Abstract
BackgroundThe present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women.MethodsAmong 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.ResultsThe 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.ConclusionsObesity and underweight increased the risk for fragility fractures in postmenopausal Korean women.
Highlights
The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women
Mean height was not different among the three groups; weight, BMI, and waist circumference were different from the normal weight group
The mean waist circumferences of the normal, underweight, and obese groups were 76.96 ± 0.29 cm, 65.30 ± 0.86 cm, and 89.47 ± 0.37 cm, respectively, which was significantly different from the normal weight group
Summary
The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women. Osteoporosis is a musculoskeletal disorder characterized by a decrease in bone density and abnormal changes in bone microstructure [1]. It is one of the most common diseases in postmenopausal women due to the agerelated reduction in estrogen levels. Kim et al BMC Women’s Health (2021) 21:60 osteoporosis have a higher risk for fragility fractures due to reduced bone density, and increased risk for resulting complications and mortality rates [2]. In Korea, the National Health Examination Program, under the National Health Insurance Service, was designed for women aged 54 and 66 to undergo testing for bone mineral density in the lumbar spine to diagnose, treat, and manage diseases related to osteoporosis
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