Fracture risk in Korean postmenopausal women: The influence of BMI, age, and bone density
Fracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors. This retrospective cohort study analyzed 18,151 Korean postmenopausal women aged...
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| Published in: | Osteoporosis and Sarcopenia Vol. 11; no. 2; pp. 65 - 68 |
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01.06.2025
Korean Society of Osteoporosis Elsevier 대한골다공증학회 |
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| Abstract | Fracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors.
This retrospective cohort study analyzed 18,151 Korean postmenopausal women aged 50 or older who underwent dual-energy X-ray absorptiometry (DXA) at Ajou University Hospital from years of 2006–2014. Fracture risk was assessed using multivariable Cox proportional hazard models, adjusted for BMI, BMD, and age.
The median age of the cohort was 59.1 years, and the overall fracture incidence was 2.3 per 1,000 person-years. Fracture risk significantly increased with age, with hazard ratios (HRs) of 1.36 (95% CI: 1.08–1.70) for women aged 60–69 and 2.10% (95% CI: 1.62–2.73) for those aged 70 or older, compared to the reference group (50–59 years). Underweight women exhibited the highest fracture cumulative incidence (3.3%), though their risk increase was not statistically significant. Overweight and obese women demonstrated higher BMD but did not show significant fracture risk reductions.
These findings highlight age as a dominant predictor of fracture risk, while BMI plays a complex, less pronounced role. The discrepancy between osteoporosis prevalence and actual fracture risk, particularly in obese elderly women, suggests limitations in BMD-focused assessments. Simple, measurable parameters like age and BMI should complement BMD in fracture risk evaluation to better target high-risk populations and enhance preventive strategies in clinical practice. |
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| AbstractList | Objectives: Fracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors. Methods: This retrospective cohort study analyzed 18,151 Korean postmenopausal women aged 50 or older who underwent dual-energy X-ray absorptiometry (DXA) at Ajou University Hospital from years of 2006–2014. Fracture risk was assessed using multivariable Cox proportional hazard models, adjusted for BMI, BMD, and age. Results: The median age of the cohort was 59.1 years, and the overall fracture incidence was 2.3 per 1,000 person-years. Fracture risk significantly increased with age, with hazard ratios (HRs) of 1.36 (95% CI: 1.08–1.70) for women aged 60–69 and 2.10% (95% CI: 1.62–2.73) for those aged 70 or older, compared to the reference group (50–59 years). Underweight women exhibited the highest fracture cumulative incidence (3.3%), though their risk increase was not statistically significant. Overweight and obese women demonstrated higher BMD but did not show significant fracture risk reductions. Conclusions: These findings highlight age as a dominant predictor of fracture risk, while BMI plays a complex, less pronounced role. The discrepancy between osteoporosis prevalence and actual fracture risk, particularly in obese elderly women, suggests limitations in BMD-focused assessments. Simple, measurable parameters like age and BMI should complement BMD in fracture risk evaluation to better target high-risk populations and enhance preventive strategies in clinical practice. Fracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors. This retrospective cohort study analyzed 18,151 Korean postmenopausal women aged 50 or older who underwent dual-energy X-ray absorptiometry (DXA) at Ajou University Hospital from years of 2006–2014. Fracture risk was assessed using multivariable Cox proportional hazard models, adjusted for BMI, BMD, and age. The median age of the cohort was 59.1 years, and the overall fracture incidence was 2.3 per 1,000 person-years. Fracture risk significantly increased with age, with hazard ratios (HRs) of 1.36 (95% CI: 1.08–1.70) for women aged 60–69 and 2.10% (95% CI: 1.62–2.73) for those aged 70 or older, compared to the reference group (50–59 years). Underweight women exhibited the highest fracture cumulative incidence (3.3%), though their risk increase was not statistically significant. Overweight and obese women demonstrated higher BMD but did not show significant fracture risk reductions. These findings highlight age as a dominant predictor of fracture risk, while BMI plays a complex, less pronounced role. The discrepancy between osteoporosis prevalence and actual fracture risk, particularly in obese elderly women, suggests limitations in BMD-focused assessments. Simple, measurable parameters like age and BMI should complement BMD in fracture risk evaluation to better target high-risk populations and enhance preventive strategies in clinical practice. Fracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors.ObjectivesFracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors.This retrospective cohort study analyzed 18,151 Korean postmenopausal women aged 50 or older who underwent dual-energy X-ray absorptiometry (DXA) at Ajou University Hospital from years of 2006-2014. Fracture risk was assessed using multivariable Cox proportional hazard models, adjusted for BMI, BMD, and age.MethodsThis retrospective cohort study analyzed 18,151 Korean postmenopausal women aged 50 or older who underwent dual-energy X-ray absorptiometry (DXA) at Ajou University Hospital from years of 2006-2014. Fracture risk was assessed using multivariable Cox proportional hazard models, adjusted for BMI, BMD, and age.The median age of the cohort was 59.1 years, and the overall fracture incidence was 2.3 per 1,000 person-years. Fracture risk significantly increased with age, with hazard ratios (HRs) of 1.36 (95% CI: 1.08-1.70) for women aged 60-69 and 2.10% (95% CI: 1.62-2.73) for those aged 70 or older, compared to the reference group (50-59 years). Underweight women exhibited the highest fracture cumulative incidence (3.3%), though their risk