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Taller women at increased risk for fracture
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Postmenopausal women who are taller have an overall increased risk for fracture, particularly at the femoral neck, according to study findings published in the Journal of Bone and Mineral Research.
Miranda E. G. Armstrong, PhD, of the cancer epidemiology unit at the University of Oxford, United Kingdom, analyzed data from 796,081 postmenopausal women participating in the Million Women Study through the British National Health Service. Researchers analyzed survey responses collected 3 years after recruitment on various health and lifestyle factors, including fracture and fall history and history of osteoporosis. Researchers linked survey information to hospital admission database information for the participants to analyze admissions for incident fracture at nine sites: humerus, radius and ulna, wrist, femoral neck, femur, patella, tibia and fibula, and ankle. Researchers calculated RR per 10-cm increase in height as a trend across six height category means.
During an average of 8.4 years of follow-up, there were 28,431 hospital admissions for fracture within the cohort; most hospitalizations were for wrist (n = 9,684), femoral neck (n = 5,734) and ankle fracture (n = 5,523).
After adjustment, RR for any fracture increased by 21% for each 10-cm increase in height (95% CI, 1.18-1.24). Researchers found the greatest risk for fracture at the femoral neck (RR = 1.48 per 10-cm increase; 95% CI, 1.39-1.57) and the proportional increase in risk was greater than all other fracture sites (P < .001).
Researchers also found an increased risk for fracture with height at all other sites (RR = 1.15 per 10 cm; 95% CI, 1.12-1.18), but noted that evidence for a possible difference in risk between the sites was very weak
“Height appears to be an independent risk factor for fractures, with little evidence of substantial confounding or effect modification by other factors for any of the fracture sites,” the researchers wrote. “Although height is not a modifiable risk factor, among individuals already at a higher risk for fracture, such as those suffering from osteoporosis or those with low adiposity or sarcopenia, it may be an important predictor of fracture risk.”
The researchers said a combination of biomechanical mechanisms may influence the relationships between height and fracture risk. Taller or heavier women may experience greater impact during a fall vs. shorter or lighter women, while height has also been associated with femur axis length, potentially increasing the incidence of femoral neck fractures. – by Regina Schaffer
Disclosure: One of the researchers reports serving as a non-executive director of the Medicines and Healthcare Products Regulatory Agency. Armstrong and the other researchers report no relevant financial disclosures.
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