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Body mass index, height, and osteoporotic fracture risk in community-dwelling Japanese people aged 40–74 years

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Abstract

Introduction

The association between body size and fracture risk is complex and varies by sex and ethnicity. This study aimed to examine associations of body mass index (BMI) and height with osteoporotic fracture risk in middle-aged and older people.

Materials and Methods

This 10-year cohort study included 13,151 community-dwelling Japanese people aged 40–74 years. A self-administered questionnaire survey was conducted at baseline to obtain information on demographic characteristics, body size, lifestyle, and disease history. BMI (kg/m2) was categorized as underweight (< 18.5), low-normal (18.5–21.7), high-normal (21.8–24.9), overweight (25.0–29.9), and obese (≥ 30.0). Height was categorized into quartiles. All incident cases of major osteoporotic fractures, including fractures of the distal radius, neck of the humerus, neck or trochanter of the femur, and vertebrae, were obtained from medical records during follow-up.

Results

Mean participant age was 58.8 years. In men, the underweight group had a significantly higher hazard ratio (HR) for total fracture (adjusted HR = 2.46), and the obese group had significantly higher HRs for total (adjusted HR = 3.01) and vertebral (HR = 3.77) fractures relative to the reference (overweight) group. No significant associations were observed between BMI and risk of any fracture in women. Higher quartiles of height were associated with higher vertebral fracture risk (adjusted P for trend = 0.023) only in women.

Conclusion

BMI and osteoporotic fracture risk showed a U-shaped association in men, whereas higher height was associated with higher vertebral fracture risk in women, suggesting sex-dependent differences in these associations.

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Acknowledgements

We thank the Murakami Public Health Center, Murakami City Government, Sekikawa Village Government, and Awashimaura Village Government for their valuable support in data collection. This work was supported by JSPS KAKENHI Grant Numbers JP23249035, JP15H04782, and JP19H03897, and the National Cancer Center Research and Development Fund [23-A31(toku) (since 2010)]. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding

Japan Society for the Promotion of Science, JP23249035, Kazutoshi Nakamura, JP15H04782, Kazutoshi Nakamura, JP19H03897, Kazutoshi Nakamura, National Cancer Center Research and Development Fund, [23-A31(toku)],Shoichiro Tsugane.

Author information

Authors and Affiliations

  1. Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata, 951-8510, Japan

    Toshi Nishikura, Kaori Kitamura, Yumi Watanabe, Toshiko Saito & Kazutoshi Nakamura

  2. Department of Rehabilitation, Niigata University of Rehabilitation, 2-16, Kaminoyama, Murakami, Niigata, 958-0053, Japan

    Toshi Nishikura, Akemi Takahashi, Ryosaku Kobayashi & Rieko Oshiki

  3. Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata, 951-8510, Japan

    Keiko Kabasawa

  4. Department of Food Science and Nutrition, Nara Women’s University Graduate School of Humanities and Sciences, Kitauoya-Higashimachi, Nara, 630-8506, Japan

    Ribeka Takachi

  5. International University of Health and Welfare Graduate School of Public Health, 4-1-26 Akasaka, Minato-Ku, Tokyo, 107-8402, Japan

    Shoichiro Tsugane

  6. Niigata Prefectural Government, 4-1 Shinko-Cho, Niigata, 950-8570, Japan

    Osamu Yamazaki

  7. Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-Dori, Niigata, 951-8520, Japan

    Kei Watanabe

Authors
  1. Toshi Nishikura
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  2. Kaori Kitamura
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  3. Yumi Watanabe
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  4. Keiko Kabasawa
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  5. Akemi Takahashi
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  6. Toshiko Saito
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  7. Ryosaku Kobayashi
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  8. Rieko Oshiki
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  9. Ribeka Takachi
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  10. Shoichiro Tsugane
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  11. Osamu Yamazaki
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  12. Kei Watanabe
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  13. Kazutoshi Nakamura
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Contributions

TN and KN conceived the study; TN, KKi, YW, KKa, ST, KW, and KN designed the study; KKi, YW, AT, TS, RK, RO, RT, OY, and KN conducted research; TN and KN analyzed data; TN and KN wrote the paper draft; and KKa, ST, and KW critically reviewed and revised the manuscript. KN had primary responsibility for the final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kazutoshi Nakamura.

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Nishikura, T., Kitamura, K., Watanabe, Y. et al. Body mass index, height, and osteoporotic fracture risk in community-dwelling Japanese people aged 40–74 years. J Bone Miner Metab 42, 47–59 (2024). https://doi.org/10.1007/s00774-023-01478-z

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  • DOI: https://doi.org/10.1007/s00774-023-01478-z

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