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Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study

  • Authors:
    • Wenjian Zhao
    • Weizheng Zhang
    • Kok-Yong Chin
    • Xiaodong Ma
    • Hashwin Singh Tejpal Singh
    • Sophia Ogechi Ekeuku
    • Yuanzhong Wang
    • Xia Ji
    • Yang Guo
    • Sok Kuan Wong
    • Norliza Muhammad
    • Teh Rohaila Jamil
    • Saharuddin Ahmad
  • View Affiliations / Copyright

    Affiliations: Department of Pathology, College of Basic Medicine, Xiangnan University, Chenzhou, Hunan 423043, P.R. China, Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia, Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia, Department of Traditional Chinese Medicine, Universiti Tunku Abdul Rahman, Kajang, Selangor 43000, Malaysia, Department of Nursing, School of Medicine, Shaanxi University of International Trade and Commerce of Pharmacy College, Xianyang, Shaanxi 712046, P.R. China, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia
    Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 28
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    Published online on: November 21, 2025
       https://doi.org/10.3892/etm.2025.13023
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Abstract

The relationship between adiposity and bone health is controversial because of the various direct and indirect bone regulatory functions of adipose tissue. Given the limitations of the body mass index (BMI) as a reliable marker of adiposity, several alternative indices have been developed. The different indices show varying associations with bone health. The present study aimed to determine the association between various adiposity indices and bone health amongst Malaysians. In October and November 2024, this cross‑sectional study recruited 320 subjects (231 women and 89 men) from a bone health screening event via purposive sampling. The subjects' body weight, height, and waist and hip circumference were measured, and adiposity indices [BMI, waist‑to‑hip ratio (WHR), waist‑to‑height ratio (WtHR), body roundness index (BRI), conicity index (CI) and a body shape index (ABSI)] were derived from these basic parameters. The subjects' bone health was evaluated by using a calcaneal bone quantitative ultrasonometer‑derived osteoporosis index (OI). Linear regression analysis was used to determine the relationship between adiposity indices and bone health after adjustment for potential confounders. The strength of association was indicated as beta coefficient (β). The results indicated that after adjustment for confounders, a significant relationship existed between the OI and all adiposity indices, with the exception of CI. The BMI (β=0.172, P<0.001), waist circumference (β=0.184, P=0.001), WHR (β=0.124, P=0.025), WtHR (β=0.160, P=0.002) and BRI (β=0.165, P=0.001) showed a positive association with bone health, whereas the ABSI (β=‑0.183, P=0.008) showed a negative association. In conclusion, adiposity indices associated with body size showed a positive relationship with bone health, whereas the ABSI, which has already been adjusted for body size, showed a negative relationship with bone health.
View Figures

Figure 1

Formula for calculating indices of
adiposity.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Zhao W, Zhang W, Chin K, Ma X, Tejpal Singh H, Ogechi Ekeuku S, Wang Y, Ji X, Guo Y, Wong SK, Wong SK, et al: Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study. Exp Ther Med 31: 28, 2026.
APA
Zhao, W., Zhang, W., Chin, K., Ma, X., Tejpal Singh, H., Ogechi Ekeuku, S. ... Ahmad, S. (2026). Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study. Experimental and Therapeutic Medicine, 31, 28. https://doi.org/10.3892/etm.2025.13023
MLA
Zhao, W., Zhang, W., Chin, K., Ma, X., Tejpal Singh, H., Ogechi Ekeuku, S., Wang, Y., Ji, X., Guo, Y., Wong, S. K., Muhammad, N., Jamil, T., Ahmad, S."Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study". Experimental and Therapeutic Medicine 31.1 (2026): 28.
Chicago
Zhao, W., Zhang, W., Chin, K., Ma, X., Tejpal Singh, H., Ogechi Ekeuku, S., Wang, Y., Ji, X., Guo, Y., Wong, S. K., Muhammad, N., Jamil, T., Ahmad, S."Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study". Experimental and Therapeutic Medicine 31, no. 1 (2026): 28. https://doi.org/10.3892/etm.2025.13023
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x
Spandidos Publications style
Zhao W, Zhang W, Chin K, Ma X, Tejpal Singh H, Ogechi Ekeuku S, Wang Y, Ji X, Guo Y, Wong SK, Wong SK, et al: Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study. Exp Ther Med 31: 28, 2026.
APA
Zhao, W., Zhang, W., Chin, K., Ma, X., Tejpal Singh, H., Ogechi Ekeuku, S. ... Ahmad, S. (2026). Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study. Experimental and Therapeutic Medicine, 31, 28. https://doi.org/10.3892/etm.2025.13023
MLA
Zhao, W., Zhang, W., Chin, K., Ma, X., Tejpal Singh, H., Ogechi Ekeuku, S., Wang, Y., Ji, X., Guo, Y., Wong, S. K., Muhammad, N., Jamil, T., Ahmad, S."Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study". Experimental and Therapeutic Medicine 31.1 (2026): 28.
Chicago
Zhao, W., Zhang, W., Chin, K., Ma, X., Tejpal Singh, H., Ogechi Ekeuku, S., Wang, Y., Ji, X., Guo, Y., Wong, S. K., Muhammad, N., Jamil, T., Ahmad, S."Adiposity indices and bone health amongst Malaysian adults: Evidence from a cross‑sectional study". Experimental and Therapeutic Medicine 31, no. 1 (2026): 28. https://doi.org/10.3892/etm.2025.13023
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