Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Chinese Academy of Medical Sciences, Beijing, China.
Arch Osteoporos. 2020 Apr 19;15(1):60. doi: 10.1007/s11657-020-00734-3.
In a Chinese population from both urban and rural areas, weight loss of ≥ 5 kg from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.
This study investigates the association of the long-term weight loss from young adulthood through the middle ages with the subsequent 10-year risk of hospitalized fracture and calcaneus bone mineral density (BMD).
China Kadoorie Biobank (CKB) was established during 2004-2008 in ten areas across China. Weight at age 25 years was self-reported at baseline, and weight at baseline and resurvey was measured by the calibrated equipment. Outcomes were hospitalized fracture during follow-up and calcaneus BMD measured at resurvey. Analysis for fracture risk included 411,812 participants who were free of fracture in the last 5 years before baseline, cancer, or stroke at any time before baseline. Analysis for BMD included 21,453 participants who participated in the resurvey of 2013-2014 with the same exclusion criteria as above.
The mean age was 50.8 at baseline and 58.4 at resurvey. Median weight change from age 25 to baseline was 4.4 kg, with 20.7% losing weight and 58.5% gaining weight. During a median follow-up of 10.1 years, we documented 13,065 cases of first diagnosed fracture hospitalizations, including 1222 hip fracture. Compared with participants whose weight was stable (± 2.4 kg), the adjusted hazard ratios (95% CIs) for those with weight loss of ≥ 5.0 kg from age 25 to baseline was 1.39 (1.17 to 1.66) for hip fracture. Weight loss was not associated with fracture risk at other sites. Those with weight loss from age 25 to resurvey had the lowest BMD measures, with β (95% CIs) of - 4.52 (- 5.08 to - 3.96) for broadband ultrasound attenuation (BUA), - 4.83 (- 6.98, - 2.67) for speed of sound (SOS), and - 4.36 (- 5.22, - 3.49) for stiffness index (SI).
Weight loss from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.
在中国城乡人群中，从青年到中年的体重减轻≥5kg 与晚年髋部骨折风险增加和骨密度（BMD）降低有关。
中国慢性病前瞻性研究（CKB）于 2004 年至 2008 年在中国十个地区开展。参与者在基线时报告 25 岁时的体重，使用校准设备测量基线和复查时的体重。随访期间的住院骨折和复查时的跟骨 BMD 为结局。骨折风险分析纳入 411812 名在基线前 5 年内无骨折、癌症或任何时间前基线卒中的参与者。BMD 分析纳入 21453 名参加 2013-2014 年复查且具有相同排除标准的参与者。
基线时的平均年龄为 50.8 岁，复查时为 58.4 岁。从 25 岁到基线时体重变化的中位数为 4.4kg，体重减轻的占 20.7%，体重增加的占 58.5%。在中位随访 10.1 年期间，我们记录了 13065 例首次诊断为骨折的住院病例，包括 1222 例髋部骨折。与体重稳定（±2.4kg）的参与者相比，从 25 岁到基线时体重减轻≥5.0kg 的参与者的髋部骨折校正风险比（95%可信区间）为 1.39（1.17 至 1.66）。体重减轻与其他部位骨折风险无关。从 25 岁到复查时体重减轻的参与者的 BMD 测量值最低，宽带超声衰减（BUA）的β（95%可信区间）为-4.52（-5.08 至-3.96），声速（SOS）为-4.83（-6.98，-2.67），刚度指数（SI）为-4.36（-5.22，-3.49）。
从青年到中年的体重减轻与晚年髋部骨折风险增加和骨密度降低有关。
