Abstract
Background
Body composition disorders such as sarcopenia, obesity, and osteoporosis are common; however, the body composition of patients with dizziness and vestibular dysfunction (VD) has not been thoroughly assessed.
Methods
This cross-sectional study included 9,682 participants aged over 40. Based on the results of a dizziness questionnaire and modified Romberg test, they were classified into three groups: dizziness associated with VD, dizziness without VD, and controls. A body composition analysis focused on muscles, bones, and fats.
Results
Multivariate regression analysis revealed that sarcopenia was associated with a higher risk of dizziness with VD when compared to dizziness without VD (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.09–2.49; P = 0.017) and the control group (OR, 1.92; 95% CI, 1.28–2.88; P = 0.002). The proportions of bone mineral and fat were comparable among the groups.
Conclusion
Sarcopenia was found to be significantly associated with dizziness in the group with VD but not in those without it. While this study does not establish a causal relationship, maintaining muscle mass through proper diet and physical activity may be beneficial for individuals with VD. Such efforts could help manage overall health, potentially reducing risks associated with sarcopenia and improving balance. Further longitudinal studies are necessary to explore the potential causal pathways between VD and sarcopenia.
Keywords: Muscle, Bone, Obesity, Dizziness, Vestibular Dysfunction, Sarcopenia
Graphical Abstract
INTRODUCTION
Dizziness, a prevalent symptom affecting daily functioning, has an estimated 1-year prevalence of 20–25% in the general population.1,2 It can stem from various factors, including neurological, metabolic, and psychological impairments.3,4 Among these, vestibular dysfunction (VD) significantly contributes to balance issues and fall-related injuries.5,6 While extensive research has explored the causes and management of dizziness, modifiable risk factors such as body composition remain underexamined. Body composition—encompassing muscle mass, bone density, and fat distribution—may influence vestibular function and balance control. However, its role in VD remains insufficiently studied.5,7,8
Previous research highlights associations between body composition and vestibular issues: low bone mineral density (BMD) with benign paroxysmal positional vertigo,9,10 low muscle mass with chronic dizziness,11 and a combination of low muscle mass and high fat mass with unilateral vestibulopathy.12 Despite these findings, most studies have examined individual components of body composition in isolation rather than their combined impact, leaving their clinical relevance unclear.9,10,11,12 Given that body composition evolves with aging and can be modified through lifestyle interventions,7 understanding its influence on vestibular function is crucial. Identifying which components—muscle, bone, or fat—are most critical for balance could inform targeted prevention and management strategies for VD. This study, therefore, aims to investigate the integrative relationship between body composition and dizziness, particularly in patients with VD.
METHODS
Study population and data sources
This cross-sectional study utilized data from the 2008–2010 Korea National Health and Nutrition Examination Survey (KNHANES), a comprehensive survey program designed to assess the health and nutritional status of the non-institutionalized South Korean population. Participants aged ≥ 40 years were included, and the cohort was weighted toward those who reside in the non-institutionalized Korean general population. The standard clinical examination, including an interview, a physical exam, and a laboratory test, was performed with the guidance of a physician. The current study sample comprised participants from the dizziness sub-study. Between 2008 and 2010, 9,682 participants completed a dizziness questionnaire and the modified Romberg test. Dizziness was assessed using the following question: “During the past 12 months, have you had dizziness or difficulty with balance?”13,14 Participants who responded “yes” to this question were considered to have dizziness. In the dizziness group, those who failed only Condition 4 of the modified Romberg test were classified as ‘dizziness associated with vestibular dysfunction’ (dizziness with VD), whereas those who passed all four conditions were classified as ‘dizziness without vestibular dysfunction’ (dizziness without VD). The control group comprised participants without dizziness or imbalance in the past year who passed all four conditions of the modified Romberg test (Fig. 1, visit https://knhanes.kdca.go.kr/knhanes/eng/main.do for more information).
Fig. 1. Flowchart of the study. Participants with dizziness with VD experienced dizziness or imbalance in the past year and failed only Condition 4 on the modified Romberg test. Those with dizziness without VD experienced dizziness or imbalance in the past year and passed Conditions 1–4 on the modified Romberg test. The control group consisted of participants without dizziness or imbalance in the past year and passed Conditions 1–4 of the modified Romberg test.
