Abstract
Summary
Weight and body mass index are associated with low bone mineral density and fractures in older women. This retrospective cohort study confirms a similar relationship in women aged 40 to 59 years.
Introduction
Risk factors for the prediction of osteoporosis and fractures have been less thoroughly studied in younger women. We evaluated the associations between weight, body mass index (BMI), the Osteoporosis Self-Assessment Tool (OST), bone mineral density (BMD) and fracture risk in women aged 40 to 59 years.
Methods
Using administrative health management databases, we conducted a retrospective cohort study in 8,254 women aged 40–59 years who had baseline BMD testing. Linear regression and Cox proportional multivariate models were created to examine the associations with weight, BMI, OST, BMD, and subsequent fractures throughout a 3.3-year follow-up.
Results
Body weight, BMI, and OST had a similar overall performance in their ability to classify women with femoral neck T-score ≤ −2.5. Throughout 27,256 person years of observation, 225 women experienced one or more fractures. After adjustment for age, prevalent fractures, and use of corticosteroids, each standard deviation decrease in weight was associated with a 19% increase in the risk of incident fracture (95% CI: 1.01–1.35). Femoral neck BMD and the presence of prevalent fractures were also associated with the risk of incident fractures.
Conclusions
Low weight and BMI predict osteoporosis and are associated with increased fracture risk in younger women. The negative impact of low body weight on bone health should be more widely recognized.
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Acknowledgements
We are indebted to Manitoba Health for providing data. The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The results and conclusions are those of the authors, and no official endorsement by Manitoba Health is intended or should be inferred. This article has been reviewed and approved by the members of the Manitoba Bone Density Program Committee. This study was supported in part by an unrestricted educational grant from the CHAR/GE Healthcare Development Awards Programme.
Conflicts of interest
S. Morin: honoraria for lecture and advisory board membership from Merck Frosst, Procter & Gamble, sanofi-aventis, Novartis, E. Lilly, Servier, and Amgen.
W.D. Leslie: honoraria for lectures in the past year: Merck Frosst Canada.
Unrestricted educational and research grants: Merck Frosst Canada, The Alliance for Better Bone Health - sanofi-aventis and Procter & Gamble Pharmaceuticals Canada, Novartis Pharmaceuticals Canada.
James T. Tsang: No conflicts.
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On behalf of the Manitoba Bone Density Program.
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Morin, S., Tsang, J.F. & Leslie, W.D. Weight and body mass index predict bone mineral density and fractures in women aged 40 to 59 years. Osteoporos Int 20, 363–370 (2009). https://doi.org/10.1007/s00198-008-0688-x
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DOI: https://doi.org/10.1007/s00198-008-0688-x