Body Anthropometry and the Risk of Hip and Wrist Fractures in Men: Results from a Prospective Study

Department of Nutrition , Harvard University, Cambridge, Massachusetts, United States
Obesity research (Impact Factor: 4.95). 01/1998; 6(1):12-9. DOI: 10.1002/j.1550-8528.1998.tb00309.x
Source: PubMed


Available epidemiological information on the associations between body anthropometry and the incidence of fractures in men is limited. We therefore prospectively investigated the association between body anthropometry and the incidence of hip and wrist fractures from low and moderate trauma among 43,053 men who were 40 years to 75 years of age in 1986 when they first enrolled in the Health Professionals Follow-Up Study. After 8 years of follow-up, 201 wrist fracture cases and 56 hip fracture cases were reported. Greater height was associated with significant elevations in both hip and wrist fractures, whereas nonsignificant inverse associations were observed with weight and body mass index. Men in the highest quintile of waist circumference had a relative risk (RR) of 2.57 (95% confidence interval [CI] 0.64 to 10.3) for hip fracture and 2.05 (95% CI 1.06 to 3.96) for wrist fracture when compared with men in the lowest quintile. Waist-to-hip ratio was also positively related to fracture incidence; comparing highest with lowest quintile, the RRs were 3.92 (95% CI 1.07 to 14.3) for hip fracture and 1.50 (95% CI 0.85 to 2.66) for wrist fracture. These anthropometric indicators, in particular waist-to-hip ratio, may be useful for the prediction of hip fracture in adult men.

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    • "However, the relationship between visceral adiposity and fracture incidence has shown conflicting results. Waist‐to‐hip ratio has been described as being positively related to fracture incidence in non‐diabetic males31. However, Yamaguchi et al. "
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    ABSTRACT: Aims/Introduction Discordant results about the relationship between diabetes complications and the risk of fragility fractures have been reported. Our aims were to analyze the factors related to morphometric vertebral fractures (VFs) in patients with type 2 diabetes mellitus, and to explore the association between the presence of VFs and the main cardiovascular risk factors. Materials and Methods We carried out a cross‐sectional study including 123 patients with type 2 diabetes mellitus, and in 72 of these patients we recorded data about the risk factors for VFs and comorbidities of diabetes including diabetes‐related microvascular disease and cardiovascular disease. Results In the crude analysis, diabetic retinopathy (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.01–12.5), ischemic heart disease (OR 5.02, 95% CI 1.1–9.7) and waist circumference (OR 1.06, 95% CI 1.006–1.114) were related to VFs. In the full model (adjusted for age, sex, body mass index), ischemic heart disease was the only determinant of VF (OR 3.33, CI 1.02–10.91, P = 0.047); whereas diabetic retinopathy did not reached significance (OR 2.27, CI 0.71–7.27, P = 0.16). Conclusions In summary, ischemic heart disease is associated with an increased risk of VFs in type 2 diabetes mellitus.
    Full-text · Article · May 2013 · Journal of Diabetes Investigation
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    • "The interaction between low body mass, low muscle mass and muscular weakness leading to failure of protective responses, could also be expected to heighten the risk of incurring a hip fracture, regardless of femoral bone density status (Meunier, 1997). However, although many people who fracture their hips could be classified as being thin, and high body weight has been deemed protective (Farahmand et al., 2000), in accord with Cumming and Klineberg (1994b) and Maffulli et al. (1999) that one risk factor for hip fracture could be excessive body weight, or an elevated waist-to-hip ratio (Owusa et al., 1998) we recently noted that among 35 elderly community-dwelling elders hospitalized with acute hip fractures and a mean age of 76.2 ± 7.6 years, 51.4% were overweight or obese, and only 2.9% were underweight, as indicated by their body mass index. Dretakis and Christadoulou (1983) too, noted similar rates of overweight and underweight hip fracture cases among their 373 patients. "
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    ABSTRACT: This review examines all pertinent literature sources published in the English language between 1966 to the present concerning hip fracture epidemiology, hip fracture injury mechanisms, and hip fracture management strategies. These data reveal hip fractures have several causes, but among these, the impact of falls and muscle weakness, along with low physical activity levels seems to be the most likely explanation for the rising incidence of hip fracture injuries. Related determinants of suboptimal nutrition, drugs that increase fall risk and lower the safety threshold and comorbid conditions of the neuromuscular system may also contribute to hip fracture disability. A number of interventions may help to prevent hip fracture injuries, including, interventions that optimize bone mass and quality, interventions that help prevent falls and falls dampening interventions. Rehabilitation outcomes may be improved by comprehensive interventions, prolonged follow-up strategies and ensuring that all aging adults enjoy optimal health.
    Full-text · Article · Feb 2003 · Ageing Research Reviews
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    • "More important, the overall effects are not linearly related to the increased inertia. It has been reported that waist circumference, hip circumference , and waist-to-hip ratio are all positively related to fracture incidence [5] and presumably to an increased risk of falling. Obese children suffer more from traumatic accidents to anterior teeth than nonobese children [37], also suggesting that obesity imposes additional constraints on the postural control system. "
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    ABSTRACT: Recent epidemiological studies report that obesity is positively related to fracture incidence. In the present experiment, a model of postural control was used to examine the impact of an abnormal distribution of body fat in the abdominal area upon postural stability. Obese and lightweight humanoids were destabilized by imposing a small initial angular speed from a neutral standing position. To avoid a loss of stability yielding a stepping reaction or a fall, an ankle torque is necessary to counteract the perturbation. Three torque parameters--ankle torque onset, time to peak torque, and muscular ankle torque--were entered in a program to simulate the intrinsic variability of the human postural control system. A loss of stability was detected when the center of pressure exceeded stability margins. The most striking observation is the nonlinear increase of torque needed to stabilize the humanoid when the motor response was characterized by delayed temporal parameters. The effect was more pronounced when an anterior position of the center of mass was included in the simulations. This suggests that, when submitted to daily postural stresses and perturbations, obese persons (particularly those with an abnormal distribution of body fat in the abdominal area) may be at higher risk of falling than lightweight individuals.
    Full-text · Article · Jul 2001 · IEEE Transactions on Neural Systems and Rehabilitation Engineering
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