Text box 1. Contributions to the literature
Osteoporosis dramatically threatens the health status of the middle-aged and elderly population, with more than 9 million worldwide suffering from osteoporotic fractures yearly.
Bone mineral density (BMD) is an essential indicator for evaluating osteoporosis. Studies have shown that obesity is strongly associated with BMD, but conflicting results have emerged among existing studies.
Lean body mass to visceral fat mass ratio was positively and nonlinearly correlated with BMD, and there was a threshold effect.
There is an urgent need for appropriate public health policies to guide people to maintain an appropriate muscle-fat ratio to improve BMD.