Study links obesity with increased risk of bone fracture in women – 05/09/2022

The association between people with obesity and an increased risk of bone fractures has been studied for a long time. They even said that the disease would actually be a protective factor against the problem. But on Friday (6), a study on the subject, with new results, was released at the European Congress on Obesity, in Maastricht, Netherlands, which Live well followed since Tuesday (3).

According to the researchers, obese or overweight women — particularly those with a high waist circumference — are more susceptible to fractures than those with an ideal weight. In men, however, being underweight, not overweight, is associated with a higher risk of bone fractures.

Anne-Frederique Turcotte, the study’s lead author, from the Endocrinology and Nephrology unit at the Center for Research in Quebec, in Canada, explained, in a press conference, that it is still unclear why the association between the risk of fracture in women with obesity. However, there are some possibilities.

Most fractures are the result of a fall, which is more common among overweight people. The ankle, unlike the hip and femur, is not protected by soft tissue, which can make it more likely to break during a fall.

“Waist circumference was more strongly associated with fractures in women than BMI (body mass index). This could be due to visceral fat — which is metabolically very active and stored in the depths of the abdomen, involving the organs— that can release compounds that negatively affect bone strength,” said the author.

Another point, according Turcotte, is that people with obesity may take longer to stabilize their bodies when they stumble, for example. “This is particularly pronounced when weight is concentrated in the front of the body, suggesting that individuals with a distribution of body fat in the abdominal region may be at greater risk of falling,” she says.

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In an interview with Live wellthe Canadian researcher explains that the study has some limitations, such as using BMI as one of the methods.

“As a measure of BMI, we don’t know for sure where the fat is located, as it only shows a final value. And we know that depending on where the fat is located, it can affect the metabolism. in the abdominal region, this can increase the risk of metabolic and cardiovascular problems, in addition to diabetes”, he says.

How the study was done

Turcotte and his university colleagues analyzed data from the CARTAGENEa database of 20,000 individuals aged between 40 and 70 years of age. Quebec.

Participants were randomly selected between 2009 and 2010. They were assessed once at enrollment and followed until March 2016. BMI and waist circumference (WC, a measure of abdominal obesity) were measured at baseline. Fractures were identified using a previously validated algorithm.

Analyzes were adjusted for various factors that could cause confusion, such as age, menopausal status, ethnicity, marital status, education, income, area of ​​residence, smoking, alcohol consumption, physical activity level, supplemental calcium and vitamin D intake. , fracture history and comorbidities, and medications known to influence fracture risk.

The main findings

  • During a median follow-up of 5.8 years, 497 women and 323 men suffered a fracture (820 of 19,357 participants).
  • 415 major osteoporotic fractures (fractures of the hip, femur, spine, wrist, or humerus) were identified: 260 in women and 155 in men.
  • There were 353 fractures of the distal lower limb (the part of the leg below the knee), such as ankle, foot and lower tibia or tibia injuries: 219 in women and 134 in men.
  • The researchers found 203 fractures of the distal upper limb (the forearm from the elbow down), in the wrist, forearm or elbow region: 141 in women and 62 in men.
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Image: iStock

Differences between women and men

In women, greater waist circumference (WC) was associated with an increased risk of fracture. For every 5 cm (two inch) increase in WC, the risk of fracture at any location was 3% greater and the risk of distal fracture of the lower limb was 7% greater. The association between CC and ankle fractures was particularly strong.

In women, higher BMI was associated with an increased risk of ankle, foot and tibial fractures.

Compared with women with a BMI of 25 kg/m², those with a BMI of 27.5-40 kg/m² had a higher risk of lower limb distal fractures. The increased risk linearly increased from 5% in those with a BMI of 27.5 kg/m² to 40% in those with a BMI of 40 kg/m².

Women with a lower BMI (22.5 kg/m²) had a 5% lower risk of distal fractures of the lower limbs than those with a BMI of 25 kg/m².

In men, increases in BMI and CC were not significantly associated with fractures. However, participants with low weight had a higher risk of wrist, forearm or elbow fractures than those with weight considered within the ideal.

Men with a BMI greater than or equal to 17.5 kg/m² were twice as likely to have a distal upper limb fracture than men with a BMI of 25 kg/m².

The researchers say a greater number of fractures in men is needed to determine whether this is a true outcome or the pattern for men. Follow that of women.

Results help to think about ways of prevention

For the author of the study, the discovery of the relationship between obesity (especially that which is related to increased fat in the abdominal region) and increased risk of fractures has a great impact on public health.

“We know that obese individuals who suffer a fracture are more likely to have other health problems that can cause slower rehabilitation, increase the risk of post-operative complications and malunion (fractures that may not heal properly), generating costs. substantial health benefits”, explains Turcotte.

Another point of concern cited by the author is that the aging of the population and the increase in the incidence of obesity may lead to an increase in fracture rates in the coming years.

And that is exactly why health agencies must create prevention campaigns to avoid the increase in obesity and, consequently, greater numbers of bone fractures, in addition to other complications that the disease can cause.

*The reporter traveled at the invitation of Novo Nordisk.

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