School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200000, China.
State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, 200000, China.
J Transl Med. 2023 Aug 12;21(1):536. doi: 10.1186/s12967-023-04397-9.
Studies have examined the effect of weight change on osteoporosis, but the results were controversial. Among them, few had looked at weight change over the life span. This study aimed to fill this gap and investigate the association between lifetime body mass index (BMI) trajectories and bone loss.
In this cross-sectional study, participants at age 50 and above were selected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Dual-energy X-ray Absorptiometry was used to measure the bone mineral density at the femoral neck and lumbar spine. Standard BMI criteria were used, with < 25 kg/m for normal, 25-29.9 kg/m for overweight, and ≥ 30 kg/m for obesity. The latent class trajectory model (LCTM) was used to identify BMI trajectories. Multinomial logistic regression models were fitted to evaluate the association between different BMI trajectories and osteoporosis or osteopenia.
For the 9,706 eligible participants, we identified four BMI trajectories, including stable (n = 7,681, 70.14%), slight increase (n = 1253, 12.91%), increase to decrease (n = 195, 2.01%), and rapid increase (n = 577, 5.94%). Compared with individuals in the stable trajectory, individuals in the rapid increase trajectory had higher odds of osteoporosis (OR = 2.25, 95% CI 1.19-4.23) and osteopenia (OR = 1.49, 95% CI 1.02-2.17). This association was only found in the lumbar spine (OR = 2.11, 95% CI 1.06-4.2) but not in the femoral neck. In early-stage (age 25-10 years ago) weight change, staying an obesity and stable weight seemed to have protective effects on osteoporosis (OR = 0.26, 95% CI 0.08-0.77) and osteopenia (OR = 0.46, 95% CI 0.25-0.84). Meanwhile, keeping an early-stage stable and overweight was related to lower odds of osteopenia (OR = 0.53, 95% CI 0.34-0.83). No statistically significant association between recent (10 years ago to baseline) weight change and osteoporosis was found.
Rapid and excess weight gain during adulthood is associated with a higher risk of osteoporosis. But this association varies by skeletal sites. Maintaining stable overweight and obesity at an early stage may have potentially beneficial effects on bone health.
已有研究探讨了体重变化对骨质疏松症的影响，但结果存在争议。其中，很少有研究关注一生中体重的变化。本研究旨在填补这一空白，并调查终生体重指数（BMI）轨迹与骨丢失之间的关系。
本横断面研究从 2005-2018 年的国家健康和营养检查调查（NHANES）中选择 50 岁及以上的参与者。双能 X 线吸收法测量股骨颈和腰椎的骨密度。使用标准 BMI 标准，<25kg/m2 为正常，25-29.9kg/m2 为超重，≥30kg/m2 为肥胖。使用潜在类别轨迹模型（LCTM）来识别 BMI 轨迹。拟合多分类逻辑回归模型来评估不同 BMI 轨迹与骨质疏松症或骨量减少之间的关系。
对于 9706 名合格参与者，我们确定了四种 BMI 轨迹，包括稳定（n=7681，70.14%）、轻度增加（n=1253，12.91%）、增加后减少（n=195，2.01%）和快速增加（n=577，5.94%）。与稳定轨迹的个体相比，快速增加轨迹的个体发生骨质疏松症（OR=2.25，95%CI 1.19-4.23）和骨量减少（OR=1.49，95%CI 1.02-2.17）的可能性更高。这种关联仅在腰椎（OR=2.11，95%CI 1.06-4.2）中发现，而在股骨颈中未发现。在早期（25 岁至 10 年前）体重变化时，保持肥胖和稳定体重似乎对骨质疏松症（OR=0.26，95%CI 0.08-0.77）和骨量减少（OR=0.46，95%CI 0.25-0.84）有保护作用。同时，保持早期稳定和超重与较低的骨量减少风险相关（OR=0.53，95%CI 0.34-0.83）。最近（10 年前至基线）体重变化与骨质疏松症之间没有统计学上的显著关联。
成年期快速和超重体重增加与骨质疏松症风险增加有关。但这种关联因骨骼部位而异。在早期保持稳定的超重和肥胖可能对骨骼健康有潜在的有益影响。
