Abstract
Background: This cohort study aimed to determine the association between body fat percentage (BF%), incident fractures and calcaneal broadband ultrasound attenuation (BUA).
Methods: Participants were drawn from EPIC-Norfolk (median follow-up = 16.4 years). Cox models analysed the relationship between BF% and incident all and hip fractures. Linear and restricted cubic spline (RCS) regressions modelled the relationship between BF% and BUA.
Results: 14,129 participants (56.2% women) were included. There were 1283 and 537 incident all and hip fractures respectively. Mean (standard deviation) age of 61.5 (9.0) years for women and 62.9 (9.0) years for men. Amongst men, BF% was not associated with incident all fractures. While BF%23% was associated with increased risk of hip fractures by up to 50% (hazard ratio (95% confidence interval) = 1.49 (1.06-2.12)). In women, BF%35% was not associated with this outcome. Higher BF% was associated with lower risk of incident hip fractures in women. Higher BF% was associated with higher BUA amongst women.
Higher BF% up to ~23% was associated with higher BUA amongst men.
Conclusions: Higher BF% is associated with lower risk of fractures in women. While there was no association between BF% and all fractures in men, increasing BF% >23% was associated with higher risk of hip fractures in men. This appears to be independent of estimated bone mineral density. Fracture prevention efforts need to consider wider physical, clinical, and environmental factors.
Methods: Participants were drawn from EPIC-Norfolk (median follow-up = 16.4 years). Cox models analysed the relationship between BF% and incident all and hip fractures. Linear and restricted cubic spline (RCS) regressions modelled the relationship between BF% and BUA.
Results: 14,129 participants (56.2% women) were included. There were 1283 and 537 incident all and hip fractures respectively. Mean (standard deviation) age of 61.5 (9.0) years for women and 62.9 (9.0) years for men. Amongst men, BF% was not associated with incident all fractures. While BF%23% was associated with increased risk of hip fractures by up to 50% (hazard ratio (95% confidence interval) = 1.49 (1.06-2.12)). In women, BF%35% was not associated with this outcome. Higher BF% was associated with lower risk of incident hip fractures in women. Higher BF% was associated with higher BUA amongst women.
Higher BF% up to ~23% was associated with higher BUA amongst men.
Conclusions: Higher BF% is associated with lower risk of fractures in women. While there was no association between BF% and all fractures in men, increasing BF% >23% was associated with higher risk of hip fractures in men. This appears to be independent of estimated bone mineral density. Fracture prevention efforts need to consider wider physical, clinical, and environmental factors.
| Original language | English |
|---|---|
| Pages (from-to) | 71-77 |
| Number of pages | 7 |
| Journal | Maturitas |
| Volume | 168 |
| Early online date | 8 Dec 2022 |
| DOIs | |
| Publication status | Published - 1 Feb 2023 |
Bibliographical note
Funding: MPT, SM, SHK and PKM are recipients of a Malaysian Ministry of HigherEducation Fundamental Research Grant Scheme grant (FP102-2019A) which funds SHK’s salary. SRN received Vacation Scholarship Grant from Medical Research Scotland (Vac26 1196-2018). The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK (C864/A14136).
Data Availability Statement
Supplementary data to this article can be found online at https://doi.org/10.1016/j.maturitas.2022.11.005Keywords
- Ageing
- Fracture
- Body Composition
- Osteoporosis
Access to Document
- Pana_etal_M_Body_Fat_Percentage_VoR
© 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)