Journal of Clinical Medicine (Feb 2023)

Association between Metabolic Obesity Phenotypes and the Burden of Hospitalized Postmenopausal Patients Concomitant with Osteoporosis: A Retrospective Cohort Study Based on the National Readmission Database

  • Jie Jiang,
  • Chao Xu,
  • Zinuo Yuan,
  • Junming Han,
  • Zhixiang Wang,
  • Yang Tian,
  • Yingchun Dong,
  • Weibo Xia,
  • Xiude Fan,
  • Jiajun Zhao

DOI
https://doi.org/10.3390/jcm12041623
Journal volume & issue
Vol. 12, no. 4
p. 1623

Abstract

Read online

Background: The present definition of obesity based on body mass index (BMI) is not accurate and effective enough to identify hospitalized patients with a heavier burden, especially for postmenopausal hospitalized patients concomitant with osteoporosis. The link between common concomitant disorders of major chronic diseases such as osteoporosis, obesity, and metabolic syndrome (MS) remains unclear. Here, we aim to evaluate the impact of different metabolic obesity phenotypes on the burden of postmenopausal hospitalized patients concomitant with osteoporosis in view of unplanned readmissions. Methods: Data was acquired from the National Readmission Database 2018. The study population was classified into metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) patients. We estimated the associations between metabolic obesity phenotypes and 30- and 90-day unplanned readmissions. A multivariate Cox Proportional Hazards (PH) model was used to assess the effect of factors on endpoints, with results expressed as HR and 95% CI. Results: The 30-day and 90-day readmission rates for the MUNO and MUO phenotypes were higher than that of the MHNO group (all p p p = 0.002), and MUO further elevated this risk (HR = 1.238, p p p = 0.014, respectively), and MUO had the highest risk (HR = 1.263, p < 0.001). Conclusions: Metabolic abnormalities were associated with elevated rates and risks of 30- or 90-day readmission among postmenopausal hospitalized women complicated with osteoporosis, whereas obesity did not seem to be innocent, and the combination of these factors led to an additional burden on healthcare systems and individuals. These findings indicate that clinicians and researchers should focus not only on weight management but also metabolism intervention among patients with postmenopausal osteoporosis.

Keywords