Association between bone marrow adipose tissue, abdominal adipose tissue distribution, and volumetric bone mineral density in the Chinese adult population: a retrospective cohort study

Background Increasing studies have suggested that bone closely interacts with bone marrow adipose tissue (BMAT) and abdominal adipose tissue. However, this relationship remains debated. This study aimed to explore the association among BMAT, abdominal adipose tissue, and lumbar volumetric bone mineral density (vBMD). Methods A total of 306 Chinese adult living liver transplant donors were enrolled in this cross-sectional study. vBMD and abdominal adipose tissue in terms of total adipose tissue (TAT), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), were derived using quantitative computed tomography (QCT). Chemical shift encoded magnetic resonance imaging (MRI) of the lumbar spine was performed, and proton density fat fraction (PDFF) maps were calculated. Correlation analysis and multiple linear regression were used to assess the associations among BMAT, abdominal adipose tissue distribution, and vBMD. Results The mean age of the participants was 38.1 ± 9.5 years (range: 19–66 years). The vBMD was significantly negatively associated with age ( r = −0.508, p < 0.001), VAT ( r = −0.235, p < 0.001), TAT ( r = −0.127, p = 0.03), and BMAT measured by PDFF ( r = −0.642, p < 0.001). After adjusting for age, gender, and BMI, multiple linear regression analysis showed BMAT (β = −0.523, p < 0.001), SAT (β = 0.116, p = 0.045) and VAT (β = −0.108, p = 0.037) to be independent factors influencing vBMD. Conclusion Our results indicated a negative association between BMAT and BMD. The association between abdominal adipose tissue distribution and BMD was dual; there was a positive association between SAT and BMD and a negative association between VAT and BMD. These findings suggest that the distribution of abdominal adipose tissue, particularly visceral adipose tissue accumulation, should be prioritized over total body weight in considerations of bone health.