[Reading Science] "Quitting Smoking Alone Is Not Enough"... Fracture Risk Doubles in Diabetic Men Who Lose Weight

Analysis of National Health Insurance Big Data
Fracture Risk Decreases When Weight Is Maintained After Smoking Cessation

For male smokers newly diagnosed with type 2 diabetes, quitting smoking alone does not reduce the risk of fractures. However, maintaining weight after quitting is associated with a lower risk. Conversely, if weight is lost after quitting smoking, the risk of fractures increases significantly.

On April 17, a research team led by Professor Park Sangmin from the Department of Biomedical Sciences at Seoul National University College of Medicine announced these findings, which were derived by analyzing big data from the National Health Insurance Service.

Photo for article reference. Photo by Jo Yongjun

The research team analyzed data from 43,564 male smokers who were newly diagnosed with type 2 diabetes between 2009 and 2015. The participants were divided into a persistent smoking group and a smoking cessation group. The smoking cessation group was further subdivided based on changes in body mass index (BMI) into weight maintenance, weight gain, and weight loss groups.

As a result of the analysis, the overall fracture risk for the smoking cessation group did not significantly decrease compared to the persistent smoking group. However, among those who maintained their weight after quitting, the overall fracture risk decreased by 22%, and the risk of hip fracture decreased by 45%.

On the other hand, those who lost weight after quitting experienced a 47% increase in overall fracture risk, and their risk of hip fracture more than doubled. While there was a tendency for increased risk among those who gained weight, this was not statistically significant.

The analysis of fracture risk based on weight changes after smoking cessation in male smokers newly diagnosed with type 2 diabetes showed that those who maintained their weight after quitting smoking had an approximately 22% lower fracture risk compared to continuous smokers. In contrast, those who lost weight experienced up to a 146% increase in fracture risk. Image and description: Provided by the research team

The researchers interpreted weight loss after quitting smoking not as a simple change in body weight but as a "signal of fracture vulnerability." They pointed out that weight loss is highly likely to be associated with decreased bone density, reduced muscle mass, and deterioration in nutritional status. In contrast, they explained that when weight is stably maintained, the positive effects of quitting smoking may be reflected in bone health.

Accordingly, the research team emphasized the need for comprehensive management, including weight control, nutritional intake, and strength training, alongside smoking cessation counseling. Jung Jina, a researcher at Seoul National University College of Medicine and the first author of the study, stated, "We have confirmed that weight changes after quitting smoking can be closely related to fracture risk in people with diabetes."

Professor Park Sangmin, corresponding author, said, "Quitting smoking alone did not immediately reduce the risk of fractures, but the association with risk reduction was confirmed when weight was stably maintained. If weight change occurs after quitting smoking, bone health assessment and tailored management should be conducted together."

This content was produced with the assistance of AI translation services.