Abstract
BACKGROUND: The effects of visceral fat and body fat on osteoporosis (OP) have long been controversial. This study investigated the correlation between visceral fat and bone mineral density (BMD) in perimenopausal women aged 40-60. The goal was to evaluate the current state of BMD and its influencing factors, with the specific objective of establishing a foundation for preventing and treating osteoporosis in this demographic. METHODS: This case-control study included female participants (n = 330), aged 40-60 years, from the Health Management Center of Guilin Medical College Affiliated Hospital, China, between January 2020 to August 2023. Their BMD was assessed using an ultrasound bone mineral density meter, and the visceral fat area was determined utilizing a body composition analyzer. Furthermore, past medical history, dietary habits, and lifestyle factors were collected through a telephonic questionnaire survey. Additionally, we analyzed the baseline characteristics of the population, bone status and visceral fat status, and the relationship between these variables. RESULTS: Among perimenopausal women with varying bone mineral density statuses, there was no significant difference regarding body fat percentage (p = 0.359). In contrast, a statistically significant difference was observed regarding visceral fat area (p < 0.001) and vitamin D (p < 0.001). The visceral fat area exhibited an inverse correlation with bone density (r = -0.313, p < 0.001). Additionally, mediation analysis outcomes did not support the hypothesis that visceral fat affects bone density through its influence on vitamin D levels (p = 0.92). CONCLUSIONS: Among perimenopausal women, visceral fat is negatively associated with bone density, suggesting that the distribution of body fat rather than the total amount plays a pivotal role in the development of osteoporosis. These findings suggest the significance of regular physical exercise and the abdominal fat distribution for perimenopausal women.