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Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage

Gandham, A, Zengin, A, Bonham, MP, Winzenberg, T ORCID: 0000-0002-4112-3491, Balogun, S ORCID: 0000-0001-6415-5536, Wu, F ORCID: 0000-0003-3753-974X, Aitken, D ORCID: 0000-0001-5685-7634, Cicuttini, F, Ebeling, PR, Jones, G ORCID: 0000-0002-9814-0006 and Scott, D 2020 , 'Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage' , Bone, vol. 140 , pp. 1-7 , doi: 10.1016/j.bone.2020.115546.

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Abstract

Purpose: The aim of this study was to determine and compare risk factors associated with incident fractures in older adults with and without obesity, defined by both body mass index (BMI) and body fat percentage. Methods: 1,099 older adults (mean ± standard deviation age = 63.0 ± 7.5) years, participated in this prospective cohort study. Obesity status at baseline was defined by BMI (≥30 kg/m2) obtained by anthropometry and body fat percentage (≥30% for men and ≥40% for women) assessed by dual-energy X-ray absorptiometry (DXA). Total hip and lumbar spine areal bone mineral density (aBMD) were assessed by DXA up to five years. Incident fractures were self-reported up to 10 years. Results: Prevalence of obesity was 28% according to BMI and 43% according to body fat percentage. Obese older adults by BMI, but not body fat percentage, had significantly higher aBMD at the total hip and spine compared with non-obese (both p-value 0.05). Mediation analysis confirmed that aBMD meditated the effects of BMI, but not body fat percentage, on all incident fractures. Higher baseline falls risk score was the only consistent predictor of increased likelihood of incident fracture in obese individuals only, according to both BMI and body fat percentage (both p-value Conclusions: Obesity defined by body fat percentage is associated with increased likelihood of incident fractures in community-dwelling older adults, whereas those who are obese according to BMI have reduced likelihood of incident fracture which appears to be explained by higher aBMD. Falls risk assessment may improve identification of obese older adults at increased risk of incident fractures.

Item Type: Article
Authors/Creators:Gandham, A and Zengin, A and Bonham, MP and Winzenberg, T and Balogun, S and Wu, F and Aitken, D and Cicuttini, F and Ebeling, PR and Jones, G and Scott, D
Keywords: aging, bone, fracture, obesity, older adults
Journal or Publication Title: Bone
Publisher: Elsevier Science Inc
ISSN: 8756-3282
DOI / ID Number: 10.1016/j.bone.2020.115546
Copyright Information:

© 2020 Elsevier Inc. All rights reserved.

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