Regional fat distribution as a novel predictor of fracture risk in inflammatory bowel disease: a DXA-based cohort study
Abstract
Objective: To determine whether dual-energy X-ray absorptiometry (DXA)-derived femoral and abdominal fat percentage was independently associated with fracture history in adults with inflammatory bowel disease (IBD), with a focus on the glucocorticoid-treated IBD population.
Methods: A retrospective cohort study of adults with a confirmed diagnosis of IBD underwent clinically recommended DXA scanning to quantify abdominal and femoral fat mass, bone mineral density (BMD) and total body composition between June 2004 and February 2024 in northwest England. Fracture history was the main outcome. After controlling for hip lean mass, body mass index (BMI), BMD, comorbidities and glucocorticoid exposure, multivariable logistic regression models assessed relationships between regional fat percentages and fracture history. To determine if the association was independent of peripheral lean mass, a subgroup analysis of 300 glucocorticoid-exposed patients and a sensitivity model incorporating hip lean mass were performed.
Results: A total of 1302 patients with IBD underwent DXA scanning. Abdominal fat percentage showed a positive correlation throughout the full cohort (OR 1.02, 95% CI 1.001 to 1.037). The correlation remained in patients receiving glucocorticoids (OR 1.06, 95% CI 1.01 to 1.11) and in the lean-mass sensitivity model (OR 1.05, 95% CI 1.01 to 1.09). In all models, there was no correlation between the femoral fat percentage and fracture history. In the full cohort, low BMI…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,302 participants or records.
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