{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T03:10:26Z","timestamp":1789096226339,"version":"build-2803163510"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Obesity is a global health issue linked to conditions like metabolic syndrome and heart disease, but its relationship with fracture risk is complex. While higher body mass index (BMI) is associated with increased bone mineral density (BMD) due to mechanical loading, it does not uniformly protect against fractures. Obese individuals face higher risks of proximal humerus and ankle fractures, along with propensity for increased falls and sarcopenic obesity. Higher fat mass, particularly visceral adiposity, correlates with lower bone quality and increased fracture risk, independent of BMD. Obesity triggers inflammatory pathways (e.g., TNF-\u03b1, Monocyte Chemotactic Protein-1 [MCP-1]) and adipokine imbalances (e.g., adiponectin, leptin), impairing bone formation and resorption. Vitamin D deficiency and secondary hyperparathyroidism further exacerbate cortical bone loss. Diagnostic challenges arise as dual-energy X-ray absorptiometry and FRAX tools may underestimate fracture risk in obesity. Preventive strategies emphasize lifestyle interventions, including moderate weight loss targeting subcutaneous fat, resistance training, and optimal dairy intake to enhance BMD.<\/jats:p>","DOI":"10.4103\/ijem.ijem_818_25","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:01:55Z","timestamp":1788195715000},"page":"297-301","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Obesity and Osteoporotic Fractures: Solving the Paradox"],"prefix":"10.4103","volume":"30","author":[{"given":"Khushboo","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Endocrinology, GSVM Medical College, Kanpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinjan","family":"Patra","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"R1-20260911","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s00198-005-1863-y","article-title":"Body mass index as a predictor of fracture risk: A meta-analysis","volume":"16","author":"De Laet","year":"2005","journal-title":"Osteoporos Int"},{"key":"R2-20260911","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/jbmr.5650080507","article-title":"Effects of weight and body mass index on bone mineral density in men and women: The Framingham study","volume":"8","author":"Felson","year":"1993","journal-title":"J Bone Miner Res"},{"key":"R3-20260911","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1002\/jbmr.2469","article-title":"Hip fractures risk in older men and women associated with DXA-derived measures of thigh subcutaneous fat thickness, cross-sectional muscle area, and muscle density","volume":"30","author":"Malkov","year":"2015","journal-title":"J Bone Miner Res"},{"key":"R4-20260911","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.amjmed.2011.06.013","article-title":"Obesity is not protective against fracture in postmenopausal women: GLOW","volume":"124","author":"Compston","year":"2011","journal-title":"Am J Med"},{"key":"R5-20260911","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1046\/j.1532-5415.2001.49082.x","article-title":"The relationship between body mass index and self-reported functional limitation among older adults: A gender difference","volume":"49","author":"Friedmann","year":"2001","journal-title":"J Am Geriatr Soc"},{"key":"R6-20260911","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1002\/jbmr.1466","article-title":"The association between fracture and obesity is site-dependent: A population-based study in postmenopausal women","volume":"27","author":"Prieto-Alhambra","year":"2012","journal-title":"J Bone Miner Res"},{"key":"R7-20260911","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1002\/jbmr.2017","article-title":"A meta-analysis of the association of fracture risk and body mass index in women","volume":"29","author":"Johansson","year":"2014","journal-title":"J Bone Miner Res"},{"key":"R8-20260911","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1359\/jbmr.091004","article-title":"Obesity and fractures in postmenopausal women","volume":"25","author":"Premaor","year":"2010","journal-title":"J Bone Miner Res"},{"key":"R9-20260911","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1359\/jbmr.090307","article-title":"Does obesity really make the femur stronger? 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