The relationship between weight change and risk of hip fracture: meta-analysis of prospective studies

Lv, Qingyu; Fu, Xin; Jin, Haiming; Xu, Haichao; Huang, Zhenfeng; Xu, Huazi; Chi, Yong-Long; Wu, Ai-Min

doi:10.1038/srep16030

Cited by 26 publications

(22 citation statements)

References 49 publications

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“…Body weight correlated positively with the bone mineral density of the proximal femur in postmenopausal women aged 75 years and older [29]. Weight loss is shown to be a risk factor of hip fracture in a recent systematic review and meta-analysis paper [30]. Among the six included studies, five used the CHS criteria or LASA frailty instrument, both of which contain weight loss as a criterion.…”

Section: Discussionmentioning

confidence: 97%

Frailty as a predictor of fractures among community-dwelling older people: A systematic review and meta-analysis

Kojima¹

2016

Bone

127

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Section: Discussionmentioning

confidence: 97%

Frailty as a predictor of fractures among community-dwelling older people: A systematic review and meta-analysis

Kojima¹

2016

Bone

127

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“…Although an emerging area, our findings are in general agreement with other studies monitoring legacy effects of WL on bone health, and suggest that declining bone mass may persist after WL ceases, or reverses. (13)(14)(15)(16)(17) Large prospective studies consistently show that WL is associated with higher hip fracture risk in older adults, (57) even among those who are overweight or obese. (7) Importantly, newly published results from the Look AHEAD study (the only RCT, to our knowledge, which has examined the effect of longterm intentional WL on fracture incidence in overweight and obese adults) confirms that 6% to 9% WL achieved and maintained over nearly a decade increases frailty fracture by 39%, (58) with concomitant loss in BMD (59,60) -although it is worth noting that the overall fracture incidence was the same for those randomized to WL versus education control.…”

Section: Discussionmentioning

confidence: 99%

Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome: A Randomized Controlled Trial

Beavers

Walkup

Weaver

et al. 2018

Journal of Bone and Mineral Research

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The objective of this study was to determine the ability of either aerobic or resistance training to counter weight-loss-associated bone loss in older adults. There were 187 older adults (67 years, 70% women, 64% white) with obesity (BMI = 34.5 ± 3.7 kg/m ) and cardiovascular disease and/or metabolic syndrome who were randomized to participate in an 18-month, community-based trial, with a follow-up assessment at 30 months. Intervention arms included: weight loss alone (WL; 7% to 10% baseline weight), WL plus aerobic training (WL + AT), and WL plus resistance training (WL + RT), as well as DXA-acquired total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD), and trabecular bone score (TBS). Biomarkers of bone turnover (procollagen type 1 N-terminal propeptide, C-terminal telopeptide of type 1 collagen) were measured at baseline, 6, 18, and 30 (aBMD and TBS only) months. CT-acquired hip and spine volumetric BMD (vBMD), cortical thickness, and bone strength were measured in a subset at baseline (n = 55) and 18 months. Total hip aBMD was reduced by 2% in all groups at 18 months, with a primary analysis showing no significant treatment effects for any DXA, biomarker, or CT outcome. After adjustment for WL and follow-up at 30 months, secondary analyses revealed that total hip [-0.018 (-0.023 to -0.012) g/cm versus -0.025 (-0.031 to -0.019) g/cm ; p = 0.05] and femoral neck [-0.01 (-0.009 to 0.008) g/cm versus -0.011 (-0.020 to -0.002) g/cm ; p = 0.06] aBMD estimates were modestly attenuated in the WL + RT group compared with the WL group. Additionally, lumbar spine aBMD was increased in the WL [0.015 (0.007 to 0.024) g/cm ] and the WL + RT [0.009 (0.000 to 0.017) g/cm ] groups compared with the WL + AT [-0.003 (-0.012 to 0.005)g/cm ] group; both p ≤ 0.01. Community-based exercise does not prevent bone loss during active WL in older adults; however, adding RT may help minimize long-term hip bone loss. © 2018 American Society for Bone and Mineral Research.

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“…It is suggested that the number of hip fracture in the world will increase from 1.66 million in 1990 to 6.26 million by 2050 [2]. There is a demonstrated research show that approximately 19% of all hip fractures were attributed to cigarette smoking, and the relative risk (RR) for current smokers comparing with never smokers was consistently higher in male than in female [3].…”

Section: Introductionmentioning

confidence: 99%

Effect of Cigarette Smoking on Risk of Hip Fracture in Men: A Meta-Analysis of 14 Prospective Cohort Studies

Zhao

Liu

et al. 2016

PLoS ONE

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BackgroundSeveral observational studies have suggested an association between cigarette smoking and risk of hip fracture. However, no formal systematic review or meta-analysis was performed to summarize this risk in men.Materials and MethodsA search was applied to MEDLINE, EMBASE, and web of science (up to November 1 2016). All prospective cohort studies assessing risk of hip fracture with the factor of cigarette smoking in men without language restriction were reviewed, and qualities of all included studies were assessed using the Newcastle-Ottawa Scale. Two authors independently assessed literatures and extracted information eligibility, and any disagreement was resolved by consensus. Newcastle-Ottawa quality assessment scale was used to evaluate studies’ quality in meta-analyses. We calculated the RR with 95% CIs in a random-effects model as well as the fixed-effects model using the metan command in the STATA version 12.0 (StataCorp, USA).ResultsFourteen prospective cohort studies were eligible for the present analysis. A meta-analysis of 12 prospective studies showed that the relative risk (RR) for current male smoking was 1.47 [95% confidence interval (CI) (1.28–1.66), p = 0.54; I2 = 0%]. Subgroup analyses show study characteristics (including geography region, length of follow-up, size of cohorts and study quality) did not substantially influence these positive associations. Eight studies reported the RRs for former smokers compared with never smokers and the pooled RR was 1.15 [95% CI, (0.97–1.34), (I2 = 0%, p = 0.975)].ConclusionsThe present meta-analysis of 14 prospective studies suggests that, compared with never smokers, cigarette smoking increases risk of hip fracture in man, specifically in current smokers. However, further larger prospective cohorts with more power or meta-analysis of individual patient data are needed to confirm this association.

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The relationship between weight change and risk of hip fracture: meta-analysis of prospective studies

Cited by 26 publications

References 49 publications

Frailty as a predictor of fractures among community-dwelling older people: A systematic review and meta-analysis

Frailty as a predictor of fractures among community-dwelling older people: A systematic review and meta-analysis

Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome: A Randomized Controlled Trial

Effect of Cigarette Smoking on Risk of Hip Fracture in Men: A Meta-Analysis of 14 Prospective Cohort Studies

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