A D Kaze1, H N Rosen2, J M Paik3,4,5. 1. Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, USA. ark892@mail.harvard.edu. 2. Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 3. Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, USA. 4. Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 5. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Abstract
We conducted a meta-analysis of prospective studies to assess the association between BMI and incident vertebral fracture. We found that as body mass index (BMI) increases, the risk of vertebral fracture decreases in men, but not in women, suggesting possible gender differences in the relationship of BMI with risk of vertebral fracture. INTRODUCTION: Recent evidence suggests that the relationship between BMI and fracture risk may be site-specific. We conducted a systematic review and meta-analysis of prospective studies to investigate the association between BMI and risk of incident vertebral fracture. METHODS: PubMed and Embase were searched for relevant articles published from inception through February 15, 2017. Extracted relative risks (RR) from the prospective studies were pooled using random-effects meta-analysis. RESULTS: Six studies were included, with a total of 105,129 participants followed for 3 to 19 years. The pooled RR (95% confidence interval [CI]) for vertebral fracture per each standard deviation increase in BMI was 0.94 (95% CI = 0.80-1.10) with significant heterogeneity (I 2 = 88.0%, p < 0.001). In subgroup analysis by gender, we found a significant inverse association between BMI and risk of vertebral fracture in men (RR = 0.85, 95% CI = 0.73-0.98, n = 25,617 participants) but not in women (RR = 0.98, 95% CI = 0.81-1.20, n = 79,512 participants). Across studies of women not adjusting for bone mineral density (BMD), there was no significant association between BMI and risk of vertebral fracture (RR = 0.91, 95% CI = 0.80-1.04, p = 0.18, n = 72,755 participants). However, BMI was associated with an increased risk of vertebral fracture in studies of women that adjusted for BMD (RR = 1.28, 95% CI = 1.17-1.40, p < 0.001, n = 6757 participants). Substantial heterogeneity was found among studies of women (I 2 = 90.1%, p < 0.001), which was partly explained by the adjustment for BMD (adjusted R 2 = 61%). We found no evidence of publication bias (p = 0.40). CONCLUSIONS: In conclusion, our findings suggest that there might be gender differences in the relationship of BMI with risk of vertebral fracture. Further research is needed, including the assessment of other measures of adiposity, such as visceral adiposity, on the risk of vertebral fracture.
We conducted a meta-analysis of prospective studies to assess the association between BMI and incident vertebral fracture. We found that as body mass index (BMI) increases, the risk of vertebral fracture decreases in men, but not in women, suggesting possible gender differences in the relationship of BMI with risk of vertebral fracture. INTRODUCTION: Recent evidence suggests that the relationship between BMI and fracture risk may be site-specific. We conducted a systematic review and meta-analysis of prospective studies to investigate the association between BMI and risk of incident vertebral fracture. METHODS: PubMed and Embase were searched for relevant articles published from inception through February 15, 2017. Extracted relative risks (RR) from the prospective studies were pooled using random-effects meta-analysis. RESULTS: Six studies were included, with a total of 105,129 participants followed for 3 to 19 years. The pooled RR (95% confidence interval [CI]) for vertebral fracture per each standard deviation increase in BMI was 0.94 (95% CI = 0.80-1.10) with significant heterogeneity (I 2 = 88.0%, p < 0.001). In subgroup analysis by gender, we found a significant inverse association between BMI and risk of vertebral fracture in men (RR = 0.85, 95% CI = 0.73-0.98, n = 25,617 participants) but not in women (RR = 0.98, 95% CI = 0.81-1.20, n = 79,512 participants). Across studies of women not adjusting for bone mineral density (BMD), there was no significant association between BMI and risk of vertebral fracture (RR = 0.91, 95% CI = 0.80-1.04, p = 0.18, n = 72,755 participants). However, BMI was associated with an increased risk of vertebral fracture in studies of women that adjusted for BMD (RR = 1.28, 95% CI = 1.17-1.40, p < 0.001, n = 6757 participants). Substantial heterogeneity was found among studies of women (I 2 = 90.1%, p < 0.001), which was partly explained by the adjustment for BMD (adjusted R 2 = 61%). We found no evidence of publication bias (p = 0.40). CONCLUSIONS: In conclusion, our findings suggest that there might be gender differences in the relationship of BMI with risk of vertebral fracture. Further research is needed, including the assessment of other measures of adiposity, such as visceral adiposity, on the risk of vertebral fracture.
