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Distribution of Fracture Sites in Postmenopausal Overweight and Obese Women: The FRISBEE Study

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Abstract

The association between obesity and fracture sites in postmenopausal women has been little studied. We examined the most common types of fractures in obese and overweight postmenopausal women compared to subjects with a normal BMI in the FRISBEE study, a cohort of postmenopausal women followed since 9.1 (7.2–10.6) years. Chi-squared tests and logistic regressions were used to compare the percentages of fracture sites in overweight/obese subjects to subjects with a normal BMI. Their mean (± SD) age was 76.7 ± 6.9 years and their mean BMI was 26.4 ± 4.4. Seven hundred seventy-seven subjects suffered at least one validated fragility fracture with a total of 964 fractures in the whole cohort. Subjects with a BMI higher than 25 had significantly more ankle fractures and less pelvic fractures than subjects with a normal BMI (OR 1.63, 95% CI 1.02–2.56, P = 0.04 and OR 0.55, 95% CI 0.34–0.89, P = 0.01, respectively). There were no significant differences between overweight and obese subjects. Among those older than 75, there were significantly fewer pelvic fractures in overweight/obese subjects (OR 0.49, 95% CI 0.27–0.87, P = 0.01), but before 75, ankle fractures were significantly more frequent in overweight/obese subjects than in subjects with a normal BMI (OR 1.89, 95% CI 1.01–3.57, P = 0.04). In conclusion, the proportion of ankle and pelvic fractures in obese and overweight subjects differs from that in subjects with a normal BMI, but these differences are age dependent. Fracture prevention strategies should take into account the differential effects of excess weight according to age and the site of fracture.

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References

  1. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733. https://doi.org/10.1007/s00198-006-0172-4

    Article  CAS  PubMed  Google Scholar 

  2. Dixon JB (2010) The effect of obesity on health outcomes. Mol Cell Endocrinol 316:104–108. https://doi.org/10.1016/j.mce.2009.07.008

    Article  CAS  PubMed  Google Scholar 

  3. Kanis JA, Johnell O, Oden A et al (2008) FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397. https://doi.org/10.1007/s00198-007-0543-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tang X, Liu G, Kang J et al (2013) Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. PLoS ONE 8:6–12. https://doi.org/10.1371/journal.pone.0055077

    Article  CAS  Google Scholar 

  5. Viester L, Verhagen EA, Hengel KMO et al (2013) The relation between body mass index and musculoskeletal symptoms in the working population. BMC Musculoskelet Disord. https://doi.org/10.1186/1471-2474-14-238

    Article  PubMed  PubMed Central  Google Scholar 

  6. Reid IR (2010) Fat and bone. Arch Biochem Biophys 503:20–27. https://doi.org/10.1016/j.abb.2010.06.027

    Article  CAS  PubMed  Google Scholar 

  7. Johansson H, Kanis JA, Odén A et al (2014) A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 29:223–233. https://doi.org/10.1002/jbmr.2017

    Article  PubMed  Google Scholar 

  8. Compston JE, Watts NB, Chapurlat R et al (2011) Obesity is not protective against fracture in postmenopausal women: glow. Am J Med 124:1043–1050. https://doi.org/10.1016/j.amjmed.2011.06.013

    Article  PubMed  PubMed Central  Google Scholar 

  9. Fassio A, Idolazzi L, Rossini M et al (2018) The obesity paradox and osteoporosis. Eat Weight Disord 23:293–302. https://doi.org/10.1007/s40519-018-0505-2

    Article  PubMed  Google Scholar 

  10. Turcotte AF, O’Connor S, Morin SN et al (2021) Association between obesity and risk of fracture, bone mineral density and bone quality in adults: a systematic review and meta-analysis. PLoS ONE 16(6):e0252487

    Article  CAS  Google Scholar 

  11. Cappelle SI, Ramon I, Dekelver C et al (2017) Distribution of clinical risk factors for fracture in a Brussels cohort of postmenopausal women: the FRISBEE study and comparison with other major cohort studies. Maturitas 106:1–7. https://doi.org/10.1016/j.maturitas.2017.08.010

    Article  CAS  PubMed  Google Scholar 

  12. Caffarelli C, Alessi C, Nuti R, Gonnelli S (2014) Divergent effects of obesity on fragility fractures. Clin Interv Aging 9:1629–1636. https://doi.org/10.2147/CIA.S64625

