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dc.contributor.authorØyen, Jannikeeng
dc.contributor.authorGjesdal, Clara Grameng
dc.contributor.authorNygård, Ottareng
dc.contributor.authorLie, Stein Atleeng
dc.contributor.authorMeyer, Haakoneng
dc.contributor.authorApalset, Ellen M.eng
dc.contributor.authorUeland, Per Magneeng
dc.contributor.authorPedersen, Eva Kristine Ringdaleng
dc.contributor.authorMidttun, Øivindeng
dc.contributor.authorVollset, Stein Emileng
dc.contributor.authorTell, Grethe Seppolaeng
dc.date.accessioned2015-02-24T12:55:59Z
dc.date.available2015-02-24T12:55:59Z
dc.date.issued2014-03-25eng
dc.identifier.issn1932-6203eng
dc.identifier.urihttp://hdl.handle.net/1956/9425
dc.description.abstractLower bone mineral density (BMD) in smokers may be attributable to lower body weight or fat mass, rather than to a direct effect of smoking. We analyzed the effects of smoking exposure, assessed by plasma cotinine, and body fat on BMD and the risk of subsequent hip fracture. In the community-based Hordaland Health Study (HUSK), 3003 participants 46–49 years and 2091 subjects 71–74 years were included. Cotinine was measured in plasma and information on health behaviors was obtained from self-administered questionnaires. BMD and total body soft tissue composition were measured by dual X-ray absorptiometry. Information on hip fracture was obtained from computerized records containing discharge diagnoses for hospitalizations between baseline examinations 1997–2000 through December 31st, 2009. In the whole cohort, moderate and heavy smokers had stronger positive associations between fat mass and BMD compared to never smokers (differences in regression coefficient (95% CI) per % change in fat mass = 1.38 (0.24, 2.52) and 1.29 (0.17, 2.4), respectively). In moderate and heavy smokers there was a nonlinear association between BMD and fat mass with a stronger positive association at low compared to high levels of fat mass (Davies segmented test, p<0.001). In elderly women and men, heavy smokers had an increased risk of hip fracture compared to never smokers (hazard ratio = 3.31, 95% CI: 2.05, 5.35; p<0.001). In heavy smokers there was a tendency of a lower risk of hip fracture with higher percentage of fat mass. The deleterious effect of smoking on bone health is stronger in lean smokers than in smokers with high fat mass.en_US
dc.language.isoengeng
dc.publisherPLoSeng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.titleSmoking and body fat mass in relation to bone mineral density and hip fracture: The Hordaland Health Studyeng
dc.typeJournal articleeng
dc.date.updated2015-02-24T12:49:56Z
dc.rights.holderCopyright 2014 Øyen et al
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
bora.journalTitlePLoS ONEeng
bibo.volume9eng
bibo.issue3eng
bibo.numbere92882eng
bibo.doihttp://dx.doi.org/10.1371/journal.pone.0092882eng
bora.accessRightsinfo:eu-repo/semantics/openAccesseng
dc.identifier.cristinID1155850eng
dc.identifier.doi10.1371/journal.pone.0092882


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