Abstract
SummaryIn a Chinese population from both urban and rural areas, weight loss of ≥ 5 kg from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.IntroductionThis study investigates the association of the long-term weight loss from young adulthood through the middle ages with the subsequent 10-year risk of hospitalized fracture and calcaneus bone mineral density (BMD).MethodsChina Kadoorie Biobank (CKB) was established during 2004–2008 in ten areas across China. Weight at age 25 years was self-reported at baseline, and weight at baseline and resurvey was measured by the calibrated equipment. Outcomes were hospitalized fracture during follow-up and calcaneus BMD measured at resurvey. Analysis for fracture risk included 411,812 participants who were free of fracture in the last 5 years before baseline, cancer, or stroke at any time before baseline. Analysis for BMD included 21,453 participants who participated in the resurvey of 2013–2014 with the same exclusion criteria as above.ResultsThe mean age was 50.8 at baseline and 58.4 at resurvey. Median weight change from age 25 to baseline was 4.4 kg, with 20.7% losing weight and 58.5% gaining weight. During a median follow-up of 10.1 years, we documented 13,065 cases of first diagnosed fracture hospitalizations, including 1222 hip fracture. Compared with participants whose weight was stable (± 2.4 kg), the adjusted hazard ratios (95% CIs) for those with weight loss of ≥ 5.0 kg from age 25 to baseline was 1.39 (1.17 to 1.66) for hip fracture. Weight loss was not associated with fracture risk at other sites. Those with weight loss from age 25 to resurvey had the lowest BMD measures, with β (95% CIs) of − 4.52 (− 5.08 to − 3.96) for broadband ultrasound attenuation (BUA), − 4.83 (− 6.98, − 2.67) for speed of sound (SOS), and − 4.36 (− 5.22, − 3.49) for stiffness index (SI).ConclusionsWeight loss from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.
Highlights
Materials and methodsThe prevalence of weight loss attempts, for which concerns about health and appearance are the most common motivators, has been increasing among adults worldwide in the last decades [1]
A few prospective studies conducted in the Western countries and mostly in women have reported that weight loss since early adulthood was associated with a higher risk of hip fracture [11,12,13] and lower bone mineral density (BMD) [14, 15] in late adulthood
Among the eligible 411,812 participants at baseline, the mean age was 50.8 ± 10.4 years; 57.5% were women; and 47.9% resided in urban areas
Summary
Materials and methodsThe prevalence of weight loss attempts, for which concerns about health and appearance are the most common motivators, has been increasing among adults worldwide in the last decades [1]. A few prospective studies conducted in the Western countries and mostly in women have reported that weight loss since early adulthood was associated with a higher risk of hip fracture [11,12,13] and lower BMD [14, 15] in late adulthood. The findings of the association between weight loss and fractures at sites other than hip, such as upper limb [6, 7] and spine [7, 16], were inconsistent These three available studies were conducted in either postmenopausal women [6, 7] or men ≥ 65 years old [16] and to address the association of weight loss after baseline with the risk of fracture at various body sites during the follow-up. The weight loss from overweight or normal weight occurs frequently in the Asian populations, compared with the weight loss from morbid obesity or obesity in the Western populations
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