OBJECTIVE We aimed to investigate the associations of body composition and the risk of fracture in postmenopausal women, stratified based on bone mineral density. METHODS A population-based cohort study using the database of the National Screening Program for Transitional Ages with women aged 66 years was performed. Bone mineral density was categorized as normal, osteopenia, and osteoporosis. The following body mass index (BMI) categories for general obesity were used: underweight (<18.5), normal (18.5-22.9), overweight (23-24.9), obese (25-29.9), and severely obese (≥30 kg/m2). Waist circumference (WC) used for central obesity assessment was categorized into 5 groups. Newly diagnosed fracture during the follow-up period defined based on ICD-10 codes was the primary outcome. RESULTS During 7.7 ± 1.4 years of follow-up, 41 672 (17.9%) participants experienced any fracture, 20 326 (8.7%) experienced vertebral fractures (VFs), and 2883 (1.2%) experienced hip fractures (HFs). The adjusted hazard ratios (aHRs) for any fracture showed a progressive increase with higher BMI and WC categories in individual with osteopenia and osteoporosis. Regarding VF, aHR was highest in severely obese individuals with osteoporosis (aHR [95% CI], 3.45 [2.99-3.97]) and in individuals with WC ≥ 95 cm with osteoporosis (4.79 [4.09-5.60]). The aHR [95% CI] for HF was highest in the underweight group with osteopenia (1.94 [1.16-3.27]) and osteoporosis (2.96 [2.15-4.10]). In central obesity individuals with WC ≥ 95 cm, aHR [95% CI] for HF was 2.80 [1.91-4.91]. CONCLUSIONS General obesity and central obesity are not protective against any fracture, VF and HF in postmenopausal women with osteopenia or osteoporosis.

中文翻译：

---

根据绝经后妇女的骨矿物质密度，身体成分与骨折风险之间的关联：基于人群的数据库队列研究。

目的 我们旨在调查绝经后妇女的身体成分与骨折风险之间的关系，并根据骨矿物质密度进行分层。方法 使用国家过渡时期筛查计划数据库对 66 岁女性进行一项基于人群的队列研究。骨密度分为正常、骨质减少和骨质疏松。一般性肥胖的体重指数 (BMI) 类别如下：体重不足 (<18.5)、正常 (18.5-22.9)、超重 (23-24.9)、肥胖 (25-29.9) 和严重肥胖 (≥30 kg/平方米）。用于中心性肥胖评估的腰围（WC）分为5组。主要结局是根据 ICD-10 代码定义的随访期间新诊断的骨折。结果 在 7.7 ± 1.4 年的随访期间，41 672 名参与者 (17.9%) 经历过任何骨折，20 326 名参与者 (8.7%) 经历过椎体骨折 (VF)，2883 名参与者 (1.2%) 经历过髋部骨折 (HF)。在患有骨质减少和骨质疏松症的个体中，任何骨折的调整后风险比 (aHR) 都随着 BMI 和 WC 类别的升高而逐渐增加。关于 VF，aHR 在患有骨质疏松症的严重肥胖个体中最高（aHR [95% CI]，3.45 [2.99-3.97]）和 WC ≥ 95 cm 的骨质疏松症个体（4.79 [4.09-5.60]）。心衰的 aHR [95% CI] 在患有骨质减少 (1.94 [1.16-3.27]) 和骨质疏松 (2.96 [2.15-4.10]) 的体重不足组中最高。在 WC ≥ 95 cm 的中心性肥胖个体中，HF 的 aHR [95% CI] 为 2.80 [1.91-4.91]。结论 对于患有骨质减少或骨质疏松症的绝经后妇女来说，全身性肥胖和向心性肥胖并不能预防任何骨折、心室颤动和心力衰竭。