Obesity and risk of fracture in postmenopausal women: a meta-analysis of cohort studies.

Hong-Fei Liu, Dong-Fang Meng, Peng Yu, Ji-Cao De, Hui-Ying Li

Journal: Annals of medicine 2023;55(1):2203515

PMID: 37190975

Plain Language Summary

Obesity is a complex chronic condition that increases the risk of long-term medical complications and shortens life expectancy. Obesity is a risk factor for fractures at different sites in both children and adults. The aim of this study was to clarify the association between obesity and the risk of fractures in postmenopausal women, providing insights that could inform clinical practice and prevention strategies. This study was a meta-analysis, pooling data from eight cohort studies with 671,532 postmenopausal women. Results showed that obesity increased the risk of all-cause fractures and vertebral fractures, but it appeared to reduce the risk of pelvic fractures. Authors concluded that obesity is linked to a higher risk of all-cause and vertebral fractures but may protect against pelvic fractures in postmenopausal women. The findings of this study underscore the importance of weight regulation in reducing fracture risk among this population.

Abstract

BACKGROUND

Obesity is associated with an increased risk of fracture in adults, but is unclear in postmenopausal women. We aim to determine the association of obesity with the risk of fracture in postmenopausal women.

METHODS

PubMed, EMBASE, Cochrane Library and Web of Science were searched up to 11 April 2022 for cohort studies. And the included studies regarding the relationship between obesity with all cause of fracture in postmenopausal women were included in our meta-analysis. Data were screened and extracted independently by two reviewers. The relative risks (RR) were estimated using a random-effects model. Between-study heterogeneity was assessed using Cochran's and statistics.

RESULTS

Eight cohort studies comprising 671,532 postmenopausal women and 40,172 fractures were included. Overall, the pooling analysis shows that obesity in postmenopausal women is associated with an increased risk of all-cause fracture (relative ratio (RR) = 1.18; 95% confidence interval (CI):1.09-1.28, = 86.3%, = .000). Sub-analyses for each site of fracture indicate that obesity was associated with an increased risk of vertebral fracture in postmenopausal women (RR = 1.154, 95% CI: 1.020-1.305, = 94.5%, = .023), but reduced the risk of pelvic fracture (RR = 0.575, 95% CI:0.470-0.702, = 0.0%, .000). There is no statistically significant difference in the risk of hip and humerus fractures associated with obesity in postmenopausal women.

CONCLUSION

Obesity is associated with an increased risk of all-cause and vertebral fractures in postmenopausal women, but is a protective factor for pelvic fractures. Our findings suggest that postmenopausal women who regulate their weight might lower their risk of fractures. (PROSPERO: CRD42022324973)KEY MESSAGESObesity is associated with an increased risk of all-cause and vertebral fractures in postmenopausal women.Obesity maybe a protective factor for pelvic fractures in postmenopausal women.Postmenopausal women should regulate their weight to prevent fractures.

Address: College of Orthopaedics and Traumatology, Henan University of Chinese Medicine, Zhengzhou, Henan, China.; Orthopaedic Department, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China.; Clinical Medicine, Gannan Tibetan Autonomous Prefecture Tibetan Medical Hospital, Gannan, Gansu, China.

DOI: 10.1080/07853890.2023.2203515