This article is more than 5 years old. Information may no longer be current.
Risk factors differ by fracture site in postmenopausal women
Click Here to Manage Email Alerts
BMI and physical activity are modifiable risk factors for fracture in postmenopausal women; however, their associations with fracture risk vary substantially by site, according to recent study findings.
Jason Lacombe, of the faculty of kinesiology and physical education at the University of Toronto, and colleagues analyzed data from 1,154,821 women participating in the Million Women Study, a population-based, prospective cohort of women in the United Kingdom recruited between 1996 and 2001 (mean age, 56 years at enrollment). Women provided health and lifestyle data via questionnaires; all participants were linked to National Health Service hospital records for admissions information, with a mean follow-up of 11 years. Researchers used Cox regression models to calculate adjusted absolute and relative risks for seven site-specific incident fractures.
Over the course of follow-up, 4,931 women had a fracture of the humerus; 2,926 had a forearm fracture; 15,883 had a wrist fracture; 9,887 had a femoral neck fracture; 1,166 had a femur fracture (not femoral neck); 3,199 had a lower leg fracture; and 10,092 had an ankle fracture. Researchers found that age-specific incidence rates, measured in 5-year age bands, increased gradually with age for fractures of the forearm, femur, lower leg and ankle, with a steeper risk observed for humerus, femoral neck and wrist fracture. Cumulative absolute risks over 35 years from ages 50 to 84 years were 3 for humerus fracture (95% CI, 2.7-3.4), 1.2 for forearm fracture (95% CI, 1-1.4), 6.3 for wrist fracture (95% CI, 5.9-6.7), 9.1 for femoral neck fracture (95% CI, 8.4-9.8), 0.7 for femur (95% CI, 0.6-0.9), 1.3 for lower leg fracture (95% CI, 1.1-1.5) and 3.2 for ankle fracture (95% CI, 2.9-3.4).
Researchers found that women with a higher BMI had a lower risk for fracture of the femoral neck, forearm and wrist; however, these women also had a higher risk for fracture of the humerus, lower leg, ankle and femur. Compared with women who had a BMI between 20 and 24.9 kg/m², having a lower BMI was associated with higher risk for fracture at all sites except the ankle (P < .001).
Women who reported regular strenuous physical activity had a lower risk ratio for fractures of the femur and femoral neck (P < .001). Researchers found no link between strenuous activity and fracture risk of the lower leg, ankle, forearm or wrist (P .2). – by Regina Schaffer
Disclosure: Lacombe reports receiving support from a Sir Frederick Banting and Charles Best Canada Graduate Scholarship-Master’s from CIHR and from the Psychosocial Oncology Research Training Program Master’s, as well as support from the Michael Smith Foreign Study Supplements Program. Please see the full study for the other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts