Impact Of Body Mass Index on Osteoporosis Risk Factors: A MetaAnalysis

Abstract

Objectives: This meta-analysis aimed to evaluate the association between body mass index (BMI) and the risk of osteoporosis.

Methods: Domestic and international databases were systematically searched for case-control studies published between January 1, 1990, and December 31, 2022, using medical subject headings (MeSH) and relevant keywords. Statistical analyses were conducted with Review Manager 5.3. A fixed-effects model was applied when heterogeneity was low (I² < 50%), and a random-effects model was used when heterogeneity was high (I² > 50%).

Results: A total of 18 case-control studies comprising 9,078 participants were included. Pooled analysis revealed that low BMI is a significant risk factor for osteoporosis in individuals with type 2 diabetes and for primary osteoporosis. High BMI was identified as a risk factor for osteoporosis among postmenopausal women. In addition, BMI was a risk factor for osteoporosis in patients with frequent glucocorticoid use or chronic obstructive pulmonary disease (COPD). However, no clear association was established between BMI and primary osteoporosis at normal or high levels, nor between BMI and osteoporosis risk in stroke patients.

Conclusions: This meta-analysis demonstrates that low BMI increases the risk of osteoporosis in patients with type 2 diabetes and those with primary osteoporosis, while high BMI contributes to osteoporosis risk among postmenopausal women. Furthermore, BMI is a risk factor in patients with frequent glucocorticoid use or COPD. These findings provide important theoretical evidence to support the prevention and management of osteoporosis in clinical practice.