The association between fracture site and obesity in men: a population-based cohort study
Abstract
A site-dependent association between obesity and fracture has been reported in postmenopausal women. In this study we investigated the relationship between body mass index (BMI) and fracture at different skeletal sites in older men (≥65 years). We carried out a population-based cohort study using data from the Sistema d‘Informació per al Desenvolupament de l‘Investigació en Atenció Primària (SIDIAPQ) database. SIDIAPQ contains the primary care and hospital admission computerized medical records of >1300 general practitioners (GPs) in Catalonia (Northeast Spain), with information on a representative 30% of the population (>2 million people). In 2007, 186,171 men ≥65 years were eligible, of whom 139,419 (74.9%) had an available BMI measurement. For this analysis men were categorized as underweight/normal (BMI < 25 kg/m2, n = 26,298), overweight (25 ≤ BMI < 30 kg/m2, n = 70,851), and obese (BMI ≥ 30 kg/m2, n = 42,270). Incident fractures in the period 2007 to 2009 were ascertained using International Classification of Diseases, 10th edition (ICD-10) codes. A statistically significant reduction in clinical spine and hip fractures was observed in obese (relative risk [RR], 0.65; 95% confidence interval [CI], 0.53–0.80 and RR, 0.63; 95% CI, 0.54–0.74, respectively), and overweight men (RR, 0.77; 95% CI, 0.64–0.92 and RR, 0.63; 95% CI 0.55–0.72, respectively) when compared with underweight/normal men. Additionally, obese men had significantly fewer wrist/forearm (RR, 0.77; 95% CI, 0.61–0.97) and pelvic (RR, 0.44; 95% CI, 0.28–0.70) fractures than underweight/normal men. Conversely, multiple rib fractures were more frequent in overweight (RR, 3.42; 95% CI, 1.03–11.37) and obese (RR, 3.96; 95% CI, 1.16–13.52) men. In this population-based cohort of older men, obesity was associated with a reduced risk of clinical spine, hip, pelvis, and wrist/forearm fracture and increased risk of multiple rib fractures when compared to normal or underweight men. Further work is needed to identify the mechanisms underlying these associations.
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Obesity and changes in fat mass introduce artifacts that may compromise DXA accuracy and precision.
“Limitations due to DXA technology include the fact that obesity itself and changes in fat mass introduce artifacts that may compromise accuracy and precision.30-33”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [32]
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Bone loss after bariatric surgery: causes, consequences, and management
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- Authors
- Premaor, M. O., Compston, J. E., Fina Avilés, F., Pagès-Castellà, A., Nogués, X., Díez-Pérez, A., & Prieto-Alhambra, D.
- Affiliations
- Universidade Federal de Santa Maria (BR)
- National Health Service (GB)
- Primary Care Department, Institut Català de la SalutBarcelonaSpain
- Universitat Autònoma de Barcelona (ES)
- Instituto de Salud Carlos III (ES)
- URFOA (Unitat de Recerca de la Fisiopatologia Òssia i Articular) and RETICEFIMIM (Parc de Salut Mar) – Instituto de Salud Carlos IIIBarcelonaSpain
- Medical Research Council (MRC) Lifecourse Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-01-31
- Volume
- 28
- Issue
- 8
- Pages
- 1771-1777
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W1500266469
- Cited by
- 122
- References
- 37
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 10 · 2022: 8 · 2021: 5 · 2020: 16 · 2019: 6 · 2018: 9 · 2017: 10 · 2016: 13 · 2015: 9 · 2014: 17 · 2013: 5
- FWCI
- 15.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Keywords
- obesity, body mass index, fracture location, older men, hip fracture, spinal fractures, wrist fractures, rib fractures, pelvic fractures, overweight, underweight, fracture risk, primary care records, Catalonia, sex differences in fracture risk, alcohol consumption, physical activity
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Male, Obesity, Spain, Cohort Studies, Body Mass Index, Incidence, Fractures, Bone, Kaplan-Meier Estimate
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