Associations of Dietary Indices with Hip Fracture in Postmenopausal Women and Subsequent Major Osteoporotic Fracture in the Japanese Clinical Setting

Background: Nutritional status affects bone fragility and related fractures. We investigated the relationships between bone fragility fractures and nutritional indicators, including the Geriatric Nutrition Risk Index (GNRI), Prognostic Nutrition Index (PNI), Control Nutrition Status (CONUT) score, and body mass index (BMI). Methods: Postmenopausal female outpatients aged 75 or older who experienced a hip fracture 2 to 4 weeks ago (hip fracture group; G-HF) or who have no history of hip fracture without secondary osteoporosis but have a T-score of bone mineral density less than −2.5 (primary osteoporosis group; G-POP) were studied using both cross-sectional and longitudinal methods. Variables, including blood test results, T-scores, and nutritional indicators at baseline, were compared between the two groups using a crude dataset and after propensity score matching (PSM). Correlations between hip fracture (HF) and baseline variables were statistically analyzed. The relationship between nutritional indicators and the development of subsequent major osteoporotic fractures (MOFs) after baseline was examined, and the relationship between dietary indicators and functional capacity was also investigated. Results: A total of 1201 patients were recruited from these 113 G-HF and 1088 G-POP groups (crude dataset), of whom 113 were included after PSM. There were many differences between the two groups using the crude dataset. However, no items were significantly different after PSM except for white blood cell count (WBC) and serum phosphorus levels. GNRI < 105.5 demonstrated a typical regression curve regarding prevalent hip fractures. Developing MOF was significantly correlated with T-scores in the femoral neck and the presence of a prevalent fragility fracture. PNI and GNRI demonstrated a significant correlation between functional capacity; however, there was no correlation with the development of MOF. Conclusions: GNRI < 105.5 was significantly correlated with the presence of hip fracture, although no significant association was found with the development of MOF.