Beyond BMI: body composition phenotypes and their systemic inflammatory profiles in patients with osteoporotic vertebral compression fracture

作者：Qing Wang, Mingjiao Liao, Shuxing Xing, Yulin Liao · 发表于：BMC Musculoskeletal Disorders · 年份：2026 · DOI：10.1186/s12891-026-10230-3 · 研究领域：Bone health and osteoporosis research、Spinal Fractures and Fixation Techniques、Bone and Joint Diseases

PURPOSE: Body mass index (BMI) cannot distinguish fat from muscle mass, masking metabolic heterogeneity. We aimed to characterize body composition phenotypes based on the intersection of BMI and low muscle mass in patients with osteoporotic vertebral compression fracture (OVCF), and to compare systemic inflammatory profiles across phenotypes. METHODS: In this cross-sectional study, 245 hospitalized OVCF patients aged ≥ 50 years were consecutively enrolled. Appendicular muscle mass was measured by dual-energy X-ray absorptiometry, and low muscle mass was defined per the 2025 Asian Working Group for Sarcopenia criteria. Four phenotypes were delineated: normal weight/normal muscle (NW/NM), overweight/obese/normal muscle (OW/OB/NM), normal weight/low muscle (NW/LM), and overweight/obese low muscle (LMO). Systemic inflammatory markers were compared across groups: platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) as positive markers, and prealbumin and albumin as negative markers. RESULTS: The overall prevalence of low muscle mass was 53.47% (95% CI: 47.22%-59.61%). Phenotype distribution was: NW/NM 11.02%, OW/OB/NM 35.51%, NW/LM 38.78%, and LMO 14.69%. Significant overall differences were observed for all systemic inflammatory markers: PLR (P < 0.001, ε²=0.059, small), CRP (P = 0.022, ε²=0.028, small), prealbumin (P = 0.007, ε²=0.037, small), and albumin (P = 0.015, ε²=0.031, small). For albumin, prealbumin, and PLR, the OW/OB/NM phenotype consistently exhibited the ...