Abdominal obesity increases the risk of hip fracture. A population‐based study of 43 000 women and men aged 60–79 years followed for 8 years. Cohort of <scp>N</scp>orway

Søgaard, Anne‐Johanne; Holvik, Kristin; Omsland, Tone Kristin; Tell, Grethe S.; Dahl, Cecilie; Schei, Berit; Falch, Jan A.; Eisman, John A.; Meyer, Haakon E

doi:10.1111/joim.12230

Cited by 69 publications

(67 citation statements)

References 53 publications

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“…Our findings may in part explain the increased fracture risk in obese individuals, as has been reported previously [1,5,32,33]. Especially in the radius, we identified a tendency for impaired bone structure in obese men compared with controls in the fully adjusted model.…”

Section: Discussionsupporting

confidence: 66%

“…We report here a smaller bone size both in distal radius and tibia in obese subjects after adjusting for BMI. In a recent Norwegian study consisting of 43,000 men and women aged from 60 to 79 years, abdominal obesity was associated with an increased risk of hip fractures when BMI was taken into account [33]. Some other studies have similarly shown an inverse association between visceral fat and BMD [1,28].…”

Section: Discussionmentioning

confidence: 89%

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Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity

et al. 2015

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Childhood obesity is associated with compromised bone health. We studied bone characteristics and their determinants in obese young adults. The study included 68 subjects with early-onset severe obesity and 73 normal-weight controls. Data on physical activity (PA), diet and smoking were collected. Bone characteristics were measured using peripheral QCT. The obese and control subjects were similar in age (mean 19.6 ± 2.6 years) and height but BMIs differed (39.7 and 22.6 kg/m(2)). A clustering of unhealthy lifestyles was marked: Obese subjects reported less supervised PA in childhood, adolescence and currently (p < 0.03) and were more likely to smoke (p = 0.005), and had a lower healthy eating index (HEI) (p = 0.007) but similar alcohol consumption compared with controls. In obese women, all crude bone characteristics were higher than in controls; in men, the differences were smaller. Associations of lifestyle factors with bone characteristics were tested using partial correlations. Independently of BMI, supervised PA in adolescence and alcohol consumption were related positively to bone characteristics in both groups. HEI associated positively with bone characteristics only in controls, while smoking was a positive determinant of bone characteristics only in obese subjects. The multivariate model showed that the contribution of lifestyle factors to bone characteristics was minimal compared with BMI. Early-onset obesity is accompanied by poor dietary quality, sedentary lifestyle, and more frequent smoking, but the overall contribution of these lifestyle factors to bone strength is limited. Bone strength is more likely to be compromised in men and in unloaded bone sites in subjects with early-onset severe obesity. The impact of obesity-related endocrine changes on bone characteristics need to be evaluated in future studies.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 89%

Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity

et al. 2015

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“…This is consistent with a recent study reporting that bone turnover was lower and the BMD was higher in obese subjects than in normal people (Walsh et al, 2016). Although the results were sometimes controversial, many epidemiological studies have reported that postmenopausal women with higher BMI had a reduced risk for hip or pelvis fracture (DiPietro et al, 1993, Gnudi et al, 2009, Prieto-Alhambra et al, 2012, Sogaard et al, 2015). However, it was estimated that, for obese populations, there is a U-shape relationship between BMI and fracture risk and that the protective effects of weight on bone are reduced along with the increment of BMI (Palermo et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Bioavailable 25(OH)D but Not Total 25(OH)D Is an Independent Determinant for Bone Mineral Density in Chinese Postmenopausal Women