Authors: Juliet E Compston; Nelson B Watts; Roland Chapurlat; Cyrus Cooper; Steven Boonen; Susan Greenspan; Johannes Pfeilschifter; Stuart Silverman; Adolfo Díez-Pérez; Robert Lindsay; Kenneth G Saag; J Coen Netelenbos; Stephen Gehlbach; Frederick H Hooven; Julie Flahive; Jonathan D Adachi; Maurizio Rossini; Andrea Z Lacroix; Christian Roux; Philip N Sambrook; Ethel S Siris Journal: Am J Med Date: 2011-11 Impact factor: 4.965
Authors: Russel Burge; Bess Dawson-Hughes; Daniel H Solomon; John B Wong; Alison King; Anna Tosteson Journal: J Bone Miner Res Date: 2007-03 Impact factor: 6.741
Authors: D K Roy; T W O'Neill; J D Finn; M Lunt; A J Silman; D Felsenberg; G Armbrecht; D Banzer; L I Benevolenskaya; A Bhalla; J Bruges Armas; J B Cannata; C Cooper; J Dequeker; M N Diaz; R Eastell; O B Yershova; B Felsch; W Gowin; S Havelka; K Hoszowski; A A Ismail; I Jajic; I Janott; O Johnell; J A Kanis; G Kragl; A Lopez Vaz; R Lorenc; G Lyritis; P Masaryk; C Matthis; T Miazgowski; C Gennari; H A P Pols; G Poor; H H Raspe; D M Reid; W Reisinger; C Scheidt-Nave; J J Stepan; C J Todd; K Weber; A D Woolf; J Reeve Journal: Osteoporos Int Date: 2003-01 Impact factor: 4.507
Authors: Juliet E Compston; Julie Flahive; David W Hosmer; Nelson B Watts; Ethel S Siris; Stuart Silverman; Kenneth G Saag; Christian Roux; Maurizio Rossini; Johannes Pfeilschifter; Jeri W Nieves; J Coen Netelenbos; Lyn March; Andrea Z LaCroix; Frederick H Hooven; Susan L Greenspan; Stephen H Gehlbach; Adolfo Díez-Pérez; Cyrus Cooper; Roland D Chapurlat; Steven Boonen; Frederick A Anderson; Silvano Adami; Jonathan D Adachi Journal: J Bone Miner Res Date: 2014-02 Impact factor: 6.741
Authors: Julie M Paik; Harold N Rosen; Jeffrey N Katz; Bernard A Rosner; Eric B Rimm; Catherine M Gordon; Gary C Curhan Journal: Obesity (Silver Spring) Date: 2019-07-18 Impact factor: 5.002
Authors: Julia Amariti; Brandon D McGuire; Anna R Ogilvie; Kristen M Beavers; Karen E Hansen; Yvette Schlussel; Michael P Walkup; Sue A Shapses Journal: Calcif Tissue Int Date: 2022-04-06 Impact factor: 4.000
Authors: L Veras; F Diniz-Sousa; G Boppre; V Devezas; H Santos-Sousa; J Preto; J P Vilas-Boas; L Machado; J Oliveira; H Fonseca Journal: Osteoporos Int Date: 2020-01-21 Impact factor: 4.507
Authors: Egon Burian; Lioba Grundl; Tobias Greve; Daniela Junker; Nico Sollmann; Maximilian Löffler; Marcus R Makowski; Claus Zimmer; Jan S Kirschke; Thomas Baum Journal: Diagnostics (Basel) Date: 2021-02-04