The mediating role of syndecan-4 in the negative association of healthy eating index with body mass index and android percent fat in premenopausal women

<b>Background:</b> Diet quality has been implicated in the development of abdominal obesity. Yet, the molecular components involved in this relationship remain largely unknown. <b>Aim:</b> This pilot study examined whether syndecan-4 (SDC4) may serve as a molecular link between diet quality and abdominal obesity. <b>Methods:</b> Serum SDC4 levels were measured in 41 women (aged 21-45) who self-identified as African American or European American. Diet quality was assessed using the healthy eating index (HEI) score derived from a food frequency questionnaire, while android percent fat was measured using dual-energy X-ray absorptiometry. Regression and mediation analyses were performed to examine the data. <b>Results:</b> Significant (<i>p</i> < 0.05) negative correlations were observed between HEI scores and both body mass index (BMI) and android percent fat. SDC4 emerged as a significant predictor of HEI and mediated the negative associations of HEI with BMI and android percent fat, independent of race and age. <b>Conclusion:</b> Our findings suggest that SDC4 may play a key mechanistic role in linking adherence to dietary recommendations with reductions in android adiposity.