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Osteoporosis International

Erschienen in:

01.07.2006 | Original Article

Risk factors for fragility fracture in middle age. A prospective population-based study of 33,000 men and women

verfasst von: A. H. Holmberg, O. Johnell, P. M. Nilsson, J. Nilsson, G. Berglund, K. Åkesson

Erschienen in: Osteoporosis International | Ausgabe 7/2006

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Abstract

The incidence of fragility fractures begins to increase in middle age. We investigated prospectively risk factors for low-energy fractures in men and women, and specifically for forearm, proximal humerus, vertebral, and ankle fractures. The population-based Malmö Preventive Project consists of 22,444 men and 10,902 women, mean age 44 and 50 years, respectively, at inclusion. Baseline assessment included multiple examinations and lifestyle information. Mean follow-up was 19 and 15 years for men and women, respectively, regarding incident fractures. Fractures were ascertained from radiographic files. At least one low-energy fracture occurred in 1,262 men and 1,257 women. In men, the risk factors most strongly associated with low-energy fractures were diabetes [relative risk (RR) 2.38, confidence interval (CI) 95% 1.65–3.42] and hospitalization for mental health problems (RR 1.92, CI 95% 1.47–2.51). Factors associated with mental health and lifestyle significantly increased the fracture risk in most of the specific fracture groups: hospitalizations for mental health problems (RR 2.28–3.38), poor appetite (RR 3.05–3.43), sleep disturbances (RR 1.72–2.95), poor self-rated health (RR 1.80–1.83), and smoking (RR 1.70–2.72). In women, the risk factors most strongly associated with low-energy fractures were diabetes (RR 1.87, CI 95% 1.26–2.79) and previous fracture (RR 2.00, CI 95% 1.56–2.58). High body mass index (BMI) significantly increased the risk of proximal humerus and ankle fractures (RR 1.21–1.33) while, by contrast, lowering the risk of forearm fractures (RR 0.88, CI 95% 0.81–0.96). Risk factors for fracture in middle-aged men and women are similar but with gender differences for forearm, vertebral, proximal humerus, and hip fracture whereas risk factors for ankle fractures differ to a certain extent. The risk-factor pattern indicates a generally impaired health status, with mental health problems as a major contributor to fracture risk, particularly in men.

Obrant KJ et al (1989) Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 44(3):157–167PubMedCrossRef

Kannus P et al (2002) Why is the age-standardized incidence of low-trauma fractures rising in many elderly populations? J Bone Miner Res 17(8):1363–1367PubMedCrossRef

van Staa TP et al (2001) Epidemiology of fractures in England and Wales. Bone 29(6):517–522PubMedCrossRef

Kanis JA, Pitt FA (1992) Epidemiology of osteoporosis. Bone 13(Suppl 1):S7–S15PubMedCrossRef

Melton LJ 3rd et al (2003) Cost-equivalence of different osteoporotic fractures. Osteoporos Int 14(5):383–388PubMedCrossRef

Ettinger B et al (2003) Limb fractures in elderly men as indicators of subsequent fracture risk. Arch Intern Med 163(22):2741–2747PubMedCrossRef

Klotzbuecher CM et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739PubMedCrossRef

Johnell O et al (2004) Fracture risk following an osteoporotic fracture. Osteoporos Int 15(3):175–179PubMedCrossRef

Berglund G et al (1996) Cardiovascular risk groups and mortality in an urban Swedish male population: the Malmo Preventive Project. J Intern Med 239(6):489–497PubMedCrossRef

10.

Holmberg A et al (2004) Forearm bone mineral density in 1294 middle-aged women: a strong predictor of fragility fractures. J Clin Densitom 7(4):419–423PubMedCrossRef

11.

Holmberg AH et al (2005) Risk factors for hip fractures in a middle-aged population: a study of 33,000 men and women. Osteoporos Int 16(12):2185–2194PubMedCrossRef

12.

Jonsson B et al (1993) Life-style and different fracture prevalence: a cross-sectional comparative population-based study. Calcif Tissue Int 52(6):425–433PubMedCrossRef

13.

Sanders KM et al (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10(3):240–247PubMedCrossRef

14.

Kanis JA et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11(8):669–674PubMedCrossRef

15.

Melton LJ 3rd et al (1998) Long-term trends in the incidence of distal forearm fractures. Osteoporos Int 8(4):341–348PubMedCrossRef

16.

Chu SP et al (2004) Risk factors for proximal humerus fracture. Am J Epidemiol 160(4):360–367PubMedCrossRef

17.

Nguyen TV et al (2001) Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study. Am J Epidemiol 153(6):587–595PubMedCrossRef

18.

Olsson C, Nordqvist A, Petersson CJ (2004) Increased fragility in patients with fracture of the proximal humerus: a case control study. Bone 34(6):1072–1077PubMedCrossRef

19.

