Differing risk profiles for individual fracture sites: Evidence from the global longitudinal study of osteoporosis in women (GLOW)
Authors
FitzGerald, GordonBoonen, Steven
Compston, Juliet E.
Pfeilschifter, Johannes
LaCroix, Andrea Z.
Hooven, Frederick H.
Gehlbach, Stephen H.
UMass Chan Affiliations
Center for Outcomes ResearchDocument Type
Journal ArticlePublication Date
2012-09-01Keywords
OsteoporosisOsteoporosis, Postmenopausal
Osteoporotic Fractures
Fractures, Bone
Health Services Research
Musculoskeletal Diseases
Metadata
Show full item recordAbstract
The purposes of this study were to examine fracture risk profiles at specific bone sites, and to understand why model discrimination using clinical risk factors is generally better in hip fracture models than in models that combine hip with other bones. Using 3-year data from the GLOW study (54,229 women with more than 4400 total fractures), we present Cox regression model results for 10 individual fracture sites, for both any and first-time fracture, among women aged >/=55 years. Advanced age is the strongest risk factor in hip (hazard ratio [HR] = 2.3 per 10-year increase), pelvis (HR = 1.8), upper leg (HR = 1.8), and clavicle (HR = 1.7) models. Age has a weaker association with wrist (HR = 1.1), rib (HR = 1.2), lower leg (not statistically significant), and ankle (HR = 0.81) fractures. Greater weight is associated with reduced risk for hip, pelvis, spine, and wrist, but higher risk for first lower leg and ankle fractures. Prior fracture of the same bone, although significant in nine of 10 models, is most strongly associated with spine (HR = 6.6) and rib (HR = 4.8) fractures. Past falls are important in all but spine models. Model c indices are >/=0.71 for hip, pelvis, upper leg, spine, clavicle, and rib, butSource
J Bone Miner Res. 2012 Sep;27(9):1907-1915. doi: 10.1002/jbmr.1652. Link to article on publisher's siteDOI
10.1002/jbmr.1652Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27166PubMed ID
22550021Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1002/jbmr.1652