Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study
Abstract Background Fractures present serious health challenges for older adults, including premature mortality and reduced quality of life. Obesity has become significantly prevalent in China. However, the association between obesity and fractures remains unclear. This study aimed to assess the ass...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17494-7 |
| _version_ | 1797362770079907840 |
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| author | Hui Li Qunying Xu Yunli Ye Bei Chang Rui Wang Guangwen Li |
| author_facet | Hui Li Qunying Xu Yunli Ye Bei Chang Rui Wang Guangwen Li |
| author_sort | Hui Li |
| collection | DOAJ |
| description | Abstract Background Fractures present serious health challenges for older adults, including premature mortality and reduced quality of life. Obesity has become significantly prevalent in China. However, the association between obesity and fractures remains unclear. This study aimed to assess the association between obesity and fractures among Chinese women above 50 years of age. Methods A prospective cohort study was designed based on the China Health and Nutrition Survey, using data from 1997 to 2015. The average follow-up duration was seven years. Trained investigators measured body mass index (BMI) and waist circumference (WC) at baseline. Obesity was defined according to World Health Organization recommendations. Waist-to-height ratio (W-HtR) was calculated, with 0.5 as the cutoff value. Onset of fractures, self-reported by the participants during the follow-up period, was the primary outcome. Cox hazard regression models were used to assess the association between BMI, WC, W-HtR and subsequent risk of fracture. A sensitivity analysis was conducted by multiple imputation of missing data on the variables at baseline. Results A total of 2,641 women aged ≥ 50 years were involved in the study. In all the models, no significant association existed between BMI and fracture risk. However, women with WC ≥ 88 cm had significantly higher risk of fracture than those with WC < 80 cm according to both the unadjusted (HR = 1.744, 95% CI: 1.173–2.591) and adjusted models (HR = 1.796, 95% CI: 1.196–2.695). In addition, W-HtR and fracture risk were positively associated according to both the unadjusted (HR = 1.798, 95% CI: 1.230–2.627) and adjusted models (HR = 1.772, 95% CI: 1.209–2.599). Results of the sensitivity analysis were consistent with those of the above analyses. Conclusions Abdominal obesity increased the risk of all-cause fractures in Chinese women ≥ 50 years old. Intervention strategies and measures to prevent or address abdominal obesity would be helpful to decrease the fracture incidence. |
| first_indexed | 2024-03-08T16:12:13Z |
| format | Article |
| id | doaj.art-4d77f386b4e74586af6bb825c5d4febc |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T16:12:13Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-4d77f386b4e74586af6bb825c5d4febc2024-01-07T12:52:26ZengBMCBMC Public Health1471-24582024-01-0124111210.1186/s12889-023-17494-7Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort studyHui Li0Qunying Xu1Yunli Ye2Bei Chang3Rui Wang4Guangwen Li5School of Public Health, Southwest Medical UniversitySchool of Public Health, Southwest Medical UniversitySchool of Public Health, Southwest Medical UniversityChinese People’s Liberation Army Rocket Force Characteristic Medical CenterTangdu Hospital, Air Force Military Medical UniversityDepartment of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Oral & Maxillofacial Reconstruction and Regeneration of Luzhou Key LaboratoryAbstract Background Fractures present serious health challenges for older adults, including premature mortality and reduced quality of life. Obesity has become significantly prevalent in China. However, the association between obesity and fractures remains unclear. This study aimed to assess the association between obesity and fractures among Chinese women above 50 years of age. Methods A prospective cohort study was designed based on the China Health and Nutrition Survey, using data from 1997 to 2015. The average follow-up duration was seven years. Trained investigators measured body mass index (BMI) and waist circumference (WC) at baseline. Obesity was defined according to World Health Organization recommendations. Waist-to-height ratio (W-HtR) was calculated, with 0.5 as the cutoff value. Onset of fractures, self-reported by the participants during the follow-up period, was the primary outcome. Cox hazard regression models were used to assess the association between BMI, WC, W-HtR and subsequent risk of fracture. A sensitivity analysis was conducted by multiple imputation of missing data on the variables at baseline. Results A total of 2,641 women aged ≥ 50 years were involved in the study. In all the models, no significant association existed between BMI and fracture risk. However, women with WC ≥ 88 cm had significantly higher risk of fracture than those with WC < 80 cm according to both the unadjusted (HR = 1.744, 95% CI: 1.173–2.591) and adjusted models (HR = 1.796, 95% CI: 1.196–2.695). In addition, W-HtR and fracture risk were positively associated according to both the unadjusted (HR = 1.798, 95% CI: 1.230–2.627) and adjusted models (HR = 1.772, 95% CI: 1.209–2.599). Results of the sensitivity analysis were consistent with those of the above analyses. Conclusions Abdominal obesity increased the risk of all-cause fractures in Chinese women ≥ 50 years old. Intervention strategies and measures to prevent or address abdominal obesity would be helpful to decrease the fracture incidence.https://doi.org/10.1186/s12889-023-17494-7Body mass indexFractureObesityWaist circumferenceWaist-to-height ratio |
| spellingShingle | Hui Li Qunying Xu Yunli Ye Bei Chang Rui Wang Guangwen Li Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study BMC Public Health Body mass index Fracture Obesity Waist circumference Waist-to-height ratio |
| title | Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study |
| title_full | Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study |
| title_fullStr | Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study |
| title_full_unstemmed | Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study |
| title_short | Association between obesity and fracture risk in Chinese women above 50 years of age: a prospective cohort study |
| title_sort | association between obesity and fracture risk in chinese women above 50 years of age a prospective cohort study |
| topic | Body mass index Fracture Obesity Waist circumference Waist-to-height ratio |
| url | https://doi.org/10.1186/s12889-023-17494-7 |
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