VD = vestibular dysfunction, DEXA = dual-energy X-ray absorptiometry, KNHANES = Korea National Health and Nutrition Examination Survey.
Vestibular function assessment
To assess balance, a modified Romberg test was performed with four conditions on stable and compliant surfaces. A compliant surface refers to an 18 cm thick, 22 kg/m3 polyurethane foam pad used in Conditions 3 and 4 to reduce the somatosensory input. In Condition 1, participants stood on a firm surface with feet 10 cm apart, arms crossed, eyes open for 15 seconds, and then closed eyes for Condition 2. Conditions 3 and 4 required participants to stand on a compliant surface to reduce the somatosensory input for at least 20 seconds. Condition 3 involved opened eyes, and Condition 4, with eyes closed, focused on assessing the vestibular system’s role in postural stability by eliminating visual and minimizing somatosensory inputs. A failed modified Romberg test regarding VD was defined as the participant failing Condition 4 while passing test Conditions 1–3. This methodology isolates the vestibular contributions to postural stability and is a well-established clinical tool.6,15,16 Patients who could not stand independently, needed a leg brace, weighed over 120 kg, had severe dizziness, and refused to consent were excluded.17
Body composition analysis
Each participant’s body composition (bone, muscle, and fat) was measured using a dual-energy X-ray absorptiometry (DEXA) machine (Hologic Discovery; Hologic, Madison, WI, USA) following a 12-hour overnight fast. Sarcopenia was defined according to the Asian Working Group for Sarcopenia’s guidelines using the appendicular skeletal muscle mass (ASM) index (ASM/height in square meters, < 7.0 kg/m2 for men and < 5.4 kg/m2 for women).18 Obesity was defined as a body fat percentage of ≥ 25% for men and ≥ 35% for women.19 Abnormal BMD was defined as the lowest T-score of the total femur, femoral neck, and lumbar spine of smaller than −1.0; osteopenia was defined as a T-score between −2.5 and −1.0; and osteoporosis was defined as a T-score of −2.5 or lower.20,21,22
Risk factors and covariates
Risk factors and covariates were measured in the contemporaneous examination. Essential demographic characteristics (age, sex, body mass index [BMI], waist circumference, education level, marital status, and household income) and information about other conditions that could cause dizziness (perceived stress, hypertension, diabetes mellitus, abdominal obesity, sleep disturbance, hyperlipidemia, stroke, renal failure, tinnitus, depressive mood, and depression disorder) were used as covariates. BMI was calculated as weight in kg divided by height in m squared (kg/m2). Waist circumference was measured to the nearest 0.1 cm using SECA200 (SECA, Hamburg, Germany) at the midpoint between the bottom of the last rib and the top of the iliac crest.17 The educational level was divided into two groups (lower than high school and higher than high school). Household income was classified by quartiles as low (1st quartile), lower-middle (2nd quartile), upper-middle (3rd quartile), and high (4th quartile). Perceived stress refers to the stress level felt in daily life and is categorized as low (rare or mild) or high (moderate or severe). Hypertension was defined as systolic blood pressure of ≥ 140 mmHg, diastolic blood pressure of ≥ 90 mmHg, or the use of antihypertensive medication even for prehypertension. Diabetes mellitus was defined as a fasting glucose level of > 126 mg/dL, the use of a hypoglycemic agent, the receipt of insulin injections, or a diagnosis by a doctor. Abdominal obesity was defined as a waist circumference of ≥ 90 cm for men and ≥ 85 cm for women according to the 2020 guideline for obesity management by the Korean Society for the Study of Obesity.23 The average daily sleep time was assessed by a self-reported questionnaire (“How many hours do you usually sleep in a day?”).13,14 Sleep disturbance was defined as an average daily sleeping time of ≤ 5 hours or ≥ 9 hours.24,25 Participants diagnosed with medical conditions (stroke, kidney disease, hyperlipidemia, and depression disorder) were considered to have the disease. Tinnitus was defined as hearing sounds (e.g., cracking, beeping, buzzing, and mechanical sounds) in one’s ears for > 5 minutes over the past 12 months. Depression mood was a state of feeling sad or hopeless of sufficient severity to interfere with daily life for > 2 consecutive weeks in the past 12 months. Health behaviors, such as smoking, alcohol consumption, weight training, and physical activity, were also assessed using the KNHANES questionnaire.13,14 Smoking was classified into two groups: current smoker (defined as currently smoking or having smoked more than five packs [100 cigarettes] over one’s lifetime) and non-current smoking (defined as never smoking or having smoked fewer than five packs [100 cigarettes] over