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Association of central adiposity and metabolic markers with osteopenia and osteoporosis in Chinese adults: a QCT-based cross-sectional study
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  • Published: 11 February 2026

Association of central adiposity and metabolic markers with osteopenia and osteoporosis in Chinese adults: a QCT-based cross-sectional study

  • Lihua Wang1,
  • Pingping Yu1,
  • Yao Chen1,
  • Mengxue Chen1,
  • Jing Deng1 na1 &
  • …
  • Lehua Yu1 na1 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Endocrinology
  • Health care
  • Medical research
  • Risk factors

Abstract

To evaluate the associations and comparative performance of novel anthropometric and metabolic indices with osteopenia and osteoporosis among middle-aged and older Chinese adults. A cross-sectional study was conducted among 10,142 Chinese adults aged ≥ 45 years who underwent quantitative computed tomography (QCT) for lumbar spine BMD assessment. Participants were categorized as normal, osteopenia, and osteoporosis. Associations and predictive capabilities of anthropometric indices were analyzed using multivariable logistic regression and receiver operating characteristic (ROC) curve analyses. The prevalences of osteopenia and osteoporosis were 35.14% and 14.05%, respectively. After adjusting for confounders, weight-adjusted waist index (WWI), relative fat mass (RFM), a body shape index (ABSI), triglyceride–glucose (TyG) index, and glycated hemoglobin (HbA1c) were found to be independently associated with osteopenia and osteoporosis. Among all indices, WWI demonstrated the strongest predictive value for osteoporosis (area under the curve = 0.726), followed by RFM and ABSI. In contrast, BMI and the visceral adiposity index (VAI) showed no significant associations with low BMD. Indices associated with central adiposity and metabolic dysfunction, especially WWI, may provide more precise prediction of osteoporosis risk. Incorporating such indices into early risk stratification for osteoporosis among older Chinese adults may have potential clinical utility.

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Data availability

The datasets generated and analyzed during the current study are not publicly available due to institutional restrictions but are available from the corresponding author upon reasonable request.

Abbreviations

BMD:

Bone mineral density

QCT:

Quantitative computed tomography

DXA:

Dual-energy X-ray absorptiometry

ISCD:

International Society for Clinical Densitometry

SD:

Standard deviation

IQR:

Interquartile range

VIF:

Variance inflation factor

BMI:

Body mass index

WWI:

Weight-adjusted waist index

ABSI:

A body shape index

RFM:

Relative fat mass

VAI:

Visceral adiposity index

TyG:

Triglyceride-glucose index

HbA1c:

Hemoglobin A1c

ROC:

Receiver operating characteristic

AUC:

Area under the curve

OR:

Odds ratio

CI:

Confidence interval

MASLD:

Metabolic-associated steatotic liver disease

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

UA:

Uric acid

BUN:

Blood urea nitrogen

SCr:

Serum creatinine

FPG:

Fasting plasma glucose

HDLC:

High-density lipoprotein cholesterol

LDLC:

Low-density lipoprotein cholesterol

NHHR:

Non-HDL-C to HDL-C ratio

MCH:

Mean corpuscular hemoglobin

MCHC:

Mean corpuscular hemoglobin concentration

HGB:

Hemoglobin

PLT:

Platelet

WBC:

White blood cell count

ALB:

Albumin

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

5-NT:

5’-nucleotidase

DBiL:

Direct bilirubin

IDBiL:

Indirect bilirubin

TBil:

Total bilirubin

LFC:

Liver fat content

VAA:

Visceral adipose area

RANKL:

Receptor activator of nuclear kB ligand

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Acknowledgements

The authors would like to thank all the participants and staff of the Health Management Center of the Second Affiliated Hospital of Chongqing Medical University for their cooperation and support during data collection.

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Author notes

  1. Jing Deng and Lehua Yu contributed equally to this work.

Authors and Affiliations

  1. Health Medical Center, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Lihua Wang, Pingping Yu, Yao Chen, Mengxue Chen, Jing Deng & Lehua Yu

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Contributions

All the authors contributed significantly to this study. LHW designed and supervised the study. PPY and MXC performed data collection and statistical analysis. JD interpreted the results and drafted the manuscript. LHY and YC critically revised the manuscript for intellectual content. All the authors have read and approved the final version of this manuscript.

Corresponding authors

Correspondence to Jing Deng or Lehua Yu.

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Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University (Approval Number: 2022(129)). Written informed consent was obtained from all participants prior to enrollment.

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The authors declare no competing interests.

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Wang, L., Yu, P., Chen, Y. et al. Association of central adiposity and metabolic markers with osteopenia and osteoporosis in Chinese adults: a QCT-based cross-sectional study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37749-8

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  • Received: 21 July 2025

  • Accepted: 24 January 2026

  • Published: 11 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-37749-8

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Keywords

  • Osteopenia
  • Osteoporosis
  • Anthropometric indices
  • Metabolic indices
  • Bone mineral density
  • Quantitative computed tomography
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