The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis

Yupeng Liu; Yi Liu; Yufeng Huang; Siyu Le; Huinan Jiang; Binye Ruan; Xuemei Ao; Xudong Shi; Xiaoyi Fu; Shuran Wang

doi:10.1016/j.clnu.2023.10.013

The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis

Clin Nutr. 2023 Dec;42(12):2457-2467. doi: 10.1016/j.clnu.2023.10.013. Epub 2023 Oct 18.

Authors

Yupeng Liu¹, Yi Liu², Yufeng Huang², Siyu Le², Huinan Jiang², Binye Ruan², Xuemei Ao², Xudong Shi², Xiaoyi Fu³, Shuran Wang⁴

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.
² Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.
³ Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China. Electronic address: fuxiaoyi@wmu.edu.cn.
⁴ Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China. Electronic address: shuranwang@wmu.edu.cn.

PMID: 37925778
DOI: 10.1016/j.clnu.2023.10.013

Abstract

Background: Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent.

Objective: Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis.

Methods: From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis.

Results: There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096).

Conclusions: General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.

Keywords: Central obesity; Meta-analysis; Obesity; Osteoporosis; Overweight.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Body Mass Index
Humans
Obesity / complications
Obesity / epidemiology
Obesity, Abdominal
Overweight* / complications
Overweight* / epidemiology
Thinness*