POS0311 REGIONAL VARIATIONS IN ADIPOSITY IS A STRONG PREDICTOR OF ONE VS MANY FRAGILITY FRACTURES
Authors: H. Amin, A. Khan, Z. Sultan, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> BMI is a core component of fracture risk calculators. Increases in BMI is thought to be protective of fracture [1]. However, BMI is non-specific and does not incarnate compositional analysis into its calculations. New research is highlighting a deleterious effect of adiposity on bone via hormonal, inflammatory and psychosocial mechanisms. Little is known about how fat distribution affects fracture risk in patients who have had one vs multiple fractures. <h3>Objectives:</h3> We aim to assess regional variations in adiposity as a predictor of one vs many fragility fractures. <h3>Methods:</h3> Patients were referred to our scanner in the northwest of England between 2004 – 2019. They underwent DEXA scanning as well as assessment of demographic variables via a questionnaire. Patients were only included in the analysis if they had either a hip fracture, a single non-hip fracture or multiple non-hip fractures. A logistic regression analysis reporting odds ratios (OR) was conducted looking at whether the percentage fat at the abdomen, left and right hips was able to predict hip fractures, a single non-hip or multiple non-hip fractures respectively. All results were adjusted for age, gender, smoking status, excess alcohol use (&gt;3 units per day) and the left femoral t-score. <h3>Results:</h3> 31,547 patients were included in our analysis with 5390 male patients and 26156 female patients. The mean age was 64.9 (SD 12.9) height 162.0 cm (SD 8.6) and weight 71.1 kg (SD 16.0). Patients had a mean fat percentage at the abdomen (FPA%) of 30.3% (SD 11.0), fat percentage at the left hip (FPLH%) 29.7% (SD 7.1) and fat percentage at the right hip (FPRH%) 29.2% (SD 7.0).11,875 fractures were reported of which 1,375 (11.6%) were hip fractures. 8,599 patients reported a single non-hip fracture. 2,060 patients reported multiple non-hip fractures. Table 1 demonstrates the results of our analysis. <h3>Conclusion:</h3> Both central and peripheral adiposity predicted non-hip fractures, however, peripheral fat seems to be a better predictor of non-hip fractures. Adiposity also predicts multiple non-hip fractures strongly. Only the fat percentage at the left hip predicted hip fractures potentially owing to the adjustment of the left femoral t-score. Changes in adiposity as well as a history of a fracture may be an important predictor of future fracture risk. More research is needed to validate our findings and confirm this relationship. <h3>REFERENCES:</h3> [1] Analysis of the Association of Fracture Risk and Body Mass Index in Women. Journal of Bone and Mineral Research. 2014;29(1):223-33. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Hamzah Amin: None declared, Aqib Khan: None declared, Zain Sultan: None declared, Marwan Bukhari Marwan Bukhari has been sponsored to attend regional, national and international meetings by UCB celltech, Roche/Chugai, Pfizer, Abbvie, Merck, Mennarini, Janssen, Bristol-Myers Squib, Novartis and Eli-lilly He has received honoraria for speaking and attended advisory boards with Bristol-Myers Squib, UCB celltech, Roche/Chugai, Pfizer, Abbvie, Merck, Mennarini, Sanofi-aventis, Eli-Lilly, Janssen, Amgen, Novartis and Gilead. He has received honoraria from educational groups revalidaid and TREG consultants.