Effect of Body Surface Area on Severe Osteoporotic Fractures: A Study of Osteoporosis in Changsha China

Abstract

Clinical vertebral fractures and femoral neck fractures are severe osteoporotic fractures that increase morbidity and mortality. Anthropometric variables are associated with an increased risk of osteoporotic fractures, but it is not clear whether body surface area (BSA) has an effect on clinically severe osteoporotic fractures. The study included total of 3,694 cases of clinical vertebral fractures and femoral neck fractures (2,670 females and 1,024 males) and 3,694 controls without fractures who were matched with the cases by sex and age. There was a significant positive correlation between BSA and bone mineral density (BMD) in female and male fracture patients (females: r = 0.430–0.471, P < 0.001; males: r = 0.338–0.414, P < 0.001). There was a significant systematic increase in BMD in both genders at various skeletal sites, grouped by BSA quartile. The osteoporosis rates of the lumbar spine (97.9%), femoral neck (92.4%) and total hip (87.1%) in the female Q1 group were significantly higher than those in the Q4 group (P < 0.001), which were 80.0%, 57.9% and 36.9%, respectively, in the Q4 group; the osteoporosis rates of the lumbar spine, femoral neck, and total hip were 53.9%, 59.4%, and 36.3% in the male Q1 group, and 15.2%, 21.9%, and 7.03% in the Q4 group, which were significantly lower than those in the Q1 group (P < 0.001). In age-adjusted Cox regression models, the risk of fracture in the remaining three groups (Q2, Q3, and Q4) for weight, BMI, and BSA for both genders, compared with the highest quartile (Q1 by descending quartile stratification) were significantly higher. In models adjusted for age and BMD, only men in the BSA Q3 (HR = 1.55, 95% CI = 1.09–2.19) and BSA Q4 groups (HR = 1.41, 95% CI = 1.05–1.87) had significantly higher fracture risks. In models adjusted for age, height, weight, BMI, and BSA, low BMD was the greatest fracture risks for both sexes. Our results showed that BSA was closely related to BMD, prevalence of osteoporosis, and fracture risk, and that a decline in BSA may be a new potential risk factor for osteoporotic fractures in Chinese men.

Resveratrol Alleviates Osteoporosis by Promoting Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells via SITR1/PI3K/AKT Pathway

“…Epidemiological statistics show that 20 % of men and 50 % of women will experience a decrease in bone density after the age of 50, and OP is one of the main causes of fractures in elderly patients (Lorentzon, 2019;Imamudeen et al, 2022). In China, there were about 2.69 million new cases of major osteoporotic fractures (hip, vertebral body, and wrist) in 2015, and about 4.83 million new cases are expected in 2035 and about 5.99 million new cases in 2050 (Wang et al, 2021;Wu et al, 2022). At present, most of the drug mechanisms of action for the treatment of osteoporosis are by inhibiting bone resorption and promoting bone formation, the former including calcitonin, bisphosphonates, estrogens, etc., and the latter including parathyroid hormone and its analogues, but its long-term application also brings many toxic side effects (Slupski et al, 2021;Reid & Billington, 2022).…”

“…Osteoporosis is prone to osteoporotic fractures due to the decrease in bone strength, while the disability and mortality rate of osteoporotic fractures and their complications increase significantly, bringing great economic burden to families and society, and seriously affecting the quality of life (Kanis et al, 2020;Cheng et al, 2021). The causes of osteoporosis are complex, including decreased estrogen levels, aging due to aging, and excessive use of glucocorticoids (Wang et al, 2021;Wu et al, 2022).…”

Association of High Fat Diet with Bone Mineral Density in the General American Population

“…Hip fracture is considered as a typical osteoporotic fracture, which is closely related to the decrease of BMD at hip [8]. Among the numerous risk factors for osteoporosis such as age, gender, body weight, estrogen, genetic factors, smoking, alcohol consumption, environmental and various metabolic diseases, low BMD is of utmost importance [9]. Bone mass begins to decrease with age after peak bone mass in adults, and bone health is also affected by dietary macronutrient intake [10,11].…”

Breaking Back and Bones: A Review on Osteoporotic Vertebral Fracture

“…It lowers the population's quality of life and causes prolonged immobility, which could lead to social isolation, decreased body mass, and low self-esteem. Having osteoporotic vertebral fractures also has high clinical consequences leading to an increased risk of fractures involving the proximal femoral, radial, sacral, or pelvis, contributing to high societal cost and mortality and is therefore important to be picked up by radiologists [4]. According to Lyritis 1989, these fractures with silent symptomatology are prone to a series of acute back pain that could exceed 20 months in total [5].…”