Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: The global longitudinal study of osteoporosis in women (GLOW)
Authors
Compston, Juliet E.Flahive, Julie M.
Hosmer, David W. Jr.
Watts, Nelson B.
Siris, Ethel S.
Saag, Kenneth G.
Roux, Christian
Rossini, Maurizio
Pfeilschifter, Johannes
Nieves, Jeri W.
Netelenbos, J. Coen
March, Lyn
LaCroix, Andrea Z.
Hooven, Frederick H.
Greenspan, Susan L.
Gehlbach, Stephen H.
Diez-Perez, Adolfo
Cooper, Cyrus
Chapurlat, Roland D.
Boonen, Steven
Anderson, Frederick A. Jr.
Adami, Silvano
Adachi, Jonathan D.
GLOW Investigators
UMass Chan Affiliations
Center for Outcomes ResearchDocument Type
Journal ArticlePublication Date
2013-07-22Keywords
Osteoporosis, PostmenopausalFractures, Bone
Health Services Research
Musculoskeletal Diseases
Women's Health
Metadata
Show full item recordAbstract
Low body mass index (BMI) is a well-established risk factor for fracture in postmenopausal women. Height and obesity have also been associated with increased fracture risk at some sites. We investigated the relationships of weight, BMI, and height with incident clinical fracture in a practice-based cohort of postmenopausal women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). Data were collected at baseline and 1, 2, and 3 years. For hip, spine, wrist, pelvis, rib, upper arm/shoulder, clavicle, ankle, lower leg, and upper leg fractures, we modeled the time to incident self-reported fracture over a 3-year period using the Cox proportional hazards model and fitted the best linear or non-linear models containing height, weight, and BMI. Of 52,939 women, 3628 (6.9%) reported an incident clinical fracture during the 3-year follow-up period. Linear BMI showed a significant inverse association with hip, clinical spine, and wrist fractures: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) per increase of 5 kg/m2 were 0.80 (0.71-0.90), 0.83 (0.76-0.92), and 0.88 (0.83-0.94), respectively (all p < 0.001). For ankle fractures, linear weight showed a significant positive association: adjusted HR per 5-kg increase 1.05 (1.02-1.07) (p < 0.001). For upper arm/shoulder and clavicle fractures, only linear height was significantly associated: adjusted HRs per 10-cm increase were 0.85 (0.75-0.97) (p = 0.02) and 0.73 (0.57-0.92) (p = 0.009), respectively. For pelvic and rib fractures, the best models were for non-linear BMI or weight (p = 0.05 and 0.03, respectively), with inverse associations at low BMI/body weight and positive associations at high values. These data demonstrate that the relationships between fracture and weight, BMI, and height are site-specific. The different associations may be mediated, at least in part, by effects on bone mineral density, bone structure and geometry, and patterns of falling.Source
J Bone Miner Res. 2013 Jul 22. doi: 10.1002/jbmr.2051. Link to article on publisher's siteDOI
10.1002/jbmr.2051Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27149PubMed ID
23873741Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1002/jbmr.2051