Association between obesity and the prevalence of fractures: a population-based cross-sectional study in China
Authors' conclusion
Obesity was associated with higher BMD in a non-linear manner. However, BMI was positively associated with the prevalence of VFs, and there was a U-shaped relationship between BMI and the prevalent fractures.
Study context
- Population
- Individuals from the COPS cohort, Mainland ChinaCOPS cohort
- Participants
- 8,251 individuals
- Exposure
- Obesity vs normal weight
- Outcome
- Prevalence of fractures: VFs (spine X-ray) and prevalent fractures (self-reported, recent 5 years)
Methodological detailspopulation-based, grouped by BMI level, restricted cubic spline, multivariable logistic regression
- Population-based
- Grouped by BMI level
- Restricted cubic spline
- Multivariable logistic regression
Main finding
As reported in the abstract
Each group vs normal weightOdds ratio (95% CI)
ObesityVFs; independent of Sharpened Romberg test and lumbar spine BMD
1.88(1.38–2.56)
Obesityprevalent fractures; independent of Sharpened Romberg test and lumbar spine BMD
2.18(1.39–3.41)
Low-weightprevalent fractures
2.62(1.34–4.75)
- Per SD increase in BMI: increase in prevalence of vertebral fractures (VFs)
- 21%
- Per SD increase in BMI: increase in prevalence of prevalent fractures
- 22%
Observational data: associations, not effects.
Further findings
BMD and bone turnover
- Significant non-linear correlations between BMI and BMD, rapid increase and plateau at extremely high BMI
- p for non-linear < 0.001 for all
- Obesity correlated with reduced bone turnover rate and increased BMD
Balance ability (5R-STS, Sharpened Romberg test)
- Obesity associated with longer 5R-STS time and more likely positive Sharpened Romberg test, especially in women
Original publication
Association between obesity and the prevalence of fractures: a population-based cross-sectional study in China. Osteoporos Int. Published 28 April 2025. doi:10.
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