Association between A body shape index and bone mineral density in middle-aged and elderly adults: a retrospective analysis of NHANES 2005–2018

作者：Z. Wang, Guo-Liang Ma, Bo Xu, Xin Chen, Bowen Yang, Xiaokuan Qin, Weili Duan, Minshan Feng, He Yin, Kai Sing Sun, Liguo Zhu · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1506841 · 被引用次数：8 · 研究领域：Bone health and osteoporosis research、Nutrition and Health in Aging、Body Composition Measurement Techniques

Introduction Despite accumulating evidence on central obesity and osteoporosis, the role of a body shape index (ABSI), a nonlinear index quantifying body shape via body mass index (BMI), waist circumference (WC), and height, remains controversial and underexplored. Although recent meta-analyses suggest central obesity may modulate fracture risk bidirectionally, no research has comprehensively compared ABSI with traditional adiposity metrics, such as BMI, WC, and waist-to-height ratio (WHtR), to predict site-specific changes in bone mineral density (BMD) across anatomical regions. Methods This study utilized National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018, involving 12,421 participants. ABSI was computed using the formula: ABSI = WC/(BMI²/³ × Height¹/²). BMD was assessed at four sites—the total femur (TF), femoral neck (FN), trochanter (TR), and intertrochanter (IN) regions—via dual-energy X-ray absorptiometry (DXA). The association between ABSI and BMD was analyzed via multiple regression models and a generalized additive model (GAM). To compare ABSI’s predictive efficacy with conventional adiposity indices, regression analyses juxtaposed ABSI against BMI, WC, and WHtR in assessing correlations with site-specific BMD. Results After full covariate adjustment, a significant negative association was observed between ABSI and BMD in four femoral regions ( P < 0.01). Smoothed curve fitting revealed a significant nonlinear relationship and threshold...