The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis.

Yupeng Liu, Yi Liu, Yufeng Huang, Siyu Le, Huinan Jiang, Binye Ruan, Xuemei Ao, Xudong Shi, Xiaoyi Fu, Shuran Wang

Journal: Clinical nutrition (Edinburgh, Scotland) 2023;42(12):2457-2467

PMID: 37925778

Abstract

BACKGROUND

Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent.

OBJECTIVE

Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis.

METHODS

From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis.

RESULTS

There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096).

CONCLUSIONS

General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.

Copyright © 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Address: Department of Epidemiology and Biostatistics, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.; Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.; Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China. Electronic address: [email protected].; Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China. Electronic address: [email protected].
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