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Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses

BACKGROUND: Obesity is protective of bone health; however, abdominal obesity is associated with a higher fracture risk. Little is known about whether body composition protects or adversely affects osteoporotic fractures because of practical issues regarding assessment tools. This study aimed to eval...

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Autores principales: Hong, Changbin, Choi, Seulggie, Park, Minseon, Park, Sang Min, Lee, Gyeongsil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718033/
https://www.ncbi.nlm.nih.gov/pubmed/34706399
http://dx.doi.org/10.1002/jcsm.12850
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author Hong, Changbin
Choi, Seulggie
Park, Minseon
Park, Sang Min
Lee, Gyeongsil
author_facet Hong, Changbin
Choi, Seulggie
Park, Minseon
Park, Sang Min
Lee, Gyeongsil
author_sort Hong, Changbin
collection PubMed
description BACKGROUND: Obesity is protective of bone health; however, abdominal obesity is associated with a higher fracture risk. Little is known about whether body composition protects or adversely affects osteoporotic fractures because of practical issues regarding assessment tools. This study aimed to evaluate the association of predicted body composition with fracture risk to determine the distinctive and differing effects of muscle or fat mass on bone health outcomes in the general population. METHODS: This population‐based, longitudinal cohort study used 2009–2010 Korean National Health Insurance Service data and follow‐up data from 1 January 2011 to 31 December 2013, to determine the incidence of osteoporotic fracture (total, spine, and non‐spine) defined using the International Classification of Diseases, Tenth Revision codes. The study participants were aged ≥50 years (men, 158 426; women, 131 587). The predicted lean body mass index (pLBMI), appendicular skeletal muscle index (pASMI), and body fat mass index (pBFMI) were used to assess body composition, using anthropometric prediction equations. RESULTS: Over a 3 year follow‐up, we identified 2350 and 6175 fractures in men and women, respectively. The mean age of the participants was 60.2 ± 8.3 and 60.7 ± 8.4 years in men and women, respectively. In a multivariable‐adjusted Cox proportional hazards regression model, increasing pLBMI or pASMI was significantly associated with a decreased risk of total fractures in men and women. When comparing individuals in the lowest pLBMI and pASMI (reference groups), men with the highest pLBMI and pASMI had adjusted hazard ratios of 0.63 [95% confidence interval (CI) 0.47–0.83] and 0.62 (95% CI 0.47–0.82), and women with the highest pLBMI and pASMI had adjusted hazard ratios of 0.72 (95% CI 0.60–0.85) and 0.71 (95% CI 0.60–0.85), respectively, for total fractures. The pBFMI had no significant association with total fractures in men or women. Regarding sex‐specific or site‐specific differences, the protective effects of the pLBMI and pASMI on fractures were greater in men and reduced the risk of spinal fractures. An increased pBFMI was associated with an increased risk of spinal fractures in women. CONCLUSIONS: An increased pLBMI or pASMI was significantly associated with decreased total osteoporotic fracture risk; however, the pBFMI showed no statistically significant association. Muscle mass was more important than fat mass in preventing future osteoporotic fractures based on anthropometric prediction equations.
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spelling pubmed-87180332022-01-06 Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses Hong, Changbin Choi, Seulggie Park, Minseon Park, Sang Min Lee, Gyeongsil J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: Obesity is protective of bone health; however, abdominal obesity is associated with a higher fracture risk. Little is known about whether body composition protects or adversely affects osteoporotic fractures because of practical issues regarding assessment tools. This study aimed to evaluate the association of predicted body composition with fracture risk to determine the distinctive and differing effects of muscle or fat mass on bone health outcomes in the general population. METHODS: This population‐based, longitudinal cohort study used 2009–2010 Korean National Health Insurance Service data and follow‐up data from 1 January 2011 to 31 December 2013, to determine the incidence of osteoporotic fracture (total, spine, and non‐spine) defined using the International Classification of Diseases, Tenth Revision codes. The study participants were aged ≥50 years (men, 158 426; women, 131 587). The predicted lean body mass index (pLBMI), appendicular skeletal muscle index (pASMI), and body fat mass index (pBFMI) were used to assess body composition, using anthropometric prediction equations. RESULTS: Over a 3 year follow‐up, we identified 2350 and 6175 fractures in men and women, respectively. The mean age of the participants was 60.2 ± 8.3 and 60.7 ± 8.4 years in men and women, respectively. In a multivariable‐adjusted Cox proportional hazards regression model, increasing pLBMI or pASMI was significantly associated with a decreased risk of total fractures in men and women. When comparing individuals in the lowest pLBMI and pASMI (reference groups), men with the highest pLBMI and pASMI had adjusted hazard ratios of 0.63 [95% confidence interval (CI) 0.47–0.83] and 0.62 (95% CI 0.47–0.82), and women with the highest pLBMI and pASMI had adjusted hazard ratios of 0.72 (95% CI 0.60–0.85) and 0.71 (95% CI 0.60–0.85), respectively, for total fractures. The pBFMI had no significant association with total fractures in men or women. Regarding sex‐specific or site‐specific differences, the protective effects of the pLBMI and pASMI on fractures were greater in men and reduced the risk of spinal fractures. An increased pBFMI was associated with an increased risk of spinal fractures in women. CONCLUSIONS: An increased pLBMI or pASMI was significantly associated with decreased total osteoporotic fracture risk; however, the pBFMI showed no statistically significant association. Muscle mass was more important than fat mass in preventing future osteoporotic fractures based on anthropometric prediction equations. John Wiley and Sons Inc. 2021-10-27 2021-12 /pmc/articles/PMC8718033/ /pubmed/34706399 http://dx.doi.org/10.1002/jcsm.12850 Text en © 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Hong, Changbin
Choi, Seulggie
Park, Minseon
Park, Sang Min
Lee, Gyeongsil
Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
title Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
title_full Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
title_fullStr Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
title_full_unstemmed Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
title_short Body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
title_sort body composition and osteoporotic fracture using anthropometric prediction equations to assess muscle and fat masses
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718033/
https://www.ncbi.nlm.nih.gov/pubmed/34706399
http://dx.doi.org/10.1002/jcsm.12850
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