Association Between Anthropometric Adiposity Indexes And Osteoporosis Among Chinese Middle-and Older-aged Adults

Objectives This study aims to analyze the associations of anthropometric adiposity indexes(AAI),including body mass index(BMI),waist circumstance(WC),waist-to-hip ratio(WHR),waist-to-height ratio(WHtR)and a body shape index(ABSI),with osteoporosis(OP).Methods 3,405 participants aged 40-82 years old,including 1,272 males and 2,133 females,were included based on China Action on Spine and Hip status(CASH)study.Related information and spine bone mineral density(BMD)data was measured by standardized questionnaires and quantitative computed tomography(QCT).The total population were divided into OP group(?80 mg/cm3)and non-OP group(>80 mg/cm3)based on BMD.AAI was standardized by Z-score and then included into the unconditional logistic regression models to explore the associations of OP with BMI,WC,WHR,WHtR and ABSI,respectively.Further subgroup analysis was based on the results of interaction analysis.Area under curve(AUC),sensitivity,specificity and Youden's index were used to compare the screening value of AAIs.Results WHR and ABSI were positively correlated with OP in total population of this study,with OR values of 1.12(1.02,1.24)and 1.19(1.08,1.31),respectively,and ORABSI>ORWHR.Statistically significant was observed only between gender and age with AAIs(P<0.05)in all the interaction analyses.No statistically significant ORs were observed in both total males and age subgroups among males.The ORs of ABSI were statistically significant in both total females and females aged ?60 years old in this study,with ORs of 1.23(1.07,1.41)and 1.28(1.04,1.57),respectively.It was found that ORABSI>ORWC>ORWHR>ORWHtR among females aged<60 years old.It's found that AUCABSI>AUCXHrR>AUCWHR>AUCwc,the Youden's index was ranked as ABSI>WHtR>(WC and WHR)>BMI,and the ABSI's Youden's index and the cut off point were 0.13 and 0.077,respectively,in total population of this study.In males of this study,only ABSI had screening value for OP(P<0.001),ABSI's Yoden index and cut off point were 0.13 and 0.77,respectively.While among females,AUCABSI>AUCWHR>AUCWHrR>AUCwc>AUCBMI,the Youden's index was ranked as ABSI>WHR>(WC and WHtR)>BMI,and the ABSI's Youden's index and the cut off point were 0.19 and 0.075,respectively.ABSI's Yoden index was the largest among females aged<60 years old when the sensitivity was 90%,and the Yoden index and cut off point of ABSI were 0.06 and 0.069,respectively.Conclusion There were gender differences and age differences in the association between AAI and OP in the middle-and older-aged population.Among middle-and older-aged females,obesity represented by ABSI was a risk factor for OP,and ABSI has the strongest association with OP.