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Background <p>The occurrence of osteosarcopenia is usually accompanied by changes in body fat distribution (BFD). However, it is still unclear whether there are differences in the BFD patterns of individuals with osteosarcopenia compared to those with osteoporosis or sarcopenia alone.</p> Aims <p>This study aims to evaluate the feasibility of BFD parameters as an auxiliary assessment tool for osteosarcopenia in postmenopausal women.</p> Methods <p>In this retrospective cross-sectional study, 342 postmenopausal women who underwent musculoskeletal function assessments in our hospital between January 2015 and December 2022 were enrolled. Osteoporosis was diagnosed according to the World Health Organization criteria, whereas sarcopenia was diagnosed according to the 2019 consensus of the Asian Working Group for Sarcopenia.</p> Results <p>After adjusting for confounding covariates, BFD parameters showed no significant independent association with bone mineral density (BMD), but were consistently associated with muscle mass and strength indicators. Compared with the osteosarcopenia group, participants in the osteoporosis alone group had significantly higher Android fat levels (odds ratio [OR]: 1.728, 95% confidence interval [CI]: 1.118–2.670), while participants in the sarcopenia alone group had significantly lower trunk-to-total body fat ratio and appendicular-to-trunk fat ratio (OR: 0.333, 95% CI: 0.132–0.842, and OR: 0.737, 95% CI: 0.573–0.948; respectively). The diagnostic panels containing Android fat demonstrated high accuracy in distinguishing osteosarcopenia from osteoporosis alone (area under the curve [AUC] values &gt; 0.9). The diagnostic panels containing trunk-to-total body fat ratio and appendicular-to-trunk fat ratio exhibited moderate diagnostic accuracy in differentiating osteosarcopenia from sarcopenia alone (AUC values &gt; 0.7).</p> Conclusions <p>Distinct <i>BFD</i> patterns are associated with different musculoskeletal phenotypes in postmenopausal women, with parameters more closely linked to muscle measures than to BMD. Specific fat distribution indicators correlate with osteosarcopenia, and these exploratory diagnostic panels provide preliminary reference value for differential diagnosis, while external validation in independent cohorts is required before clinical application.</p>

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Diagnostic utility of body fat distribution parameters in distinguishing osteosarcopenia from osteoporosis or sarcopenia alone in postmenopausal women: a retrospective cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Jiacong Hong,
  • Bailing Chen,
  • Haonan Li,
  • Xiaoyan Zhang,
  • Xiaohua Pan,
  • Shengli Zhao

摘要

Background

The occurrence of osteosarcopenia is usually accompanied by changes in body fat distribution (BFD). However, it is still unclear whether there are differences in the BFD patterns of individuals with osteosarcopenia compared to those with osteoporosis or sarcopenia alone.

Aims

This study aims to evaluate the feasibility of BFD parameters as an auxiliary assessment tool for osteosarcopenia in postmenopausal women.

Methods

In this retrospective cross-sectional study, 342 postmenopausal women who underwent musculoskeletal function assessments in our hospital between January 2015 and December 2022 were enrolled. Osteoporosis was diagnosed according to the World Health Organization criteria, whereas sarcopenia was diagnosed according to the 2019 consensus of the Asian Working Group for Sarcopenia.

Results

After adjusting for confounding covariates, BFD parameters showed no significant independent association with bone mineral density (BMD), but were consistently associated with muscle mass and strength indicators. Compared with the osteosarcopenia group, participants in the osteoporosis alone group had significantly higher Android fat levels (odds ratio [OR]: 1.728, 95% confidence interval [CI]: 1.118–2.670), while participants in the sarcopenia alone group had significantly lower trunk-to-total body fat ratio and appendicular-to-trunk fat ratio (OR: 0.333, 95% CI: 0.132–0.842, and OR: 0.737, 95% CI: 0.573–0.948; respectively). The diagnostic panels containing Android fat demonstrated high accuracy in distinguishing osteosarcopenia from osteoporosis alone (area under the curve [AUC] values > 0.9). The diagnostic panels containing trunk-to-total body fat ratio and appendicular-to-trunk fat ratio exhibited moderate diagnostic accuracy in differentiating osteosarcopenia from sarcopenia alone (AUC values > 0.7).

Conclusions

Distinct BFD patterns are associated with different musculoskeletal phenotypes in postmenopausal women, with parameters more closely linked to muscle measures than to BMD. Specific fat distribution indicators correlate with osteosarcopenia, and these exploratory diagnostic panels provide preliminary reference value for differential diagnosis, while external validation in independent cohorts is required before clinical application.