Obesity and Risk of Hip Fracture in Adults: a Meta-analysis of Prospective Cohort Studies

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2013 Apr 18

PMID 23593112

Citations 71

Authors

Xianye Tang

Gang Liu

Jian Kang

Yang Hou

Fungui Jiang

Wen Yuan

Jiangang Shi

Affiliations

Soon will be listed here.

Abstract

Background: Many observational studies assessed the association between obesity and risk of hip fracture in adults, but reported controversial results. Our goal was to evaluate the association between obesity and risk of hip fracture in adults by conducting a meta-analysis of prospective cohort studies.

Methods: Three databases, PubMed, Embase and Web of Science, were searched through May 2012 to identify eligible cohort studies. Either a fixed- or a random-effects model was used to calculate the pooled relative risk (RR) with its 95% confidence interval (95%CI).

Results: Fifteen prospective cohort studies involving a total 3,126,313 participants were finally included into this meta-analysis. Overall, adults with obesity compared with the normal weight group had a significantly decreased risk of hip fracture (RR: 0.66, 95% CI 0.57 to 0.77, P<0.001). Meta-analyses by the adjusted status of RRs also suggested adults with obesity compared with the reference group had a significantly decreased risk of hip fracture (adjusted RR: 0.48, 95% CI 0.39 to 0.58, P<0.001; unadjusted RR: 0.66, 95% CI 0.56 to 0.78, P<0.001). Subgroup analyses by gender suggested individuals with obesity had a significantly decreased risk for developing hip fracture compared with the reference group in both men (RR 0.54, 95% CI 0.48 to 0.60, P<0.001) and women (RR 0.70, 95% CI 0.58 to 0.84, P<0.001). No evidence of publication bias was observed in this meta-analysis.

Conclusions: This meta-analysis of prospective cohort studies suggests that obesity significantly decreases the risk of hip fracture in adults, and obesity is probably a protective factor of hip fracture in adults.

Citing Articles

Risk of first hip fracture under treatment with zoledronic acid versus alendronate: a NOREPOS cohort study of 88,000 Norwegian men and women in outpatient care.

Riska B, Gunnes N, Finnes T, Meyer H, Hoff M, Omsland T Arch Osteoporos. 2024; 19(1):102.

PMID: 39443347 PMC: 11499353. DOI: 10.1007/s11657-024-01458-4.

Impact of High-Fat Diet and Exercise on Bone and Bile Acid Metabolism in Rats.

Alonso N, Almer G, Semeraro M, Rodriguez-Blanco G, Fauler G, Anders I Nutrients. 2024; 16(11).

PMID: 38892677 PMC: 11174439. DOI: 10.3390/nu16111744.

Links among Obesity, Type 2 Diabetes Mellitus, and Osteoporosis: Bone as a Target.

Martiniakova M, Biro R, Penzes N, Sarocka A, Kovacova V, Mondockova V Int J Mol Sci. 2024; 25(9).

PMID: 38732046 PMC: 11084398. DOI: 10.3390/ijms25094827.

Associations between the Gene rs731236 (TaqI) Polymorphism and Bone Mineral Density in Postmenopausal Women from the RAC-OST-POL.

Gorczynska-Kosiorz S, Tabor E, Niemiec P, Pluskiewicz W, Gumprecht J Biomedicines. 2024; 12(4).

PMID: 38672272 PMC: 11048207. DOI: 10.3390/biomedicines12040917.

Association between BMI and osteoporotic fractures at different sites in Chinese women: a case-control retrospective study in Changsha.

Li H, Shen Y, Tan L, Fu S, Guan C, Zhen D BMC Musculoskelet Disord. 2024; 25(1):187.

PMID: 38424521 PMC: 10903060. DOI: 10.1186/s12891-024-07271-x.

