Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway.
Osteoporos Int. 2011 Apr;22(4):1237-45. doi: 10.1007/s00198-010-1318-y. Epub 2010 Jun 12.
Few studies have examined the association between body mass index (BMI) change and fracture in a general population. We observed that BMI loss was associated with increased fracture risk in non-smoking men and women, but not in smokers. BMI gain was associated with decreased fracture risk in women.
Weight loss has been associated with increased fracture risk, but few studies have included men. The aim of this study was to examine the association between BMI change and fracture risk in both genders.
A population-based cohort study in Tromsø, Norway, of adults, aged 20 to 54 years in 1979, who participated in two or three health surveys in 1979-1980, 1986-1987, and 1994-1995. Weight and height were measured at each survey. Information about lifestyle was obtained by questionnaires. Poisson regression was used to estimate incidence rates and Cox proportional hazards regression model to assess the association between fracture risk and BMI change. Fractional polynomials were used to accommodate non-linear associations.
A total of 5,549 men and 5,428 women participated. There were 1,135 fractures during 10 years of follow-up. Reduction in BMI was associated with increased non-vertebral fracture risk in non-smokers, but not in smokers. The hazard ratio in male and female non-smokers per 10-year BMI decrease of 2 kg/m(2) versus a BMI increase of 1 kg/m(2) was 1.79 (95% confidence interval (CI), 1.17-2.75) and 1.60 (95% CI, 1.28-1.99), respectively. The association was not significantly modified by initial BMI or age or by exclusion of subjects with cardiovascular diseases, diabetes, or cancer. In female non-smokers, weight gain was inversely associated with fracture risk.
In a general Norwegian population, reduction in BMI was significantly associated with increased fracture risk in male and female non-smokers, but not in smokers. These findings could not be explained by preexisting disease.
体重减轻与骨折风险增加有关，但很少有研究纳入男性。本研究旨在探讨男性和女性 BMI 变化与骨折风险之间的关系。
挪威特罗姆瑟的一项基于人群的队列研究，纳入 1979 年年龄在 20 至 54 岁的成年人，他们参加了 1979-1980 年、1986-1987 年和 1994-1995 年的两次或三次健康调查。在每次调查时测量体重和身高。通过问卷获取生活方式信息。使用泊松回归估计发病率，使用 Cox 比例风险回归模型评估 BMI 变化与骨折风险之间的关系。分数多项式用于容纳非线性关系。
共有 5549 名男性和 5428 名女性参与了研究。在 10 年的随访期间发生了 1135 例骨折。在非吸烟者中，BMI 降低与非椎体骨折风险增加相关，但在吸烟者中则不相关。与 BMI 每增加 1kg/m2 相比，男性和女性非吸烟者每 10 年 BMI 降低 2kg/m2 的非椎体骨折风险的危害比分别为 1.79（95%可信区间（CI），1.17-2.75）和 1.60（95%CI，1.28-1.99）。这种关联不受初始 BMI 或年龄的影响，也不受排除患有心血管疾病、糖尿病或癌症的患者的影响。在女性非吸烟者中，体重增加与骨折风险呈负相关。
在一般的挪威人群中，BMI 的降低与男性和女性非吸烟者的骨折风险增加显著相关，但与吸烟者则不相关。这些发现不能用预先存在的疾病来解释。
