Associations of visceral adipose tissue with bone mineral density and fracture: observational and Mendelian randomization studies

Table 3 Associations of VAT^ with incident fractures in men and women by BMI categories

Outcome	Subgroup	Cases/participants	HR (95%CI)	P	P for VAT^-BMI interaction
Men
Total fractures	All	3716/179,368	1.01 (0.95, 1.07)	0.75
	BMI < 25 kg/m²	1028/44,469	0.82 (0.71, 0.95)	0.007	2.7 × 10⁻⁴
	BMI ≥ 25 kg/m²	2688/134,899	1.10 (1.02, 1.18)	0.02	2.7 × 10⁻⁴
Hip fractures	All	512/179,368	0.78 (0.67, 0.91)	0.002
	BMI < 25 kg/m²	188/44,469	0.64 (0.50, 0.81)	2.9 × 10⁻⁴	5.7 × 10⁻³
	BMI ≥ 25 kg/m²	324/134,899	0.94 (0.76, 1.16)	0.55	5.7 × 10⁻³
Vertebrae fractures	All	335/179,368	1.17 (0.96, 1.43)	0.12
	BMI < 25 kg/m²	74/44,469	1.07 (0.58, 1.99)	0.82	0.50
	BMI ≥ 25 kg/m²	261/134,899	1.19 (0.94,1.50)	0.15	0.50
Other fractures	All	3074/179,368	1.03 (0.96, 1.10)	0.45
	BMI < 25 kg/m²	833/44,469	0.86 (0.72, 1.01)	0.07	6.8 × 10⁻³
	BMI ≥ 25 kg/m²	2241/134,899	1.10 (1.01, 1.19)	0.02	6.8 × 10⁻³
Women
Total fractures	All	5972/175,788	0.93 (0.86, 1.01)	0.08
	BMI < 25 kg/m²	2458/72,917	0.95 (0.78, 1.15)	0.60	0.91
	BMI ≥ 25 kg/m²	3514/102,871	0.99 (0.89, 1.10)	0.85	0.91
Hip fractures	All	778/175,788	0.78 (0.63, 0.96)	0.02
	BMI < 25 kg/m²	361/72,917	0.89 (0.58,1.36)	0.59	0.87
	BMI ≥ 25 kg/m²	417/102,871	0.91 (0.67, 1.22)	0.52	0.87
Vertebrae fractures	All	285/175,788	0.95 (0.67, 1.36)	0.79
	BMI < 25 kg/m²	122/72,917	0.88 (0.41, 1.89)	0.73	0.41
	BMI ≥ 25 kg/m²	163/102,871	1.21 (0.78,1.89)	0.40	0.41
Other fractures	All	5125/175,788	0.97 (0.89, 1.05)	0.44
	BMI < 25 kg/m²	2063/72,917	0.96 (0.78, 1.20)	0.75	0.92
	BMI ≥ 25 kg/m²	3062/102,871	1.00 (0.89, 1.11)	0.95	0.92

HR (95% CI) was estimated from the Cox proportional hazards model. All models were adjusted for age, household income, lean mass, standing height, smoking status, alcohol consumption, physical activity, calcium supplement use, vitamin D supplement use, overall health rating, diabetes, cardiovascular disease, cancer, and for women, menopause status and use of hormone replacement therapy. VAT^, predicted values of VAT (visceral adipose tissue) mass; BMI body mass index; HR hazard ratio; and CI confidence interval. P for VAT^-sex interaction = 1.9 × 10⁻⁴ for total fractures; 0.06 for hip fractures; 0.39 for vertebrae fractures; 1.5 × 10⁻⁴ for other fractures

ISSN: 1743-7075