Plain language summary
Osteoporosis is a musculoskeletal disorder characterized by a decrease in bone density and abnormal changes in bone microstructure. It is one of the most common diseases in postmenopausal women. Additionally, postmenopausal women exhibit a 20% increase in fat mass, especially in central adiposity. The aim of this study was to investigate the relationship between body mass index and fragility fractures in postmenopausal Korean women. This study is a cross-sectional study based on the Korean National Health and Nutrition Examination Survey which is a statutory survey addressing the health behaviour, prevalence of chronic disease, and food and nutrition intake of Korean individuals. Out of the total registered women, 2114 were included as the final participant group. Results indicate that in both the underweight and obese groups, the fragility fracture rates were 5.48 and 3.33 times higher, respectively, compared with the normal weight group. Thus, these findings show that postmenopausal women who were underweight or obese exhibited higher rates of fragility fracture(s). Authors conclude that even though this study showed the impact of the body mass index, further research is required since there are various factors that affect fragility fractures.
Abstract
BACKGROUND The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women. METHODS Among subjects who participated in the 4th Korea National Health and Nutrition Examination Survey (2008-2009), 2114 women ≥ 40 years of age were included. BMI was based on standards set by the Korean Society for the Study of Obesity, as follows: < 18.5 kg/m2, underweight; 18.5 ≤ to < 25 kg/m2, normal weight; and ≥ 25 kg/m2, obese. Subjects were also divided into three groups according to the location of fragility fracture: spine, hip, or wrist. RESULTS The mean (± SD) rate of fragility fracture was significantly different among the three groups: 5.9 ± 2.9% (underweight), 1.1 ± 0.3% (normal weight), and 3.0 ± 0.7% (obese) (p = 0.001). After correcting for age, family history, and treatment history of osteoporosis and rheumatoid arthritis, smoking and drinking status, and level of exercise, multivariable regression analysis revealed that the odds ratio for fragility fracture in the underweight group was 5.48 [95% confidence interval (CI) 1.80-16.73] and 3.33 (95% CI 1.61-6.87) in the obese group. After subdividing fragility fractures into vertebral and non-vertebral, the odds ratio for vertebral fracture in the underweight group was 5.49 (95% CI 1.31-23.09) times higher than that in the normal weight group; in the obese group, the non-vertebral fracture odds ratio was 3.87 (95% CI 1.45-10.33) times higher. Analysis of non-vertebral fractures in the obese group revealed an odds ratio for fracture 22.05 (95% CI 1.33-365.31) times higher for hip fracture and 3.85 (95% CI 1.35-10.93) times higher for wrist fracture. CONCLUSIONS Obesity and underweight increased the risk for fragility fractures in postmenopausal Korean women.
Methodological quality
Jadad score
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Allocation concealment
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