References

Sienkiewicz E, Magkos F, Aronis K, Brinkoetter M, Chamberland J, Chou S . Long-term metreleptin treatment increases bone mineral density and content at the lumbar spine of lean hypoleptinemic women. Metabolism. 2011; 60(9):1211-21. DOI: 10.1016/j.metabol.2011.05.016. View

Begg C, Mazumdar M . Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50(4):1088-101. View

Feskanich D, Willett W, Colditz G . Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA. 2002; 288(18):2300-6. DOI: 10.1001/jama.288.18.2300. View

Johnell O, Kanis J, Oden A, Johansson H, De Laet C, Delmas P . Predictive value of BMD for hip and other fractures. J Bone Miner Res. 2005; 20(7):1185-94. DOI: 10.1359/JBMR.050304. View

Prieto-Alhambra D, Premaor M, Fina Aviles F, Hermosilla E, Martinez-Laguna D, Carbonell-Abella C . The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res. 2011; 27(2):294-300. DOI: 10.1002/jbmr.1466. View

Cummings S, Melton L . Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002; 359(9319):1761-7. DOI: 10.1016/S0140-6736(02)08657-9. View

Meyer H, Tverdal A, Falch J . Body height, body mass index, and fatal hip fractures: 16 years' follow-up of 674,000 Norwegian women and men. Epidemiology. 1995; 6(3):299-305. View

Stolee P, Poss J, Cook R, Byrne K, Hirdes J . Risk factors for hip fracture in older home care clients. J Gerontol A Biol Sci Med Sci. 2009; 64(3):403-10. PMC: 2654998. DOI: 10.1093/gerona/gln035. View

Tang B, Eslick G, Nowson C, Smith C, Bensoussan A . Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007; 370(9588):657-66. DOI: 10.1016/S0140-6736(07)61342-7. View

10.

Visschedijk J, Achterberg W, van Balen R, Hertogh C . Fear of falling after hip fracture: a systematic review of measurement instruments, prevalence, interventions, and related factors. J Am Geriatr Soc. 2010; 58(9):1739-48. DOI: 10.1111/j.1532-5415.2010.03036.x. View

11.

Mantel N, Haenszel W . Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959; 22(4):719-48. View

12.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

13.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

14.

Chudyk A, Ashe M, Gorman E, Al Tunaiji H, Crossley K . Risk of hip fracture with hip or knee osteoarthritis: a systematic review. Clin Rheumatol. 2012; 31(5):749-57. DOI: 10.1007/s10067-012-1970-z. View

15.

LaFleur J, McAdam-Marx C, Alder S, Sheng X, Asche C, Nebeker J . Clinical risk factors for fracture among postmenopausal patients at risk for fracture: a historical cohort study using electronic medical record data. J Bone Miner Metab. 2010; 29(2):193-200. DOI: 10.1007/s00774-010-0207-y. View

16.

Ottenbacher K, Ostir G, Peek M, Goodwin J, Markides K . Diabetes mellitus as a risk factor for hip fracture in mexican american older adults. J Gerontol A Biol Sci Med Sci. 2002; 57(10):M648-53. DOI: 10.1093/gerona/57.10.m648. View

17.

Compston J, Watts N, Chapurlat R, Cooper C, Boonen S, Greenspan S . Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med. 2011; 124(11):1043-50. PMC: 4897773. DOI: 10.1016/j.amjmed.2011.06.013. View

18.

Renehan A, Tyson M, Egger M, Heller R, Zwahlen M . Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008; 371(9612):569-78. DOI: 10.1016/S0140-6736(08)60269-X. View

19.

Romero-Corral A, Montori V, Somers V, Korinek J, Thomas R, Allison T . Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006; 368(9536):666-78. DOI: 10.1016/S0140-6736(06)69251-9. View

20.

Haara M, Heliovaara M, Impivaara O, Arokoski J, Manninen P, Knekt P . Low metacarpal index predicts hip fracture: a prospective population study of 3,561 subjects with 15 years of follow-up. Acta Orthop. 2006; 77(1):9-14. DOI: 10.1080/17453670610045632. View