Effect of BMI-Discordant Abdominal Tissue Thickness on Fracture Probability: A Registry-Based Study
Main finding · Incident MOFResult — go to the resultHazard ratio 1.23 95% CI 1.12–1.35Authors' conclusion
In conclusion, these data support the need to investigate increased abdominal thickness beyond that predicted by BMI and sex as a FRAX-independent risk factor for fracture.
Study context
- Population
- Individuals with DXA-measured abdominal thickness; mean age 64.2 years; Abdominal thickness index (ATI) = DXA abdominal thickness minus thickness predicted by body mass index (BMI) (sex-stratified regression)
- Participants
- 73,105 individuals
- Exposure
- ATI categories vs referent, adjusted for FRAX probability
- Outcome
- Incident MOF and hip fracture, adjusted for FRAX probability
- Follow-up
- Mean 8.7 years
Main finding
Incident MOF
Hazard ratio
1.23
95% CI 1.12–1.35
>+2 cmvs −1 to +1 cm
HR 1.23 (95% CI 1.12–1.35)
As reported in the abstract
- Increasing ATI associated with incident major osteoporotic fracture (MOF) and hip fracture, adjusted for FRAX probability
- P < 0.001
- Incident MOF, all individuals
- 7048 (9.6%)
Observational data: associations, not effects.
Further findings
Hip fracture, highest ATI category, independent of FRAX probability
- HR, highest ATI category
- 1.28 (95% CI 1.09-1.51)
Age <65 years, highest ATI category (significant age-interaction)
- HR for MOF
- 1.44 (95% CI 1.23-1.69)
- HR for hip fracture
- 2.29 (95% CI 1.65-3.18)
Individuals with diabetes, lowest ATI category
- HR for MOF
- 1.73 (95% CI 1.12-2.65)
- HR for hip fracture
- 2.81 (95% CI 1.59-4.97)
Calibration across ATI categories in women
- Calibration slope for MOF
- 2.26
- Calibration slope for hip fracture
- 2.83
- Deviation from the line of identity
Men
- An effect of ATI was not found in men; inconclusive as sex-interaction terms did not show significant effect modification
Original publication
Effect of BMI-Discordant Abdominal Tissue Thickness on Fracture Probability: A Registry-Based Study. J Bone Miner Res. Published 18 October 2023. doi:10.
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