Effect of BMI‐Discordant Abdominal Tissue Thickness on Fracture Probability: A Registry‐Based Study

Author:

Leslie William D.1ORCID,Binkley Neil2ORCID,Schousboe John T.3ORCID,McCloskey Eugene V.4ORCID,Johansson Helena45,Harvey Nicholas C.67ORCID,Kanis John A.45

Affiliation:

1. Department of Internal Medicine University of Manitoba Winnipeg Canada

2. Division of Medicine University of Wisconsin Madison WI USA

3. Division of Health Policy and Management HealthPartners Institute and the University of Minnesota Minneapolis MN USA

4. Centre for Metabolic Bone Diseases University of Sheffield Medical School Sheffield UK

5. Mary McKillop Institute for Health Research Australian Catholic University Melbourne Australia

6. MRC Lifecourse Epidemiology Centre University of Southampton Southampton UK

7. NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK

Abstract

ABSTRACTFRAX, which is used to assess fracture probability, considers body mass index (BMI), but BMI may not reflect individual variation in body composition and distribution. We examined the effect of BMI‐discordant abdominal thickness on FRAX‐derived fracture probability for major osteoporotic fracture (MOF) and hip fracture. We studied 73,105 individuals, mean age 64.2 years. During mean 8.7 years, 7048 (9.6%) individuals sustained incident MOF, including 2155 (3.0%) hip fractures. We defined abdominal thickness index (ATI) as the difference between abdominal thickness measured by dual‐energy X‐ray absorptiometry (DXA) and thickness predicted by BMI using sex‐stratified regression. ATI was categorized from lower (<−2 cm, −2 to −1 cm) to higher (1–2 cm, >+2 cm) with referent around zero (−1 to +1 cm). Adjusted for FRAX probability, increasing ATI was associated with incident MOF and hip fracture (p < 0.001). For the highest ATI category, MOF risk was increased (hazard ratio [HR] = 1.23, 95% confidence interval [CI] 1.12–1.35) independent of FRAX probability. Similar findings were noted for hip fracture probability (HR = 1.28, 95% CI 1.09–1.51). There was significant age‐interaction with much larger effects before age 65 years (HR = 1.44, 95% CI 1.23–1.69 for MOF; 2.29, 95% CI 1.65–3.18 for hip fracture). In contrast, for the subset of individuals with diabetes, there was also increased risk for those in the lowest ATI category (HR = 1.73, 95% CI 1.12–2.65 for MOF; 2.81, 95% CI 1.59–4.97 for hip fracture). Calibration plots across ATI categories demonstrated deviation from the line of identity in women (calibration slope 2.26 for MOF, 2.83 for hip fracture). An effect of ATI was not found in men, but this was inconclusive as the sex‐interaction terms did not show significant effect modification. In conclusion, these data support the need to investigate increased abdominal thickness beyond that predicted by BMI and sex as a FRAX‐independent risk factor for fracture. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Publisher

Oxford University Press (OUP)

Subject

Orthopedics and Sports Medicine,Endocrinology, Diabetes and Metabolism

Reference44 articles.

1. Clinical Use of Bone Densitometry

2. International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions

3. A reference standard for the description of osteoporosis

4. KanisJA.Assessment of osteoporosis at the primary health‐care level. Technical Report. Sheffield UK: University of Sheffield;2007. Available from:http://www.shef.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdf

5. Scaling of human body composition to stature: new insights into body mass index

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3