Sex-specific associations of fat and lean indices with vertebral fractures

Abstract The relationship between body composition and fracture sites is complex. Previous studies have reported that a site-dependent relationship between body mass index (BMI) and fractures in postmenopausal women and older men. This study aimed to investigate sex-specific associations of fat and...

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Main Authors: Yen-Huai Lin, Michael Mu Huo Teng
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-07552-y
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author Yen-Huai Lin
Michael Mu Huo Teng
author_facet Yen-Huai Lin
Michael Mu Huo Teng
author_sort Yen-Huai Lin
collection DOAJ
description Abstract The relationship between body composition and fracture sites is complex. Previous studies have reported that a site-dependent relationship between body mass index (BMI) and fractures in postmenopausal women and older men. This study aimed to investigate sex-specific associations of fat and lean indices with vertebral fractures. This cross-sectional study included 1,479 participants, with body composition assessed using dual-energy X-ray absorptiometry. Fat indices included BMI, body fat percentage, and waist circumference, whereas the lean index was represented by appendicular lean mass (ALM)/height². Prevalent vertebral fractures were identified through radiographic confirmation. When both fat and lean indices simultaneously were considered, BMI (odds ratio [OR], 1.15; 95% confidence interval [CI] 1.08–1.22), body fat percentage (OR, 1.06; 95% CI 1.02–1.10), and waist circumference (OR, 1.06; 95% CI, 1.03–1.08) were significantly associated with vertebral fractures in postmenopausal women, whereas ALM/height² did not show such an association. In contrast, for men aged ≥ 50 years, ALM/height² was significantly associated with vertebral fractures, whereas fat indices showed no such an association. Furthermore, a significant interaction between ALM/height² and sex was observed. Fat indices were predominantly associated with vertebral fractures in women, whereas the lean index was more strongly associated with vertebral fractures in men. These findings highlight a sex-specific association between body composition and vertebral fractures.
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spelling doaj-art-e1f901442b41465eaf8dc82f6f3b10d02025-08-20T03:38:15ZengNature PortfolioScientific Reports2045-23222025-07-011511610.1038/s41598-025-07552-ySex-specific associations of fat and lean indices with vertebral fracturesYen-Huai Lin0Michael Mu Huo Teng1Department of Medical Imaging, Cheng Hsin General HospitalDepartment of Medical Imaging, Cheng Hsin General HospitalAbstract The relationship between body composition and fracture sites is complex. Previous studies have reported that a site-dependent relationship between body mass index (BMI) and fractures in postmenopausal women and older men. This study aimed to investigate sex-specific associations of fat and lean indices with vertebral fractures. This cross-sectional study included 1,479 participants, with body composition assessed using dual-energy X-ray absorptiometry. Fat indices included BMI, body fat percentage, and waist circumference, whereas the lean index was represented by appendicular lean mass (ALM)/height². Prevalent vertebral fractures were identified through radiographic confirmation. When both fat and lean indices simultaneously were considered, BMI (odds ratio [OR], 1.15; 95% confidence interval [CI] 1.08–1.22), body fat percentage (OR, 1.06; 95% CI 1.02–1.10), and waist circumference (OR, 1.06; 95% CI, 1.03–1.08) were significantly associated with vertebral fractures in postmenopausal women, whereas ALM/height² did not show such an association. In contrast, for men aged ≥ 50 years, ALM/height² was significantly associated with vertebral fractures, whereas fat indices showed no such an association. Furthermore, a significant interaction between ALM/height² and sex was observed. Fat indices were predominantly associated with vertebral fractures in women, whereas the lean index was more strongly associated with vertebral fractures in men. These findings highlight a sex-specific association between body composition and vertebral fractures.https://doi.org/10.1038/s41598-025-07552-yAppendicular lean massBody fat percentageBody mass indexSexVertebral fracturesWaist circumference
spellingShingle Yen-Huai Lin
Michael Mu Huo Teng
Sex-specific associations of fat and lean indices with vertebral fractures
Scientific Reports
Appendicular lean mass
Body fat percentage
Body mass index
Sex
Vertebral fractures
Waist circumference
title Sex-specific associations of fat and lean indices with vertebral fractures
title_full Sex-specific associations of fat and lean indices with vertebral fractures
title_fullStr Sex-specific associations of fat and lean indices with vertebral fractures
title_full_unstemmed Sex-specific associations of fat and lean indices with vertebral fractures
title_short Sex-specific associations of fat and lean indices with vertebral fractures
title_sort sex specific associations of fat and lean indices with vertebral fractures
topic Appendicular lean mass
Body fat percentage
Body mass index
Sex
Vertebral fractures
Waist circumference
url https://doi.org/10.1038/s41598-025-07552-y
work_keys_str_mv AT yenhuailin sexspecificassociationsoffatandleanindiceswithvertebralfractures
AT michaelmuhuoteng sexspecificassociationsoffatandleanindiceswithvertebralfractures