Older women with lower abdominal fat mass are at a substantially higher risk for fractures, particularly of the vertebrae, an Australian prospective study found.


Higher body weight is associated with greater bone mineral density (BMD) and lower fracture risk. However, the relationship between abdominal fat mass and fracture risk is unclear due to limited prospective data.

The new study, reported in the Journal of Clinical Endocrinology and Metabolism, sought to examine the association between abdominal fat mass, BMD and fracture risk.

The study was designed as a prospective investigation, in which a sample of 1126 participants (360 men and 766 women) aged 50 plus years had been continuously followed up for an average of 5 years.

The mean age of participants was 71 years (range: 57-94). At baseline, BMD at the femoral neck and lumbar spine, and abdominal fat mass were measured by dual energy X-ray absorptiometry (GE-LUNAR Corp, Madison, WI). The incidence of low-trauma and non-pathological fractures was ascertained prospectively from X-ray reports.

During the follow-up period, 19 men and 107 women had sustained a fracture.

In women, each 1 kg lower abdominal fat mass was associated with a 50 percent higher risk of fracture after adjusting for age, femoral neck BMD, falls, stature, physical activity and prior fracture.

Subgroup analysis by fracture type found that the association was mainly observed in clinical vertebral fracture .

In men, although there was no statistically significant association between abdominal fat mass and fracture risk, the strength this finding is negatively impacted by low number of fractures.