Guggenbuhl P, Meadeb J, Chales G (2005) Osteoporotic fractures of the proximal humerus, pelvis, and ankle: epidemiology and diagnosis. Jt Bone Spine 72(5):372–375CrossRef

20.

Honkanen R et al (1998) Relationships between risk factors and fractures differ by type of fracture: a population-based study of 12,192 perimenopausal women. Osteoporos Int 8(1):25–31PubMedCrossRef

21.

Valtola A et al (2002) Lifestyle and other factors predict ankle fractures in perimenopausal women: a population-based prospective cohort study. Bone 30(1):238–242PubMedCrossRef

22.

Seeley DG et al (1996) Predictors of ankle and foot fractures in older women. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11(9):1347–1355PubMed

23.

Ahmed LA et al (2005) Diabetes mellitus and the risk of non-vertebral fractures: the Tromso study. Osteoporos Int :1–6

24.

Forsen L et al (1999) Diabetes mellitus and the incidence of hip fracture: results from the Nord-Trondelag Health Survey. Diabetologia 42(8):920–925PubMedCrossRef

25.

Ottenbacher KJ et al (2002) Diabetes mellitus as a risk factor for hip fracture in Mexican American older adults. J Gerontol A Biol Sci Med Sci 57(10):M648–M653PubMed

26.

Schwartz AV et al (2001) Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metab 86(1):32–38PubMedCrossRef

27.

Vestergaard P, Rejnmark L, Mosekilde L (2005) Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia 48(7):1292–1299PubMedCrossRef

28.

Adami S et al (2004) Relationship between lipids and bone mass in 2 cohorts of healthy women and men. Calcif Tissue Int 74(2):136–142PubMedCrossRef

29.

Lidfeldt J et al (2002) The influence of hormonal status and features of the metabolic syndrome on bone density: a population-based study of Swedish women aged 50 to 59 years. The women’s health in the Lund area study. Metabolism 51(2):267–270PubMedCrossRef

30.

Conigrave KM et al (2003) Traditional markers of excessive alcohol use. Addiction 98(Suppl 2):31–43PubMedCrossRef

31.

Conigrave KM, Saunders JB, Whitfield JB (1995) Diagnostic tests for alcohol consumption. Alcohol Alcohol 30(1):13–26PubMed

32.

Banciu T et al (1983) Serum gamma-glutamyltranspeptidase assay in the detection of alcohol consumers and in the early and stadial diagnosis of alcoholic liver disease. Med Interne 21(1):23–29PubMed

33.

Trell E, Kristenson H, Fex G (1984) Alcohol-related problems in middle-aged men with elevated serum gamma-glutamyltransferase: a preventive medical investigation. J Stud Alcohol 45(4):302–309PubMed

34.

Yokoyama H et al (2003) Association between gamma-glutamyl transpeptidase activity and status of disorders constituting insulin resistance syndrome. Alcohol Clin Exp Res 27(8 Suppl):22S–25SPubMedCrossRef

35.

Kanis J et al (1999) Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos Int 9(1):45–54PubMedCrossRef

36.

Johnell O et al (1995) Risk factors for hip fracture in European women: the MEDOS Study. Mediterranean Osteoporosis Study. J Bone Miner Res 10(11):1802–1815PubMedCrossRef

37.

Clark MK et al (2003) Bone mineral density and fractures among alcohol-dependent women in treatment and in recovery. Osteoporos Int 14(5):396–403PubMedCrossRef

38.

Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16(3):229–238PubMedCrossRef

39.

Law MR, Hackshaw AK (1997) A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. BMJ 315(7112):841–846PubMed

40.

Huopio J et al (2000) Risk factors for perimenopausal fractures: a prospective study. Osteoporos Int 11(3):219–227PubMedCrossRef

41.

Kiel DP et al (1996) The effect of smoking at different life stages on bone mineral density in elderly men and women. Osteoporos Int 6(3):240–248PubMedCrossRef

42.

Gerdhem P, Obrant KJ (2002) Effects of cigarette-smoking on bone mass as assessed by dual-energy X-ray absorptiometry and ultrasound. Osteoporos Int 13(12):932–936PubMedCrossRef

43.

Ahmed LA et al (2006) Self-reported diseases and the risk of non-vertebral fractures: the Tromso study. Osteoporos Int 17(1):46–53PubMedCrossRef

Titel: Risk factors for fragility fracture in middle age. A prospective population-based study of 33,000 men and women
verfasst von: A. H. Holmberg
O. Johnell
P. M. Nilsson
J. Nilsson
G. Berglund
K. Åkesson
Publikationsdatum: 01.07.2006
Verlag: Springer-Verlag
Erschienen in: Osteoporosis International / Ausgabe 7/2006
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-006-0137-7

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