Abdominal fat volume predicts bone mass reduction in women with metabolic syndrome: an energy spectral CT analysis

OBJECTIVES: Metabolic syndrome (MetS) presents significant health risks, but studies on individual component of MetS or its combined impact on bone mass have shown conflicting results. Therefore, this study aimed to analyze the relationship between abdominal fat and bone mineral density (BMD) in women with MetS using gemstone spectral imaging (GSI). METHODS: A retrospective study was performed on 76 women with MetS scheduled for sleeve gastrectomy between June and November 2021. Based on cluster analysis of BMD parameters, the patients were categorized into the high (54) and low (22) BMD groups. Clinical, BMD, and body composition metrics were analyzed separately. Univariate and multivariate logistic regression analyses were used to evaluate patients' clinical and body composition parameters. Receiver operating characteristic (ROC) curves were generated to determine the optimal diagnostic thresholds of various parameters for diagnosing the high and low BMD groups. Furthermore, taking lumbar vertebral BMD as the dependent variable, multiple linear regression analysis was performed. RESULTS: Significant differences in body composition were observed between the high and low BMD groups, with lower abdominal fat in patients in the high BMD group. The ROC curves showed a total abdominal fat volume threshold of 4733.2mL for predicting BMD (P = 0.008). Furthermore, using multiple linear regression adjusted for age, a statistically significant negative correlation was observed between the lumbar vertebral BMD and abdominal fat volume. CONCLUSION: Abdominal fat volume influenced the GSI-BMD in women with MetS. As the abdominal fat increased, the patients' GSI-BMD in the lumbar spine also decreased.