Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.

Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.

<h4>Background</h4>The association between obesity and fracture risk may be skeletal site- and sex-specific but results among studies are inconsistent. Whilst several studies reported higher bone mineral density (BMD) in patients with obesity, altered bone quality could be a major determ...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Anne-Frédérique Turcotte, Sarah O'Connor, Suzanne N Morin, Jenna C Gibbs, Bettina M Willie, Sonia Jean, Claudia Gagnon
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
Materias:
Medicine
R
Science
Q
Acceso en línea:https://doaj.org/article/e8563bb57c5240d38964833c3ed711e6
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:e8563bb57c5240d38964833c3ed711e6
record_format dspace
spelling oai:doaj.org-article:e8563bb57c5240d38964833c3ed711e62021-12-02T20:07:12ZAssociation between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.1932-620310.1371/journal.pone.0252487https://doaj.org/article/e8563bb57c5240d38964833c3ed711e62021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252487https://doaj.org/toc/1932-6203<h4>Background</h4>The association between obesity and fracture risk may be skeletal site- and sex-specific but results among studies are inconsistent. Whilst several studies reported higher bone mineral density (BMD) in patients with obesity, altered bone quality could be a major determinant of bone fragility in this population.<h4>Objectives</h4>This systematic review and meta-analysis aimed to compare, in men, premenopausal women and postmenopausal women with obesity vs. individuals without obesity: 1) the incidence of fractures overall and by site; 2) BMD; and 3) bone quality parameters (circulating bone turnover markers and bone microarchitecture and strength by advanced imaging techniques).<h4>Data sources</h4>PubMed (MEDLINE), EMBASE, Cochrane Library and Web of Science were searched from inception of databases until the 13th of January 2021.<h4>Data synthesis</h4>Each outcome was stratified by sex and menopausal status in women. The meta-analysis was performed using a random-effect model with inverse-variance method. The risks of hip and wrist fracture were reduced by 25% (n = 8: RR = 0.75, 95% CI: 0.62, 0.91, P = 0.003, I2 = 95%) and 15% (n = 2 studies: RR = 0.85, 95% CI: 0.81, 0.88), respectively, while ankle fracture risk was increased by 60% (n = 2 studies: RR = 1.60, 95% CI: 1.52, 1.68) in postmenopausal women with obesity compared with those without obesity. In men with obesity, hip fracture risk was decreased by 41% (n = 5 studies: RR = 0.59, 95% CI: 0.44, 0.79). Obesity was associated with increased BMD, better bone microarchitecture and strength, and generally lower or unchanged circulating bone resorption, formation and osteocyte markers. However, heterogeneity among studies was high for most outcomes, and overall quality of evidence was very low to low for all outcomes.<h4>Conclusions</h4>This meta-analysis highlights areas for future research including the need for site-specific fracture studies, especially in men and premenopausal women, and studies comparing bone microarchitecture between individuals with and without obesity.<h4>Systematic review registration number</h4>CRD42020159189.Anne-Frédérique TurcotteSarah O'ConnorSuzanne N MorinJenna C GibbsBettina M WillieSonia JeanClaudia GagnonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252487 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Anne-Frédérique Turcotte
Sarah O'Connor
Suzanne N Morin
Jenna C Gibbs
Bettina M Willie
Sonia Jean
Claudia Gagnon
Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.
description <h4>Background</h4>The association between obesity and fracture risk may be skeletal site- and sex-specific but results among studies are inconsistent. Whilst several studies reported higher bone mineral density (BMD) in patients with obesity, altered bone quality could be a major determinant of bone fragility in this population.<h4>Objectives</h4>This systematic review and meta-analysis aimed to compare, in men, premenopausal women and postmenopausal women with obesity vs. individuals without obesity: 1) the incidence of fractures overall and by site; 2) BMD; and 3) bone quality parameters (circulating bone turnover markers and bone microarchitecture and strength by advanced imaging techniques).<h4>Data sources</h4>PubMed (MEDLINE), EMBASE, Cochrane Library and Web of Science were searched from inception of databases until the 13th of January 2021.<h4>Data synthesis</h4>Each outcome was stratified by sex and menopausal status in women. The meta-analysis was performed using a random-effect model with inverse-variance method. The risks of hip and wrist fracture were reduced by 25% (n = 8: RR = 0.75, 95% CI: 0.62, 0.91, P = 0.003, I2 = 95%) and 15% (n = 2 studies: RR = 0.85, 95% CI: 0.81, 0.88), respectively, while ankle fracture risk was increased by 60% (n = 2 studies: RR = 1.60, 95% CI: 1.52, 1.68) in postmenopausal women with obesity compared with those without obesity. In men with obesity, hip fracture risk was decreased by 41% (n = 5 studies: RR = 0.59, 95% CI: 0.44, 0.79). Obesity was associated with increased BMD, better bone microarchitecture and strength, and generally lower or unchanged circulating bone resorption, formation and osteocyte markers. However, heterogeneity among studies was high for most outcomes, and overall quality of evidence was very low to low for all outcomes.<h4>Conclusions</h4>This meta-analysis highlights areas for future research including the need for site-specific fracture studies, especially in men and premenopausal women, and studies comparing bone microarchitecture between individuals with and without obesity.<h4>Systematic review registration number</h4>CRD42020159189.
format article
author Anne-Frédérique Turcotte
Sarah O'Connor
Suzanne N Morin
Jenna C Gibbs
Bettina M Willie
Sonia Jean
Claudia Gagnon
author_facet Anne-Frédérique Turcotte
Sarah O'Connor
Suzanne N Morin
Jenna C Gibbs
Bettina M Willie
Sonia Jean
Claudia Gagnon
author_sort Anne-Frédérique Turcotte
title Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.
title_short Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.
title_full Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.
title_fullStr Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.
title_full_unstemmed Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis.
title_sort association between obesity and risk of fracture, bone mineral density and bone quality in adults: a systematic review and meta-analysis.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/e8563bb57c5240d38964833c3ed711e6
work_keys_str_mv AT annefrederiqueturcotte associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
AT sarahoconnor associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
AT suzannenmorin associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
AT jennacgibbs associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
AT bettinamwillie associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
AT soniajean associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
AT claudiagagnon associationbetweenobesityandriskoffracturebonemineraldensityandbonequalityinadultsasystematicreviewandmetaanalysis
_version_ 1718375335870857216

Ejemplares similares