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Abdominal obesity and hip fracture: results from the Nurses’ Health Study and the Health Professionals Follow-up Study

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Abstract

Summary

Abdominal obesity might increase fracture risk. We studied the prospective associations between waist circumference, waist-to-hip ratio, and hip fracture. The indicators of abdominal obesity were associated with increased hip fracture risk in women, but not in men. The increased risk was restricted to women with low physical activity.

Introduction

Low weight is an established risk factor for osteoporosis and hip fracture. However, the association between fat tissue, muscle, and bone is complex, and abdominal obesity might increase fracture risk. We studied the prospective associations between indicators of abdominal obesity and hip fracture in two large US cohorts.

Methods

At baseline in 1986 and through biennial follow-up, information on hip fracture and potential risk factors was collected in 61,677 postmenopausal women and 35,488 men above age 50. Waist and hip circumferences were reported at baseline and updated twice.

Results

During follow-up, 1168 women and 483 men sustained a hip fracture. After controlling for known risk factors, there was a significant association in women between increasing waist circumference and hip fracture (RR per 10-cm increase 1.13 (95 % CI 1.04–1.23) and between increasing waist-to-hip ratio and hip fracture (RR per 0.1 unit increase 1.14 (95 % CI 1.04–1.23), but these associations were not seen in men. In women, both measures interacted with physical activity. Those in the highest (≥0.90) versus lowest (<0.75) category of waist-to-hip ratio had increased risk of hip fracture if their activity was less than the population median (RR = 1.61, 95 % CI 1.18–2.19) but not if their activity was higher (RR = 1.00, 95 % CI 0.72–1.40). A similar pattern was found for waist circumference.

Conclusion

Indicators of abdominal obesity were associated with increased hip fracture risk after controlling for BMI in women. The increased risk was restricted to women with low physical activity. In men, no significant associations were found.

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Acknowledgments

We wish to thank the participants and staff of the Nurses’ Health Study and the Health Professionals Follow-up Study for their valuable contributions. This work was supported by the National Institutes of Health grants UM1 CA186107, P01 CA87969, UM1 CA167552, and AG031395.

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Authors and Affiliations

  1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    H. E. Meyer, W. C. Willett & A. J. Flint

  2. Section for Preventive Medicine and Epidemiology, Department of Community Medicine, University of Oslo, P.O. Box 1130 Blindern, 0318, Oslo, Norway

    H. E. Meyer

  3. Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway

    H. E. Meyer

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    W. C. Willett & A. J. Flint

  5. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    W. C. Willett & D. Feskanich

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  1. H. E. Meyer
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Correspondence to H. E. Meyer.

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Meyer, H.E., Willett, W.C., Flint, A.J. et al. Abdominal obesity and hip fracture: results from the Nurses’ Health Study and the Health Professionals Follow-up Study. Osteoporos Int 27, 2127–2136 (2016). https://doi.org/10.1007/s00198-016-3508-8

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  • DOI: https://doi.org/10.1007/s00198-016-3508-8

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