Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 1/2013

01-03-2013 | Current Therapeutics (SL Silverman, Section Editor)

Obesity and Bone

Author: Juliet Compston

Published in: Current Osteoporosis Reports | Issue 1/2013

Login to get access

Abstract

Recent studies indicate that fractures in obese postmenopausal women and older men contribute significantly to the overall fracture burden. The effect of obesity is to some extent site-dependent, the risk being increased for some fractures and decreased for others, possibly related to different patterns of falling and the presence or absence of soft tissue padding. Risk factors for fracture in obese individuals appear to be similar to those in the nonobese population, although falls may be particularly important in the obese. There is some evidence that the morbidity associated with fractures in obese individuals is greater than in the nonobese; however, a recent study indicates that the mortality associated with fracture is lower in obese and overweight people than in those of normal weight. The evidence base for strategies to prevent fractures in obese individuals is weak and is an important area for future research.
Literature
1.
2.
3.
Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377:557–67.PubMedCrossRef
4.
Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303:235–41.PubMedCrossRef
5.
Haby MM, Markwick A, Peeters A, et al. Future predictions of body mass index and overweight prevalence in Australia, 2005–2025. Health Promot Int. 2012;27:250–60.PubMedCrossRef
6.
7.
Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Publ Health. 2009;9:88.CrossRef
8.
De Laet C, Kanis JA, Oden A, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005;16:1330–8.PubMedCrossRef
9.
Johansson H, Kanis J, Oden A, et al. High body mass index, adjusted for BMD, is a risk factor for fracture in women. Paper presented at: American Society for Bone & Mineral Research (ASBMR) 2011 Annual Meeting, San Diego, CA, September 16–20, 2011.
10.
Premaor MO, Pilbrow L, Tonkin C, et al. Obesity and fractures in postmenopausal women. J Bone Miner Res. 2010;25:292–7.PubMedCrossRef
11.
•• Compston JE, Watts NB, Chapurlat R, et al. Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med. 2011;124:1043–50. Large population-based study examining associations between obesity and fracture in postmenopausal women. PubMedCrossRef
12.
Armstrong ME, Spencer EA, Cairns BJ, et al. Body mass index and physical activity in relation to the incidence of hip fracture in postmenopausal women. J Bone Miner Res. 2011;26:1330–8.PubMedCrossRef
13.
• Premaor MO, Ensrud K, Lui L, Study of Osteoporotic Fractures, et al. Risk factors for nonvertebral fracture in obese older women. J Clin Endocrinol Metab. 2011;96:2414–21. Reports risk factors for fracture in obese postmenopausal women and demonstrates lower bone density in obese women with than without fracture. PubMedCrossRef
14.
•• Nielson CM, Marshall LM, Adams AL, et al. BMI and fracture risk in older men: the Osteoporotic Fractures in Men Study (MrOS). J Bone Miner Res. 2011;26:496–502. Population-based study reporting on the association between obesity and fractures in older men. PubMedCrossRef
15.
Nielson CM, Srikanth P, Orwoll ES. Obesity and fracture in men and women: an epidemiologic perspective. J Bone Miner Res. 2012;27:1–10.PubMedCrossRef
16.
Bergkvist D, Hekmat K, Svensson T, Dahlberg L. Obesity in orthopedic patients. Surg Obes Relat Dis. 2009;5:670–2.PubMedCrossRef
17.
King CM, Hamilton GA, Cobb M, et al. Association between ankle fractures and obesity. J Foot Ankle Surg. 2012;51(5):543–7.PubMedCrossRef
18.
Gnudi S, Emanuela S, Lisi L. Relationship of body mass index with main limb fragility fractures in postmenopausal women. J Bone Miner Metab. 2009;27:479–84.PubMedCrossRef
19.
Prieto-Alhambra D, Premaor MO, Fina Avilés F, et al. The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res. 2012;27:294–300.PubMedCrossRef
20.
Pirro M, Fabbriciani G, Leli C, et al. High weight or body mass index increases the risk of vertebral fractures in postmenopausal osteoporotic women. J Bone Miner Metab. 2010;28:88–93.PubMedCrossRef
21.
Laslett LL, Just Nee Foley SJ, Quinn SJ, et al. Excess body fat is associated with higher risk of vertebral deformities in older women but not in men: a cross-sectional study. Osteoporos Int. 2012;23:67–74.PubMedCrossRef
22.
