Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2023; 14(9): 720-732
Published online Sep 18, 2023. doi: 10.5312/wjo.v14.i9.720
Relationships among body weight, lipids and bone mass in elderly individuals with fractures: A case-control study
Xiang-Xu Chen, Chu-Wei Tian, Li-Yong Bai, Ya-Kuan Zhao, Cheng Zhang, Liu Shi, Yuan-Wei Zhang, Wen-Jun Xie, Huan-Yi Zhu, Hui Chen, Yun-Feng Rui
Xiang-Xu Chen, Cheng Zhang, Liu Shi, Wen-Jun Xie, Hui Chen, Yun-Feng Rui, Department of Orthopaedics, Trauma Center, Southeast University, Nanjing 210009, Jiangsu Province, China
Chu-Wei Tian, Li-Yong Bai, Ya-Kuan Zhao, Yuan-Wei Zhang, Huan-Yi Zhu, Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Author contributions: Chen XX and Tian CW contributed equally to this work; Chen XX and Tian CW designed the study, including the research questions and methodology; Bai LY, Zhao YK, Zhang C, Shi L, Zhang YW, Xie WJ, Zhu HY, Chen H asisted in study design, contributed to data collection and management; Tian CW performed data analysis, provided critical insights into data interpretation; Rui YF supervised the entire study, provided guidance on research design and took a lead in manuscript writing and revision; All authors have read and approve the final manuscript.
Supported by Jiangsu Elderly Health Research Project, No. LD2021010; Jiangsu Elderly Health Research Project, Key Project of Elderly Health Research Project, No. LKZ2022010; Open Project of National Key Professional Base for Standardized Training of Resident Physicians in Zhongda Hospital Affiliated to Southeast University, No. ZDZYJD-QK-2022-7.
Institutional review board statement: The study was reviewed and approved by the IEC for Clinical Research of Zhongda Hospital, Affiliated to Southeast University [Approval No.2022ZDSYLL183-P01].
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no competing financial interests or conflicts of interest that could have influenced the design, data collection, analysis, interpretation, or publication of this study.
Data sharing statement: The data presented in this study are available upon reasonable request to qualified researchers for the purpose of academic and scientific collaboration. Requests for data access should be directed to the corresponding author at ruiyunfeng@126.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Feng Rui, MD, PhD, Chief Doctor, Deputy Director, Professor, Surgeon, Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. ruiyunfeng@126.com
Received: July 6, 2023
Peer-review started: July 6, 2023
First decision: August 4, 2023
Revised: August 15, 2023
Accepted: August 29, 2023
Article in press: August 29, 2023
Published online: September 18, 2023
Research background

The increasing incidence of osteoporosis and low bone mass, affecting a significant portion of individuals aged 50 years or older in China, underscores the urgent need to address this public health concern. While obesity's potential protective role and the complex interplay between body mass index (BMI), lipid profiles, and bone health are subjects of recent investigation, their specific impact on populations with osteoporosis and fragility fractures remains relatively unexplored.

Research motivation

The relationship between BMI, bone mass, and lipid profiles in populations with osteoporosis and fragility fractures remains understudied.

Research objectives

This study aims to shed light on the potential impact of weight gain and lipid profiles on bone health in individuals with fragility fractures which may provide a new method for the treatment of osteoporosis.

Research methods

This retrospective study conducted at a single orthopaedic trauma center between January 2017 and December 2020 included participants aged 65 years and above with diagnosed fractures in specific region. Participants' comprehensive clinical data, including gender, age groups, BMI ranges, DXA scores, and laboratory measurements, were collected and analyzed using statistical software. Data were analyzed using IBM SPSS and GraphPad Prism software, employing t-tests, nonparametric tests, one-way ANOVA, multiple linear regression, and Pearson correlation tests (aP < 0.05, bP < 0.01, cP < 0.001, dP < 0.0001 denoting significance) after assessing normality with the Shapiro-Wilk test.

Research results

In this study involving 520 participants aged ≥ 65 years, distinct gender and age-related disparities were observed in osteoporosis prevalence and associated factors. While a significant divergence in age, sex, BMI, alkaline phosphatase (ALP), and triglyceride (TG) concentrations was noted among normal, osteopenic, and osteoporotic groups, multivariate analysis revealed age, sex, BMI, ALP, and TG concentrations as independent risk factors for osteoporosis. Differential correlations between BMI and bone health parameters, along with lipid profiles, were elucidated across age and gender cohorts. Notably, these findings underscore the intricate interplay between metabolic and skeletal factors in the context of osteoporosis.

Research conclusions

In conclusion, osteoporotic patients showed significantly decreased BMI and TG levels in comparison with patients with normal bone mass in our study.

Research perspectives

These results indicate an association between TG metabolism and bone metabolism and provide a new method for the treatment of osteoporosis.