ODP077 Adipopenia is associated with low bone mass in community-dwelling non-underweight adults, independent of sarcopenia

The interaction between fat, muscle, and bone mass is complex. Although sarcopenia and underweight are well-established risk factors for osteoporosis, the association between low body fat percent (adipopenia) and low bone mass in non-underweight adults remains unclear. In Korean National Health and Nutrition Examination Survey dataset 2008-2011, we analyzed individuals aged 50 or older with body mass index (BMI)≥18.5 kg/m 2 . Appendicular skeletal muscle mass (ASMM) and body fat percent were measured using dual-energy x-ray absorptiometry. Sarcopenia was defined as ASMM/height 2 <7. 0 kg/m 2 and <5.4 kg/m 2 in men and women, respectively. Subjects were grouped into adipopenia (<17% in men and <30% in women; 1 standard deviation below the mean of the study population with round down to integer value), normal, or obesity (>30% in men and >40% in women) according to body fat percent. Osteoporosis was defined as T-score≤ -2.5 at the lumbar spine, femoral neck, or total hip. Among 5830 subjects (women 50.2%, mean age 63.9±8.5 years), 793 subjects had adipopenia (13.6%). The adipopenia group had a higher prevalence of osteoporosis (31%) compared to normal (21%) or obesity groups (27%; p<0. 001). Body fat percent showed a positive association with bone mineral density at all sites after adjustment for age, sex, height, and lean mass. In the multivariable logistic model, the presence of adipopenia was associated with 61% elevated odds of osteoporosis (adjusted odds ratio [aOR] 1.61, p<0. 001), independent of sarcopenia (aOR 1.71, p<0. 001), age, sex, height, and covariates, which remained robust in sensitivity analysis with sex-specific lowest 20% quantile thresholds (roughly <18.4% in men; <31.5% in women). In conclusion, adipopenia was associated with osteoporosis independent of sarcopenia in non-underweight adults, which merits further investigation. Presentation: No date and time listed