The Association Of Different Adiposity Indices With Osteopenia And Osteoporosis In Rural Adults Of Henan

ObjectiveTo investigate the association of different adiposity indices including body mass index（BMI）,body fat percentage（BFP）,waist circumference（WC）,waist to height ratio（WHt R）,waist to hip ratio（WHR）and visceral fat index（VFI）with the risk of osteopenia and osteoporosis in Henan rural areas.MethodsThe study participatnts were from the Henan Rural Cohort Study（registration number:Chi CTR-OOC-15006699）,and only 8033 participatnts completed bone mineral density（BMD）measurement.Finally,a total of 8,031 subjects were analyzed after excluding 2 participatnts who lacked of obesity information.The detailed information of subjects about demographic characteristics,physical information,and health status were obtained through face-to-face questionnaires,standardized anthropometry measurements,and laboratory tests.The calcaneus BMD was measured using a Sahara quantitative ultrasound bone densitometer.We performed tests for linear trend to analyze the tendency of prevalence of osteopenia and osteoporosis in different adiposity levels.Linear regression model was used to explore the relationship between different adiposity indices and BMD.Multiple logistic regression model was used to analyze the association of different adiposity levels with the risk of osteopenia and osteoporosis.Restricted cubic spline was used to further analyze the dose-response relationship between different adiposity indices and the risk of osteopenia and osteoporosis.ResultsA total of 8031 participatnts were included in this study and the mean age were55.83±10.79 years,which included 3001 men and 5030 women.1.With the increase of BMI,BFP,WC,WHt R,WHR,and VFI levels,the value of BMD increased but the prevalence of osteoporosis decreased in men(P_trend<0.001).However,the prevalence of osteoporosis decreased with the increase of adiposity levels in women(P_trend<0.001).2.In men,for a standard deviation（SD）increment of BMI,BFP,WC,WHt R,WHR,and VFI,there was 0.016 g/cm²,0.008 g/cm²,0.010 g/cm²,0.014 g/cm²,0.009g/cm² and 0.015 g/cm² BMD increase after controlling for confounding factors,and the results were statistically significant（P<0.05）.In women,there was 0.015 g/cm²,0.011 g/cm²,0.011 g/cm²,0.012 g/cm²,0.010 g/cm²and 0.015 g/cm²BMD increase,and the results were statistically significant（P<0.05）.3.After adjusting for confounding factors,different adiposity indices were negatively associated with the risk of osteoporosis both in men and women.In men,the odds ratio（OR）and 95%confidence interval（CI）in the highest BMI,BFP,WC,WHt R,WHR,and VFI levels was 0.31（0.22,0.43）,0.53（0.39,0.72）,0.34（0.24,0.47）,0.32（0.23,0.44）,0.44（0.32,0.59）and 0.34（0.25,0.46）,respectively,compared with the lowest levels（Q1）.While the OR（95%CI）in women were 0.51（0.42,0.62）,0.67（0.55,0.82）,0.47（0.39,0.58）,0.49（0.40,0.60）,0.46（0.38,0.57）,and 0.52（0.42,0.64）,respectively.4.After adjustment for potential confounders,there was a nonlinear association of BMI,and VFI with the risk of osteoporosis,and there was a nonlinear association of VFI with the risk of osteopenia(P_{no-linear-association}<0.05)in men.While in women,restricted cubic splines showed a nolinear dose-response relationship between the six adiposity indices and the risk of osteoporosis,but only WHR were associated with osteopenia(P_{no-linear-association}<0.05).Conclusions1.There was a positive correlation between different adiposity indices and BMD among Henan rural population.2.There was a U-shaped relationship between different adiposity indices and the risk of osteopenia,while a linear dose-response relationship between different adiposity indices and the risk of osteoporosis in Henan rural population.