title: Association between metabolic syndrome and incident fractures in Korean men: a 3-year follow-up observational study using national health insurance claims data.
abstract: BACKGROUND
  Although the prevalence of both metabolic syndrome (MetS) and fractures increases with advancing age, studies on possible associations between these conditions in men are limited and the results are inconsistent.
  
  
  OBJECTIVE
  The objective of the study was to clarify the impact of MetS on the male risk of incident fractures.
  
  
  METHODS
  This was a large, longitudinal study with an average 3-year follow-up period.
  
  
  METHODS
  Korean men (n = 16 078) aged 50 years or older who had undergone comprehensive routine health examinations participated in the study.
  
  
  METHODS
  Incident fractures found after baseline examinations were identified using selected International Classification of Diseases, tenth revision, codes in the nationwide claims database of the Health Insurance Review and Assessment Service of Korea.
  
  
  RESULTS
  In total, 158 men (1.0%) developed incident fractures. The fracture event rates for subjects with and without MetS were 26.2 and 35.7 per 10 000 person-years, respectively. After adjustment for potential confounders, subjects with MetS had a much lower risk of incident fractures than subjects without MetS (hazard ratio 0.662, 95% confidence interval 0.445-0.986). Furthermore, subjects with three and four or more MetS components had a 49.4% and 50.4% lower risk, respectively, of incident fractures compared with the subjects without any MetS components. Importantly, additional adjustment for body mass index eliminated the statistical significance of these associations.
  
  
  CONCLUSIONS
  Our current results indicate that the beneficial effects of MetS in reducing fracture risk could be explained by the general obesity that accompanies MetS, although other related factors, such as greater padding effect, peripheral aromatization, or adipokine changes, may also contribute.
authors: Divisions of Endocrinology and Metabolism (S.H.L., S.H.A., J.-M.K., B.-J.K., G.S.K.) and Cardiology (G.-M.P., Y.-H.K.), Departments of Biostatistics (S.B.) and Preventive Medicine (M.-W.J.), and Health Screening and Promotion Center (S.J.B., H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, 138-736, Seoul, Korea; and Department of Nursing (S.H.K.), College of Medicine, Dankook University, 330-715 Cheonan, Korea.
authors: Seung Hun
authors: SH
authors: Lee
authors: Seunghee
authors: S
authors: Baek
authors: Seong Hee
authors: SH
authors: Ahn
authors: Seon Ha
authors: SH
authors: Kim
authors: Min-Woo
authors: MW
authors: Jo
authors: Sung Jin
authors: SJ
authors: Bae
authors: Hong-Kyu
authors: HK
authors: Kim
authors: Jaewon
authors: J
authors: Choe
authors: Gyung-Min
authors: GM
authors: Park
authors: Young-Hak
authors: YH
authors: Kim
authors: Jung-Min
authors: JM
authors: Koh
authors: Beom-Jun
authors: BJ
authors: Kim
authors: Ghi Su
authors: GS
authors: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D015992:Body Mass Index; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009313:National Health Programs; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012306:Risk