one’s lifetime). Alcohol consumption was categorized into three groups: non-drinker (< 1 drink/week), moderate drinker (1–13 drinks/week for men, 1–6 drinks/week for women), and heavy drinker (≥ 14 drinks/week for men, ≥ 7 drinks/week for women).26 The number of drinks was calculated by multiplying the average drinking frequency per week by the amount of drinking (by cup) per occasion. Weight training was defined as doing strength training (e.g., push-ups, sit-ups, dumbbells, weights, and iron bars) > 2 days a week. While weight training is a form of physical activity, it primarily involves anaerobic exercise and does not directly contribute to Metabolic Equivalent Task-minutes (METs)-based calculations, which are used for aerobic activities. Therefore, weight training was assessed separately from METs-based aerobic exercise to better account for its independent effects on health outcomes. The International Physical Activity Questionnaire scoring guidelines were used to calculate METs by multiplying the days of physical activity per week by the duration (minutes) per day by a constant determined for each activity (vigorous activity: 8, moderate activity: 4, and walking: 3.3).27 Vigorous physical activities refer to activities requiring hard physical effort and resulting in heavier than normal breathing; these activities included running (jogging), hiking, riding a bicycle at a fast pace, fast swimming, soccer, basketball, jumping rope, squash, or carrying heavy objects. Moderate physical activities refer to activities slightly more difficult than normal or result in slightly heavier breathing; these activities included slow swimming, doubles tennis, volleyball, badminton, table tennis, and carrying light objects. Walking should be performed for at least 10 minutes per session. The physical activity level was classified into three groups based on the total METs as low (< 600 METs/week), moderate (600–2,999 METs/week), and vigorous (≥ 3,000 METs/week).28,29
Statistical analysis
To estimate the general population outside institutions, all analyses used survey sample weights, which were calculated by considering the sampling rate, response rate, and age/sex proportions of the reference population (based on the 2005 Population Census of Korea). Each category was marked with different numbers because of missing values: “non-responses” and “unknown”; thus, the missing values were treated as valid values and reflected in the statistical analysis following the KNHANES guidelines.30 Statistical analyses were conducted using SPSS 21.0 for Windows (version 21.0; SPSS, Chicago, IL, USA). The χ2 test and analysis of variance were performed to determine the weighted prevalence and compare clinical parameters. Categorical variables were presented as weighted percentages (standard errors); continuous variables were expressed as the weighted mean ± standard error. Univariable and multivariable multinomial logistic regressions were adopted to analyze the relationship between dizziness with vestibular disorders and body composition. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each regression model. ORs were recalculated using different reference groups within the same multinomial logistic regression model, allowing different perspectives on the relationships between the predictor and outcome variables. The analyses were performed using three models: unadjusted (Model 1); adjusted for sex and age (Model 2); and adjusted for age, sex, household income, hypertension, stroke, kidney failure, depressive disorder, hyperlipidemia, stress, alcohol drinking, current smoking, physical activity, tinnitus, educational level, sleep disorder, depression mood, and weight training (Model 3).
Ethics statement
The KNHANES protocols were reviewed and approved by the Institutional Review Board (IRB) of the Korea Centers for Disease Control and Prevention (IRB No. 2008-04EXP-01-C, 2009-01CON-03-2C, 2010-02CON-21-C). Written informed consent was obtained from all participants for each KNHANES. This study was deemed exempt by the IRB of the Chungnam National University Hospital (IRB No. 2023-04-025) because only publicly available and anonymized data were used.
RESULTS
Prevalence and clinical characteristics of dizziness and VD
A total of 9,682 participants from the KNHANES were analyzed, with 19.52% reporting dizziness in the past year. Among those, 1.41% met our criteria for VD, defined as a failure in Condition 4 of the modified Romberg test (dizziness with VD). In comparison, the remaining 18.11% did not exhibit signs of VD (dizziness without VD, Supplementary Table 1). The mean ages were 67.37, 57.09, and 53.62 years for the dizziness with VD, without VD, and control groups, respectively. The detailed demographic and clinical characteristics of the study population are shown in Supplementary Tables 2 and 3, outlining a comprehensive profile of the study population.
