Observational studyBMJ open2025
Exploring BMI categories and their association with fragility fractures in Thai men: a retrospective study at Burapha University Hospital.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine the association between body mass index (BMI) categories and the fragility fractures in Thai men and to identify the most common anatomical sites of these fractures. We hypothesised that BMI is associated with the risk of fragility fractures in this population.
designRetrospective observational study.
settingA tertiary care centre in eastern Thailand, based on data from Burapha University Hospital.
participantsThe study included 419 Thai men aged 40 years or older who underwent bone mineral density (BMD) assessment between 2014 and 2022. Participants were classified according to the presence or absence of documented fragility fractures. Exclusion criteria included pathological fractures, high-energy trauma and incomplete BMI or BMD data. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was the association between BMI categories and the risk of fragility fractures. The secondary outcome was the anatomical distribution of these fractures.
resultsAmong 419 participants, 147 (35.1%) had fragility fractures and 272 (64.9%) did not. Underweight men had significantly increased odds of fragility fractures (OR, 3.44; 95% CI, 1.03 to 11.47; p=0.044) and vertebral fractures (OR, 4.30; 95% CI, 1.36 to 13.58; p=0.013), compared with men of normal BMI. In contrast, overweight men had lower odds of overall fractures (OR, 0.50; 95% CI, 0.31 to 0.80; p=0.004) and vertebral fractures (OR, 0.48; 95% CI, 0.27 to 0.84; p=0.010). Among underweight participants, BMI was moderately positively correlated with BMD at the lumbar spine (r=0.607; p=0.028) and at the one-third radius (r=0.557; p=0.084).
conclusionsLower BMI was significantly associated with increased risk of fragility fractures, particularly vertebral fractures. These findings support prior evidence in Asian populations and reveal a fracture pattern, predominantly vertebral followed by hip fractures, which differs from those observed in predominantly Caucasian populations.
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