J Korean Med Sci.  2023 Feb;38(7):e48. 10.3346/jkms.2023.38.e48.

The Impact of Persistent Low Weight Status on the Occurrence of Vertebral Fractures: A Nationwide PopulationBased Cohort Study

• Park SM
• Park J
• Han S
• Jang HD
• Hong JY
• Han K
• Kim HJ
• Yeom JS

• KMID: 2539533
• DOI: http://doi.org/10.3346/jkms.2023.38.e48

Abstract

Background
Although, being underweight is commonly associated with osteoporosis and sarcopenia, its association with vertebral fractures (VFs), is less well researched. We investigated the influence of cumulative, chronic periods of low weight and changes in body weight on VF development.
Methods
We used a nationwide, population-based database with data on people (> 40 years) who attended three health screenings between January 1, 2007, and December 31, 2009 to assess the incidence of new VFs. Cox proportional hazard analyses were used to establish the hazard ratios (HRs) for new VFs based on the degree of body mass index (BMI), the cumulative numbers of underweight participants, and temporal change in weight.
Results
Of the 561,779 individuals in this analysis, 5,354 (1.0%) people were diagnosed three times, 3,672 (0.7%) were diagnosed twice, and 6,929 (1.2%) were diagnosed once. The fully adjusted HR for VFs in underweight individuals was 1.213. Underweight individuals diagnosed only once, twice, or three times had an adjusted HR of 0.904, 1.443, and 1.256, respectively. Although the adjusted HR was higher in adults who were consistently underweight, there was no difference in those who experienced a temporal change in body weight. BMI, age, sex, and household income were significantly associated with VF incidence.
Conclusion
Low weight is a risk factor for VFs in the general population. Given the significant correlation between cumulative periods of low weight and the risk of VFs, it is necessary to treat underweight patients before a VF to prevent its development and other osteoporotic fractures.

Keyword

Claim Database; Vertebral Fracture; Osteoporosis; Underweight

Figure

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  Fig. 1 Flow chart of study population.

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  Fig. 2 Incidence and hazard ratios of vertebral fractures according to several subgroups and body mass index.BMI = body mass index, CI = confidence interval.

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  Fig. 3 Incidence and hazard ratios of vertebral fractures according to several subgroups and the cumulative numbers of underweight participants.CI = confidence interval.

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