increase was not statistically significant. Overweight and obese women demonstrated higher BMD but did not show significant fracture risk reductions.ResultsThe median age of the cohort was 59.1 years, and the overall fracture incidence was 2.3 per 1,000 person-years. Fracture risk significantly increased with age, with hazard ratios (HRs) of 1.36 (95% CI: 1.08-1.70) for women aged 60-69 and 2.10% (95% CI: 1.62-2.73) for those aged 70 or older, compared to the reference group (50-59 years). Underweight women exhibited the highest fracture cumulative incidence (3.3%), though their risk increase was not statistically significant. Overweight and obese women demonstrated higher BMD but did not show significant fracture risk reductions.These findings highlight age as a dominant predictor of fracture risk, while BMI plays a complex, less pronounced role. The discrepancy between osteoporosis prevalence and actual fracture risk, particularly in obese elderly women, suggests limitations in BMD-focused assessments. Simple, measurable parameters like age and BMI should complement BMD in fracture risk evaluation to better target high-risk populations and enhance preventive strategies in clinical practice.ConclusionsThese findings highlight age as a dominant predictor of fracture risk, while BMI plays a complex, less pronounced role. The discrepancy between osteoporosis prevalence and actual fracture risk, particularly in obese elderly women, suggests limitations in BMD-focused assessments. Simple, measurable parameters like age and BMI should complement BMD in fracture risk evaluation to better target high-risk populations and enhance preventive strategies in clinical practice. Objectives: Fracture risk in postmenopausal women is influenced by bone mineral density (BMD), age, and body mass index (BMI). However, fracture prevention strategies primarily focus on low BMD, often overlooking other key factors. Methods: This retrospective cohort study analyzed 18,151 Korean postmenopausal women aged 50 or older who underwent dual-energy X-ray absorptiometry (DXA) at Ajou University Hospital from years of 2006–2014. Fracture risk was assessed using multivariable Cox proportional hazard models, adjusted for BMI, BMD, and age. Results: The median age of the cohort was 59.1 years, and the overall fracture incidence was 2.3 per 1,000 person-years. Fracture risk significantly increased with age, with hazard ratios (HRs) of 1.36 (95% CI: 1.08–1.70) for women aged 60–69 and 2.10% (95% CI: 1.62–2.73) for those aged 70 or older, compared to the reference group (50–59 years). Underweight women exhibited the highest fracture cumulative incidence (3.3%), though their risk increase was not statistically significant. Overweight and obese women demonstrated higher BMD but did not show significant fracture risk reductions. Conclusions: These findings highlight age as a dominant predictor of fracture risk, while BMI plays a complex, less pronounced role. The discrepancy between osteoporosis prevalence and actual fracture risk, particularly in obese elderly women, suggests limitations in BMD-focused assessments. Simple, measurable parameters like age and BMI should complement BMD in fracture risk evaluation to better target high-risk populations and enhance preventive strategies in clinical practice. KCI Citation Count: 0 |
| Author | Kim, Kwang Yoon Choi, Yong Jun Lee, Sangmi Noh, O Kyu Park, Joo-hyun Shin, Junghwa Chung, Yoon-Sok Kim, Bom-Taeck |
| Author_xml | – sequence: 1 givenname: Junghwa orcidid: 0000-0002-4151-8952 surname: Shin fullname: Shin, Junghwa organization: Department of Family Medicine, Korea University College of Medicine, Ansan, South Korea – sequence: 2 givenname: Kwang Yoon orcidid: 0000-0001-9844-9540 surname: Kim fullname: Kim, Kwang Yoon organization: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, South Korea – sequence: 3 givenname: Joo-hyun orcidid: 0000-0002-4358-4208 surname: Park fullname: Park, Joo-hyun organization: Department of Family Medicine, Korea University College of Medicine, Ansan, South Korea – sequence: 4 givenname: Sangmi orcidid: 0000-0003-4121-2782 surname: Lee fullname: Lee, Sangmi organization: Pyeongtaek St. Mary's Hospital, Pyeongtaek, South Korea – sequence: 5 givenname: O Kyu orcidid: 0000-0001-9066-780X surname: Noh fullname: Noh, O Kyu organization: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea – sequence: 6 givenname: Yong Jun orcidid: 0000-0003-3960-8470 surname: Choi fullname: Choi, Yong Jun organization: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea – sequence: 7 givenname: Yoon-Sok orcidid: 0000-0003-0179-4386 surname: Chung fullname: Chung, Yoon-Sok organization: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea – sequence: 8 givenname: Bom-Taeck orcidid: 0000-0002-0395-0410 surname: Kim fullname: Kim, Bom-Taeck email: lovesong@ajou.ac.kr organization: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, South Korea |
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| Cites_doi | 10.1136/bmj.312.7041.1254 10.1136/annrheumdis-2015-207907 10.1371/journal.pone.0244759 10.1093/jbmr/zjae068 10.1007/s11606-018-4696-z 10.1359/JBMR.050504 10.1007/s00198-020-05557-z 10.1136/bmjopen-2021-049157 10.1007/s00198-005-0027-4 10.3346/jkms.2011.26.8.1087 10.1016/S2213-8587(24)00225-0 10.1359/jbmr.090722 10.1186/s12889-023-15940-0 10.1359/jbmr.070320 10.1359/JBMR.050609 10.22540/JFSF-06-086 10.1007/s001980170006 10.1093/qjmed/hch097 10.1007/s00198-017-3996-1 10.3346/jkms.2015.30.4.483 10.7570/jomes.2019.28.1.40 10.3390/jcm10091896 10.1002/jbmr.2017 10.1056/NEJM199503233321202 10.1016/j.jocd.2017.06.024 10.4158/GL-2020-0524 |
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| Keywords | Obesity Body mass index Bone mineral density Osteoporosis prevalence Fracture rate |
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| SubjectTerms | Body mass index Bone mineral density Fracture rate Obesity Original Osteoporosis prevalence 정형외과학 |
| Title | Fracture risk in Korean postmenopausal women: The influence of BMI, age, and bone density |
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