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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1365587
This article is part of the Research Topic Inter-Organ Communication in the Pathogenesis of Obesity and Associated Metabolic Disorder View all 4 articles

Association of Obesity with Osteoporotic Fracture Risk in Individuals with Bone Metabolism-Related Conditions: A Cross-Sectional Analysis

Provisionally accepted
Guijun Yang Guijun Yang 1Hejun Jiang Hejun Jiang 1Dan Xie Dan Xie 2Shuhua Yuan Shuhua Yuan 1Jinhong Wu Jinhong Wu 1Jing Zhang Jing Zhang 1Lei Zhang Lei Zhang 1Jilei Lin Jilei Lin 1Jiande Chen Jiande Chen 1Yong Yin Yong Yin 1,2,3,4,5,6*
  • 1 Shanghai Children's Medical Center, Shanghai, China
  • 2 Sanya Maternal and Child Health Hospital, Sanya, China
  • 3 Linyi Maternity and Child Health Care Hospital, Linyi, Shandong Province, China
  • 4 Shanghai Children's Medical Center Pediatric Medical Complex (Pudong), Shanghai, China
  • 5 Pediatric AI clinical application and research center, Shanghai Children’s Medical Center, Shanghai, China
  • 6 Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China

The final, formatted version of the article will be published soon.

    This study aimed to investigate the individual and composite associations of different indices of obesity on osteoporotic fractures at three different sites among individuals affected by conditions influencing bone metabolism. 5377 participants were included from the National Health and Nutrition Examination Survey (NHANES), a national cross-sectional survey. BMI and WC were used separately and in combination to evaluate the presence of obesity. Obesity was defined as BMI ≥ 30 kg/m², WC ≥ 88 cm in females, and WC ≥102 cm in males. Associations between obesity and osteoporotic fractures were assessed using multivariable logistic regression and OR curves. Associations modified by age, sex, race, and alcohol consumption were also evaluated. In multivariable logistic regression analyses, we found that BMI, WC, BMI defining obesity, and WC defining obesity were negatively associated with hip fracture (all P < 0.05). However, harmful associations between WC and BMI defining obesity and spine fracture were found (all P < 0.05). OR curves revealed that BMI and WC had a linear relationship with hip and spine fractures (all P for non-linearity > 0.05). Further analyses showed that the highest WC quartile was harmfully associated with a higher risk of spine fractures (P < 0.05). Obese participants diagnosed by both BMI and WC were less likely to have hip fractures but more likely to have spine fractures (all P for trend < 0.05). A significant interaction between age (Ref: age < 50 years) and BMI and WC was detected for hip fractures (all P for interaction < 0.05). In people with conditions influencing bone metabolism, obesity diagnosed by BMI and WC was associated with a lower risk of hip fracture, while obesity diagnosed by BMI and the highest WC quartile were associated with a higher risk of spine fracture.

    Keywords: Obesity, Osteoporotic Fractures, bone metabolism, BMI (Body mass Index), WC (waist circumference)

    Received: 04 Jan 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Yang, Jiang, Xie, Yuan, Wu, Zhang, Zhang, Lin, Chen and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yong Yin, Shanghai Children's Medical Center, Shanghai, China

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