Table 2.
HRs (95% CIs) for association between weight change from age 25 to baseline and risk of fracture among 411,812 participants
| Weight change from age 25 to baseline (kg) | Ptrend | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| ≤ − 5.0 | − 4.9–2.5 | − 2.4–2.4 | 2.5–4.9 | 5.0–9.9 | 10.0–14.9 | ≥ 15.0 | |||
| Any fracture | |||||||||
| No. of cases | 13,065 | 2357 | 1182 | 2768 | 1366 | 2426 | 1596 | 1370 | |
| Cases/PYs (1/1000) | 3.21 | 4.64 | 3.80 | 3.26 | 2.99 | 2.88 | 2.77 | 2.62 | |
| Model 1 | 1.10 (1.04, 1.17) | 1.03 (0.96, 1.10) | 1.00 | 0.99 (0.92, 1.05) | 0.98 (0.92, 1.03) | 0.96 (0.90, 1.02) | 0.97 (0.91, 1.04) | < 0.001 | |
| Model 2 | 1.07 (1.01, 1.13) | 1.01 (0.95, 1.09) | 1.00 | 0.99 (0.93, 1.06) | 0.98 (0.93, 1.04) | 0.97 (0.91, 1.03) | 0.97 (0.90, 1.03) | < 0.001 | |
| Model 3 | 1.07 (1.01, 1.14) | 1.02 (0.95, 1.09) | 1.00 | 0.99 (0.93, 1.06) | 0.98 (0.93, 1.04) | 0.96 (0.91, 1.03) | 0.96 (0.90, 1.03) | 0.003 | |
| Upper limb fracture | |||||||||
| No. of cases | 3411 | 567 | 294 | 763 | 386 | 636 | 414 | 351 | |
| Cases/PYs (1/1000) | 0.83 | 1.10 | 0.93 | 0.89 | 0.84 | 0.75 | 0.71 | 0.67 | |
| Model 1 | 0.98 (0.87, 1.09) | 0.91 (0.80, 1.04) | 1.00 | 1.00 (0.89, 1.13) | 0.93 (0.84, 1.03) | 0.92 (0.81, 1.04) | 0.97 (0.85, 1.10) | 0.588 | |
| Model 2 | 0.95 (0.85, 1.06) | 0.90 (0.79, 1.03) | 1.00 | 1.01 (0.89, 1.14) | 0.94 (0.85, 1.05) | 0.93 (0.83, 1.05) | 0.99 (0.87, 1.13) | 0.745 | |
| Model 3 | 0.92 (0.82, 1.03) | 0.89 (0.78, 1.02) | 1.00 | 1.01 (0.90, 1.15) | 0.96 (0.86, 1.06) | 0.95 (0.84, 1.08) | 1.02 (0.89, 1.17) | 0.285 | |
| Lower limb fracture | |||||||||
| No. of cases | 3640 | 667 | 352 | 784 | 344 | 660 | 457 | 376 | |
| Cases/PYs (1/1000) | 0.89 | 1.29 | 1.12 | 0.91 | 0.75 | 0.78 | 0.79 | 0.71 | |
| Model 1 | 1.11 (1.00, 1.24) | 1.07 (0.94, 1.21) | 1.00 | 0.88 (0.77, 1.00) | 0.95 (0.85, 1.05) | 0.99 (0.88, 1.11) | 0.98 (0.86, 1.11) | 0.015 | |
| Model 2 | 1.08 (0.98, 1.21) | 1.06 (0.94, 1.20) | 1.00 | 0.88 (0.78, 1.00) | 0.95 (0.86, 1.05) | 0.98 (0.87, 1.10) | 0.95 (0.83, 1.08) | 0.018 | |
| Model 3 | 1.10 (0.99, 1.23) | 1.07 (0.94, 1.21) | 1.00 | 0.88 (0.77, 1.00) | 0.94 (0.85, 1.05) | 0.97 (0.86, 1.10) | 0.93 (0.82, 1.06) | 0.013 | |
| Spine fracture | |||||||||
| No. of cases | 1973 | 311 | 172 | 369 | 221 | 376 | 282 | 242 | |
| Cases/PYs (1/1000) | 0.48 | 0.60 | 0.55 | 0.43 | 0.48 | 0.44 | 0.48 | 0.46 | |
| Model 1 | 0.98 (0.84, 1.15) | 1.08 (0.90, 1.29) | 1.00 | 1.18 (1.00, 1.39) | 1.07 (0.93, 1.24) | 1.16 (0.99, 1.36) | 1.15 (0.98, 1.36) | 0.029 | |
| Model 2 | 0.95 (0.82, 1.11) | 1.06 (0.89, 1.27) | 1.00 | 1.19 (1.00, 1.40) | 1.09 (0.94, 1.26) | 1.18 (1.01, 1.38) | 1.17 (0.99, 1.38) | 0.006 | |
| Model 3 | 0.98 (0.84, 1.15) | 1.07 (0.89, 1.29) | 1.00 | 1.18 (1.00, 1.39) | 1.08 (0.93, 1.25) | 1.16 (0.99, 1.36) | 1.14 (0.96, 1.35) | 0.071 | |
| Pelvis fracture | |||||||||
| No. of cases | 229 | 35 | 34 | 51 | 28 | 47 | 20 | 14 | |
| Cases/PYs (1/1000) | 0.06 | 0.07 | 0.11 | 0.06 | 0.06 | 0.06 | 0.03 | 0.03 | |
| Model 1 | 0.89 (0.57, 1.37) | 1.56 (1.01, 2.41) | 1.00 | 1.12 (0.70, 1.77) | 1.10 (0.74, 1.64) | 0.75 (0.45, 1.26) | 0.70 (0.39, 1.28) | 0.166 | |
| Model 2 | 0.83 (0.54, 1.30) | 1.53 (0.99, 2.36) | 1.00 | 1.12 (0.71, 1.78) | 1.10 (0.74, 1.64) | 0.75 (0.44, 1.26) | 0.67 (0.37, 1.22) | 0.215 | |
| Model 3 | 0.90 (0.57, 1.42) | 1.57 (1.01, 2.43) | 1.00 | 1.10 (0.70, 1.75) | 1.07 (0.72, 1.60) | 0.71 (0.42, 1.21) | 0.62 (0.34, 1.15) | 0.079 | |
