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. 2022 Feb 7;11(1):32-41.
doi: 10.7762/cnr.2022.11.1.32. eCollection 2022 Jan.

Risk of Osteoporotic Fractures Among Obese Women Based on Body Mass Index and Waist Circumference: A Nationwide Cohort in South Korea

Gyeongsil Lee  1 , Seulggie Choi  2 , Yoosun Cho  3 , Sang Min Park  1   2
Affiliations

Risk of Osteoporotic Fractures Among Obese Women Based on Body Mass Index and Waist Circumference: A Nationwide Cohort in South Korea

Gyeongsil Lee et al. Clin Nutr Res. .

Abstract

We evaluated the association between obesity status by body mass index (BMI) or waist circumference (WC) and osteoporotic fracture risk. We collected data of 143,673 women with a mean age of 58.5 years without history of osteoporotic fracture from the Korean National Health Insurance Service Cohort. Participants were divided into four groups according to obesity by BMI and WC, normal BMI/WC (BMI 18.5-24.9 kg/m2 and WC < 85 cm, reference), obese BMI/normal WC (BMI ≥ 25 kg/m2 and WC < 85 cm), normal BMI/obese WC (BMI < 25 kg/m2 and WC ≥ 85 cm), and obese BMI/WC (BMI ≥ 25 kg/m2 and WC < 85cm). Cox proportional hazards regression analyses were performed to obtain hazard ratios (HRs) with 95% confidence intervals (CIs) for the subsequent median 6.0 years, which were adjusted for age, socioeconomic status, lifestyle, morbidity index, and osteoporosis medication. Compared with the normal group, normal BMI/obese WC was associated with a higher osteoporotic fracture risk after multivariable adjustment (HRs [95% CI], 1.13 [1.05-1.21]), and obese BMI/normal WC was associated with a lower osteoporotic fracture risk (0.89 [0.84-0.94]). Obese BMI/normal WC was associated with a lower risk for hip fractures (0.75 [0.57-0.99]). Obese BMI/normal WC was associated with decreased risk of osteoporotic fracture, whereas normal BMI/obese WC was associated with increased risk of osteoporotic fracture compared with the normal group among East Asian women in their late 40s or more.

Keywords: Abdominal obesity; Hip fractures; Obesity; Osteoporotic fractures.

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Conflict of interest statement

Conflict of Interest: The authors declare that they have no competing interests.

References

    1. GBD 2015 Obesity Collaborators. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, Salama JS, Vos T, Abate KH, Abbafati C, Ahmed MB, Al-Aly Z, Alkerwi A, Al-Raddadi R, Amare AT, Amberbir A, Amegah AK, Amini E, Amrock SM, Anjana RM, Ärnlöv J, Asayesh H, Banerjee A, Barac A, Baye E, Bennett DA, Beyene AS, Biadgilign S, Biryukov S, Bjertness E, Boneya DJ, Campos-Nonato I, Carrero JJ, Cecilio P, Cercy K, Ciobanu LG, Cornaby L, Damtew SA, Dandona L, Dandona R, Dharmaratne SD, Duncan BB, Eshrati B, Esteghamati A, Feigin VL, Fernandes JC, Fürst T, Gebrehiwot TT, Gold A, Gona PN, Goto A, Habtewold TD, Hadush KT, Hafezi-Nejad N, Hay SI, Horino M, Islami F, Kamal R, Kasaeian A, Katikireddi SV, Kengne AP, Kesavachandran CN, Khader YS, Khang YH, Khubchandani J, Kim D, Kim YJ, Kinfu Y, Kosen S, Ku T, Defo BK, Kumar GA, Larson HJ, Leinsalu M, Liang X, Lim SS, Liu P, Lopez AD, Lozano R, Majeed A, Malekzadeh R, Malta DC, Mazidi M, McAlinden C, McGarvey ST, Mengistu DT, Mensah GA, Mensink GBM, Mezgebe HB, Mirrakhimov EM, Mueller UO, Noubiap JJ, Obermeyer CM, Ogbo FA, Owolabi MO, Patton GC, Pourmalek F, Qorbani M, Rafay A, Rai RK, Ranabhat CL, Reinig N, Safiri S, Salomon JA, Sanabria JR, Santos IS, Sartorius B, Sawhney M, Schmidhuber J, Schutte AE, Schmidt MI, Sepanlou SG, Shamsizadeh M, Sheikhbahaei S, Shin MJ, Shiri R, Shiue I, Roba HS, Silva DAS, Silverberg JI, Singh JA, Stranges S, Swaminathan S, Tabarés-Seisdedos R, Tadese F, Tedla BA, Tegegne BS, Terkawi AS, Thakur JS, Tonelli M, Topor-Madry R, Tyrovolas S, Ukwaja KN, Uthman OA, Vaezghasemi M, Vasankari T, Vlassov VV, Vollset SE, Weiderpass E, Werdecker A, Wesana J, Westerman R, Yano Y, Yonemoto N, Yonga G, Zaidi Z, Zenebe ZM, Zipkin B, Murray CJL. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27. - PMC - PubMed
    1. Kling JM, Clarke BL, Sandhu NP. Osteoporosis prevention, screening, and treatment: a review. J Womens Health (Larchmt) 2014;23:563–572. - PMC - PubMed
    1. Rubin CT, Lanyon LE. Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am. 1984;66:397–402. - PubMed
    1. Edelstein SL, Barrett-Connor E. Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol. 1993;138:160–169. - PubMed
    1. Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res. 1993;8:567–573. - PubMed