The association between fracture site and obesity in men: A population-Based cohort study

Premaor, Melissa Orlandin; Compston, Juliet; Avilés, Francesc Fina; Pagès-Castellà, A; Nogués, Xavier; Díez-Pérez, Adolfo; Prieto-Alhambra, Daniel

doi:10.1002/jbmr.1878

Cited by 109 publications

(91 citation statements)

References 34 publications

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“…In men, it has been reported that multiple rib fractures are associated with obesity. In a population based-study in Spain, analysing 139,419 men aged 65 years or over, hip fractures in obese individuals were significantly less common than in non-obese men (11). These data are in contrast to those of Nielson and cols., who found an increased incidence of hip fracture in men after adjustment for BMD (16).…”

Section: Site Of Fracturementioning

confidence: 70%

“…Several studies have demonstrated that the relationship between BMI and fracture is site-specific (8,11,12,14,16,21,22). While obesity is protective against hip fracture in women, it is associated with higher risk of fractures at some other sites.…”

Section: Site Of Fracturementioning

confidence: 99%

“…Subsequently, other investigators have studied the impact of obesity on bone mass and the risk of fracture (9)(10)(11)(12)(13)(14). The present review focuses on the epidemiology, risk factors, diagnosis, and management of fractures in obese postmenopausal women and older men.…”

mentioning

confidence: 99%

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Obesity and fractures

Premaor

Comim

Compston³

2014

Arq Bras Endocrinol Metab

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Until recently obesity was believed to be protective against fractures. However, a report from a Fracture Liaison Clinic in the UK (2010) reported a surprisingly high proportion of obese postmenopausal women attending the clinic with fractures, and in the GLOW study (2011), a similar prevalence and incidence of fractures in obese and non-obese postmenopausal women was observed. Subsequently, other studies have demonstrated the importance of obesity in the epidemiology of fractures. Obese women are at increased risk of fracture in ankle, leg, humerus, and vertebral column and at lower risk of wrist, hip and pelvis fracture when compared to non-obese women. In men, it has been reported that multiple rib fractures are associated with obesity. Furthermore, falls appear to play an important role in the pathogenesis of fractures in obese subjects. Regarding hip fracture and major fractures, the FRAX algorithm has proven to be a useful predictor in obese individuals. Obese people are less likely to receive bone protective treatment; they have a longer hospital stay and a lower quality of life both before and after fracture. Moreover, the efficacy of antiresorptive therapies is not well established in obese people. The latter is a field for future research. Arq Bras Endocrinol Metab. 2014;58(5):470-7 Keywords Obesity; fractures; osteoporosis; osteopenia ReSumo Acreditava-se que pessoas obesas estavam protegidas contra fraturas. No entanto, um estudo realizado no Reino Unido (2010) encontrou uma proporção surpreendentemente alta de obesidade entre as mulheres na pós-menopausa que se consultaram em uma Clínica de Fraturas Ósseas. Da mesma maneira, o estudo GLOW (2011) observou prevalência e incidência semelhantes de fraturas em mulheres na pós-menopausa obesas e não obesas. Posteriormente, vários outros estudos têm demonstrado a importância da obesidade na epidemiologia de fraturas. Mulheres obesas têm maior risco de fratura no tornozelo, na perna, no úmero e na coluna vertebral e têm menor risco de fratura de punho, quadril e pelve quando comparadas às mulheres não obesas. A associação entre fraturas múltiplas de costelas e obesidade foi descrita em homens. Além disso, as quedas parecem desempenhar um papel importante na patogênese de fraturas em pacientes obesos. O algoritmo FRAX parece ser uma ferramenta útil na predição do risco de fraturas em indivíduos obesos. Indivíduos obesos são menos propensos a receber tratamento preventivo para as fraturas ósseas e, quando sofrem uma fratura óssea, sua internação costuma ser mais longa do que a internação de indivíduos magros. A qualidade de vida dos indivíduos obesos é menor antes e depois da fratura. Não obstante, a eficácia de terapias antirreabsorção não está bem estabelecida em pessoas obesas. Este último é um campo para pesquisas futuras. Arq Bras Endocrinol Metab. 2014;58(5):470-7 Descritores Obesidade; fraturas ósseas; osteoporose, osteopenia

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Section: Site Of Fracturementioning

confidence: 70%

Section: Site Of Fracturementioning

confidence: 99%

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Obesity and fractures

Premaor

Comim

Compston³

2014

Arq Bras Endocrinol Metab

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“…Inverse correlation between E2 levels, LBMD, and HBMD (p < 0.001, r(2) = −0.20; p < 0.001, r(2) = −0.19) Yang et al [2013] 1126 (360 men and 766 women), >50 years Lower abdominal fat was significantly associated with a higher fracture risk in women. There was no statistically significant association between aFM and fracture risk (HR 1.15; 95% CI 0.58-2.25) in men Greco et al [2013] 340 obese women Trunk fat negatively correlates with BMD at lumbar spine and femoral neck independently from vitamin D levels Premaor et al [2013] 139,419 old men Multiple rib fractures were more frequent in overweight (RR 3.42; 95% CI 1.03-11.37) and obese (RR 3.96; 95% CI 1.16-13.52) old men. Obesity was associated with a reduced risk of clinical spine, hip, pelvis, and wrist or forearm fracture and increased risk of multiple rib fractures when compared with normal weight or underweight men Watts [2014] 60,393 obese women aged ⩾ 55 years…”

Section: Studymentioning

confidence: 89%

The obesity of bone

Greco

Lenzi

Migliaccio

2015

Therapeutic Advances in Endocrinology

132

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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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“…Obesity is responsible for a high incidence of fall mainly because an obese subject is less well able to protect itself against a fall [22][23][24] . There are several studies that support that the site of fracture is depended on BMI (body mass index) [25][26][27][28][29][30] . In Global Longitudinal Study of Osteoporosis in Women (GLOW) was found that obesity, in contrast to widespread belief, is not protective against fracture, but also responsible for certain fractures, mainly in the ankle and upper leg.…”

Section: Obesity and Site Of Fracturementioning

confidence: 99%

Obesity and its relationship with falls, fracture site and bone mineral density in postmenopausal women

Sotiriadi-Vlachou¹

2017

JFSF

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The association between fracture site and obesity in men: A population-Based cohort study

Cited by 109 publications

References 34 publications

Obesity and fractures

Obesity and fractures

The obesity of bone

Obesity and its relationship with falls, fracture site and bone mineral density in postmenopausal women

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