Premaor MO, Compston J, Martinez-Laguna D, et al. The association between fracture site and obesity in men: a population-based study. Presented at the ASBMR Annual Meeting in Minneapolis. 2012;abstract SU0335.
23.
Green E, Lubahn JD, Evans J. Risk factors, treatment, and outcomes associated with nonunion of the midshaft humerus fracture. J Surg Orthop Adv. 2005;14:64–72.PubMed
24.
25.
Strauss EJ, Frank JB, Walsh M, et al. Does obesity influence the outcome after the operative treatment of ankle fractures? J Bone Joint Surg Br. 2007;89:794–8.PubMedCrossRef
26.
Porter SE, Graves ML, Qin Z, Russell GV. Operative experience of pelvic fractures in the obese. Obes Surg. 2008;18:702–8.PubMedCrossRef
27.
Sems SA, Johnson M, Cole PA, Minnesota Orthopaedic Trauma Group, et al. Elevated body mass index increases early complications of surgical treatment of pelvic ring injuries. J Orthop Trauma. 2010;24:309–14.PubMedCrossRef
28.
Baldwin KD, Matuszewski PE, Namdari S, Esterhai JL, Mehta S. Does morbid obesity negatively affect the hospital course of patients undergoing treatment of closed, lower-extremity diaphyseal long-bone fractures? Orthopedics. 2011;34:18.PubMed
29.
Compston J, Flahive J, Boonen S, et al. Effect of obesity on healthcare utilization and quality of life after fracture in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW). Presented at the ASBMR Annual Meeting in Minneapolis. 2012; abstract FR0353.
30.
Prieto-Alhambra D, Premaor MO, Aviles FF, et al. Obese and overweight patients have reduced mortality after a hip fracture: the latest obesity paradox. Presented at the ASBMR Annual Meeting in Minneapolis. 2012;abstract MO0332.
31.
32.
Schenkeveld L, Magro M, Oemrawsingh RM, et al. The influence of optimal medical treatment on the 'obesity paradox', body mass index, and long-term mortality in patients treated with percutaneous coronary intervention: a prospective cohort study. BMJ Open. 2012;2:e000535. Print 2012.PubMedCrossRef
33.
Batsis JA, Huddleston JM, Melton 4th LJ, et al. Body mass index and risk of adverse cardiac events in elderly patients with hip fracture: a population-based study. J Am Geriatr Soc. 2009;57:419–26.PubMedCrossRef
34.
Batsis JA, Huddleston JM, Melton 3rd LJ, et al. Body mass index (BMI) and risk of noncardiac postoperative medical complications in elderly hip fracture patients: a population-based study. J Hosp Med. 2009;4:E1–9.PubMedCrossRef
35.
Zhao LJ, Jiang H, Papasian CJ, et al. Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis. J Bone Miner Res. 2008;23:17–29.PubMedCrossRef
36.
Rosen CJ, Klibanski A. Bone, fat, and body composition: evolving concepts in the pathogenesis of osteoporosis. Am J Med. 2009;122:409–14.PubMedCrossRef
37.
Lecka-Czernik B, Rosen CJ, Kawai M. Skeletal aging and the adipocyte program: new insights from an "old" molecule. Cell Cycle. 2010;9:3648–54.PubMedCrossRef
38.
39.
Gilsanz V, Chalfant J, Mo AO, et al. Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab. 2009;94:3387–93.PubMedCrossRef
40.
Barbour KE, Zmuda JM, Boudreau R, et al. Adipokines and the risk of fracture in older adults. J Bone Miner Res. 2011;26:1568–76.PubMedCrossRef
41.
Barbour KE, Zmuda JM, Boudreau R, et al. The effects of adiponectin and leptin on changes in bone mineral density. Osteoporos Int. 2012;23:1699–710.PubMedCrossRef
42.
Napoli N, Pedone C, Pozzilli P, et al. Adiponectin and bone mass density: the InCHIANTI study. Bone. 2010;47:1001–5.PubMedCrossRef
43.
Russell M, Mendes N, Miller KK, et al. Visceral fat is a negative predictor of bone density measures in obese adolescent girls. J Clin Endocrinol Metab. 2010;95:1247–55.PubMedCrossRef
44.
Bredella MA, Torriani M, Ghomi RH, et al. Determinants of bone mineral density in obese premenopausal women. Obesity. 2011;19:49–53.PubMedCrossRef
45.
Bredella MA, Torriani M, Ghomi RH, et al. Vertebral bone marrow fat is positively associated with visceral fat and inversely associated with IGF-1 in obese women. Obesity. 2011;19:49–53.PubMedCrossRef
46.
Amati F, Pennant M, Azuma K, et al. Lower thigh subcutaneous and higher visceral abdominal adipose tissue content both contribute to insulin resistance. Obesity. 2012;20:1115–7.PubMedCrossRef
47.
Ducy P. The role of osteocalcin in the endocrine cross-talk between bone remodelling and energy metabolism. Diabetologia. 2011;54:1291–7.PubMedCrossRef
48.
