ArticleBMC musculoskeletal disorders2024
Association between BMI and osteoporotic fractures at different sites in Chinese women: a case-control retrospective study in Changsha.
Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Association between uric acid to high-density lipoprotein cholesterol ratio (UHR) and osteoporosis in type 2 diabetes with MASLD.Asia Pacific journal of clinical nutrition · 2026Article
- An intelligent auxiliary diagnostic system for early osteoporosis screening using stacking ensemble learning.BMC medical informatics and decision making · 2026Article
- Interpretable machine learning model for low bone density screening in older adults using demographic and anthropometric data: findings from 2005 to 2020 NHANES.BMC medical informatics and decision making · 2025Article
- The correlation between TyG-BMI and the risk of osteoporosis in middle-aged and elderly patients with type 2 diabetes mellitus.Frontiers in nutrition · 2025Article
- Early Prediction Model for Osteoporotic Fracture in Type 2 Diabetes Patients: A Nomogram Approach Based on a Single-Center Retrospective Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Association of obesity with osteoporotic fracture risk in individuals with bone metabolism-related conditions: a cross sectional analysis.Frontiers in nutrition · 2024Article
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Abstract
backgroundOsteoporotic fractures are a growing problem in an aging society. The association between body mass index (BMI) and osteoporotic fractures varies by fracture site and ethnicity. Limited knowledge exists regarding this association in native Chinese, particularly utilizing local databases as reference sources.
objectiveTo investigate the association between BMI and osteoporotic fractures at different sites in Chinese women.
methodsThree thousand ninety-eight female patients with radiographic fractures and 3098 age- and sex-matched healthy controls without fractures were included in the study. Both of them underwent assessment using dual-energy X-ray absorptiometry (DXA), with BMD measurements calculated using our own BMD reference database. Participants were classified into underweight (BMI < 18.5 kg/m
resultsThere were 2296 (74.1%) vertebral fractures, 374 (12.1%) femoral neck fractures, and 428 (13.8%) other types of fractures in the case group. Bone mineral density (BMD) was almost lower in the fracture groups compared to the control groups (p = 0.048 to < 0.001). Compared with normal weight, underweight had a protective effect on total [odds ratio (OR) = 0.61; 95% confidence interval (CI), 0.49 -0.75; P< 0.001], and lumbar fractures (OR = 0.52; 95% CI, 0.41 - 0.67; P < 0.001), while obesity was associated with an increased risk for total (OR = 2.26; 95% CI, 1.85 - 2.76; P < 0.001), lumbar (OR = 2.17; 95% CI, 1.72 - 2.73; P < 0.001), and femoral neck fractures (OR = 4.08; 95% CI, 2.18 - 7.63; P < 0.001). Non-linear associations were observed between BMI and fractures: A J-curve for total, lumbar, and femoral neck fractures, and no statistical change for other types of fractures. Underweight was found to be a risk factor for other types of fracturess after adjusting for BMD (OR = 2.29; 95% CI, 1.09 - 4.80; P < 0.001). Osteoporosis and osteopenia were identified as risk factors for almost all sites of fracture when compared to normal bone mass.
conclusionsUnderweight has a protective effect on total and lumbar spine fractures in Chinese women, while obesity poses a risk factor for total, lumbar, and femoral neck fractures. The effect of BMI on fractures may be mainly mediated by BMD.
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