PDF
Citation
Print
Abstract
Objectives
Whether osteoporotic vertebral fracture is associated with obesity is under debate. Therefore, this study aims to determine the relationship between osteoporotic vertebral fracture and body mass index (BMI) by comparing it with other types of osteoporotic fractures.
Summary of Literature Review
Several authors have reported the factors that predict the risk of osteoporotic vertebral fracture in individuals with obesity, but the objective risk factors are still controversial.
Materials and Methods
A retrospective study was conducted on postmenopausal women, including 100 people with osteoporotic vertebral fractures, 104 with femur neck fractures, 107 with distal radius fractures, and 103 with osteoporosis or osteopenia but without fractures. The BMI was calculated and bone mineral density (BMD) test was administered within 3 days after injury. For each type of fracture, the relationships with age, height, weight, BMI, and BMD were investigated. The relationship with the number of osteoporotic vertebral fractures according to BMI was also evaluated.
Results
In comparing osteoporotic vertebral fractures and osteoporotic non-vertebral fractures, there were no significant differences in the relationship with age, height, or BMD (p>0.05). Osteoporotic vertebral fractures showed a statistically higher average weight and BMI, compared to other osteoporotic non-vertebral fracture groups (p<0.05). Among those with osteoporotic vertebral fractures, the number of fractures did not show a significant relationship with BMI (p=0.177).
REFERENCES
1. Melton LJ, Eddy DM, Johnston CC Jr. Screening for osteoporosis. Ann Intern Med. 1990; 112:516–28.
2. Johnell O, Kanis J. Epidemiology of osteoporotic fracture. Osteoporos Int. 2005; 16:3–7.
3. Braithwaite RS, Col N, Wong JB. Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc. 2003; 51:364–70.
4. Felson DT, Zhang Y, Hannan MT, et al. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res. 1993; 8:567–73.
5. Koval KJ, Zuckerman JD. Functional recovery after fracture of the hip. J Bone Joint Surg Am. 1994; 76:751–8.
6. Zuckerman JD, Skovron ML, Koval KJ, et al. Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am. 1995; 77:1551–6.
7. De Laet C, Kanis JA, Odé n A, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005; 16:1330–8.
8. Kim KC, Shin DH, Lee SY, et al. Relation between obesity and bone mineral density and vertebral fractures in korean postmenopausal women. Yonsei Med J. 2010; 51:857–63.
9. Gilsanz V, Chalfant J, Mo AO, et al. Reciprocal Relations of Subcutaneous and Visceral Fat to Bone Structure and Strength. J Clin Endocrinol Metab. 2009; 94:3387–93.
10. Holecki M, Zahorska-Markiewicz B, Wiecek A, et al. Obesity and bone metabolism. Endokrynol Pol. 2008; 59:218–23.
11. Crepaldi G, Romanato G, Tonin P, et al. Osteoporosis and body composition. J Endocrinol Invest. 2007; 30:42–7.
12. LaFleur J, McAdam-Marx C, Kirkness C, et al. Clinical risk factors for fracture in postmenopausal osteoporotic women: a review of the recent literature. Ann Pharmaco-ther. 2008; 42:375–86.
13. Papaioannou A, Joseph L, Ioannidis G, et al. Risk factors associated with incident clinical vertebral and nonverte-bral fractures in postmenopausal women: the Canadian Multicentre Osteoporosis Study(CaMos). Osteoporos Int. 2005; 16:568–78.
14. Hollaender R, Hartl F, Krieg MA, et al. Prospective evaluation of risk of vertebral fractures using quantitative ultrasound measurements and bone mineral density in a population-based sample of postmenopausal women: results of the Basel Osteoporosis Study. Ann Rheum Dis. 2009; 68:391–6.
15. Pirro M, Fabbriciani G, Leli C, et al. High weight or body mass index increase the risk of vertebral fractures in post-menopausal osteoporotic women. J Bone Miner Metab. 2010; 28:88–93.
