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Bone mineral density T-scores comparison between obese and non-obese individuals included in a Fracture Liaison Service following a recent fragility fracture

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Abstract

Mini-abstract

We used data from a Fracture Liaison Service to compare the mean T-scores of obese and non-obese patients after a recent fragility fracture. After adjusting for age, sex, and diabetes mellitus, T-score values were significantly higher at all measurement sites in obese patients, with a mean difference of 1 SD.

Purpose

This study aimed to compare the mean T-scores of obese and non-obese patients after recent fragility fractures.

Methods

Over a period of 5 and a half years, from January 2016 to May 2021, patients from a fracture liaison service were identified and their demographic characteristics, osteoporosis risk factors, BMD T-scores, and fracture sites were compared between obese (BMI ≥ 30 kg/m2) and non-obese (19 kg/m2 < BMI < 30 kg/m2) patients.

Results

A total of 712 patients were included (80.1% women; mean age 73.8 ± 11.3 years). Sixteen % had type 2 diabetes mellitus and 80% had a major osteoporotic fracture (MOF). 135 patients were obese and 577 non-obese, with obese patients younger (p < 0.001) and more frequently female (p = 0.03). Obese patients presented with fewer hip fractures (10% vs. 21%, p = 0.003) and more proximal humerus fractures (16% vs. 7%, p < 0.001) than non-obese patients. After adjusting for age, sex, and diabetes mellitus, BMD T-score values were significantly higher at all measurement sites (lumbar spine, total hip, and femoral neck) in obese patients than in non-obese patients for all types of fractures, with a mean difference of 1 standard deviation (p < 0.001 for all comparisons). The same results were observed in the population limited to MOF.

Conclusions

Given the crucial role of BMD T-score in determining the need for anti-osteoporotic medication following fragility fractures, it is reasonable to question the existing T-score thresholds in obese patients.

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Authors and Affiliations

  1. Department of Rheumatology, Univ. Lille, CHU Lille, Lille University Hospital, 59000, Lille, France

    Gauthier Marchasson & Cécile Philippoteaux

  2. Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France

    Isabelle Legroux-Gérot, Bernard Cortet & Julien Paccou

  3. Department of Biostatistics, CHU Lille, 59000, Lille, France

    Béhal Hélène

Authors
  1. Gauthier Marchasson
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  2. Cécile Philippoteaux
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  3. Isabelle Legroux-Gérot
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  4. Béhal Hélène
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  5. Bernard Cortet
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  6. Julien Paccou
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Correspondence to Julien Paccou.

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Marchasson, G., Philippoteaux, C., Legroux-Gérot, I. et al. Bone mineral density T-scores comparison between obese and non-obese individuals included in a Fracture Liaison Service following a recent fragility fracture. Arch Osteoporos 19, 20 (2024). https://doi.org/10.1007/s11657-024-01379-2

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