Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax

Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax Publisher Pubmed

Harvey NC ; Johansson H ; Mccloskey EV ; Liu E ; Akesson KE ; Anderson FA ; Azagraledesma R ; Bager CL ; Beaudart C ; Bischoffferrari HA ; Biver E ; Bruyere O ; Cauley JA ; Center JR Show All Authors

Harvey NC
Johansson H
Mccloskey EV
Liu E
Akesson KE
Anderson FA
Azagraledesma R
Bager CL
Beaudart C
Bischoffferrari HA
Biver E
Bruyere O
Cauley JA
Center JR
Chapurlat R
Christiansen C
Cooper C
Crandall CJ
Cummings SR
Da Silva JAP
Dawsonhughes B
Diezperez A
Dufour AB
Eisman JA
Elders PJM
Ferrari S
Fujita Y
Fujiwara S
Gluer CC
Goldshtein I
Goltzman D
Gudnason V
Hall J
Hans D
Hoff M
Hollick RJ
Huisman M
Iki M
Ishshalom S
Jones G
Karlsson MK
Khosla S
Kiel DP
Koh WP
Koromani F
Kotowicz MA
Kroger H
Kwok T
Lamy O
Langhammer A
Larijani B
Lippuner K
Mcguigan FEA
Mellstrom D
Merlijn T
Nguyen TV
Nordstrom A
Nordstrom P
Oneill TW
Obermayerpietsch B
Ohlsson C
Orwoll ES
Pasco JA
Rivadeneira F
Schei B
Schott AM
Shiroma EJ
Siggeirsdottir K
Simonsick EM
Sornayrendu E
Sund R
Swart KMA
Szulc P
Tamaki J
Torgerson DJ
Van Schoor NM
Van Staa TP
Vila J
Wareham NJ
Wright NC
Yoshimura N
Zillikens MC
Zwartsalmeron M
Vandenput L
Lorentzon M
Leslie WD
Kanis JA

Source: Journal of Bone and Mineral Research Published:2025

Abstract

The aim of this international meta-analysis was to quantify the predictive value of BMI for incident fracture and relationship of this risk with age, sex, follow-up time, and BMD. A total of 1667922 men and women from 32 countries (63 cohorts), followed for a total of 16.0 million person-years were studied. 293325 had FN BMD measured (2.2 million person-years follow-up). An extended Poisson model in each cohort was used to investigate relationships between WHO-defined BMI categories (Underweight: <18.5 kg/m2; Normal: 18.5-24.9 kg/m2; Overweight: 25.0-29.9 kg/m2; Obese I: 30.0-34.9 kg/m2; Obese II: ≥35.0 kg/m2) and risk of incident osteoporotic, major osteoporotic and hip fracture (HF). Inverse-variance weighted β-coefficients were used to merge the cohort-specific results. For the subset with BMD available, in models adjusted for age and follow-up time, the hazard ratio (95% CI) for HF comparing underweight with normal weight was 2.35 (2.10-2.60) in women and for men was 2.45 (1.90-3.17). Hip fracture risk was lower in overweight and obese categories compared to normal weight [obese II vs normal: women 0.66 (0.55-0.80); men 0.91 (0.66-1.26)]. Further adjustment for FN BMD T-score attenuated the increased risk associated with underweight [underweight vs normal: women 1.69 (1.47-1.96); men 1.46 (1.00-2.13)]. In these models, the protective effects of overweight and obesity were attenuated, and in both sexes, the direction of association reversed to higher fracture risk in Obese II category [Obese II vs Normal: women 1.24 (0.97-1.58); men 1.70 (1.06-2.75)]. Results were similar for other fracture outcomes. Underweight is a risk factor for fracture in both men and women regardless of adjustment for BMD. However, while overweight/obesity appeared protective in base models, they became risk factors after additional adjustment for FN BMD, particularly in the Obese II category. This effect in the highest BMI categories was of greater magnitude in men than women. These results will inform the second iteration of FRAX®. © 2025 Elsevier B.V., All rights reserved.