Body composition analysis
Participants with dizziness associated with VD exhibited a higher prevalence of decreased BMD (84.72%) than those without VD (61.72%) or controls (52.54%, P < 0.001; Fig. 2, Supplementary Table 4). The prevalence of sarcopenia was higher in the dizziness with VD group (39.71%) than in the dizziness without VD (25.23%) and control (21.32%, P < 0.001) groups. In contrast, the three groups had comparable obesity rates (Fig. 2, Supplementary Table 4).
Fig. 2. Prevalence of body composition disorders in participants with dizziness with or without VD and in controls. The error bar denotes the 95% confidence interval. The figure illustrates that decreased bone density was most prevalent in individuals with dizziness and VD (84.72%), followed by those with dizziness without VD (61.72%) and healthy controls (52.54%, P < 0.001). Sarcopenia, characterized by the loss of muscle mass, was more prevalent in people with dizziness and VD than in those with dizziness without VD and in controls (39.71%, 25.23%, and 21.32%, respectively; P < 0.001). However, obesity rates were comparable across the three groups.
VD = vestibular dysfunction, BMD = bone mineral density.
*The asterisk at the top of the bar indicates that the P value was significant at Bonferroni correction (P < 0.017).
Relationship between body composition disorders and VD
Sarcopenia was a significant independent risk factor for dizziness with VD. Compared to controls, the multivariable-adjusted ORs for sarcopenia were 1.92 (95% CI, 1.28–2.88; P = 0.002; Fig. 3, Table 1). and 1.65 (95% CI, 1.09–2.49; P = 0.017; Fig. 3, Table 1) when compared to dizziness without VD. In contrast, no association was found between sarcopenia and dizziness without VD (OR, 1.17; 95% CI, 0.99–1.37; P = 0.069). Additionally, abnormal BMD and obesity were not significantly correlated with dizziness with VD (Table 1, Fig. 3).
Fig. 3. Multinomial logistic regression for dizziness and VD by body composition. Forest plot showing ORs and 95% CIs for sarcopenia, abnormal BMD, and obesity as risk factors for dizziness and vestibular function. Sarcopenia was identified as a significant independent risk factor for dizziness with VD, with adjusted ORs of 1.92 (95% CI, 1.28–2.88; P = 0.002) and 1.65 (95% CI, 1.09–2.49; P = 0.017) compared to the control and dizziness without VD groups, respectively. However, sarcopenia was not significantly associated with dizziness without VD (OR, 1.17; 95% CI, 0.99–1.37; P = 0.069). Neither abnormal BMD nor obesity was significantly correlated with dizziness with VD. Bold values indicate significant data (P < 0.05).
VD = vestibular dysfunction, OR = odds ratio, CI = confidence interval, BMD = bone mineral density.
Table 1. Multinomial logistic regression analysis between body composition disorders and VD.
| Analysis | Dependent variable | Variable | No. of case (%) | Model 1a | Model 2b | Model 3c |
|---|---|---|---|---|---|---|
| 1 | (Control: reference category) | |||||
| Dizziness with VD | Abnormal BMDd (n = 5,796) | 121 (2.18) | 4.44 (2.42–8.16) | 1.24 (0.64–2.40) | 1.08 (0.55–2.10) | |
| Sarcopeniae (n = 2,222) | 61 (2.51) | 1.90 (1.30–2.78) | 1.96 (1.33–2.90) | 1.92 (1.28–2.88) | ||
| Obesityf (n = 3,507) | 55 (1.81) | 1.48 (0.91–2.39) | 1.04 (0.64–1.70) | 1.04 (0.60–1.80) | ||
| Dizziness without VD | Abnormal BMDd (n = 5,796) | 1,277 (20.45) | 1.42 (1.25–1.62) | 0.97 (0.84–1.12) | 0.91 (0.78–1.05) | |
| Sarcopeniae (n = 2,222) | 480 (20.50) | 1.16 (0.99–1.35) | 1.21 (1.03–1.42) | 1.17 (0.99–1.37) | ||
| Obesityf (n = 3,507) | 723 (19.29) | 1.12 (0.98–1.28) | 0.95 (0.83–1.09) | 0.98 (0.85–1.12) | ||
| 2 | (Dizziness without VD: reference category) | |||||
| Dizziness with VD | Abnormal BMDd (n = 5,796) | 121 (2.18) | 3.13 (1.69–5.80) | 1.28 (0.66–2.50) | 1.19 (0.61–2.32) | |
| Sarcopeniae (n = 2,222) | 61 (2.51) | 1.65 (1.12–2.42) | 1.62 (1.09–2.40) | 1.65 (1.09–2.49) | ||
| Obesityf (n = 3,507) | 55 (1.81) | 1.32 (0.80–2.20) | 1.10 (0.66–1.83) | 1.07 (0.61–1.86) |
Values were expressed in the form of odds ratios (95% confidence intervals). Bold values indicated statistical significance (P < 0.05).
