Article :: Obesity and fractures in postmenopausal women - Journal of Bone and Mineral Research

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Original Article

Obesity and fractures in postmenopausal women

Melissa Orlandin Premaor^{1 *}, Lesley Pilbrow², Carol Tonkin², Richard A Parker³, Juliet Compston¹

¹Department of Medicine, University of Cambridge, Cambridge, United Kingdom
²Metabolic Bone Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
³Centre for Applied Medical Statistics, University of Cambridge, Cambridge, United Kingdom

email: Melissa Orlandin Premaor (mopremaor@bol.com.br)

^*Correspondence to Melissa Orlandin Premaor, Bone Research Group, Box 157, Department of Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2000, United Kingdom.

Keywords

obesity fractures bone osteoporosis postmenopause aged

Abstract

Low body mass index (BMI) is a recognized risk factor for fragility fracture, whereas obesity is widely believed to be protective. As part of a clinical audit of guidance from the National Institute of Health and Clinical Excellence (NICE), we have documented the prevalence of obesity and morbid obesity in postmenopausal women younger than 75 years of age presenting to our Fracture Liaison Service (FLS). Between January 2006 and December 2007, 1005 postmenopausal women aged less than 75 years with a low-trauma fracture were seen in the FLS. Of these women, 805 (80%) underwent assessment of bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA), and values for BMI were available in 799. The prevalence of obesity (BMI 30 to 34.9 kg/m²) and morbid obesity (BMI

35 kg/m²) in this cohort was 19.3% and 8.4%, respectively. Normal BMD was reported in 59.1% of obese and 73.1% of morbidly obese women, and only 11.7% and 4.5%, respectively, had osteoporosis (p < .0001). Multiple regression analysis revealed significant negative associations between hip T-score and age (p < .0001) and significant positive associations with BMI (p < .0001) and previous fracture (p = .001). Our results demonstrate a surprisingly high prevalence of obesity in postmenopausal women presenting to the FLS with low-trauma fracture. Most of these women had normal BMD, as measured by DXA. Our findings have important public heath implications in view of the rapidly rising increase in obesity in many populations and emphasize the need for further studies to establish the pathogenesis of fractures in obese individuals and to determine appropriate preventive strategies. © 2010 American Society for Bone and Mineral Research

Received: 17 June 2009; Revised: 21 September 2009; Accepted: 9 October 2009

Digital Object Identifier (DOI)

10.1359/jbmr.091004 About DOI