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Clinical Summary

Does Dynapaenia Modify Fracture Risk in Women With Obesity?


  • Dynapaenia was associated with a greater risk of lower extremity (ankle and leg) fractures in women with obesity, irrespective of bone mineral density.
  • Dynapaenia neutralised the protective effects of obesity on the fracture risk of the wrist, arm, hip, spine, and other bones.

Why This Matters

  • Findings may have important clinical implications for identifying and preventing the risk of falls and fractures in a growing population with overweight and obesity.

Study Design

  • This large, cross-sectional, retrospective study included 16,147 women (age 60-82 years) from the UK Biobank (2006-2010) who were categorised according to the dynapaenia status (lowest tertile of handgrip strength ≤21 kg) and body mass index categories (normal weight, overweight, and obesity).
  • Funding: Medical Research Council and others.

Key Results

  • Of 16,147 women, 3793 (23.5%) women fell, of whom 1062 reported more than one fall.
  • Overall, 1413 out of 15,570 (9.1%) eligible women reported fracture because of a fall.
  • Compared with people with normal weight, those with overweight and obesity had a significantly higher risk of lower extremity fractures, with the risk being significantly greater in people with obesity (adjusted OR [aOR] 2.08; 95% CI 1.39 to 3.11) or with dynapaenic obesity (aOR 2.78; 95% CI 1.77 to 4.37).
  • People with obesity had a lower risk of fractures of the wrist, arm, hip, spine, and other bones (aOR 0.77; 95% CI 0.61 to 0.96), except for those with low handgrip strength, who had a similar fracture risk to those with normal weight (aOR 1.06; 95% CI 0.82 to 1.38).


  • Retrospective design.
  • Participants may have misclassified or underreported their fracture sites.