VD = vestibular dysfunction, BMD = bone mineral density, ASM = appendicular skeletal muscle mass.
aModel 1: unadjusted.
bModel 2: adjusted for age and sex.
cModel 3: adjusted for age, sex, household income, hypertension, stroke, kidney failure, depression disorder, hyperlipidemia, stress, alcohol drinking, current smoking, physical activity, tinnitus, education level, sleep disorder, depression mood, and weight training.
dAbnormal BMD: lowest T-score of the total femur, femoral neck, and lumbar spine of less than −1.0.
eSarcopenia: ASM index (ASM/height in meters squared) of < 7.0 kg/m2 for men and < 5.4 kg/m2 for women.
fObesity: body fat mass percentage of ≥ 25% for men and ≥ 35% for women.
Distribution of other risk factors based on VD and dizziness
Some characteristics were more common in people who experienced dizziness than in controls, regardless of whether they had VD. These include older age, female sex, high-stress levels, less heavy drinking, tinnitus, and lower education. However, stroke diagnosis, current smoking, inadequate sleep, and depression were more common in those experiencing dizziness without VD than in the controls (Supplementary Table 5). In addition to sarcopenia, age was associated with a higher risk of dizziness with VD compared to the findings in participants with dizziness without VD (Supplementary Table 6).
DISCUSSION
The study evaluates the relationship between VD and body composition issues among individuals experiencing dizziness. Key findings reveal a higher prevalence of decreased BMD and sarcopenia among participants with dizziness associated with VD compared to those without VD and control participants. Specifically, 84.72% of participants with VD had low BMD, and 39.71% presented with sarcopenia—rates notably higher than those observed in other groups—indicating a strong association between VD and these body composition disorders. Conversely, obesity rates were similar across all groups. Multivariable analysis identified sarcopenia as an independent risk factor for dizziness in individuals with VD, with significantly higher ORs for those with VD versus controls. However, decreased BMD and obesity were not significantly linked to dizziness in individuals with VD. Unlike previous studies that primarily addressed isolated aspects of body composition, this study provides comprehensive evidence that highlights sarcopenia as a potentially modifiable factor in dizziness associated with VD. Interestingly, while sarcopenia was significantly associated with dizziness with VD, no such association was found in participants with dizziness without VD; this specificity indicates that VD may contribute to muscle loss, degradation, and atrophy, potentially owing to limited mobility and physical activity. However, the absence of differences in physical activity levels across the groups reveals that vestibular issues might directly contribute to sarcopenia, rather than indirectly through reduced activity caused by dizziness or imbalance (Supplementary Tables 5 and 6).
Previous experimental studies revealed that vestibulopathy can reduce muscle mass through neuroendocrine pathways such as the sympathetic nervous and central melanocortin systems.31,32,33 Human studies shed light on the intricate mechanisms through which vestibular sensory signals influence muscle activity, thereby underscoring the potential for VD to contribute to sarcopenia.34,35,36,37 Conversely, sarcopenia is also associated with postural instability, as well as increased fear of falling and fall risk.38 Therefore, sarcopenia could affect Romberg test performance.38,39,40,41,42
Sarcopenia, marked by reduced muscle volume and strength, compromises postural stability, affecting outcomes on balance tests such as the modified Romberg test. Several studies consistently demonstrate that sarcopenia worsens balance and increases body sway, particularly under challenging conditions in older adults.38,39,40,41,42 Skeletal muscles comprise diverse fibers, notably type I (slow-twitch) and type II (fast-twitch). Sarcopenia reduces the size and number of myofibers, especially type II fibers, which are crucial for rapid force generation and quick corrective responses during muscle contraction to maintain posture and prevent falls. The decline in fast-twitch fibers and compromised muscle spindles and Golgi tendon organs—key proprioceptive structures—result in diminished motor control and increased postural instability.43,44 Consequently, sarcopenia affects the modified Romberg test results through muscle fibers and proprioceptive systems impairment.
