{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:50:21Z","timestamp":1792785021761,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"This study was supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Program Project","award":["2023ZL136"],"award-info":[{"award-number":["2023ZL136"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-15069-7","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T20:42:53Z","timestamp":1754685773000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sex-specific associations between muscle-fat ratio and bone density in middle-aged adults"],"prefix":"10.1038","volume":"15","author":[{"given":"Fang","family":"Jin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songting","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaocong","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"15069_CR1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jor.2024.03.002","volume":"53","author":"RJ Anish","year":"2024","unstructured":"Anish, R. J. & Nair, A. Osteoporosis management-current and future perspectives - A systemic review. J. Orthop. 53, 101\u2013113 (2024).","journal-title":"J. Orthop."},{"issue":"1","key":"15069_CR2","doi-asserted-by":"publisher","first-page":"Itc1","DOI":"10.7326\/AITC202401160","volume":"177","author":"KE Ensrud","year":"2024","unstructured":"Ensrud, K. E. & Crandall, C. J. Osteoporosis. Ann. Intern. Med. 177 (1), Itc1\u2013itc16 (2024).","journal-title":"Ann. Intern. Med."},{"key":"15069_CR3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1475-2891-10-32","volume":"10","author":"JE Michalek","year":"2011","unstructured":"Michalek, J. E. et al. Changes in total body bone mineral density following a common bone health plan with two versions of a unique bone health supplement: a comparative effectiveness research study. Nutr. J. 10, 32 (2011).","journal-title":"Nutr. J."},{"issue":"1","key":"15069_CR4","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1038\/s41413-021-00164-y","volume":"9","author":"M Wan","year":"2021","unstructured":"Wan, M., Gray-Gaillard, E. F. & Elisseeff, J. H. Cellular senescence in musculoskeletal homeostasis, diseases, and regeneration. Bone Res. 9 (1), 41 (2021).","journal-title":"Bone Res."},{"key":"15069_CR5","doi-asserted-by":"publisher","first-page":"e56611","DOI":"10.2196\/56611","volume":"7","author":"NA Jamil","year":"2024","unstructured":"Jamil, N. A., Dhanaseelan, J. & Buhari, N. A. Effectiveness of an e-Book on bone health as educational material for adolescents: Single-Group experimental Study. JMIR Pediatr. Parent. 7, e56611 (2024).","journal-title":"JMIR Pediatr. Parent."},{"key":"15069_CR6","doi-asserted-by":"publisher","first-page":"112544","DOI":"10.1016\/j.exger.2024.112544","volume":"195","author":"S Fan","year":"2024","unstructured":"Fan, S. et al. Sarcopenic obesity and osteoporosis: research progress and hot spots. Exp. Gerontol. 195, 112544 (2024).","journal-title":"Exp. Gerontol."},{"key":"15069_CR7","doi-asserted-by":"crossref","unstructured":"De Lorenzo, A. et al. Association between sarcopenia and reduced bone mass: is osteosarcopenic obesity a new phenotype to consider in weight management settings? Life (Basel) 14(1), 21 (2023).","DOI":"10.3390\/life14010021"},{"issue":"4","key":"15069_CR8","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1210\/endrev\/bnaa016","volume":"41","author":"MCK Severinsen","year":"2020","unstructured":"Severinsen, M. C. K. & Pedersen, B. K. Muscle-Organ crosstalk: the emerging roles of Myokines. Endocr. Rev. 41 (4), 594\u2013609 (2020).","journal-title":"Endocr. Rev."},{"issue":"4","key":"15069_CR9","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1111\/j.1365-2796.2012.02564.x","volume":"272","author":"M Kawai","year":"2012","unstructured":"Kawai, M., de Paula, F. J. & Rosen, C. J. New insights into osteoporosis: the bone-fat connection. J. Intern. Med. 272 (4), 317\u2013329 (2012).","journal-title":"J. Intern. Med."},{"issue":"1","key":"15069_CR10","first-page":"37","volume":"11","author":"AF Deng","year":"2024","unstructured":"Deng, A. F. et al. Bone-organ axes: bidirectional crosstalk. Mil Med. Res. 11 (1), 37 (2024).","journal-title":"Mil Med. Res."},{"issue":"2","key":"15069_CR11","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.diabres.2011.06.013","volume":"93","author":"TN Kim","year":"2011","unstructured":"Kim, T. N. et al. Skeletal muscle mass to visceral fat area ratio is associated with metabolic syndrome and arterial stiffness: the Korean sarcopenic obesity study (KSOS). Diabetes Res. Clin. Pract. 93 (2), 285\u2013291 (2011).","journal-title":"Diabetes Res. Clin. Pract."