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Style	Citing Format
MLA	Harvey NC, et al.. "Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax." Journal of Bone and Mineral Research, vol. 40, no. 10, 2025, pp. 1144-1155.
APA	Harvey NC, Johansson H, Mccloskey EV, Liu E, Akesson KE, Anderson FA, Azagraledesma R, Bager CL, Beaudart C, Bischoffferrari HA, Biver E, Bruyere O, Cauley JA, Center JR, Chapurlat R, Christiansen C, Cooper C, Crandall CJ, Cummings SR, ... Kanis JA (2025). Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax. Journal of Bone and Mineral Research, 40(10), 1144-1155.
Chicago	Harvey NC, Johansson H, Mccloskey EV, Liu E, Akesson KE, Anderson FA, Azagraledesma R, et al.. "Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax." Journal of Bone and Mineral Research 40, no. 10 (2025): 1144-1155.
Harvard	Harvey NC et al. (2025) 'Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax', Journal of Bone and Mineral Research, 40(10), pp. 1144-1155.
Vancouver	Harvey NC, Johansson H, Mccloskey EV, Liu E, Akesson KE, Anderson FA, et al.. Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax. Journal of Bone and Mineral Research. 2025;40(10):1144-1155.
BibTex	@article{ author = {Harvey NC and Johansson H and Mccloskey EV and Liu E and Akesson KE and Anderson FA and Azagraledesma R and Bager CL and Beaudart C and Bischoffferrari HA and Biver E and Bruyere O and Cauley JA and Center JR and Chapurlat R and Christiansen C and Cooper C and Crandall CJ and Cummings SR and Da Silva JAP and Dawsonhughes B and Diezperez A and Dufour AB and Eisman JA and Elders PJM and Ferrari S and Fujita Y and Fujiwara S and Gluer CC and Goldshtein I and Goltzman D and Gudnason V and Hall J and Hans D and Hoff M and Hollick RJ and Huisman M and Iki M and Ishshalom S and Jones G and Karlsson MK and Khosla S and Kiel DP and Koh WP and Koromani F and Kotowicz MA and Kroger H and Kwok T and Lamy O and Langhammer A and Larijani B and Lippuner K and Mcguigan FEA and Mellstrom D and Merlijn T and Nguyen TV and Nordstrom A and Nordstrom P and Oneill TW and Obermayerpietsch B and Ohlsson C and Orwoll ES and Pasco JA and Rivadeneira F and Schei B and Schott AM and Shiroma EJ and Siggeirsdottir K and Simonsick EM and Sornayrendu E and Sund R and Swart KMA and Szulc P and Tamaki J and Torgerson DJ and Van Schoor NM and Van Staa TP and Vila J and Wareham NJ and Wright NC and Yoshimura N and Zillikens MC and Zwartsalmeron M and Vandenput L and Lorentzon M and Leslie WD and Kanis JA}, title = {Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax}, journal = {Journal of Bone and Mineral Research}, volume = {40}, number = {10}, pages = {1144-1155}, year = {2025} }
RIS	TY - JOUR AU - Harvey NC AU - Johansson H AU - Mccloskey EV AU - Liu E AU - Akesson KE AU - Anderson FA AU - Azagraledesma R AU - Bager CL AU - Beaudart C AU - Bischoffferrari HA AU - Biver E AU - Bruyere O AU - Cauley JA AU - Center JR AU - Chapurlat R AU - Christiansen C AU - Cooper C AU - Crandall CJ AU - Cummings SR AU - Da Silva JAP AU - Dawsonhughes B AU - Diezperez A AU - Dufour AB AU - Eisman JA AU - Elders PJM AU - Ferrari S AU - Fujita Y AU - Fujiwara S AU - Gluer CC AU - Goldshtein I AU - Goltzman D AU - Gudnason V AU - Hall J AU - Hans D AU - Hoff M AU - Hollick RJ AU - Huisman M AU - Iki M AU - Ishshalom S AU - Jones G AU - Karlsson MK AU - Khosla S AU - Kiel DP AU - Koh WP AU - Koromani F AU - Kotowicz MA AU - Kroger H AU - Kwok T AU - Lamy O AU - Langhammer A AU - Larijani B AU - Lippuner K AU - Mcguigan FEA AU - Mellstrom D AU - Merlijn T AU - Nguyen TV AU - Nordstrom A AU - Nordstrom P AU - Oneill TW AU - Obermayerpietsch B AU - Ohlsson C AU - Orwoll ES AU - Pasco JA AU - Rivadeneira F AU - Schei B AU - Schott AM AU - Shiroma EJ AU - Siggeirsdottir K AU - Simonsick EM AU - Sornayrendu E AU - Sund R AU - Swart KMA AU - Szulc P AU - Tamaki J AU - Torgerson DJ AU - Van Schoor NM AU - Van Staa TP AU - Vila J AU - Wareham NJ AU - Wright NC AU - Yoshimura N AU - Zillikens MC AU - Zwartsalmeron M AU - Vandenput L AU - Lorentzon M AU - Leslie WD AU - Kanis JA TI - Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax JO - Journal of Bone and Mineral Research VL - 40 IS - 10 SP - 1144 EP - 1155 PY - 2025 ER -

Style

Citing Format

MLA

Harvey NC, et al.. "Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax." Journal of Bone and Mineral Research, vol. 40, no. 10, 2025, pp. 1144-1155.

APA

Harvey NC, Johansson H, Mccloskey EV, Liu E, Akesson KE, Anderson FA, Azagraledesma R, Bager CL, Beaudart C, Bischoffferrari HA, Biver E, Bruyere O, Cauley JA, Center JR, Chapurlat R, Christiansen C, Cooper C, Crandall CJ, Cummings SR, ... Kanis JA (2025). Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax. Journal of Bone and Mineral Research, 40(10), 1144-1155.