Chen

Duan

et al. 2017

EBioMedicine

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Total 25(OH)D levels were determined to assess bone health in elderly populations; however, the bioavailability of 25(OH)D is regulated by the albumin and vitamin D binding protein (DBP) levels and DBP variations. Whether bioavailable 25(OH)D level is a superior biomarker for vitamin D than total 25(OH)D level regarding the BMD and the bone metabolism were not yet fully understood. With a community based cross-sectional study of 967 postmenopausal women, we found that the variant rs7041, but not rs4588, of DBP was significantly associated with the blood DBP level, which was positively correlated with the total 25(OH)D level but negatively associated with bioavailable 25(OH)D levels. Both total and bioavailable 25(OH)D levels were significantly correlated with the BMD value in postmenopausal women; however, only the bioavailable 25(OH)D level was an independent determinant of the BMD values when adjusted for age, body mass index and bone turnover biomarkers (OST and β-CTX). The bioavailable and total 25(OH)D were negatively correlated with bone formation biomarkers (OST, PINP and ALP) and PTH levels, while they were positively correlated with osteoprotegerin (OPG) level; however, the bone resorption biomarker (β-CTX) was not correlated with the 25(OH)D levels. An increment of PTH level, along with reduced bioavailable 25(OH)D levels, was evident when the bioavailable 25(OH)D level was < 5 ng/mL, which may be the optimal cutpoint for sufficient vitamin D in Chinese elderly women. The blood calcium, magnesium, ALP, TSH, FGF23, and phosphorus levels were not correlated with the total or the bioavailable 25(OH)D levels. These results suggested that high bioavailable 25(OH)D levels were correlated with reduced bone turnover processes and were a biomarker superior to total 25(OH)D for vitamin D in assessing the risks of bone-related diseases. The results indicate that the bioavailable 25(OH)D level should be determined in assessing the bone health.

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“…Even though body fat and lean mass are correlated with BMD, with obesity apparently exerting protection against bone loss, especially after menopause, during the last decades some evidence has described an opposite event, suggesting that probably obesity, based on the amount of fat mass, can affect bone metabolism leading to osteoporosis (Table 1). In fact, recent studies have shown that increased abdominal fat tissue might be considered a risk factor for decreased BMD and osteoporosis both in women and in men [Holecki et al 2012;Greco et al 2010Greco et al , 2013Migliaccio et al 2013;Bredella et al 2011;Kim, 2010;Kim et al 2010;Watts, 2014;Sogaard et al 2015;Compston et al 2014].…”

Section: Obesity and Osteoporosismentioning

confidence: 99%

The obesity of bone

Greco

Lenzi

Migliaccio

2015

Therapeutic Advances in Endocrinology

128

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During the last decades, obesity and osteoporosis have become important global health problems, and the belief that obesity is protective against osteoporosis has recently come into question. In fact, some recent epidemiologic and clinical studies have shown that a high level of fat mass might be a risk factor for osteoporosis and fragility fractures. Several potential mechanisms have been proposed to explain the complex relationship between adipose tissue and bone. Indeed, adipose tissue secretes various molecules, named adipokines, which are thought to have effects on metabolic, skeletal and cardiovascular systems. Moreover, fat tissue is one of the major sources of aromatase, an enzyme that synthesizes estrogens from androgen precursors, hormones that play a pivotal role in the maintenance of skeletal homeostasis, protecting against osteoporosis. Moreover, bone cells express several specific hormone receptors and recent observations have shown that bonederived factors, such as osteocalcin and osteopontin, affect body weight control and glucose homeostasis. Thus, the skeleton is considered an endocrine target organ and an endocrine organ itself, likely influencing other organs as well. Finally, adipocytes and osteoblasts originate from a common progenitor, a pluripotential mesenchymal stem cell, which has an equal propensity for differentiation into adipocytes or osteoblasts (or other lines) under the influence of several cell-derived transcription factors. This review will highlight recent insights into the relationship between fat and bone, evaluating both potential positive and negative influences between adipose and bone tissue. It will also focus on the hypothesis that osteoporosis might be considered the obesity of bone.

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Abdominal obesity increases the risk of hip fracture. A population‐based study of 43 000 women and men aged 60–79 years followed for 8 years. Cohort of Norway

Abstract: Background. The question as to whether abdominal obesity has an adverse effect on hip fracture remains unanswered. The purpose of this study was to investigate the associations of waist circumference, hip circumference, waist-hip ratio, and body mass index with incident hip fracture.

Cited by 69 publications

References 53 publications

Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity

Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity

Bioavailable 25(OH)D but Not Total 25(OH)D Is an Independent Determinant for Bone Mineral Density in Chinese Postmenopausal Women

The obesity of bone

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