},{"key":"15069_CR12","doi-asserted-by":"publisher","first-page":"1246157","DOI":"10.3389\/fnut.2023.1246157","volume":"10","author":"M Xing","year":"2023","unstructured":"Xing, M. et al. The relationship between skeletal muscle mass to visceral fat area ratio and metabolic dysfunction-associated fatty liver disease subtypes in middle-aged and elderly population: a single-center retrospective study. Front. Nutr. 10, 1246157 (2023).","journal-title":"Front. Nutr."},{"issue":"4","key":"15069_CR13","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.ecl.2024.08.008","volume":"53","author":"P Subarajan","year":"2024","unstructured":"Subarajan, P., Arceo-Mendoza, R. M. & Camacho, P. M. Postmenopausal osteoporosis: A review of latest Guidelines. Endocrinol. Metab. Clin. North. Am. 53 (4), 497\u2013512 (2024).","journal-title":"Endocrinol. Metab. Clin. North. Am."},{"key":"15069_CR14","doi-asserted-by":"crossref","unstructured":"Yuan, W. & Song, C. Crosstalk between bone and other organs. Med. Rev.  2(4), 331\u2013348 (2021).","DOI":"10.1515\/mr-2022-0018"},{"issue":"9596","key":"15069_CR15","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E von Elm","year":"2007","unstructured":"von Elm, E. et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370 (9596), 1453\u20131457 (2007).","journal-title":"Lancet"},{"issue":"50","key":"15069_CR16","doi-asserted-by":"publisher","first-page":"e36613","DOI":"10.1097\/MD.0000000000036613","volume":"102","author":"X Qin","year":"2023","unstructured":"Qin, X. et al. The association between appendicular skeletal muscle index and bone mineral density in children and adolescents with chronic kidney disease: A cross-sectional study. Med. (Baltim). 102 (50), e36613 (2023).","journal-title":"Med. (Baltim)."},{"issue":"10","key":"15069_CR17","doi-asserted-by":"publisher","first-page":"2159","DOI":"10.1002\/jbmr.1666","volume":"27","author":"NK Lebrasseur","year":"2012","unstructured":"Lebrasseur, N. K. et al. Skeletal muscle mass is associated with bone geometry and microstructure and serum insulin-like growth factor binding protein-2 levels in adult women and men. J. Bone Min. Res. 27 (10), 2159\u20132169 (2012).","journal-title":"J. Bone Min. Res."},{"key":"15069_CR18","doi-asserted-by":"crossref","unstructured":"Han, C. S., Kim, H. K. & Kim, S. Effects of adolescents\u2019 lifestyle habits and body composition on bone mineral density. Int. J. Environ. Res. Public. Health 18(11). (2021).","DOI":"10.3390\/ijerph18116170"},{"issue":"2","key":"15069_CR19","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3945\/ajcn.113.081778","volume":"101","author":"P Zhang","year":"2015","unstructured":"Zhang, P. et al. Visceral adiposity is negatively associated with bone density and muscle attenuation. Am. J. Clin. Nutr. 101 (2), 337\u2013343 (2015).","journal-title":"Am. J. Clin. Nutr."},{"key":"15069_CR20","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/1471-2431-13-37","volume":"13","author":"IF J\u00fanior","year":"2013","unstructured":"J\u00fanior, I. F. et al. The relationship between visceral fat thickness and bone mineral density in sedentary obese children and adolescents. BMC Pediatr. 13, 37 (2013).","journal-title":"BMC Pediatr."},{"issue":"2","key":"15069_CR21","doi-asserted-by":"publisher","first-page":"e3597","DOI":"10.1002\/dmrr.3597","volume":"39","author":"S Zhang","year":"2023","unstructured":"Zhang, S. et al. Increased visceral fat area to skeletal muscle mass ratio is positively associated with the risk of cardiometabolic diseases in a Chinese natural population: A cross-sectional study. Diabetes Metab. Res. Rev. 39 (2), e3597 (2023).","journal-title":"Diabetes Metab. Res. Rev."},{"key":"15069_CR22","doi-asserted-by":"crossref","unstructured":"Lim, H., Son, K. & Lim, H. Association between skeletal muscle mass-to-visceral fat ratio and dietary and cardiometabolic health risk factors among Korean women with obesity. Nutrients 15(7). (2023).","DOI":"10.3390\/nu15071574"},{"key":"15069_CR23","doi-asserted-by":"publisher","first-page":"3733","DOI":"10.2147\/DMSO.S326195","volume":"14","author":"D Liu","year":"2021","unstructured":"Liu, D. et al. Relationship between skeletal muscle mass to visceral fat area ratio and cardiovascular risk in type 2 Diabetes. Diabetes Metab. Syndr. Obes. 14, 3733\u20133742 (2021).","journal-title":"Diabetes Metab. Syndr. Obes."},{"issue":"5","key":"15069_CR24","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1007\/s00198-023-07007-y","volume":"35","author":"Y Liu","year":"2024","unstructured":"Liu, Y. et al. A comprehensive meta-analysis of risk factors associated with osteosarcopenic obesity: a closer look at gender, lifestyle and comorbidities. Osteoporos. Int. 35 (5), 759\u2013773 (2024).","journal-title":"Osteoporos. Int."