# Structural equation model analysis of the effect of visceral fat on osteoporosis

## TL;DR

This study explores how visceral fat affects osteoporosis in Moyu County, Xinjiang, using a large sample and structural equation modeling.

## Contribution

The study introduces a structural equation model to identify direct and indirect factors influencing osteoporosis, emphasizing visceral fat.

## Key findings

- Visceral fat index is a significant factor in osteoporosis, included in all logistic regression equations except for age and female menopause.
- General conditions and body composition have the highest standardized path coefficients as direct factors of osteoporosis.
- Respiratory exposure and daily diet act as indirect factors influencing osteoporosis.

## Abstract

Osteoporosis is a considerable public health challenge in Moyu County, Xinjiang. Here, we evaluated the influencing factors of osteoporosis in this region.

We recruited 7,761 participants and randomized them into normal and osteoporotic populations based on T-score. The effects of general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet on osteoporosis were analyzed. Furthermore, a structural equation model was constructed to uncover the direct and indirect influencing factors of osteoporosis.

Among the participants, 1,803 (23.23%) had normal bone mass while 1,496 (19.28%) had osteoporosis. The univariate analysis showed significant differences in the general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet. Stratification based on age (45 years) and body mass index (BMI) (18.5 kg/m2) showed variations in the body composition between the two groups; however, the visceral fat differed significantly. Logistic regression analysis affirmed the association of visceral fat index as it was included in all equations, except for age and female menopause. The structural equation exhibited that the general conditions, body composition, and, calcium sources, and exercise were direct factors of osteoporosis, while respiratory exposure and daily diet were indirect factors. The standardized path coefficient was highest in general conditions, followed by body composition, and lastly, calcium sources and exercise.

Obesity, besides age and female menopause, is also an influencing factor of osteoporosis. The visceral fat index plays a vital role in osteoporosis. Our findings may provide experimental evidence for early prevention and treatment of osteoporosis.

The online version contains supplementary material available at 10.1186/s13018-024-04888-5.