Association between obesity and the prevalence of fractures: a population-based cross-sectional study in China.

IF 5.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Osteoporosis International Pub Date : 2025-08-01 Epub Date: 2025-04-28 DOI:10.1007/s00198-025-07493-2
Wenting Qi, Lijia Cui, Xiangjun Yin, Wei Yu, Qianqian Pang, Lin Chen, Shunyu Tang, Hua Lin, Lu Cui, Xiaolan Jin, Zhongjian Xie, Zhixin Li, Mei Li, Linhong Wang, Weibo Xia
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引用次数: 0

Abstract

Although obesity is generally associated with increased bone mass, recent data have challenged its potential protective effect. Our study found that increased BMI showed beneficial effects on BMD in a non-linear way. However, individuals with obesity, especially women, were more likely to have vertebral fractures. There was a U-shaped relationship between BMI and the prevalent fractures.

Purpose: To estimate the association of obesity with the prevalence of fractures in the Mainland Chinese population.

Methods: A total of 8251 individuals from the COPS cohort were enrolled in this cross-sectional study and grouped by BMI level. The Five-Repetition Sit-to-Stand Test (5R-STS) and the Sharpened Romberg test were used to evaluate the balance ability. Vertebral fractures (VFs) were confirmed by spine X-ray examination. Prevalent fractures were defined by a self-report questionnaire which happened in the recent 5 years. The restricted cubic spline (RCS) was used to explore the non-linear relationship. Multiple linear regression and multivariable logistic regression were conducted to adjust the covariates.

Results: Obesity was correlated with a reduced bone turnover rate and increased BMD. Nevertheless, there were significant non-linear correlations between BMI and BMD, with a rapid increase and plateau at extremely high BMI levels (p for non-linear < 0.001 for all). Individuals with obesity were associated with a longer time of the 5R-STS and more likely to have a positive Sharpened Romberg test, especially in women. Compared with the normal weight group, the likelihood of prevalence of VFs and the prevalent fractures were significantly increased in the obesity group, independent of the Sharpened Romberg test and lumbar spine BMD (VFs: OR = 1.88 [95% CI 1.38-2.56]; prevalent fractures: OR = 2.18 [95% CI 1.39-3.41]). Per standard deviations (SD) increase in BMI was associated with 21% and 22% increase in the prevalence of VFs and prevalent fractures, respectively. Moreover, the prevalence of prevalent fractures also elevated in the low-weight individuals (OR = 2.62 [95% CI 1.34-4.75]), which indicated a U-shaped relationship between BMI and the prevalence of prevalent fractures.

Conclusion: Obesity was associated with higher BMD in a non-linear manner. However, BMI was positively associated with the prevalence of VFs, and there was a U-shaped relationship between BMI and the prevalent fractures.

肥胖与骨折患病率之间的关系:中国一项基于人群的横断面研究
虽然肥胖通常与骨量增加有关,但最近的数据对其潜在的保护作用提出了质疑。我们的研究发现,BMI的增加对骨密度的影响是非线性的。然而,肥胖的人,尤其是女性,更容易发生椎体骨折。BMI与骨折发生率呈u型关系。目的:评估中国大陆人群中肥胖与骨折患病率的关系。方法:来自COPS队列的8251人被纳入该横断面研究,并按BMI水平分组。采用五重复坐立测验(5R-STS)和Sharpened Romberg测验评估平衡能力。椎体骨折(VFs)经脊柱x线检查证实。通过近5年的自我报告问卷来定义常见骨折。采用限制三次样条(RCS)分析了非线性关系。采用多元线性回归和多变量逻辑回归对协变量进行调整。结果:肥胖与骨周转率降低、骨密度增加相关。然而,BMI与骨密度之间存在显著的非线性相关性,在BMI水平极高时,骨密度会迅速增加并趋于平稳(p为非线性)。结论:肥胖与骨密度升高呈非线性关系。然而,BMI与VFs患病率呈正相关,BMI与骨折患病率呈u型关系。
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来源期刊
Osteoporosis International
Osteoporosis International 医学-内分泌学与代谢
CiteScore
8.10
自引率
10.00%
发文量
224
审稿时长
3 months
期刊介绍: An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.
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