The impact of body mass index on mortality rates of hip fracture patients: a systematic review and meta-analysis

Li, J; Li, D; Wang, X; Zhang, L

doi:10.1007/s00198-022-06415-w

Cited by 12 publications

(6 citation statements)

References 35 publications

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“…For example, children or adolescents with obesity have calcium retention, more musculoskeletal complaints, and increased fracture risk compared to the normal population of the same age 114,115 . In contrast, the impact of obesity on bone strength of adults is complex, and obesity is associated with decreased fracture risks at hip and vertebrate 7,116–119 . However, the underlying mechanisms of this paradox remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Forest plot reporting SMD of HFD group and CD group in femoral (A) mineral apposition rate (MAR), (B) bone formation rate (BFR), (C) osteoblast number/bone surface (Ob.N/BS), (D) osteoblast surface/bone surface (Ob.S/BS), (E) osteoclast number/ bone surface (Oc.N/ BS), and (F) osteoclast surface/bone surface (Oc.S/BS) of C57BL/6 mice risks at hip and vertebrate 7,[116][117][118][119]. However, the underlying mechanisms of this paradox remain unclear.…”

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confidence: 99%

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How high‐fat diet affects bone in mice: A systematic review and meta‐analysis

Zhang

Pei

et al. 2022

Obesity Reviews

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High-fat diet (HFD) feeding for mice is commonly used to model obesity. However, conflicting results have been reported on the relationship between HFD and bone mass. In this systematic review and meta-analysis, we synthesized data from 80 articles to determine the alterations in cortical and trabecular bone mass of femur, tibia, and vertebrae in C57BL/6 mice after HFD. Overall, we detected decreased trabecular bone mass as well as deteriorated architecture, in femur and tibia of HFD treated mice. The vertebral trabecula was also impaired, possibly due to its reshaping into a more fragmentized pattern. In addition, pooled cortical thickness declined in femur, tibia, and vertebrae. Combined with changes in other cortical parameters, HFD could lead to a larger femoral bone marrow cavity, and a thinner and more fragile cortex.Moreover, we conducted subgroup analyses to explore the influence of mice's sex and age as well as HFD's ingredients and intervention period. Based on our data, male mice or mice aged 6-12 weeks old are relatively susceptible to HFD. HFD with > 50% of energy from fats and intervention time of 10 weeks to 5 months are more likely to induce skeletal alterations. Altogether, these findings supported HFD as an appropriate model for obesity-associated bone loss and can guide future studies.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

How high‐fat diet affects bone in mice: A systematic review and meta‐analysis

Zhang

Pei

et al. 2022

Obesity Reviews

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“…Patients with a hip fracture are at substantial risk of major complications including cardiovascular, infectious, neurocognitive, and mortality ( 12 ). Several systematic reviews have found consistently that most of the associated factors for functional recovery and mortality of elderly hip fracture are biological, sociodemographic, or inherent to patients’ baseline characteristics ( 13 – 15 ).…”

Section: Introductionmentioning

confidence: 99%

Preoperative inflammatory biomarkers reveal renal involvement in postsurgical mortality in hip fracture patients: an exploratory study

Valdes,

Ikram,

Taylor

et al. 2024

Front. Immunol.

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BackgroundHip fractures in frail patients result in excess mortality not accounted for by age or comorbidities. The mechanisms behind the high risk of mortality remain undetermined but are hypothesized to be related to the inflammatory status of frail patients.MethodsIn a prospective observational exploratory cohort study of hospitalized frail hip fracture patients, 92 inflammatory markers were tested in pre-operative serum samples and markers were tested against 6-month survival post-hip fracture surgery and incidence of acute kidney injury (AKI). After correcting for multiple testing, adjustments for comorbidities and demographics were performed on the statistically significant markers.ResultsOf the 92 markers tested, circulating levels of fibroblast growth factor 23 (FGF-23) and interleukin-15 receptor alpha (IL15RA), both involved in renal disease, were significantly correlated with 6-month mortality (27.5% overall) after correcting for multiple testing. The incidence of postoperative AKI (25.4%) was strongly associated with 6-month mortality, odds ratio = 10.57; 95% CI [2.76–40.51], and with both markers plus estimated glomerular filtration rate (eGFR)– cystatin C (CYSC) but not eGFR-CRE. The effect of these markers on mortality was significantly mediated by their effect on postoperative AKI.ConclusionHigh postoperative mortality in frail hip fracture patients is highly correlated with preoperative biomarkers of renal function in this pilot study. The effect of preoperative circulating levels of FGF-23, IL15RA, and eGFR-CYSC on 6-month mortality is in part mediated by their effect on postoperative AKI. Creatinine-derived preoperative renal function measures were very poorly correlated with postoperative outcomes in this group.