16. Tanaka S, Kuroda T, Saito M, et al. Overweight/obesity and underweight are both risk factors for osteoporotic fractures at different sites in Japanese postmenopausal women. Osteoporos Int. 2013; 24:69–76.
17. Gnudi S, Sitta E, Lisi L. Relationship of body mass index with main limb fragility fractures in postmenopausal women. J Bone Miner Metab. 2009; 4:479–84.
18. Shin HK, Jeong HJ, Kim E, et al. Association between body mass index and proximal femur fractures type in Korean people. Osteoporosis. 2014; 12:58–63.
19. Finkelstein EA, Chen H, Prabhu M, et al. The relationship between obesity and injuries among U.S. adults. Am J Health Promot. 2007; 21:460–8.
20. Tchernof A, Calles-Escandon J, Sites CK, et al. Meno-pause, central body fatness, and insulin resistance: effects of hormone-replacement therapy. Coron Artery Dis. 1998; 9:503–11.
21. Justesen J, Stenderup K, Ebbesen EN, et al. Adipocyte tissue volume in bone marrow is increased with aging and in patients with osteoporosis. Biogerontology. 2001; 2:165–71.
22. Riggs BL, Khosla S, Melton LJ. A unitary model for invo-lutional osteoporosis: estrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res. 1998; 13:763–73.
23. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy post-menopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA. 2002; 288:321–33.
24. Herrera A, Mateo J, Gil-Albarova J, et al. Prevalence of osteoporotic vertebral fracture in Spanish women over age 45. Maturitas. 2015; 80:288–95.
Table 1.
Baselin e characteristics of 414 post menopausal women
| Osteoporotic vertebral fx‡ (N=100) | Femur neck fx (N=104) | Distal radius fx (N=107) | Osteoporosis or osteopenia without fx (N=103) | Total (N=414) | p-value | |
|---|---|---|---|---|---|---|
| Mean±SD | Mean±SD | Mean±SD | Mean±SD | Mean±SD | ||
| Age (years) | 74.8±8.0 | 75.8±9.6 | 75.5±8.8 | 73.2±9.0 | 72.3 ±9.7 | 0.102 |
| Height (cm) | 153.2±5.8 | 154.4±5.6 | 154.7±6.7 | 153.6±6.9 | 154.0±6.3 | 0.342 |
| Weight (Kg) | 57.8±9.3 | 53.5±9.9 | 54.6±7.8 | 54.1±7.8 | 55.0±8.9 | <0.05 |
| BMI∗ (Kg/m2) | 24.7±4.1 | 22.4±3.9 | 22.8±2.8 | 22.9±3.1 | 23.2±3.6 | <0.05 |
| BMD† (T-score) | −2.8±1.0 | −2.6±1.2 | −2.5±0.8 | −2.7±1.0 | −2.7±1.0 | 0.175 |
Table 2.
Each distribution in the group according to body mass index
| Underweight | (N=35, 8.5%) | Normalweight | (N=184, 44.4%) | Overweigt | (N=195, 47.1%) | |
|---|---|---|---|---|---|---|
| Vertebral fx∗ | 5 | 5.0% | 34 | 34.0% | 61 | 61.0% |
| Femur neck fx | 14 | 13.5% | 51 | 49.0% | 39 | 37.5% |
| Distal radius fx | 8 | 7.5% | 49 | 45.8% | 50 | 46.7% |
| Osteoporosis or osteopenia without fx | 8 | 7.8% | 50 | 48.5% | 45 | 43.7% |
Tabe 3
Correlation between the number of verteral fracture and bone mass index in the patients with osteoporotic vertebral fracture
| Number of fractures | Numbar of patients(%) | BMI∗ |
|---|---|---|
| 1 | 72(72%) | 24.8 ± 3.8 |
| 2 | 19(19%) | 24.6 ± 3.7 |
| >3 | 9(9%) | 24.5 ± 4.4 |
| total | 100 | p = 0.177 |
XML Download