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Anemia increases risk for any, nonspine fractures in older men
The risk for any fracture and nonspine fractures is increased among older men with anemia compared with those without anemia, independent of bone loss and bone density change over time, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Joy Y. Wu, MD, PhD, associate professor of medicine, department of endocrinology, gerontology and metabolism at Stanford University, and colleagues evaluated data from the Osteoporotic Fractures in Men Study on 3,632 men to determine whether men with anemia have an increased risk for fracture. Men were aged 65 years or older and had no fractures at baseline (2000-2002) and had complete blood counts at the third study visit (2007-2009). Follow-up was a median 7.2 years after the third study visit. Anemia was present in 249 participants.
During the study period, 562 participants had a least one new fracture. During follow-up, 498 participants developed new nonspine fractures and 92 participants developed new spine fractures. Compared with participants without anemia, those with anemia were less likely to be free of any (P < .0001) and nonspine fractures (P < .0001).
After adjustment for clinic site, age, BMI, prevalent fracture, bone medication use, self-reported health, physical activity score, rheumatoid arthritis status and weight change since baseline, anemia was correlated with a 67% increased risk for any fracture (HR = 1.67; 95% CI, 1.26-2.21) and a 70% increased risk for nonspine fracture (HR = 1.7; 95% CI, 1.25-2.31). A 52% increased risk for any fracture (HR = 1.52; 95% CI, 1.37-1.69) and a 61% increased risk for nonspine fracture (HR = 1.61; 95% CI, 1.44-1.81) were associated with every 1 standard deviation decrease in total hip bone mineral density.
“We found that men with anemia had an increased risk for nonspine fracture after controlling for multiple factors,” the researchers wrote. “The mechanism of this relationship is unclear, but it appears that it is not mediated by bone density. A hemoglobin assessment may be helpful for fracture risk stratification.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.