The role of body composition and visceral fat in osteoporosis subtype differentiation: Insights from bioelectrical impedance analysis.

Abstract

Recent studies have demonstrated a close link between body composition and the development and progression of osteoporosis. Visceral fat, in particular, appears to influence bone loss through its pro-inflammatory properties. However, it remains unclear whether this mechanism is equally relevant across different forms of osteoporosis. To investigate whether body composition-especially visceral fat- differs between postmenopausal and senile osteoporosis. A total of 47 patients were prospectively enrolled. The senile osteoporosis group included patients aged ≥80 years (n = 20, mean age 87.4), the postmenopausal osteoporosis group included patients aged ≤75 years (n = 14, mean age 68.8), and the control group consisted of patients aged ≤75 years (n = 13, mean age 68.8) without osteoporotic fractures or other osteoporosis-specific risk factors. Participants underwent bioelectrical impedance analysis (BIA) to assess body composition. Additional assessments included basic osteological laboratory testing, geriatric evaluation, sarcopenia screening (SARC-F), and frailty screening using the Clinical Frailty Scale (CFS). Muscle mass, total body water, fat-free mass, and BMI were significantly reduced in the senile osteoporosis group compared to controls. Similar trends were observed in the postmenopausal group, though without statistical significance. Notably, the senile osteoporosis group had a significantly higher proportion of visceral fat relative to total fat mass than both the control and postmenopausal groups. Patients with senile and postmenopausal osteoporosis exhibit distinct differences in body composition compared to individuals without osteoporosis. In particular, the strong association between visceral fat and senile osteoporosis highlights a potential role for BIA in early risk detection and the development of tailored therapeutic strategies.