Evidence map›Paper›PMID 40295336›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Association between obesity and the prevalence of fractures: a population-based cross-sectional study in China.

Wenting Qi, Lijia Cui, Xiangjun Yin, Wei Yu, Qianqian Pang, Lin Chen, Shunyu Tang, Hua Lin, Lu Cui, Xiaolan Jin and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Wenting Qi *Department of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, The State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China.
Lijia Cui *Department of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, The State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China.
Xiangjun Yin *Division of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Wei YuDepartment of Radiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Qianqian PangDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, The State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China.
Lin ChenDepartment of Wound Repair and Rehabilitation Medicine, State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China.
Shunyu TangDivision of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Hua LinDepartment of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China.
Lu CuiDivision of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaolan JinDepartment of Endocrinology, Chengdu Military General Hospital, Chengdu, Sichuan Province, China.
Zhongjian XieDepartment of Metabolism and Endocrinology, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Zhixin LiNational Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Mei LiDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, The State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China.
Linhong WangNational Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China. wanglinhong@ncncd.chinacdc.cn.
Weibo XiaDepartment of Endocrinology, Key Laboratory of Endocrinology, National Commission of Health, The State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China. xiaweibo8301@163.com.ORCID http://orcid.org/0000-0001-7768-5536

Funding

CAMS Innovation Fund for Medical Sciences (CIFMS)2021-I2M-1-002High-level Hospital Construction Project of Guangdong Provincial People's Hospital 2022-PUMCH-D-006National Key RD Program of China 2021YFC2501700the National Natural Science Foundation of China No.81970757the National Natural Science Foundation of China No.82270938the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences 2023-PT320-10
6 · The paper itself

Abstract

Although obesity is generally associated with increased bone mass, recent data have challenged its potential protective effect. Our study found that increased BMI showed beneficial effects on BMD in a non-linear way. However, individuals with obesity, especially women, were more likely to have vertebral fractures. There was a U-shaped relationship between BMI and the prevalent fractures. PURPOSE: To estimate the association of obesity with the prevalence of fractures in the Mainland Chinese population.

methodsA total of 8251 individuals from the COPS cohort were enrolled in this cross-sectional study and grouped by BMI level. The Five-Repetition Sit-to-Stand Test (5R-STS) and the Sharpened Romberg test were used to evaluate the balance ability. Vertebral fractures (VFs) were confirmed by spine X-ray examination. Prevalent fractures were defined by a self-report questionnaire which happened in the recent 5 years. The restricted cubic spline (RCS) was used to explore the non-linear relationship. Multiple linear regression and multivariable logistic regression were conducted to adjust the covariates.

resultsObesity was correlated with a reduced bone turnover rate and increased BMD. Nevertheless, there were significant non-linear correlations between BMI and BMD, with a rapid increase and plateau at extremely high BMI levels (p for non-linear < 0.001 for all). Individuals with obesity were associated with a longer time of the 5R-STS and more likely to have a positive Sharpened Romberg test, especially in women. Compared with the normal weight group, the likelihood of prevalence of VFs and the prevalent fractures were significantly increased in the obesity group, independent of the Sharpened Romberg test and lumbar spine BMD (VFs: OR = 1.88 [95% CI 1.38-2.56]; prevalent fractures: OR = 2.18 [95% CI 1.39-3.41]). Per standard deviations (SD) increase in BMI was associated with 21% and 22% increase in the prevalence of VFs and prevalent fractures, respectively. Moreover, the prevalence of prevalent fractures also elevated in the low-weight individuals (OR = 2.62 [95% CI 1.34-4.75]), which indicated a U-shaped relationship between BMI and the prevalence of prevalent fractures.

conclusionObesity was associated with higher BMD in a non-linear manner. However, BMI was positively associated with the prevalence of VFs, and there was a U-shaped relationship between BMI and the prevalent fractures.

Indexed as

ObesityOsteoporotic FracturesSpinal FracturesAdultAgedBody Mass IndexBone DensityChinaCross-Sectional StudiesFemaleHumansMaleMiddle AgedPostural BalancePrevalenceBalance abilityBone mineral densityFracturesObesityOsteoporosis

Identifiers

PMID40295336

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.