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Research article
Sami Lee
Chungnam National University Hospital
Corresponding Author
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Background: The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women.
Method: Among subjects who participated in the 4th National Health and Nutrition Examination Survey (2008-2009), 2114 women ≥ 40 years of age were included. BMI was based on standards set by the Korean Society for the Study of Obesity, as follows: <18.5 kg/m2, underweight; 18.5 ≤ to <25 kg/m2, normal weight; and ≥25 kg/m2, obese. Subjects were also divided into three groups according to the location of fragility fracture: spine, hip, or wrist.
Results: The mean (± SD) rate of fragility fracture was significantly different among the three groups: 5.9±2.9% (underweight), 1.1±0.3% (normal weight), and 3.0±0.7% (obese) (p=0.001). After correcting for age, family history, and treatment history of osteoporosis and rheumatoid arthritis, smoking and drinking status, and level of exercise, multivariable regression analysis revealed that the odds ratio for fragility fracture in the underweight group was 5.51 (95% confidence interval [CI] 1.88–16.13) and 3.19 (95% CI 1.51–6.74) in the obese group. After subdividing fragility fractures into vertebral and non-vertebral, the odds ratio for vertebral fracture in the underweight group was 6.05 (95% CI 1.61–22.68) times higher than that in the normal weight group; in the obese group, the non-vertebral fracture odds ratio was 3.73 (95% CI 1.33–10.44) times higher. Analysis of non-vertebral fractures in the obese group revealed an odds ratio for fracture 8.29 (95% CI 1.04–66.37) times higher for hip fracture and 3.73 (95% CI 1.21–11.43) times higher for wrist fracture.
Conclusions: Obesity and underweight increased the risk for fragility fractures in postmenopausal Korean women. As such, it is important for this patient population to maintain bone health through proper weight management, sufficient exercise, and regular examination of bone density.
Keywords
Osteoporotic fractures, Body Mass Index, Obestiy, Osteoporosis, Postmenopausal
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CURRENT STATUS: Published
View the published article at BMC Women's Health.
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Editorial decision: Minor revision
On 28 Jan, 2021
Review #2 received
Received 24 Jan, 2021
Reviewer #2 agreed
On 13 Jan, 2021
Review #1 received
Received 13 Jan, 2021
Reviewers invited
Invitations sent on 12 Jan, 2021
Reviewer #1 agreed
On 12 Jan, 2021
Editor assigned
On 10 Jan, 2021
Submission checks complete
On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
Version 1
Posted 02 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 29 Dec, 2020
Review #3 received
Received 30 Oct, 2020
Reviewer #3 agreed
On 08 Sep, 2020
Review #2 received
Received 25 Aug, 2020
Reviewer #2 agreed
On 23 Aug, 2020
Review #1 received
Received 03 Aug, 2020
Reviewer #1 agreed
On 01 Aug, 2020
Reviewers invited
Invitations sent on 21 Jul, 2020
Editor assigned
On 20 Jul, 2020
Submission checks complete
On 30 Jun, 2020
Editor invited
On 29 Jun, 2020
First submitted
On 23 Jun, 2020
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See the published version of this preprint at BMC Women's Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Sami Lee
Chungnam National University Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Women's Health.
No community comments so far
Editorial decision: Minor revision
On 28 Jan, 2021
Review #2 received
Received 24 Jan, 2021
Reviewer #2 agreed
On 13 Jan, 2021
Review #1 received
Received 13 Jan, 2021
Reviewers invited
Invitations sent on 12 Jan, 2021
Reviewer #1 agreed
On 12 Jan, 2021
Editor assigned
On 10 Jan, 2021
Submission checks complete
On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
Version 1
Posted 02 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 29 Dec, 2020
Review #3 received
Received 30 Oct, 2020
Reviewer #3 agreed
On 08 Sep, 2020
Review #2 received
Received 25 Aug, 2020
Reviewer #2 agreed
On 23 Aug, 2020
Review #1 received
Received 03 Aug, 2020
Reviewer #1 agreed
On 01 Aug, 2020
Reviewers invited
Invitations sent on 21 Jul, 2020
Editor assigned
On 20 Jul, 2020
Submission checks complete
On 30 Jun, 2020
Editor invited
On 29 Jun, 2020
First submitted
On 23 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Women's Health.
Background: The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women.
Method: Among subjects who participated in the 4th National Health and Nutrition Examination Survey (2008-2009), 2114 women ≥ 40 years of age were included. BMI was based on standards set by the Korean Society for the Study of Obesity, as follows: <18.5 kg/m2, underweight; 18.5 ≤ to <25 kg/m2, normal weight; and ≥25 kg/m2, obese. Subjects were also divided into three groups according to the location of fragility fracture: spine, hip, or wrist.
Results: The mean (± SD) rate of fragility fracture was significantly different among the three groups: 5.9±2.9% (underweight), 1.1±0.3% (normal weight), and 3.0±0.7% (obese) (p=0.001). After correcting for age, family history, and treatment history of osteoporosis and rheumatoid arthritis, smoking and drinking status, and level of exercise, multivariable regression analysis revealed that the odds ratio for fragility fracture in the underweight group was 5.51 (95% confidence interval [CI] 1.88–16.13) and 3.19 (95% CI 1.51–6.74) in the obese group. After subdividing fragility fractures into vertebral and non-vertebral, the odds ratio for vertebral fracture in the underweight group was 6.05 (95% CI 1.61–22.68) times higher than that in the normal weight group; in the obese group, the non-vertebral fracture odds ratio was 3.73 (95% CI 1.33–10.44) times higher. Analysis of non-vertebral fractures in the obese group revealed an odds ratio for fracture 8.29 (95% CI 1.04–66.37) times higher for hip fracture and 3.73 (95% CI 1.21–11.43) times higher for wrist fracture.
Conclusions: Obesity and underweight increased the risk for fragility fractures in postmenopausal Korean women. As such, it is important for this patient population to maintain bone health through proper weight management, sufficient exercise, and regular examination of bone density.
Figure 1
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