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Association between obesity and femoral neck strength according to age, sex, and fat distribution

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Abstract

Summary

Indicators of total and abdominal obesity were negatively associated with femoral neck strength indices. There are age-, sex-, and fat distribution-specific differences in the magnitude of these associations. These suggested that indicators of obesity with different magnitude according to age, sex, and fat distribution associated with poor bone health.

Introduction

Fat regulates bone metabolism, but the associations of total and abdominal obesity with bone health are inconsistent. We investigated the association between indicators of obesity and composite indices of femoral neck (FN) strength reflecting the risk of hip fracture.

Methods

This population-based cross-sectional study examined data from the Korea National Health and Nutrition Examination Surveys. Participants were divided into groups according to age (25–49/≥50 years) and sex. We examined total fat mass (TFM) and percentage fat mass (pFM) as indicators of total obesity and truncal fat mass (TrFM) as an indicator of abdominal obesity. We calculated the composite indices of FN strength and anthropometric clinical indicators of abdominal obesity.

Results

TFM, pFM, and TrFM were negatively associated with the composite indices, irrespective of age and sex (P < 0.001–0.005). Most anthropometric clinical indicators of abdominal obesity showed negative associations with the composite indices regardless of age and sex (P < 0.001–0.048), except for women aged 25–49 years. In men, magnitudes of the negative contributions of TFM to the composite indices were significantly stronger at age 25–49 years than at age ≥50 years. Magnitudes of negative associations of TFM with the composite indices were greater in men than in women. TrFM had a more detrimental effect than TFM on FN strength in men aged 25–49 years and in women of both ages.

Conclusion

Indicators of total and abdominal obesity negatively associated with FN strength, and magnitudes of their effects on bone health differed according to age, sex, and fat distribution.

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Abbreviations

BMD:

Bone mineral density

FN:

Femoral neck

FNW:

Femoral neck width

HAL:

Hip axis length

FM:

Fat mass

TFM:

Total fat mass

pFM:

Percentage fat mass

TrFM:

Truncal fat mass

KNHANES:

Korea National Health and Nutrition Examination Surveys

eGFR:

Estimated glomerular filtration rate

WC:

Waist circumference

BMI:

Body mass index

TG:

Triglyceride

HDL-C:

High-density lipoprotein cholesterol

25(OH)D:

25-Hydroxyvitamin D

DXA:

Dual-energy X-ray absorptiometry

HSA:

Hip structure analysis

VAI:

Visceral adiposity index

C index:

Conicity index

WHtR:

Waist-to-height ratio

SI:

Strength index

VIF:

Variance inflation factor

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Acknowledgements

This study was supported by a grant (2014-1215) from the Asan Institute for Life Sciences, Seoul, Republic of Korea, and by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (project no.: HI14C2258).

Author information

Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, South Korea

    H. Kim, S. H. Lee, B. J. Kim & J. M. Koh

  2. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, South Korea

    S. H. Lee

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Correspondence to S. H. Lee.

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All participants in the KNHANES survey provided informed consent.

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Kim, H., Lee, S.H., Kim, B.J. et al. Association between obesity and femoral neck strength according to age, sex, and fat distribution. Osteoporos Int 28, 2137–2146 (2017). https://doi.org/10.1007/s00198-017-4015-2

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