ArticleBone2022
Load-to-strength ratio at the radius is higher in adolescent and young adult females with obesity compared to normal-weight controls.
Article in Bone, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Load-to-strength ratio as an estimate of wrist facture after gastric bypass vs gastric banding.JBMR plus · 2025Article
- Obese adolescents have higher risk for femur fracture after motor vehicle collision.Surgery open science · 2024Article
- Impact of body mass index on fracture severity, clinical, radiological and functional outcome in distal radius fractures: a retrospective observational study after surgical treatment.Archives of orthopaedic and trauma surgery · 2024Observational
- The relationship between weight-adjusted-waist index and suicidal ideation: evidence from NHANES.Eating and weight disorders : EWD · 2024Article
- Exploring the Interplay between Vitamin D, Insulin Resistance, Obesity and Skeletal Health.Journal of bone metabolism · 2024Article
- Risk of wrist fracture, estimated by the load-to-strength ratio, declines following sleeve gastrectomy in adolescents and young adults.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Effects of the energy balance transition on bone mass and strength.Scientific reports · 2023Article
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- Effect of obesity status on adolescent bone mineral density and saturation effect: A cross-sectional study.Frontiers in endocrinology · 2022Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundAmong adolescents with extremity fractures, individuals with obesity have greater representation compared with individuals of normal-weight, despite having higher areal and volumetric bone mineral density (aBMD, vBMD) than their normal-weight counterparts. The relative increase in BMD in individuals with obesity may thus be insufficient to support the greater force generated upon falling. The load-to-strength ratio is a biomechanical approach for assessing the risk of fracture by comparing applied force to bone strength, with higher load-to-strength ratios indicating higher fracture risk.
objectiveTo assess the load-to-strength ratio at the distal radius in adolescent and young adult females with severe obesity (OB) compared with normal-weight healthy controls (HC). We hypothesized that OB have a higher load-to-strength ratio compared to HC.
methodsWe examined bone parameters in 65 girls 14-21 years old: 33 OB and 32 HC. We used dual-energy X-ray absorptiometry (DXA) to assess body composition, high resolution peripheral quantitative CT (HR-pQCT) to estimate vBMD, and microfinite element analysis (μFEA) to assess bone strength at the distal radius. To quantify fracture risk, we computed the load-to-strength ratio, where the numerator is defined as the load applied to the outstretched hand during a forward fall and the denominator is the bone strength, as estimated by μFEA.
resultsAlthough OB had higher total vBMD than HC (368.3 vs. 319.9 mgHA/cm
conclusionsAdolescent and young adult females with obesity have higher load-to-strength ratio at the distal radius due to higher forces applied to bone in a fall combined with incomplete adaptation of bone to increasing body weight. This is differentially affected by lean mass, fat mass, and visceral fat mass.
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