Clemens TL, Karsenty G. The osteoblast: an insulin target cell controlling glucose homeostasis. J Bone Miner Res. 2011;26:677–80.PubMedCrossRef
49.
50.
Cheng S, Massaro JM, Fox CS, et al. Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study. Diabetes. 2010;59:242–8.PubMedCrossRef
51.
Earthman CP, Beckman LM, Masodkar K, Sibley SD. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes. 2012;36:96–107.CrossRef
52.
Bolland MJ, Grey AB, Ames RW, et al. Fat mass is an important predictor of parathyroid hormone levels in postmenopausal women. Bone. 2006;38:317–21.PubMedCrossRef
53.
Grethen E, McClintock R, Gupta CE, et al. Vitamin D and hyperparathyroidism in obesity. J Clin Endocrinol Metab. 2011;96:1320–6.PubMedCrossRef
54.
Orwoll E, Lambert LC, Marshall LM, et al. Endogenous testosterone levels, physical performance, and fall risk in older men. Arch Int Med. 2006;166:2124–31.CrossRef
55.
Sukumar D, Schlussel Y, Riedt CS, et al. Obesity alters cortical and trabecular bone density and geometry in women. Osteoporos Int. 2011;22:635–45.PubMedCrossRef
56.
Kanis JA, on behalf of the World Health Organization Scientific Group. Assessment of osteoporosis at the primary healthcare level. Technical Report, WHO Collaborating Centre for Metabolic Bone Disease, University of Sheffield, UK. 2008. Available at: http://​www.​shef.​ac.​uk/​FRAX. Accessed 11 Feb 2012.
57.
Premaor M, Parker RA, Cummings SR, et al. Predictive value of FRAX for fracture in obese older women. J Bone Miner Res. 2013;28:188–95. doi:10.​1002/​jbmr.​1729.
58.
Lee P, Greenfield JR, Seibel MJ, et al. Adequacy of vitamin D replacement in severe deficiency is dependent on body mass index. Am J Med. 2009;122:1056–60.PubMedCrossRef
59.
Ensrud KE, Fullman RL, Barrett-Connor E, et al. Voluntary weight reduction in older men increases hip bone loss: the osteoporotic fractures in men study. J Clin Endocrinol Metab. 2005;90:1998–2004.PubMedCrossRef
60.
• Villareal DT, Chode S, Parimi N, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364:1218–29. Demonstrates that when intentional weight loss is accompanied by exercise programs, bone loss can be reduced or prevented. PubMedCrossRef
61.
Chesnut III CH, Skag A, Christiansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004;19:1241–9.CrossRef
62.
Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998;280:2077–82.PubMedCrossRef
63.
Silverman SL, Christiansen C, Genant HK, et al. Efficacy of bazedoxifene in reducing new vertebral fracture risk in postmenopausal women with osteoporosis: results from a 3-year, randomized, placebo-, and active-controlled clinical trial. J Bone Miner Res. 2008;23:1923–34.PubMedCrossRef
64.
McClung M, Boonen S, Törring O, et al. Effect of denosumab treatment on the risk of fractures in subgroups of women with postmenopausal osteoporosis. J Bone Miner Res. 2012;27:211–8. doi:10.​1002/​jbmr.​536.
65.
McCloskey EV, Johansson H, Oden A, et al. Ten-year fracture probability identifies women who will benefit from clodronate therapy–additional results from a double-blind, placebo-controlled randomized study. Osteoporos Int. 2009;20:811–7.PubMedCrossRef
66.
Eastell R, Black DM, Boonen S, et al. Effect of once-yearly zoledronic acid 5 milligrams on fracture risk and change in femoral neck bone mineral density. J Clin Endocrinol Metab. 2009;94:3215–25.PubMedCrossRef
Metadata
Title
Obesity and Bone
Author
Juliet Compston
Publication date
01-03-2013
Publisher
Current Science Inc.
Published in
Current Osteoporosis Reports / Issue 1/2013
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-012-0127-y

Other articles of this Issue 1/2013

Current Osteoporosis Reports 1/2013 Go to the issue

Current Therapeutics (SL Silverman, Section Editor)

Bisphosphonate Drug Holiday: Choosing Appropriate Candidates

Current Therapeutics (SL Silverman, Section Editor)

Best Practices in Secondary Fracture Prevention: Fracture Liaison Services

Male Osteoporosis (BL Clarke, Section Editor)

Prostate Cancer and Osteoporosis

Current Therapeutics (SL Silverman, Section Editor)

Aromatase Inhibitor Adjuvant Chemotherapy of Breast Cancer Results in Cancer Therapy Induced Bone Loss

Current Therapeutics (SL Silverman, Section Editor)

Adherence with Medications Used to Treat Osteoporosis: Behavioral Insights

Current Therapeutics (SL Silverman, Section Editor)

The Potential Benefits and Inherent Risks of Vibration as a Non-Drug Therapy for the Prevention and Treatment of Osteoporosis