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Obesity, bone density relative to body weight and prevalent vertebral fracture at age 62 years: the Newcastle thousand families study

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Abstract

Summary

Obesity increases the likelihood of prevalent vertebral fracture (VF) in men and women at age 62 years. The higher absolute bone mineral density (BMD) observed in obese individuals is disproportionate to body weight, and this may partly explain the greater prevalence of VF in this group.

Introduction

Obesity is a global epidemic, and there remains uncertainty over the effect of obesity on skeletal health, particularly in the context of osteoporosis. The aim of this study was to investigate associations of body mass index (BMI) and obesity with BMD and prevalent VF in men and women aged 62 years.

Methods

Three hundred and forty-two men and women aged 62.5 ± 0.5 years from the Newcastle Thousand Families Study birth cohort underwent DXA evaluations of femoral neck and lumbar spine BMD and of the lateral spine for vertebral fracture assessment.

Results

The likelihood of prevalent VF was significantly increased in men when compared to women (OR = 2.7, p < 0.001, 95% Cl 1.7–4.4). As BMI increased in women, so did the likelihood of prevalent any-grade VF (OR = 1.09, p = 0.006, 95% CI 1.02–1.17). Compared to normal weight women, obese women were more likely to have at least one VF (OR = 2.65, p = 0.025, CI 1.13–6.20) and at least one grade 1 vertebral deformity (OR = 4.39, p = 0.005, CI 1.57–12.28). Obese men were more likely to have a grade 2 and/or grade 3 VF compared to men of normal weight (OR = 3.36, p = 0.032, CI 1.11–10.16). In men and women, BMI was negatively associated with femoral neck BMD/weight (R = − 0.65, R = − 0.66, p < 0.001) and lumbar spine BMD/weight (R = − 0.66, R − 0.60, p < 0.001).

Conclusions

Obesity appears to be a risk factor for prevalent VF, and although absolute BMD is higher in obese individuals, this does not appear commensurate to their increased body weight.

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Acknowledgements

All authors were involved with the preparation of the manuscript and interpretation of the data. HR led the preparation of the manuscript and statistical analysis. KH led the concept, MP and FB directed the data collection. MP is the lead for the Newcastle Thousand Families Study. We would like to thank the previous research teams involved in the Newcastle Thousand Families Study and the study members for taking part in the investigation. We are grateful to previous funders for supporting the research and to JGW Patterson Foundation, the NIHR BCC. Thanks also to Katherine Kirton and Emma Thompson for their excellent clerical assistance to the study.

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Authors and Affiliations

  1. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK

    H. A. Rudman & L. Treadgold

  2. Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK

    F. Birrell, S. P. Tuck & K. Hind

  3. Institute of Health and Society, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK

    M. S. Pearce & R. M. Francis

  4. Department of Sport and Exercise Sciences, Durham University, 42 Old Elvet, Durham, DH1 3HN, UK

    K. Hind

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  1. H. A. Rudman
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Correspondence to K. Hind.

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A favourable ethical opinion was obtained from the Sunderland Local Research Ethics Committee (Reference 09/H0904/40) and all included study members gave their written consent.

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Rudman, H.A., Birrell, F., Pearce, M.S. et al. Obesity, bone density relative to body weight and prevalent vertebral fracture at age 62 years: the Newcastle thousand families study. Osteoporos Int 30, 829–836 (2019). https://doi.org/10.1007/s00198-018-04817-3

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