ArticleTherapeutic advances in endocrinology and metabolism2025
Association of body mass index and sarcopenia with osteoporosis: a predictive nomogram model for risk assessment.
Article in Therapeutic advances in endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Body mass index (BMI) and sarcopenia are linked to osteoporosis, but the extent to which BMI influences osteoporosis through sarcopenia remains unclear. This study aims to assess the associations between BMI, sarcopenia, and osteoporosis, and to explore the predictive value of their combined biochemical markers for osteoporosis. Methods: We retrospectively collected clinical data from 813 inpatients in the endocrinology department to explore the relationships between serum markers and skeletal muscle mass or BMI, and to evaluate the predictive value of BMI and sarcopenia for osteoporosis. Mediation analysis was employed to examine the associations among BMI, sarcopenia, and osteoporosis. Participants were randomly divided into training ( Results: BMI and skeletal muscle mass were negatively correlated with serum 25-hydroxyvitamin D and calcium levels. The "BMI < 28 and Non-Sarcopenia" emerged as a protective factor against osteoporosis. Sarcopenia significantly mediated the association between BMI and osteoporosis (46.88%). Gender, age, high-density lipoprotein, alkaline phosphatase, BMI, and sarcopenia emerged as independent predictors of osteoporosis. The area under the curve (AUC) for the training and testing sets was 0.859 and 0.866, respectively, with calibration curves indicating good consistency. DCA and CIC demonstrated clinical net benefits at risk thresholds of 0.02-0.82 and 0.02-0.67. Sankey diagrams and partial AUCs (1.00-0.75 sensitivity and specificity) illustrate the significant negative predictive value of BMI and sarcopenia. Conclusion: Lower BMI and non-sarcopenia are negatively associated with the risk of osteoporosis. In addition, the nomogram demonstrates good predictive value, with a greater negative predictive value of the BMI and sarcopenia.
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