan, Taiwan.
⁵ Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Geriatric and Gerontology Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. Electronic address: jolindr0610@gmail.com.
⁶ Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Pharmacy, Chia Nan University of Pharmacy & Science, Tainan, Taiwan. Electronic address: wpchieh@vghks.gov.tw.

PMID: 40450512
DOI: 10.1016/j.jfma.2025.05.031

Abstract

Purpose: The relationship between visceral adipose tissue (VAT) and bone mineral density (BMD) remains controversial. To further elucidate this association, a longitudinal cohort study to examine the association between VAT and BMD was conducted at a medical center in Southern Taiwan.

Methods: We conducted a retrospective analysis of 3535 health checkup participants aged at least 50 years who initially underwent bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). Subsequently, these participants underwent follow-up DXA after a minimum of one year, from January 2017 to December 2022. The participants were stratified into two cohorts (osteoporosis and nonosteoporosis). Hazard ratios (HRs) for osteoporosis were compared using the Cox regression model in two distinct cohorts.

Results: Out of 3535 participants, 201 (5.7 %) developed osteoporosis while remaining 3334 (94.3 %) did not develop the disease. After adjusting for demographic, behavioral, and clinical variables, the VAT mass (HR: 0.79, 95 % confidence intervals (CI):0.59-0.87, P < 0.05) demonstrated a significant association with osteoporosis development. Age (HR: 1.07, 95 % CI: 1.05-1.09, P < 0.001), diabetes mellitus (HR: 0.32, 95 % CI: 0.14-0.66, P < 0.01), and muscle mass (HR: 0.95, 95 % CI: 0.91-0.97, P < 0.01) also demonstrated significant associations. Furthermore, a generalized additive model (GAM) illustrated a nonlinear relationship between VAT and the likelihood of osteoporosis.

Conclusion: The study demonstrates that lower levels of VAT are correlated with an increased incidence of osteoporosis, especially in individuals with reduced VAT. These findings highlight the potential need for BMD screening among people with reduced VAT.

Keywords: Bioelectrical impedance analysis; Bone mineral density; Dual-energy X-ray absorptiometry; Osteoporosis; Visceral adipose tissue.