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Association between change in body weight after midlife and risk of hip fracture—the Singapore Chinese Health Study

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Abstract

Summary

The relationship between change in body weight and risk of fractures is inconsistent in epidemiologic studies. In this cohort of middle-aged to elderly Chinese in Singapore, compared to stable weight, weight loss ≥10 % over an average of 6 years is associated with nearly 40 % increase in risk of hip fracture.

Introduction

Findings on the relationship between change in body weight and risk of hip fracture are inconsistent. In this study, we examined this association among middle-aged and elderly Chinese in Singapore.

Methods

We used prospective data from the Singapore Chinese Health Study, a population-based cohort of 63,257 Chinese men and women aged 45–74 years at recruitment in 1993–1998. Body weight and height were self-reported at recruitment and reassessed during follow-up interview in 1999–2004. Percent in weight change was computed based on the weight difference over an average of 6 years, and categorized as loss ≥10 %, loss 5 to <10 %, loss or gain <5 % (stable weight), gain 5 to <10 %, and gain ≥10 %. Multivariable Cox proportional hazards regression model was applied with adjustment for risk factors for hip fracture and body mass index (BMI) reported at follow-up interview.

Results

About 12 % experienced weight loss ≥10 %, and another 12 % had weight gain ≥10 %. After a mean follow-up of 9.0 years, we identified 775 incident hip fractures among 42,149 eligible participants. Compared to stable weight, weight loss ≥10 % was associated with 39 % increased risk (hazard ratio 1.39; 95 % confidence interval 1.14, 1.69). Such elevated risk with weight loss ≥10 % was observed in both genders and age groups at follow-up (≤65 and >65 years) and in those with baseline BMI ≥20 kg/m2.There was no significant association with weight gain.

Conclusions

Our findings provide evidence that substantial weight loss is an important risk factor for osteoporotic hip fractures among the middle-aged to elderly Chinese.

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Acknowledgments

We thank Siew-Hong Low of the National University of Singapore for supervising the fieldwork and Renwei Wang for the maintenance of the database in the Singapore Chinese Health Study. We also thank the Ministry of Health in Singapore for assistance with the identification of hip fracture cases and mortality via database linkages. Finally, we acknowledge the founding Principal Investigator of the Singapore Chinese Health Study, Mimi C. Yu.

Funding

This study was supported by the National Medical Research Council, Singapore (NMRC/EDG/0011/2007) and National Institutes of Health, USA (RO1 CA144034 and UM1 CA182876).

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Block MD1, 12 Science Drive 2, Singapore, 117549, Singapore

    Z. Dai & W.-P. Koh

  2. Epidemiology and Disease Control Division, Ministry of Health, Singapore, Singapore

    L.-W. Ang

  3. Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA

    J.-M. Yuan

  4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    J.-M. Yuan

  5. Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, 8 College Road Level 4, Singapore, 169857, Singapore

    W.-P. Koh

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  1. Z. Dai
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  2. L.-W. Ang
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  3. J.-M. Yuan
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  4. W.-P. Koh
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Corresponding author

Correspondence to Z. Dai.

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Dai, Z., Ang, LW., Yuan, JM. et al. Association between change in body weight after midlife and risk of hip fracture—the Singapore Chinese Health Study. Osteoporos Int 26, 1939–1947 (2015). https://doi.org/10.1007/s00198-015-3099-9

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  • DOI: https://doi.org/10.1007/s00198-015-3099-9

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