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“…14 However, most studies among elderly patients with hip fracture used body mass index (BMI) as a proxy measure of adiposity, which does not reflect the amount and location of body fat. 17 Although there have been some studies exploring the prognostic value of thigh composition in elderly patients with hip fracture, they have focused on predicting surgical complication, functional recovery or mortality rather than adverse CV events. [18][19][20] Few studies have examined the relationship between thigh fat and muscle measurements and CV outcomes following hip fracture.…”

Section: Introductionmentioning

confidence: 99%

“…Lower limb fat is mainly stored as a subcutaneous adipose tissue in gluteofemoral (or thigh) region and its CV protective effects by acting as a metabolic buffer for the excess dietary lipids are well known 14 . However, most studies among elderly patients with hip fracture used body mass index (BMI) as a proxy measure of adiposity, which does not reflect the amount and location of body fat 17 …”

Section: Introductionmentioning

confidence: 99%

Shape phenotype of thigh fat and muscle and risk of major adverse cardiovascular events after fragility hip fracture

Lee,

Kim,

2023

J cachexia sarcopenia muscle

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BackgroundAlthough sarcopenia has been recognized as a predictor of mortality in elderly patients with hip fracture, the association of thigh fat and muscle with cardiovascular (CV) outcome remains unclear. We examined the impact of computed tomography (CT)‐derived shape features of thigh fat and muscle on major adverse CV events (MACE) in elderly patients with hip fracture.MethodsWe conducted a retrospective analysis of consecutive patients aged ≥65 years who presented with hip fracture confirmed on pelvic bone CT scan and underwent hip fracture surgery at our institution from April 2019 to December 2021. The cross‐sectional area (CSA) and compactness (CM) of both the muscle and fat at the upper‐thigh level were calculated from two‐dimensional CT images using AVIEW Research (v1.1.38, Coreline Soft, Co. Ltd, Seoul, South Korea). The shape features of thigh fat and muscle were categorized into four groups based on the combination of CSA and CM: fat CSA (fat area [FA])/fat CM (FCM), muscle CSA (muscle area [MA])/muscle CM (MCM), FA/MCM and MA/FCM. In each of them, subjects were categorized into four subgroups: high CSA/high CM, high CSA/low CM, low CSA/high CM and low CSA/low CM. The primary outcome was MACE after 30 days of surgery, defined as a composite of all‐cause death, acute myocardial infarction, stroke or hospitalization for heart failure.ResultsOf 356 patients enrolled (median age, 82 years; 76.7% females), 72 (20.2%) had MACE over a median follow‐up of 13.1 months (ranges 5.9–21.0 months). Patients with MACE had a significantly lower median FA (193.7 vs. 226.2 cm2, P < 0.0001) and FCM (0.443 vs. 0.513, P = 0.001) compared with those without MACE, but no significant differences were found in MA, MCM and FA–MA ratio between the two groups. In a multivariate Cox regression analysis, low FA (<240.1 cm2) (adjusted hazard ratio [HR] 2.99, 95% confidence interval [CI] 1.39–6.44, P = 0.005) and low FCM (<0.477) (adjusted HR 2.00, 95% CI 1.10–3.63, P = 0.023) were associated with an increased risk of MACE. Among the shape phenotypes of thigh fat and muscle, the thigh fat phenotype of low FA/low FCM (adjusted HR 3.13, 95% CI 1.81–5.42, P < 0.0001 [reference, high FA/high FCM]) was found to be an independent predictor of MACE.ConclusionsIn elderly patients with fragility hip fracture, thigh CT‐derived measures of FA and FCM may provide useful prognostic information for predicting adverse CV outcomes.

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The impact of body mass index on mortality rates of hip fracture patients: a systematic review and meta-analysis

Cited by 12 publications

References 35 publications

How high‐fat diet affects bone in mice: A systematic review and meta‐analysis

How high‐fat diet affects bone in mice: A systematic review and meta‐analysis

Preoperative inflammatory biomarkers reveal renal involvement in postsurgical mortality in hip fracture patients: an exploratory study

Shape phenotype of thigh fat and muscle and risk of major adverse cardiovascular events after fragility hip fracture

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