},{"key":"15069_CR25","doi-asserted-by":"publisher","first-page":"156052","DOI":"10.1016\/j.metabol.2024.156052","volume":"161","author":"R Conforto","year":"2024","unstructured":"Conforto, R. et al. Advances in body composition and gender differences in susceptibility to frailty syndrome: role of osteosarcopenic obesity. Metabolism 161, 156052 (2024).","journal-title":"Metabolism"},{"key":"15069_CR26","doi-asserted-by":"crossref","unstructured":"Garvey, M. E. et al. Age, sex, and race\/ethnicity associations between fat mass and lean mass with bone mineral density: NHANES data. Int. J. Environ. Res. Public. Health 18(23) (2021).","DOI":"10.3390\/ijerph182312606"},{"issue":"8","key":"15069_CR27","doi-asserted-by":"publisher","first-page":"3555","DOI":"10.1210\/jcem.86.8.7736","volume":"86","author":"S Khosla","year":"2001","unstructured":"Khosla, S. et al. Relationship of serum sex steroid levels to longitudinal changes in bone density in young versus elderly men. J. Clin. Endocrinol. Metab. 86 (8), 3555\u20133561 (2001).","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"15069_CR28","doi-asserted-by":"crossref","unstructured":"Casale, M. et al. Lean mass and body fat percentage are contradictory predictors of bone mineral density in pre-menopausal Pacific Island women. Nutrients 8(8) (2016).","DOI":"10.3390\/nu8080470"},{"key":"15069_CR29","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/978-981-13-1117-8_13","volume":"1086","author":"L Li","year":"2018","unstructured":"Li, L. & Wang, Z. Ovarian aging and Osteoporosis. Adv. Exp. Med. Biol. 1086, 199\u2013215 (2018).","journal-title":"Adv. Exp. Med. Biol."},{"issue":"68","key":"15069_CR30","doi-asserted-by":"crossref","first-page":"pt3","DOI":"10.1126\/scisignal.268pt3","volume":"2","author":"CH Turner","year":"2009","unstructured":"Turner, C. H. et al. Mechanobiology of the skeleton. Sci. Signal. 2 (68), pt3 (2009).","journal-title":"Sci. Signal."},{"key":"15069_CR31","doi-asserted-by":"crossref","unstructured":"Storlino, G. et al. Irisin protects against loss of trabecular bone mass and strength in adult ovariectomized mice by stimulating osteoblast activity. Int. J. Mol. Sci. 24(12). (2023).","DOI":"10.3390\/ijms24129896"},{"issue":"39","key":"15069_CR32","doi-asserted-by":"publisher","first-page":"12157","DOI":"10.1073\/pnas.1516622112","volume":"112","author":"G Colaianni","year":"2015","unstructured":"Colaianni, G. et al. The myokine Irisin increases cortical bone mass. Proc. Natl. Acad. Sci. U S A. 112 (39), 12157\u201312162 (2015).","journal-title":"Proc. Natl. Acad. Sci. U S A"},{"issue":"4","key":"15069_CR33","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1007\/s00774-013-0511-4","volume":"32","author":"J Mohiti-Ardekani","year":"2014","unstructured":"Mohiti-Ardekani, J. et al. Relationships between serum adipocyte hormones (adiponectin, leptin, resistin), bone mineral density and bone metabolic markers in osteoporosis patients. J. Bone Min. Metab. 32 (4), 400\u2013404 (2014).","journal-title":"J. Bone Min. Metab."},{"issue":"6","key":"15069_CR34","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1007\/s00198-011-1768-x","volume":"23","author":"KE Barbour","year":"2012","unstructured":"Barbour, K. E. et al. The effects of adiponectin and leptin on changes in bone mineral density. Osteoporos. Int. 23 (6), 1699\u20131710 (2012).","journal-title":"Osteoporos. Int."},{"key":"15069_CR35","doi-asserted-by":"crossref","unstructured":"Soare, I. et al. Body composition as a modulator of bone health changes in patients with inflammatory bowel disease. Life (Basel) 12(2). (2022).","DOI":"10.3390\/life12020272"},{"issue":"6","key":"15069_CR36","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.1016\/j.apsb.2023.01.012","volume":"13","author":"X Jin","year":"2023","unstructured":"Jin, X. et al. Pathophysiology of obesity and its associated diseases. Acta Pharm. Sin B. 13 (6), 2403\u20132424 (2023).","journal-title":"Acta Pharm. Sin B"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-15069-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-15069-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-15069-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T19:44:44Z","timestamp":1757360684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-15069-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["15069"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-15069-7","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]},"assertion":[{"value":"4 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The ethics review board of the National Center for Health Statistics approved all NHANES protocols and written informed consents were obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"29105"}}