Evidence map›Paper›PMID 40411129›Full record

ArticleMedical science monitor : international medical journal of experimental and clinical research2025

Role of Body Fat and Metabolic Rate in Site-Specific Fracture Risk: A 20-Year Taiwanese Cohort Study.

Yu-Hsiang Lin, Hei-Tung Yip, Jung-Ju Lin, Cheng-Hao Tu, Chun-Hao Tsai, XianXiu Chen, Der-Cherng Chen

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Article in Medical science monitor : international medical journal of experimental and clinical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yu-Hsiang LinDepartment of Neurosurgery, China Medical University Hospital, Taichung, Taiwan.
Hei-Tung YipManagement Office for Health Data, China Medical University Hospital, Taichung, Taiwan.ORCID 0000-0003-4077-3473
Jung-Ju LinSleep Medicine Center, China Medical University Hospital, Taichung, Taiwan.
Cheng-Hao TuGraduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.
Chun-Hao TsaiDepartment of Biomedical Engineering, College of Biomedical Engineering, Taichung, Taiwan.
XianXiu ChenDepartment of Neurosurgery, China Medical University Hospital, Taichung, Taiwan.ORCID 0000-0002-7955-9506
Der-Cherng ChenDepartment of Neurosurgery, China Medical University Hospital, Taichung, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND Osteoporotic fractures are a significant public health problem, yet traditional risk assessment methods have limitations. This retrospective study used the integrated Healthcare information (iHi) Data Platform of China Medical University Hospital (CMUH) (2000-2020) to evaluate associations between body mass index (BMI), bone mineral density (BMD), body fat percentage (BFP), basal metabolic rate (BMR), and site-specific fracture risk in 9583 Taiwanese individuals. MATERIAL AND METHODS We extracted DXA-measured BMD, BMI, BFP, and BMR data from CMUH's iHi Platform. Fracture events were identified using ICD-9/10 codes and verified through radiology reports. Cox proportional hazards regression models estimated fracture risk, adjusting for demographic and clinical factors. Mediation analysis quantified the contributions of BFP and BMR to the BMI-fracture relationship. RESULTS During median follow-up of 8.7 years, 1672 fractures (17.4%) occurred. Individuals with normal BMD showed an 82% lower fracture risk compared to those with osteoporosis (adjusted hazard ratio [aHR]=0.18, 95% CI: 0.15-0.22, p<0.001). Normal BFP significantly reduced fracture risk by 77% versus low BFP (aHR=0.23, 95% CI: 0.07-0.72, p=0.012). Higher BMR was consistently protective, with aHR=0.54 (95% CI: 0.36-0.82, p=0.004) for BMR ≥1500 versus BMR<1000. While underweight increased fracture risk (aHR=1.75, 95% CI: 1.29-2.36, p<0.001), obesity conferred no significant protection (aHR=1.04, 95% CI: 0.89-1.21, p=0.58). CONCLUSIONS This study demonstrates that fracture risk assessment should incorporate BFP and BMR alongside BMD and BMI. The "BMI paradox" was explained through mediation analysis, revealing BFP and BMR as critical intermediaries accounting for 50% and 32% of the BMI-fracture relationship, respectively. These findings support developing ethnicity-specific fracture risk models integrating body composition metrics for more precise risk stratification.

Indexed as

Adipose TissueBasal MetabolismFractures, BoneOsteoporotic FracturesAdultAgedBody Mass IndexBone DensityCohort StudiesFemaleHumansMaleMiddle AgedOsteoporosisProportional Hazards ModelsRetrospective Studies

Identifiers

PMID40411129
PMCPMC12118271

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.