VD, which disrupts balance and spatial orientation, can influence body composition by affecting muscle mass and metabolism regulation through the vestibulo-hypothalamic pathway; this pathway associates the vestibular system with the hypothalamus, a brain region that regulates hunger, energy expenditure, and metabolic processes.33,45,46 Disruptions in this pathway can lead to hormone imbalances, which increase fat storage and reduce muscle activity, thereby promoting sarcopenia.45,46,47,48,49 For instance, high-gravity conditions have increased muscle mass; however, such gains diminish with vestibular impairment, highlighting the vestibular system’s role in muscular preservation through the sympathetic nervous system.46 Furthermore, vestibular function interacts with the central melanocortin system, which manages energy balance and body composition. The activation of vestibular structures, such as the otolith organs, stimulates the arcuate nucleus and melanocortinergic neurons, which control appetite and energy expenditure through pathways involving pro-opiomelanocortin neurons.45,50,51,52 Patients with chronic vestibular hypofunction frequently show increased body and visceral fat with reduced muscle mass, even with similar weights and BMIs compared to controls.12 Thus, VD may promote sarcopenia by influencing muscle mass through the vestibulo-hypothalamic pathway, autonomic nervous system, and melanocortin system.52
VD and sarcopenia epitomize complex diseases with multifactorial etiologies that severely affect the quality of life and mortality, especially among the elderly.53,54 These conditions underscore the importance of a multidisciplinary research approach integrating genetic, lifestyle, and environmental factors.55,56,57,58,59,60 This comprehensive strategy is essential for developing effective interventions that enhance patient care and improve overall health outcomes.61,62 Our findings on body composition emphasize the need to focus on fundamental tools for evaluating muscle mass and strength, reinforcing the importance of integrated care pathways in managing patients with VD.
In modern medical practice, VD is managed using a diverse array of strategies; these strategies encompass pharmacological treatments, neuromodulation techniques, vestibular implantation, and specialized vestibular rehabilitation programs, all aimed at mitigating symptoms and improving the quality of life in patients with vestibular disorders.63,64,65,66 In addition, individuals with VD are advised to undertake targeted dietary and exercise routines designed to maintain or increase muscle mass and strength, which are essential for preventing diseases caused by sarcopenia and enhancing equilibrium.
Our study’s cross-sectional design limits the cause–effect conclusions and does not allow specific diagnoses for each participant. Although DEXA is widely used for skeletal muscle estimation, accurately delineating muscle mass from lean body mass has been limited.67,68 Future studies using whole-body muscle magnetic resonance imaging or D3-creatine dilution tests are required to improve our understanding of the relationship between body composition and vestibular function. The study’s strengths include being the first comprehensive analysis of body composition’s association with VD and using nationally representative data collected through a standardized protocol.6,16
ACKNOWLEDGMENTS
We appreciate collaborating with the Academic Clinical Research Operating and Supporting System, Chungnam National University Hospital Biomedical Research Institute.
Footnotes
Disclosure: The authors have no potential conflicts of interest to disclose.
- Conceptualization: Jeong SH.
- Data curation: Kim EJ.
- Formal analysis: Kim EJ, Jeong SH.
- Methodology: Kim EJ, Jeong SH.
- Validation: Kwon E, Jung S, Kim JS.
- Investigation: Kim EJ, Kwon E, Jung S, Kim JS, Jeong SH.
- Writing - original draft: Kim EJ, Jeong SH.
- Writing - review & editing: Kim EJ, Kwon E, Jung S, Kim JS, Jeong SH.
SUPPLEMENTARY MATERIALS
Prevalence of dizziness
Demographics and clinical characteristics of the study population (continuous variables)
Demographics and clinical characteristics of the study population (category variables)
Proportion of body composition disorders
Multinominal logistic regression analysis (vs. control)
Multinominal logistic regression analysis (vs. dizziness without vestibular dysfunction)
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Prevalence of dizziness
Demographics and clinical characteristics of the study population (continuous variables)
Demographics and clinical characteristics of the study population (category variables)
Proportion of body composition disorders
Multinominal logistic regression analysis (vs. control)
Multinominal logistic regression analysis (vs. dizziness without vestibular dysfunction)