Obesity confers no protection against fractures in older men

Older men who are obese do not appear to have a lower incidence of fracture compared with their nonobese counterparts, a study has shown in a study.

Researchers followed 1,625 out of 1,705 (95.3 percent) men who had baseline anthropometric and body composition data for incident self-reported and radiographically confirmed fractures for a mean of 6.04 years. There were 168 men (10.3 percent) who developed fractures, including those of the hip in 41 (24.4 percent), of the vertebrae in 33 (19.6 percent), and nonhip and nonvertebral in 95 (60.0 percent).

Obesity prevalence was 27 percent according to body mass index (BMI ≥30 kg/m²) and 43.6 percent according to body fat percentage (≥30 percent). Obese men by body fat percentage but not BMI were more likely to report activities of daily living (ADL) disability and falls in the previous 12 months, and also to have clinically diagnosed dementia. Additionally, compared with nonobese men, those who were obese by BMI had higher handgrip strength, whereas obese men by body fat percentage tended to have lower handgrip strength.

The incidence of any fracture was similar between nonobese and obese men by BMI (10.7 percent vs 9.3 percent, respectively; p>0.05) or body fat percentage (10.2 percent vs 10.6 percent; p>0.05).

Significant interactions were seen, such that dementia increased the risk of the incidence of any and hip fracture in nonobese men (adjusted hazard ratio [aHR], 7.08, 95 percent confidence interval [CI], 3.27–15.36 and aHR, 8.36, 95 percent CI, 3.13–22.31, respectively) but not obese men.

Furthermore, past-year falls increased the risk of any fracture (aHR, 2.86, 95 percent CI, 1.60–5.10), while higher luteinizing hormone concentrations conferred protection against hip fracture (per IU/L: aHR, 0.91, 95 percent CI, 0.85–0.97) in obese but not nonobese men.

The present data suggest that evaluation of falls history and gonadotrophin levels, in addition to established clinical risk factors for fracture, may contribute to improvements in fracture prediction in older obese men, according to the researchers.