Intentional and Unintentional Weight Loss Increase Bone Loss and Hip Fracture Risk in Older Women

作者：Kristine E. Ensrud, Susan K. Ewing, Katie L. Stone, Jane A. Cauley, Paula J. Bowman, Steven R. Cummings · 发表于：Journal of the American Geriatrics Society · 年份：2003 · DOI：10.1046/j.1532-5415.2003.51558.x · 被引用次数：337 · 研究领域：Bone health and osteoporosis research、Nutrition and Health in Aging、Hip and Femur Fractures

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 weigh...