Yang Guijun, Jiang Hejun, Xie Dan, Yuan Shuhua, Wu Jinhong, Zhang Jing, Zhang Lei, Yuan Jiajun, Lin Jilei, Chen Jiande, Yin Yong
Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Respiratory Medicine, Sanya Women and Children's Hospital Affiliated to Hainan Medical College, Hainan Branch of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Sanya, Hainan, China.
Front Nutr. 2024 Aug 6;11:1365587. doi: 10.3389/fnut.2024.1365587. eCollection 2024.
This study aimed to investigate the individual and composite associations of different indices of obesity on osteoporotic fractures at three different sites among individuals affected by conditions influencing bone metabolism.
Participants were included from the National Health and Nutrition Examination Survey (NHANES), a national cross-sectional survey. BMI and WC were used separately and in combination to evaluate the presence of obesity. Obesity was defined as BMI ≥ 30 kg/m, WC ≥ 88 cm in females, and WC ≥ 102 cm in males. Associations between obesity and osteoporotic fractures were assessed using multivariable logistic regression and OR curves. Associations modified by age, sex, race, and alcohol consumption were also evaluated.
A total of 5377 participants were included in this study. In multivariable logistic regression analyses, we found that BMI, WC, BMI defining obesity, and WC defining obesity were negatively associated with hip fracture (all < 0.05). However, harmful associations between WC and BMI defining obesity and spine fracture were found (all < 0.05). OR curves revealed that BMI and WC had a linear relationship with hip and spine fractures (all P for non-linearity >0.05). Further analyses showed that the highest WC quartile was harmfully associated with a higher risk of spine fractures ( < 0.05). Obese participants diagnosed by both BMI and WC were less likely to have hip fractures but more likely to have spine fractures (all P for trend <0.05). A significant interaction between age (Ref: age < 50 years) and BMI and WC was detected for hip fractures (all P for interaction <0.05).
In people with conditions influencing bone metabolism, obesity diagnosed by BMI and WC was associated with a lower risk of hip fracture, while obesity diagnosed by BMI and the highest WC quartile were associated with a higher risk of spine fracture.
本研究旨在调查在受影响骨代谢的疾病影响的个体中，不同肥胖指标与三个不同部位骨质疏松性骨折的个体及综合关联。
研究对象来自全国健康与营养检查调查（NHANES），这是一项全国性横断面调查。单独及联合使用体重指数（BMI）和腰围（WC）来评估肥胖情况。肥胖定义为BMI≥30kg/m²，女性WC≥88cm，男性WC≥102cm。使用多变量逻辑回归和OR曲线评估肥胖与骨质疏松性骨折之间的关联。还评估了年龄、性别、种族和饮酒量对关联的影响。
本研究共纳入5377名参与者。在多变量逻辑回归分析中，我们发现BMI、WC、定义肥胖的BMI以及定义肥胖的WC与髋部骨折呈负相关（均P<0.05）。然而，发现定义肥胖的WC和BMI与脊柱骨折之间存在有害关联（均P<0.05）。OR曲线显示BMI和WC与髋部和脊柱骨折呈线性关系（所有非线性P>0.05）。进一步分析表明，WC最高四分位数与脊柱骨折风险较高存在有害关联（P<0.05）。通过BMI和WC均诊断为肥胖的参与者发生髋部骨折的可能性较小，但发生脊柱骨折的可能性较大（所有趋势P<0.05）。对于髋部骨折，检测到年龄（参考：年龄<50岁）与BMI和WC之间存在显著交互作用（所有交互作用P<0.05）。
在受影响骨代谢的疾病影响的人群中，通过BMI和WC诊断的肥胖与髋部骨折风险较低相关，而通过BMI和WC最高四分位数诊断的肥胖与脊柱骨折风险较高相关。
