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Body Fat Percentage and the Long-term Risk of Fractures. The EPIC-Norfolk Prospective Population Cohort Study

Pana TA 1 , Kioh SH 2 , Neal SR 3 , Tan MP 4 , Mat S 5 , Moayyeri A 6 Show all authors , Luben RN 7 , Wareham NJ 8 , Khaw KT 7 , Myint PK 3

Affiliations 

  • 1 Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom. Electronic address: tiberiupana12@gmail.com
  • 2 Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom; Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
  • 3 Ageing Clinical & Experimental Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
  • 4 Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Malaysia
  • 5 Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; Center of Healthy Ageing and Wellness, Faculty of Health Sciences, National University of Malaysia, Malaysia
  • 6 University College London, London, United Kingdom
  • 7 Gonville and Caius College, University of Cambridge, United Kingdom
  • 8 MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, United Kingdom
Maturitas, 2023 Feb;168:71-77.
PMID: 36502648 DOI: 10.1016/j.maturitas.2022.11.005

Abstract

BACKGROUND: This cohort study aimed to determine the association between body fat percentage (BF%), incident fractures and calcaneal broadband ultrasound attenuation (BUA).

METHODS: Participants were drawn from the EPIC-Norfolk Prospective Population Cohort Study (median follow-up = 16.4 years). Cox models analysed the relationship between BF% and incident fractures (all and hip). Linear and restricted cubic spline (RCS) regressions modelled the relationship between BF% and BUA.

RESULTS: 14,129 participants (56.2 % women) were included. There were 1283 and 537 incident all and hip fractures respectively. The participants had a mean (standard deviation) age of 61.5 (9.0) years for women and 62.9 (9.0) years for men. Amongst men, BF% was not associated with incident all fractures. While BF%  23 % was associated with increased risk of hip fractures by up to 50 % (hazard ratio (95 % confidence interval) = 1.49 (1.06-2.12)). In women, BF%  35 % was not associated with this outcome. Higher BF% was associated with lower risk of incident hip fractures in women. Higher BF% was associated with higher BUA amongst women. Higher BF% up to ~23 % was associated with higher BUA amongst men.

CONCLUSIONS: Higher BF% is associated with lower risk of fractures in women. While there was no association between BF% and all fractures in men, increasing BF% >23 % was associated with higher risk of hip fractures in men. This appears to be independent of estimated bone mineral density. Fracture prevention efforts need to consider wider physical, clinical, and environmental factors.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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