The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study
Abstract Objectives The obesity paradox is common among older adults at risk for various diseases. Although this paradox has also been observed in the association between obesity and osteoporosis, the available evidence remains controversial. This study aimed to investigate the association between o...
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2025-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-05704-3 |
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| author | Qingfeng Luo Shiyong Zhang Zixin Liang Danni Wang Yanlin Zhong Bin Xia Peng Xie Can Wang Jinqiu Yuan Ziji Zhang Xingsheng Li |
| author_facet | Qingfeng Luo Shiyong Zhang Zixin Liang Danni Wang Yanlin Zhong Bin Xia Peng Xie Can Wang Jinqiu Yuan Ziji Zhang Xingsheng Li |
| author_sort | Qingfeng Luo |
| collection | DOAJ |
| description | Abstract Objectives The obesity paradox is common among older adults at risk for various diseases. Although this paradox has also been observed in the association between obesity and osteoporosis, the available evidence remains controversial. This study aimed to investigate the association between obesity and OP risk in an older population. Methods A cross-sectional and prospective study was conducted using data from 177,734 participants in the UK Biobank. The association of body mass index (BMI), waist circumference (WC), and fat percentage with BMD was examined using Spearman correlation analysis with baseline BMD data. Cox proportional hazards regression analysis was used to investigate the association between obesity and OP risk. Restricted cubic spline (RCS) were used to assess the nonlinear associations of BMI, WC, and fat percentage with OP. Results Baseline cross-sectional analyses revealed a significant positive association between BMI, WC, and fat percentage with BMD in women, whereas this association was very weak in men. A total of 8,998 OP patients were identified during a median follow-up period of 13.7 years. Cox analyses showed that obesity as defined by BMI, WC, and fat percentage was associated with a 33%, 23%, and 31% reduction in the risk of OP in older women but not in men, respectively. Conjoint analysis showed that lower BMI was associated with increased risk of OP in older adults, whereas the lowest risk was observed in women with higher BMI and higher body fat. RCS revealed an inverse J-shaped nonlinear association between obesity metrics and OP risk in women. Conclusion Lower BMI is an independent risk factor for OP in older adults, and the obesity paradox for OP risk exists only in women. |
| format | Article |
| id | doaj-art-4368b05524ac4647ac6d42cfa5204c36 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-4368b05524ac4647ac6d42cfa5204c362025-02-02T12:41:44ZengBMCBMC Geriatrics1471-23182025-01-0125111110.1186/s12877-025-05704-3The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective studyQingfeng Luo0Shiyong Zhang1Zixin Liang2Danni Wang3Yanlin Zhong4Bin Xia5Peng Xie6Can Wang7Jinqiu Yuan8Ziji Zhang9Xingsheng Li10Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen UniversityInstitute of Inflammation and Ageing, University of BirminghamDepartment of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Gastroenterology, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Gerontology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Joint Surgery, the First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Gerontology, The Second Affiliated Hospital of Chongqing Medical UniversityAbstract Objectives The obesity paradox is common among older adults at risk for various diseases. Although this paradox has also been observed in the association between obesity and osteoporosis, the available evidence remains controversial. This study aimed to investigate the association between obesity and OP risk in an older population. Methods A cross-sectional and prospective study was conducted using data from 177,734 participants in the UK Biobank. The association of body mass index (BMI), waist circumference (WC), and fat percentage with BMD was examined using Spearman correlation analysis with baseline BMD data. Cox proportional hazards regression analysis was used to investigate the association between obesity and OP risk. Restricted cubic spline (RCS) were used to assess the nonlinear associations of BMI, WC, and fat percentage with OP. Results Baseline cross-sectional analyses revealed a significant positive association between BMI, WC, and fat percentage with BMD in women, whereas this association was very weak in men. A total of 8,998 OP patients were identified during a median follow-up period of 13.7 years. Cox analyses showed that obesity as defined by BMI, WC, and fat percentage was associated with a 33%, 23%, and 31% reduction in the risk of OP in older women but not in men, respectively. Conjoint analysis showed that lower BMI was associated with increased risk of OP in older adults, whereas the lowest risk was observed in women with higher BMI and higher body fat. RCS revealed an inverse J-shaped nonlinear association between obesity metrics and OP risk in women. Conclusion Lower BMI is an independent risk factor for OP in older adults, and the obesity paradox for OP risk exists only in women.https://doi.org/10.1186/s12877-025-05704-3ObesityObesity paradoxOsteoporosisOlder adults |
| spellingShingle | Qingfeng Luo Shiyong Zhang Zixin Liang Danni Wang Yanlin Zhong Bin Xia Peng Xie Can Wang Jinqiu Yuan Ziji Zhang Xingsheng Li The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study BMC Geriatrics Obesity Obesity paradox Osteoporosis Older adults |
| title | The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study |
| title_full | The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study |
| title_fullStr | The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study |
| title_full_unstemmed | The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study |
| title_short | The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study |
| title_sort | obesity paradox in osteoporosis risk among older adults is mostly driven by women a population based prospective study |
| topic | Obesity Obesity paradox Osteoporosis Older adults |
| url | https://doi.org/10.1186/s12877-025-05704-3 |
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