Association of metabolic score for visceral fat (METS-VF) with lumbar spine bone mineral density in US adults

Obesity and the development of osteoporosis are closely related to abnormal visceral fat metabolism. The METS-VF is a novel body fat measurement method that integrates gender, waist circumference, and insulin resistance index. The purpose of this study was to look into the connection between METS-VF and lumbar spine bone mineral density (LS BMD). We performed a cross-sectional study to look into the connection between METS-VF and LS BMD using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. The association between METS-VF and LS BMD was analyzed using multiple linear regression with restricted cubic spline (RCS) curve analysis to assess nonlinear correlations, and threshold effects analysis to identify inflection points. Robustness checks included subgroup analysis. We also performed a sensitivity analysis. A total of 5005 participants with a weighted mean age of 39.57 ± 11.71 years were included in this study. After controlling for potential confounders, there was a significant negative correlation between METS-VF levels and LS BMD. According to further Restricted Cubic Splines (RCS) curve, METS-VF and LS BMD showed a substantial nonlinear association. According to threshold effect analysis, METS-VF's inflection point was 5.47. To the right of the inflection point, LS BMD decreased by 0.09 g/cm² per unit increase in METS-VF. Subgroup analyses showed that the correlation between METS-VF and LS BMD varied by diabetes status (P < 0.05 for interaction). Significantly reduced LS BMD was linked to elevated METS-VF levels. This study supports the hypothesis that there is an association between visceral fat metabolism levels and LS BMD in the US population, and specifically, individuals with higher METS-VF levels should be of particular concern for their increased risk of osteoporosis.