Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Pain Physician. 2022 May;25(3):E457-E468.
Obesity had been previously considered to be a protective factor against osteoporosis or fractures; however, recent research indicates that obesity, especially abdominal obesity, may increase the risk of some types of fractures.
We explored the effects of abdominal obesity on subsequent vertebral fracture (SVF) after percutaneous vertebral augmentation (PVA).
A prospective observational cohort study.
Department of Spinal Surgery of a hospital affiliated with a medical university.
A total of 390 women and 237 men aged > 50 years suffering from osteoporotic vertebral fracture (OVF) were included. Weight, height, bone mineral density (BMD), abdominal circumference, and other basic information were measured at baseline and 1-year follow-up visit.
During follow-up, 80 (33.7%) men and 143 (36.7%) women incurred SVF. Greater waist circumference (WC) and waist-to-hip ratio (WHR) increased the risk of SVF in men (WC: HR 1.83, P = 0.016; WHR: HR 1.63, P = 0.045) and women (WC: HR 2.75, P = 0.001; WHR: HR 2.63, P = 0.001) after adjustment for BMD and other potential confounders. Compared with normal BMI, being overweight was associated with lower SVF risk (women: HR 0.55, P = 0.044; men: HR 0.46, P = 0.046), and obesity was associated with greater SVF risk (women: HR 4.53, P < 0.001; men: HR 3.77, P < 0.001) in both genders. We observed a nonlinear relationship between BMI and SVF with a U-shaped curve; after adjusting BMD, this became a reverse J-curve.
There was no further statistical analysis of the relationship between abdominal obesity and other fracture sites. Asymptomatic SVF may underestimate the impact of abdominal obesity on the occurrence of SVF.
Abdominal obesity was significantly associated with a higher risk of SVF after PVA. Management of body type after PVA may be an effective prevention strategy against SVF.
肥胖先前被认为是骨质疏松症或骨折的保护因素；然而，最近的研究表明，肥胖，尤其是腹部肥胖，可能会增加某些类型骨折的风险。
我们探讨了腹部肥胖对经皮椎体强化术（PVA）后椎体骨折（SVF）的影响。
前瞻性观察队列研究。
某医科大学附属医院脊柱外科。
纳入了 390 名女性和 237 名年龄>50 岁的骨质疏松性椎体骨折（OVF）患者。在基线和 1 年随访时测量体重、身高、骨密度（BMD）、腰围和其他基本信息。
随访期间，80 名男性（33.7%）和 143 名女性（36.7%）发生了 SVF。较大的腰围（WC）和腰臀比（WHR）增加了男性（WC：HR 1.83，P = 0.016；WHR：HR 1.63，P = 0.045）和女性（WC：HR 2.75，P = 0.001；WHR：HR 2.63，P = 0.001）发生 SVF 的风险，且在调整 BMD 和其他潜在混杂因素后仍有统计学意义。与正常 BMI 相比，超重与较低的 SVF 风险相关（女性：HR 0.55，P = 0.044；男性：HR 0.46，P = 0.046），肥胖与较高的 SVF 风险相关（女性：HR 4.53，P<0.001；男性：HR 3.77，P<0.001），且这种关联在两性中均呈非线性关系，呈 U 型曲线；调整 BMD 后，这种关系变成了反向 J 型曲线。
没有进一步对腹部肥胖与其他骨折部位之间的关系进行统计分析。无症状的 SVF 可能低估了腹部肥胖对 SVF 发生的影响。
腹部肥胖与 PVA 后 SVF 的发生风险显著相关。PVA 后对体型的管理可能是预防 SVF 的有效策略。