    Article  PubMed  PubMed Central  Google Scholar 

  13. Premaor MO, Comim FV, Compston JE (2014) Obesidade e fraturas. Arq Bras Endocrinol Metabol 58:470–477. https://doi.org/10.1590/0004-2730000003274

    Article  PubMed  Google Scholar 

  14. Compston JE, Flahive J, Hosmer DW et al (2014) Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the global longitudinal study of osteoporosis in women (GLOW). J Bone Miner Res 29:487–493. https://doi.org/10.1002/jbmr.2051

    Article  PubMed  Google Scholar 

  15. King CM, Hamilton GA, Cobb M et al (2012) Association between ankle fractures and obesity. J Foot Ankle Surg 51:543–547. https://doi.org/10.1053/j.jfas.2012.05.016

    Article  PubMed  Google Scholar 

  16. Armstrong MEG, Cairns BJ, Banks E et al (2012) Different effects of age, adiposity and physical activity on the risk of ankle, wrist and hip fractures in postmenopausal women. Bone 50:1394–1400. https://doi.org/10.1016/j.bone.2012.03.014

    Article  PubMed  PubMed Central  Google Scholar 

  17. Corbeil P, Simoneau M, Rancourt D et al (2001) Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE Trans Neural Syst Rehabil Eng 9:126–136. https://doi.org/10.1109/7333.928572

    Article  CAS  PubMed  Google Scholar 

  18. Neri SGR, Harvey LA, Tiedemann A et al (2020) Obesity and falls in older women: mediating effects of muscle quality, foot loads and postural control. Gait Posture 77:138–143. https://doi.org/10.1016/j.gaitpost.2020.01.025

    Article  PubMed  Google Scholar 

  19. Fjeldstad C, Fjeldstad AS, Acree LS et al (2008) The influence of obesity on falls and quality of life. Dyn Med 7:1–6. https://doi.org/10.1186/1476-5918-7-4

    Article  Google Scholar 

  20. Prieto-Alhambra D, Premaor MO, Fina Avilés F et al (2012) The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res 27:294–300. https://doi.org/10.1002/jbmr.1466

    Article  PubMed  Google Scholar 

  21. Mignardot JB, Olivier I, Promayon E, Nougier V (2010) Obesity impact on the attentional cost for controlling posture. PLoS ONE 5:1–6. https://doi.org/10.1371/journal.pone.0014387

    Article  CAS  Google Scholar 

  22. Bouxsein ML, Szulc P, Munoz F et al (2007) Contribution of trochanteric soft tissues to fall force estimates, the factor of risk, and prediction of hip fracture risk. J Bone Miner Res 22:825–831. https://doi.org/10.1359/jbmr.070309

    Article  PubMed  Google Scholar 

  23. Vincent HK, Vincent KR, Lamb KM (2010) Obesity and mobility disability in the older adult. Obes Rev 11:568–579. https://doi.org/10.1111/j.1467-789X.2009.00703.x

    Article  CAS  PubMed  Google Scholar 

  24. Yang Y, Komisar V, Shishov N et al (2020) The effect of fall biomechanics on risk for hip fracture in older adults: a cohort study of video-captured falls in long-term care. J Bone Miner Res 35:1914–1922. https://doi.org/10.1002/jbmr.4048

    Article  CAS  PubMed  Google Scholar 

  25. Karinkanta S, Piirtola M, Sievänen H et al (2010) Physical therapy approaches to reduce fall and fracture risk among older adults. Nat Rev Endocrinol 6:396–407. https://doi.org/10.1038/nrendo.2010.70

    Article  PubMed  Google Scholar 

  26. Statista website. https://www.statista.com/statistics/1090525/body-mass-index-distribution-belgian-adult-population/

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Acknowledgements

The FRISBEE study was supported by IRIS-Research and CHU Brugmann.

Funding

Funding was provided by Iris Research.

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Correspondence to A. Charles.

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The authors declare that they have no conflict of interest.

MBB, WAH have consulted for Ascendis. MBB and RSC receive research funding from Biomarin, TherAchon/Pfizer, Ascendis, and QED.

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All procedures performed in this study were in accordance with the ethical Standards of the institutional or national research committee.

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Informed consent was obtained from all individual participants included in this study.

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Charles, A., Mugisha, A., Iconaru, L. et al. Distribution of Fracture Sites in Postmenopausal Overweight and Obese Women: The FRISBEE Study. Calcif Tissue Int 111, 29–34 (2022). https://doi.org/10.1007/s00223-022-00968-y

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  • DOI: https://doi.org/10.1007/s00223-022-00968-y

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