Jihan Kim1,2, Sami Lee3, Sung Soo Kim2, Jong-Pyo Lee4, Jong Sung Kim2, Jin Gyu Jung2, Seok Jun Yoon2, Kyu Pil Kim5, Chan-Keol Park6, Yong-Hwan Kim7. 1. Department of Family Medicine, Sejong Trinium Woman's Hospital, Sejong, Korea. 2. Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea. 3. Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea. smlee@cnuh.co.kr. 4. Department of Obstetrics and Gynecology, Sejong Trinium Woman's Hospital, Sejong, Korea. 5. Department of Family Medicine, Chungnam National University Sejong Hospital, Sejong, Korea. 6. Division of Rheumatology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea. 7. Department of Orthopedic Surgery, Chungnam National University Hospital, Daejeon, Korea.
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.
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.
Entities:
Keywords:
Body mass index; Obesity; Osteoporosis; Osteoporotic fractures; Postmenopausal
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