基于人群数据库队列研究：绝经后妇女骨密度与骨折风险的身体成分相关性。

Associations between body composition and the risk of fracture according to bone mineral density in postmenopausal women: a population-based database cohort study.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.

Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea.

出版信息

Eur J Endocrinol. 2023 Nov 8;189(5):527-536. doi: 10.1093/ejendo/lvad156.

DOI:10.1093/ejendo/lvad156

PMID:37995142

Abstract

OBJECTIVE

We aimed to investigate the associations of body composition and the risk of fracture in postmenopausal women, stratified based on bone mineral density.

METHODS

A population-based cohort study using the database of the National Screening Program for Transitional Ages with women aged 66 years was performed. Bone mineral density was categorized as normal, osteopenia, and osteoporosis. The following body mass index (BMI) categories for general obesity were used: underweight (<18.5), normal (18.5-22.9), overweight (23-24.9), obese (25-29.9), and severely obese (≥30 kg/m2). Waist circumference (WC) used for central obesity assessment was categorized into 5 groups. Newly diagnosed fracture during the follow-up period defined based on ICD-10 codes was the primary outcome.

RESULTS

During 7.7 ± 1.4 years of follow-up, 41 672 (17.9%) participants experienced any fracture, 20 326 (8.7%) experienced vertebral fractures (VFs), and 2883 (1.2%) experienced hip fractures (HFs). The adjusted hazard ratios (aHRs) for any fracture showed a progressive increase with higher BMI and WC categories in individual with osteopenia and osteoporosis. Regarding VF, aHR was highest in severely obese individuals with osteoporosis (aHR [95% CI], 3.45 [2.99-3.97]) and in individuals with WC ≥ 95 cm with osteoporosis (4.79 [4.09-5.60]). The aHR [95% CI] for HF was highest in the underweight group with osteopenia (1.94 [1.16-3.27]) and osteoporosis (2.96 [2.15-4.10]). In central obesity individuals with WC ≥ 95 cm, aHR [95% CI] for HF was 2.80 [1.91-4.91].

CONCLUSIONS

General obesity and central obesity are not protective against any fracture, VF and HF in postmenopausal women with osteopenia or osteoporosis.

摘要

目的

我们旨在研究基于骨密度分层的绝经后妇女身体成分与骨折风险的相关性。

方法

本研究使用国家过渡年龄段筛查计划数据库进行了一项基于人群的队列研究，纳入年龄为 66 岁的女性。骨密度分为正常、骨量减少和骨质疏松。以下是一般肥胖的身体质量指数（BMI）分类：体重不足（<18.5）、正常（18.5-22.9）、超重（23-24.9）、肥胖（25-29.9）和严重肥胖（≥30 kg/m2）。用于评估中心性肥胖的腰围（WC）分为 5 组。根据 ICD-10 编码，将随访期间新诊断的骨折定义为主要结局。

结果

在 7.7±1.4 年的随访期间，41672（17.9%）名参与者发生了任何部位骨折，20326（8.7%）名参与者发生了椎体骨折（VF），2883（1.2%）名参与者发生了髋部骨折（HF）。在骨量减少和骨质疏松的个体中，随着 BMI 和 WC 分类的升高，任何骨折的调整后的危险比（aHR）呈逐渐升高趋势。对于 VF，骨质疏松症的严重肥胖个体的 aHR 最高（aHR[95%CI]，3.45[2.99-3.97]），骨质疏松症和 WC≥95cm 的个体的 aHR 最高（4.79[4.09-5.60]）。骨质疏松症骨量减少和骨质疏松症个体的 aHR[95%CI]最高，分别为 1.94[1.16-3.27]和 2.96[2.15-4.10]。在 WC≥95cm 的中心性肥胖个体中，HF 的 aHR[95%CI]为 2.80[1.91-4.91]。