Structural Equation Model Analysis of the Effect of Visceral Fat on Osteoporosis

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2024 Jul 16

PMID 39014367

Authors

Min Tong

Yuanyuan Li

Kai Rong

Qi Sun

Jianghong Dai

Yifei Huang

Affiliations

Soon will be listed here.

Abstract

Background: Osteoporosis is a considerable public health challenge in Moyu County, Xinjiang. Here, we evaluated the influencing factors of osteoporosis in this region.

Methods: We recruited 7,761 participants and randomized them into normal and osteoporotic populations based on T-score. The effects of general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet on osteoporosis were analyzed. Furthermore, a structural equation model was constructed to uncover the direct and indirect influencing factors of osteoporosis.

Results: Among the participants, 1,803 (23.23%) had normal bone mass while 1,496 (19.28%) had osteoporosis. The univariate analysis showed significant differences in the general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet. Stratification based on age (45 years) and body mass index (BMI) (18.5 kg/m) showed variations in the body composition between the two groups; however, the visceral fat differed significantly. Logistic regression analysis affirmed the association of visceral fat index as it was included in all equations, except for age and female menopause. The structural equation exhibited that the general conditions, body composition, and, calcium sources, and exercise were direct factors of osteoporosis, while respiratory exposure and daily diet were indirect factors. The standardized path coefficient was highest in general conditions, followed by body composition, and lastly, calcium sources and exercise.

Conclusion: Obesity, besides age and female menopause, is also an influencing factor of osteoporosis. The visceral fat index plays a vital role in osteoporosis. Our findings may provide experimental evidence for early prevention and treatment of osteoporosis.

References

Zhang L, Zheng Y, Wang R, Wang X, Zhang H . Exercise for osteoporosis: A literature review of pathology and mechanism. Front Immunol. 2022; 13:1005665. PMC: 9509020. DOI: 10.3389/fimmu.2022.1005665. View

Ren X, Hu C, Wang W, He Q, Du L, Li T . Association between physical activity, sedentary behavior patterns with bone health among Chinese older women. Bone. 2024; 181:117025. DOI: 10.1016/j.bone.2024.117025. View

Kolb H . Obese visceral fat tissue inflammation: from protective to detrimental?. BMC Med. 2022; 20(1):494. PMC: 9795790. DOI: 10.1186/s12916-022-02672-y. View

van der Voort D, Geusens P, Dinant G . Risk factors for osteoporosis related to their outcome: fractures. Osteoporos Int. 2001; 12(8):630-8. DOI: 10.1007/s001980170062. View

Migliorini F, Giorgino R, Hildebrand F, Spiezia F, Peretti G, Alessandri-Bonetti M . Fragility Fractures: Risk Factors and Management in the Elderly. Medicina (Kaunas). 2021; 57(10). PMC: 8538459. DOI: 10.3390/medicina57101119. View

Gautier A, Bonnet F, Dubois S, Massart C, Grosheny C, Bachelot A . Associations between visceral adipose tissue, inflammation and sex steroid concentrations in men. Clin Endocrinol (Oxf). 2012; 78(3):373-8. DOI: 10.1111/j.1365-2265.2012.04401.x. View

Khosla S, Monroe D . Regulation of Bone Metabolism by Sex Steroids. Cold Spring Harb Perspect Med. 2017; 8(1). PMC: 5749141. DOI: 10.1101/cshperspect.a031211. View

Migliorini F, Colarossi G, Baroncini A, Eschweiler J, Tingart M, Maffulli N . Pharmacological Management of Postmenopausal Osteoporosis: a Level I Evidence Based - Expert Opinion. Expert Rev Clin Pharmacol. 2020; 14(1):105-119. DOI: 10.1080/17512433.2021.1851192. View

Montoro-Huguet M, Belloc B, Dominguez-Cajal M . Small and Large Intestine (I): Malabsorption of Nutrients. Nutrients. 2021; 13(4). PMC: 8070135. DOI: 10.3390/nu13041254. View

10.

Cacciatore S, Massaro C, Landi F . Preventing Osteoporosis, Sarcopenia and Obesity to Care about Quality of Life. Ann Geriatr Med Res. 2023; 27(1):87-90. PMC: 10073975. DOI: 10.4235/agmr.22.0158. View

11.

Paller C, Shiels M, Rohrmann S, Basaria S, Rifai N, Nelson W . Relationship of sex steroid hormones with bone mineral density (BMD) in a nationally representative sample of men. Clin Endocrinol (Oxf). 2008; 70(1):26-34. PMC: 3494466. DOI: 10.1111/j.1365-2265.2008.03300.x. View

12.

Ilovayskaya I, Zektser V, Lazebnik L . Factors of mineral homeostasis impairment and bone mineral density loss in women with central hypogonadism. Climacteric. 2020; 23(6):597-602. DOI: 10.1080/13697137.2020.1767567. View

13.

Khosla S, Atkinson E, Riggs B, Melton 3rd L . Relationship between body composition and bone mass in women. J Bone Miner Res. 1996; 11(6):857-63. DOI: 10.1002/jbmr.5650110618. View

14.

Cheng C, Chen L, Chen K . Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover. Int J Mol Sci. 2022; 23(3). PMC: 8836058. DOI: 10.3390/ijms23031376. View

15.

Kang D, Guo L, Guo T, Wang Y, Liu T, Feng X . Association of body composition with bone mineral density in northern Chinese men by different criteria for obesity. J Endocrinol Invest. 2014; 38(3):323-31. DOI: 10.1007/s40618-014-0167-5. View

16.

Sheng Z, Xu K, Ou Y, Dai R, Luo X, Liu S . Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. Clin Endocrinol (Oxf). 2010; 74(3):319-24. DOI: 10.1111/j.1365-2265.2010.03941.x. View

17.

Lin S, Fan Y, Pan W, Bai C . Corrigendum: Bone and Lean Mass Loss and Cognitive Impairment for Healthy Elder Adults: Analysis of the Nutrition and Health Survey in Taiwan 2013-2016 and a Validation Study With Structural Equation Modeling. Front Nutr. 2022; 8:839017. PMC: 9102797. DOI: 10.3389/fnut.2021.839017. View

18.

Li X, Gong X, Jiang W . Abdominal obesity and risk of hip fracture: a meta-analysis of prospective studies. Osteoporos Int. 2017; 28(10):2747-2757. DOI: 10.1007/s00198-017-4142-9. View

19.

Gandham A, Zengin A, Bonham M, Winzenberg T, Balogun S, Wu F . Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage. Bone. 2020; 140:115546. DOI: 10.1016/j.bone.2020.115546. View

20.

Xu J, Qiu X, Liang Z, Smiley-Jewell S, Lu F, Yu M . Exposure to tobacco smoke increases bone loss in spontaneously hypertensive rats. Inhal Toxicol. 2018; 30(6):229-238. DOI: 10.1080/08958378.2018.1506838. View