Visceral Adiposity, Bone Density Show Significant Linkage

Miriam E. Tucker

June 27, 2022

Researchers published the study covered in this summary on as a preprint that has not yet been peer reviewed.

Key Takeaways

  • The Visceral Adiposity Index (VAI), which reflects fat distribution and visceral fat metabolism, significantly, positively associated with lumbar bone mineral density (BMD), may help in the prediction, early screening, and evaluation of osteoporosis.

Why This Matters

  • The increasing prevalence of osteoporosis and obesity led to an increasing recognition of the importance of exploring the relationship between these two states. However, views currently conflict on the nature of this relationship.

  • Early identification and management of modifiable risk factors are important for reducing the prevalence of osteoporosis.

Study Design

  • The study included 9016 US residents included in the National Health and Nutrition Examination Survey (NHANES) during 2007-2010, excluding those without complete data for the study’s analyses or with a history of cancer.

  • The researchers calculated a VAI for each subject using a sex-specific formula.

  • The analysis included total femur, femoral neck, and lumbar spine bone mineral density measurements made by dual-energy-x-ray absorptiometry (DXA) bone scans.

Key Results

  • VAI significantly, positively correlated with BMD after multiple adjustments for confounders.

  • Every 1 unit increase in VAI significantly associated with a 0.002 increase in lumbar BMD. The researchers also found similar significant, positive relationships between VAI and BMD for the total femur and for the femoral neck.

  • Participants in the highest VAI quartile had a 0.049g/cm2 higher BMD than those in the lowest VAI quartile, with the link remaining significant across different BMD quartile groups.

  • The findings were consistent across gender and age subgroups.

  • However, one age-related difference in the relationship emerged. Among teens and children in the data set ≤ 18 years old, among those with a VAI < 4.86, every 1 unit increase in VAI associated with a significant 0.025g/cm2 higher lumbar BMD. But among those with a VAI > 4.86, a 1 unit increase in VAI associated with a significant 0.027g/cm2 decrease in lumbar BMD.


  • The researchers had no data on prior anti-osteoporosis treatments and hence measurements of BMD were not completely objective.

  • All people included in the study were from the United States, so the generalizability of the findings to other populations is unclear.

  • The data came from a cross-sectional assessment that lacked follow-up data and hence could not address a possible causal relationship between VAI and osteoporosis.


  • The study received no commercial funding.

  • The authors reported no disclosures.

This is a summary of a preprint research study, "Association between visceral adiposity index and bone mineral density: an NHANES study,” by researchers at the Affiliated and the Second Affiliated Hospitals of Nanjing University of Chinese Medicine, Nanjing, China, published on Research Square and provided to you by Medscape. The study has not yet been peer reviewed. The full text of the study can be found on

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.