Weight Loss ^^^ Hip Fracture Risk

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Hi folks:

It looks like this is something people on CRON need to pay attention

to:

" Intentional and unintentional weight loss increase bone loss and hip

fracture risk in older women.

Ensrud KE, Ewing SK, Stone KL, Cauley JA, Bowman PJ, Cummings SR;

Study of Osteoporotic Fractures Research Group.

Department of Medicine and Center for Chronic Disease Outcomes

Research, VA Medical Center, Minneapolis, Minnesota 55417, USA.

ensru001@...

OBJECTIVES: To test the hypothesis that unintentional weight loss

increases the rate of bone loss and risk of hip fracture more than

intentional weight loss. DESIGN: Prospective cohort study. SETTING:

Four communities within the United States. PARTICIPANTS: Six thousand

seven hundred eighty-five elderly white women with measurement of

weight change and assessment of intention to lose weight.

MEASUREMENTS: Weight change between baseline and fourth examinations

(average 5.7 years between examinations) and assessment of intention

to lose weight. Weight loss was defined as a decrease of 5% or more

from baseline weight, stable weight was defined as less than a 5%

change from baseline weight, and weight gain was defined as an

increase of 5% or more from baseline weight. Rate of change in bone

mineral density at the hip between fourth and sixth examinations

(average 4.4 years between examinations) was measured using dual-

energy x-ray absorptiometry. Incident hip fractures occurring after

the fourth examination until June 1, 2001 (average follow-up 6.6

years) was confirmed using radiographic reports. RESULTS: The

adjusted average rate of decline in total hipbone density steadily

increased from -0.52% per year in women with weight gain to -0.68%

per year in women with stable weight to -0.92% per year in women with

weight loss (P-value for trend <.001). Higher rates of hip-bone loss

were observed in women with weight loss irrespective of body mass

index (BMI) or intention to lose weight. During follow-up of an

average 6.6 years after the fourth examination, 400 (6%) of the

cohort suffered a first hip fracture. Women with weight loss had 1.8

times the risk (95% confidence interval (CI)=1.43-2.24) of subsequent

hip fracture as those with stable or increasing weight. The

association between weight loss and increased risk of hip fracture

was consistent across categories of BMI and intention to lose weight.

Even voluntary weight loss in overweight women with a BMI of 25.9

kg/m2 (median) or greater increased the risk of hip fracture

(multivariate hazard ratio=2.48, 95% CI=1.33-4.62). CONCLUSION: Older

women who experience weight loss in later years have increased rates

of hip-bone loss and a two-fold greater risk of subsequent hip

fracture, irrespective of current weight or intention to lose weight.

These findings indicate that even voluntary weight loss in overweight

elderly women increases hip fracture risk.

Publication Types:

Clinical Trial

PMID: 14687352 [PubMed - indexed for MEDLINE] "

Rodney.