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We also found that obesity was associated with an increased risk of hip and other fractures after adjustment for BMD, but this association appeared to be due at least in part http://www.selleck.cn/products/BIBW2992.html to confounding by deficits in physical performance. Similar deficits have been linked to fall rates27, 28 and might mediate the obesity-fracture relationship. However, adjustment for a history of falls in the previous year, which has been consistently predictive of incident falls,28, 29 did not alter associations. In light of our finding that many fractures occur in men of higher BMI, public health and clinical strategies must be developed to identify overweight and obese individuals at greatest risk. Moreover, since obesity appears to impart particular risk for fracture after BMD adjustment, the mechanisms that are responsible must be determined. Whereas some previous http://www.selleckchem.com/products/ly2157299.html analyses have noted a tendency for increased weight to be associated with higher fracture risk,6, 30, 31 the MrOS study design made it possible to examine fracture and BMI associations in ranges more typical of in men in the United States Very few MrOS men were in the clinical underweight category ( http://www.selleckchem.com/products/z-vad-fmk.html (27.4?kg/m2) is higher than the mean for men in a recent meta-analysis of seven studies of BMI and fracture4 that focused on the relationship of low weight and fracture risk. Our findings are not incompatible with studies that have reported a higher risk of fracture for men with low BMI than for men with a normal BMI. In fact, in the meta-analysis of BMI and fracture in men, the association was observed to be nonlinear, with greatest risk in low BMI and no additional reduction of risk among men with greater than normal BMI.4 Whereas the importance of low weight as a risk factor for fracture should not be ignored, the proportion of men 70 to 79 years of age in the United States who are underweight is small [