ECEESPE2025 ePoster Presentations Bone and Mineral Metabolism (142 abstracts)
Adolescent body mass index and osteoporosis risk: a nationwide study of one million israeli adolescents
Maya Simchoni 1 , Regev Landau 2 , Estela Derazne 3 , Orit Pinhas-Hamiel 4 , (late) Yair Zloof 5 , Afif Nekaleh 6 , Inbal Goldstein 7 , Avishai M Tsur 8 , Arnon Afek 9 , Gabriel Chodick 10 , Liana Tripto-Shkolnik 11 & Gilad Twig 12
1Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem and theIsrael Defense Forces Medical Corps, Ramat Gan, Israel, Ramat Gan, Israel; 2Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel, Ramat Gan, Israel; 3School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel, Tel Aviv, Israel; 4Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Ramat Gan, Israel and School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel, Ramat Gan, Israel; 5Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel and Schneider Children’s Medical Center, Petah Tikva, Israel. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Tel Aviv, Israel; 6Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, Haifa, Israel 8 Diabetes and Endocrinology Clinic, Maccabi Healthcare Services, Haifa, Israel, Haifa, Israel; 7Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel and School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel, Tel Aviv, Israel; 8Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan and School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel, Tel Aviv, Israel; 9Dina Recnati School of Medicine, Reichman University, Herzliya, Israel and The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel, Ramat Gan, Israel; 10Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; 11Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel; 12Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel and Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Tel Aviv, Israel
JOINT3088
Background: There is limited data regarding adolescent weight among healthy individuals and its trajectory through early adulthood with respect to bone health. We assessed the association between adolescent body mass index (BMI) and osteoporosis risk while accounting for BMI change during early adulthood.
Methods: A retrospective cohort study including Israeli-born adolescents (468,907 women; 614,584 men) aged 16-19 years, who were evaluated for military service from 1967-2019 and followed for osteoporosis outcome until 2022 using the Maccabi Healthcare osteoporosis registry. Weight and height were measured to calculate BMI at adolescence and additional sociodemographic and medical data were collected. Cox proportional hazard models were applied. Adult BMI measurement was available for 74% of the study population and was used to assess the effect of adolescence-to-adulthood weight trajectory on incident osteoporosis. Health status at baseline and incident cancer and diabetes throughout adulthood were strictly controlled.
Results: 21,497 (4.58%) women and 6,929 (1.13%) men were enrolled in the osteoporosis registry during a cumulative follow-up of 19,400,208 person-years. There was a gradual decrease in crude incidence rate (event/105 person-years) from 330.2 among extreme underweight (<3rd percentile) toward 78.9 in the obese group (≥95th perc.). Corresponding adjusted HRs for osteoporosis ranged from from 1.89 (1.74-2.04) to 0.83 (0.77-0.88) in women and 1.79 (95%CI 1.62-1.99) to 1.05 (0.94-1.16) in men (with normal BMI as the reference group). There were no differences in incident risk for those with mild vs. severe adolescent obesity. The highest risk was recorded for those who sustained underweight from adolescence to adulthood. Weight gain from underweight at adolescence was associated with a lower risk for osteoporosis. These findings persisted when analysis was restricted for individuals with unimpaired health.
Conclusion: BMI category at a young age and its trajectory to adulthood have a significant effect on the risk for osteoporosis in adult life.
Volume 110
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