General and abdominal obesity operate differently as influencing factors of fracture risk in old adults

Xiao-Wei Zhu; Ke-Qi Liu; Cheng-Da Yuan; Jiang-Wei Xia; Yu Qian; Lin Xu; Jian-Hua Gao; Xiao-Li Rong; Guo-Bo Chen; David Karasik; Shu-Yang Xie; Hou-Feng Zheng

doi:10.1016/j.isci.2022.104466

General and abdominal obesity operate differently as influencing factors of fracture risk in old adults

iScience. 2022 May 25;25(6):104466. doi: 10.1016/j.isci.2022.104466. eCollection 2022 Jun 17.

Authors

Xiao-Wei Zhu^{1

2

3}, Ke-Qi Liu⁴, Cheng-Da Yuan⁵, Jiang-Wei Xia^{2

3}, Yu Qian^{2

3}, Lin Xu⁶, Jian-Hua Gao⁴, Xiao-Li Rong⁷, Guo-Bo Chen⁸, David Karasik⁹, Shu-Yang Xie⁶, Hou-Feng Zheng^{1

2

3}

Affiliations

¹ Fudan University, Shanghai 200433, China.
² Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China.
³ Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China.
⁴ WBBC Jiangxi Center, Jiangxi Medical College, Shangrao, Jiangxi 334000, China.
⁵ Department of Dermatology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310007, China.
⁶ WBBC Shandong Center, Binzhou Medical University, Yantai, Shandong 264003, China.
⁷ Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
⁸ Clinical Research Institute, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou 310014, China.
⁹ Azrieli Faculty of Medicine, Bar-Ilan University, Safed 5290002, Israel.

Abstract

To infer the causality between obesity and fracture and the difference between general and abdominal obesity, a prospective study was performed in 456,921 participants, and 10,142 participants developed an incident fracture with follow-up period of 7.96 years. A U-shape relationship was observed between BMI and fracture, with the lowest risk of fracture in overweight participants. The obesity individuals had higher fracture risk when BMD was adjusted, and the protective effect of moderate-high BMI on fracture was mostly mediated by bone mineral density (BMD). However, for abdominal obesity, the higher WCadjBMI (linear) and HCadjBMI (J-shape) were found to be related to higher fracture risk, and less than 30% of the effect was mediated by BMD. By leveraging genetic instrumental variables, it provided additional evidences to support the aforementioned findings. In conclusion, keeping moderate-high BMI might be of benefit to old people in terms of fracture risk, whereas abdominal adiposity might increase risk of fracture.

Keywords: Health sciences; Obesity medicine; Risk factor.

Abstract

Grants and funding