Chicago

Harvey NC, Johansson H, Mccloskey EV, Liu E, Akesson KE, Anderson FA, Azagraledesma R, et al.. "Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax." Journal of Bone and Mineral Research 40, no. 10 (2025): 1144-1155.

Harvard

Harvey NC et al. (2025) 'Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax', Journal of Bone and Mineral Research, 40(10), pp. 1144-1155.

Vancouver

Harvey NC, Johansson H, Mccloskey EV, Liu E, Akesson KE, Anderson FA, et al.. Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax. Journal of Bone and Mineral Research. 2025;40(10):1144-1155.

BibTex

@article{ author = {Harvey NC and Johansson H and Mccloskey EV and Liu E and Akesson KE and Anderson FA and Azagraledesma R and Bager CL and Beaudart C and Bischoffferrari HA and Biver E and Bruyere O and Cauley JA and Center JR and Chapurlat R and Christiansen C and Cooper C and Crandall CJ and Cummings SR and Da Silva JAP and Dawsonhughes B and Diezperez A and Dufour AB and Eisman JA and Elders PJM and Ferrari S and Fujita Y and Fujiwara S and Gluer CC and Goldshtein I and Goltzman D and Gudnason V and Hall J and Hans D and Hoff M and Hollick RJ and Huisman M and Iki M and Ishshalom S and Jones G and Karlsson MK and Khosla S and Kiel DP and Koh WP and Koromani F and Kotowicz MA and Kroger H and Kwok T and Lamy O and Langhammer A and Larijani B and Lippuner K and Mcguigan FEA and Mellstrom D and Merlijn T and Nguyen TV and Nordstrom A and Nordstrom P and Oneill TW and Obermayerpietsch B and Ohlsson C and Orwoll ES and Pasco JA and Rivadeneira F and Schei B and Schott AM and Shiroma EJ and Siggeirsdottir K and Simonsick EM and Sornayrendu E and Sund R and Swart KMA and Szulc P and Tamaki J and Torgerson DJ and Van Schoor NM and Van Staa TP and Vila J and Wareham NJ and Wright NC and Yoshimura N and Zillikens MC and Zwartsalmeron M and Vandenput L and Lorentzon M and Leslie WD and Kanis JA}, title = {Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax}, journal = {Journal of Bone and Mineral Research}, volume = {40}, number = {10}, pages = {1144-1155}, year = {2025} }

RIS

TY - JOUR
AU - Harvey NC
AU - Johansson H
AU - Mccloskey EV
AU - Liu E
AU - Akesson KE
AU - Anderson FA
AU - Azagraledesma R
AU - Bager CL
AU - Beaudart C
AU - Bischoffferrari HA
AU - Biver E
AU - Bruyere O
AU - Cauley JA
AU - Center JR
AU - Chapurlat R
AU - Christiansen C
AU - Cooper C
AU - Crandall CJ
AU - Cummings SR
AU - Da Silva JAP
AU - Dawsonhughes B
AU - Diezperez A
AU - Dufour AB
AU - Eisman JA
AU - Elders PJM
AU - Ferrari S
AU - Fujita Y
AU - Fujiwara S
AU - Gluer CC
AU - Goldshtein I
AU - Goltzman D
AU - Gudnason V
AU - Hall J
AU - Hans D
AU - Hoff M
AU - Hollick RJ
AU - Huisman M
AU - Iki M
AU - Ishshalom S
AU - Jones G
AU - Karlsson MK
AU - Khosla S
AU - Kiel DP
AU - Koh WP
AU - Koromani F
AU - Kotowicz MA
AU - Kroger H
AU - Kwok T
AU - Lamy O
AU - Langhammer A
AU - Larijani B
AU - Lippuner K
AU - Mcguigan FEA
AU - Mellstrom D
AU - Merlijn T
AU - Nguyen TV
AU - Nordstrom A
AU - Nordstrom P
AU - Oneill TW
AU - Obermayerpietsch B
AU - Ohlsson C
AU - Orwoll ES
AU - Pasco JA
AU - Rivadeneira F
AU - Schei B
AU - Schott AM
AU - Shiroma EJ
AU - Siggeirsdottir K
AU - Simonsick EM
AU - Sornayrendu E
AU - Sund R
AU - Swart KMA
AU - Szulc P
AU - Tamaki J
AU - Torgerson DJ
AU - Van Schoor NM
AU - Van Staa TP
AU - Vila J
AU - Wareham NJ
AU - Wright NC
AU - Yoshimura N
AU - Zillikens MC
AU - Zwartsalmeron M
AU - Vandenput L
AU - Lorentzon M
AU - Leslie WD
AU - Kanis JA
TI - Body Mass Index and Subsequent Fracture Risk: A Meta-Analysis to Update Frax
JO - Journal of Bone and Mineral Research
VL - 40
IS - 10
SP - 1144
EP - 1155
PY - 2025
ER -

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