| Hip fracture | |||||||||
| No. of cases | 1222 | 337 | 115 | 248 | 105 | 180 | 115 | 122 | |
| Cases/PYs (1/1000) | 0.30 | 0.65 | 0.36 | 0.29 | 0.23 | 0.21 | 0.20 | 0.23 | |
| Model 1 | 1.35 (1.14, 1.59) | 1.04 (0.83, 1.29) | 1.00 | 0.85 (0.68, 1.07) | 0.76 (0.62, 0.92) | 0.67 (0.54, 0.84) | 0.74 (0.59, 0.92) | < 0.001 | |
| Model 2 | 1.32 (1.11, 1.56) | 1.03 (0.82, 1.29) | 1.00 | 0.84 (0.66, 1.05) | 0.73 (0.60, 0.88) | 0.62 (0.49, 0.77) | 0.64 (0.51, 0.80) | < 0.001 | |
| Model 3 | 1.39 (1.17, 1.66) | 1.05 (0.84, 1.32) | 1.00 | 0.83 (0.66, 1.04) | 0.71 (0.58, 0.86) | 0.59 (0.47, 0.74) | 0.60 (0.47, 0.75) | < 0.001 | |
| Other central body fracture | |||||||||
| No. of cases | 1445 | 304 | 150 | 280 | 152 | 263 | 161 | 135 | |
| Cases/PYs (1/1000) | 0.35 | 0.59 | 0.48 | 0.33 | 0.33 | 0.31 | 0.28 | 0.26 | |
| Model 1 | 1.28 (1.08, 1.50) | 1.20 (0.98, 1.46) | 1.00 | 1.16 (0.95, 1.41) | 1.15 (0.97, 1.36) | 1.07 (0.88, 1.30) | 1.12 (0.91, 1.38) | 0.209 | |
| Model 2 | 1.21 (1.03, 1.43) | 1.17 (0.96, 1.43) | 1.00 | 1.18 (0.97, 1.43) | 1.18 (1.00, 1.40) | 1.12 (0.92, 1.36) | 1.18 (0.95, 1.46) | 0.969 | |
| Model 3 | 1.16 (0.98, 1.38) | 1.15 (0.94, 1.40) | 1.00 | 1.19 (0.97, 1.44) | 1.20 (1.01, 1.42) | 1.15 (0.94, 1.40) | 1.23 (0.99, 1.52) | 0.418 | |
| Other fracture | |||||||||
| No. of cases | 2106 | 345 | 160 | 474 | 225 | 436 | 252 | 214 | |
| Cases/PYs (1/1000) | 0.51 | 0.67 | 0.51 | 0.55 | 0.49 | 0.51 | 0.43 | 0.40 | |
| Model 1 | 1.15 (1.00, 1.33) | 0.92 (0.77, 1.10) | 1.00 | 0.96 (0.82, 1.12) | 1.04 (0.92, 1.19) | 0.93 (0.80, 1.09) | 0.90 (0.76, 1.05) | 0.020 | |
| Model 2 | 1.14 (0.99, 1.31) | 0.92 (0.77, 1.10) | 1.00 | 0.96 (0.82, 1.13) | 1.05 (0.92, 1.20) | 0.94 (0.81, 1.10) | 0.89 (0.76, 1.06) | 0.037 | |
| Model 3 | 1.14 (0.98, 1.32) | 0.92 (0.77, 1.10) | 1.00 | 0.96 (0.82, 1.13) | 1.05 (0.92, 1.20) | 0.94 (0.80, 1.10) | 0.89 (0.76, 1.06) | 0.060 | |
HR, hazard ratio; CI, confidence interval; PYs, person-years; MET, metabolic equivalent of task. Multivariable models were adjusted for the following: model 1: sex (men or women); model 2: additionally included education (no formal school, primary school, middle school, high school, college, or university or above); household income (< 2500, 2500–4999, 5000–9999, 10,000–19,999, 20,000–34,999, or ≥ 35,000 RMB/year); occupation (agriculture, industrial, administrative or managerial, professional or technical, sales or service, retired, house wife or husband, self-employed, unemployed, or other); marital status (married, widowed, divorced or separated, or never married); alcohol consumption (never or occasional; former; weekly but not daily; daily consuming 1–14, 15–29, 30–59, or ≥ 60 g of pure alcohol); smoking status (never or occasional; former; daily smoking 1–14, 15–24, or ≥ 25 cigarettes or equivalent tobacco; participants who had stopped smoking because of illness were included in the current smokers); physical activity (MET-h/day); intake frequency of dairy products (assigning 0, 0.5, 2, 5, 7 to the frequency categories of never or rarely, 1–3 days/month, 1–3 days/week, 4–6 days/week, 7 days/week, respectively, and treating the variable as continuous variable); intake of supplementary calcium, iron, or zinc (yes or no); height (meters); prevalent diabetes and COPD (presence or absence); and self-rated health (excellent, good, fair, or poor); model 3: additionally included weight at age 25 (kg)