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Bone mineral density and hip fracture by body mass index.

机译：骨矿物质密度和髋部骨折的体重指数。

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摘要

Research on the intersection of obesity and bone-related outcome such as osteoporosis and fracture risk is of significant public health concern as older adults will represent 20% of the US population by 2030; the majority of whom will have either or both conditions. The mechanical loading of extra weight is assumed to prevent osteoporosis and risk of fracture. However, half of all hip fractures occur among overweight or obese older adults. Many cross-sectional studies, including Paper 1 of this dissertation, find a protective effect of obesity on osteoporosis. Paper 1, using linear regression models and data from the National Health and Nutrition Examination Survey (NHANES 2005-2008) for adults ages ≥50 (n=3,296) found every unit increase in body mass index (BMI) was associated with a 0.0082 g/cm2 increase in bone mineral density (BMD). However, Paper 2 of this dissertation using longitudinal data shows that obese older adults lose more bone density over time. Using multivariable generalized estimating equations and 10 years of data from 2,570 older adults in the Health, Aging, and Body Composition Study found that obese older adults lost 0.002 g/cm2 of femoral neck BMD per year more compared with normal weight older adults (p<0.001). Prior literature on obesity and risk of fracture is mixed, although the majority of studies, as well as Paper 3, find obesity to be protective against hip fracture risk. Cox proportional hazard models and data from 2,790 U.S. older adults in NHANES III linked to Medicare claims data (1991-2007) revealed obese older adults had a 15% lower risk of hip fracture (HR=0.85, 95% CI: 0.76, 0.96) while overweight older adults had the same risk level (HR=0.94, 95% CI: 0.85, 1.04) compared to normal weight older adults. The main strength of this dissertation was the comprehensive examination of obesity and bone-related outcomes using large diverse samples of older adults and multiple statistical methods. Future research should consider other measures of body composition and bone strength. Understanding the complex relationship between body mass, bone mass, and risk of fracture is pertinent, particularly as the majority of older adults are either overweight or obese.
机译：肥胖与骨骼相关结局（如骨质疏松症和骨折风险）的交叉研究对公共健康至关重要，因为到2030年，老年人将占美国人口的20％；他们中的大多数将有一个或两个条件。假定超重的机械负载可防止骨质疏松症和骨折风险。但是，所有髋部骨折的一半发生在超重或肥胖的老年人中。许多横断面研究，包括本论文的论文1，发现肥胖对骨质疏松症具有保护作用。论文1，使用线性回归模型和国家健康与营养检查调查（NHANES 2005-2008）中≥50岁（n = 3,296）成年人的数据发现，每单位体重指数（BMI）的增加与0.0082 g / cm2的骨矿物质密度（BMD）增加。然而，本论文的第二篇使用纵向数据显示，肥胖的老年人会随着时间的流逝失去更多的骨密度。在健康，老龄化和身体成分研究中，使用多变量广义估计方程和来自2,570名老年人的10年数据，发现肥胖的老年人比正常体重的老年人每年损失0.002 g / cm2的股骨颈BMD（p < 0.001）。尽管大多数研究以及论文3都发现肥胖可以预防髋部骨折的风险，但有关肥胖和骨折风险的现有文献不一。 Cox比例风险模型和NHANES III中来自2,790名美国老年人的数据与Medicare索赔数据（1991-2007年）相关，显示肥胖的老年人髋部骨折风险降低15％（HR = 0.85，95％CI：0.76，0.96）与正常体重的老年人相比，超重的老年人具有相同的风险水平（HR = 0.94，95％CI：0.85，1.04）。本论文的主要优势是使用大量的老年人样本和多种统计方法对肥胖和与骨相关的结果进行全面检查。未来的研究应考虑身体成分和骨骼强度的其他指标。了解体重，骨量和骨折风险之间的复杂关系非常重要，特别是因为大多数老年人超重或肥胖。

著录项

  • 作者

    Lloyd, Jennifer Tower.;

  • 作者单位

    University of Maryland, Baltimore.;

  • 授予单位 University of Maryland, Baltimore.;
  • 学科 Gerontology.;Health Sciences Aging.;Health Sciences Epidemiology.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 143 p.
  • 总页数 143
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 地球物理学;
  • 关键词

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