Diagnostic utility of body fat distribution parameters in distinguishing osteosarcopenia from osteoporosis or sarcopenia alone in postmenopausal women: a retrospective cross-sectional study
- 1Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, 510080 Guangzhou, China
- 2Orthopedic Center, The Second Affiliated Hospital of Shenzhen University (People’s Hospital of Shenzhen Baoan District), 518100 Shenzhen, China
- 3School of Basic Medical Sciences, Henan Medical University, 453003 Xinxiang, China
Abstract
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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40520-026-03469-2.
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BibTeX
@article{hong2026diagnostic,
title = {{Diagnostic utility of body fat distribution parameters in distinguishing osteosarcopenia from osteoporosis or sarcopenia alone in postmenopausal women: a retrospective cross-sectional study}},
author = {Jiacong Hong and Bailing Chen and Haonan Li and Xiaoyan Zhang and Xiaohua Pan and Shengli Zhao},
journal = {Aging Clinical and Experimental Research},
year = {2026},
month = aug,
doi = {10.1007/s40520-026-03469-2},
url = {https://doi.org/10.1007/s40520-026-03469-2},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Diagnostic utility of body fat distribution parameters in distinguishing osteosarcopenia from osteoporosis or sarcopenia alone in postmenopausal women: a retrospective cross-sectional study
AU - Jiacong Hong
AU - Bailing Chen
AU - Haonan Li
AU - Xiaoyan Zhang
AU - Xiaohua Pan
AU - Shengli Zhao
PY - 2026
DA - 2026/08/05
JO - Aging Clinical and Experimental Research
DO - 10.1007/s40520-026-03469-2
UR - https://doi.org/10.1007/s40520-026-03469-2
AB - 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40520-026-03469-2.
SN - 1594-0667
SN - 1720-8319
ER -