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Wrist fracture as a predictor of future fractures in younger versus older postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA)

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Abstract

Summary

The short-term association between wrist-fracture history and future fracture has not been simultaneously compared between younger and older postmenopausal women. This 3-year follow-up study of 158,940 women showed a similar future fracture risk in younger and older women with wrist-fracture history.

Introduction

We examined the association between prior wrist fracture and future osteoporosis-related fractures within 3 years in younger and older postmenopausal women.

Methods

In the National Osteoporosis Risk Assessment (NORA) study, 158,940 postmenopausal women, aged 50-98 (median 63) years, provided information on fracture history since age 45, and responded to follow-up surveys 1 or 3 years later when new fractures were queried. Cox regression models were used to obtain relative risk (RR) and 95% confidence interval (CI) estimates.

Results

Of the 158,940 participants, 8,665 reported a history of wrist fracture at baseline; 4,316 women reported at least one new fracture within three years. The RR for any subsequent clinical fracture, adjusted for covariates and baseline BMD T-score, was 2.4 (2.0, 2.9) for younger and 2.1 (1.9, 2.3) for older women. A prior wrist fracture increased the risk of a future wrist fracture about 3-fold and doubled the risk of any osteoporotic fracture.

Conclusions

Prior wrist fracture strongly predicts three-year risk of any future osteoporotic fracture for older and younger postmenopausal women, independent of baseline BMD and common osteoporosis risk factors. More consideration should be given to evaluating and managing osteoporosis in younger and older women with a history of wrist fracture, independent of their BMD.

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Acknowledgments

National Osteoporosis Risk Assessment (NORA) was funded and managed by Merck & Co., Inc. in collaboration with the International Society for Clinical Densitometry.

Disclaimer/Conflict of interest statement

Drs. Barrett-Connor, Siris, and Miller receive consulting fees from Merck & Co., Inc. to compensate them for time spent working on the NORA project; Drs. Sajjan, Chen, and Markson are paid employees of Merck & Co., Inc.

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Authors and Affiliations

  1. Department of Family and Preventive Medicine, University of California, San Diego, Stein Clinical Research Building, Room 349, 9500 Gilman Drive, Mail Code: 0607, La Jolla, CA, 92093-0607, USA

    E. Barrett-Connor

  2. Outcomes Research & Management, Merck & Co., Inc., West Point, PA, USA

    S. G. Sajjan, Y.-T. Chen & L. E. Markson

  3. Columbia University College of Physicians and Surgeons, New York, NY, USA

    E. S. Siris

  4. Colorado Center for Bone Research, Lakewood, CO, USA

    P. D. Miller

Authors
  1. E. Barrett-Connor
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  2. S. G. Sajjan
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  3. E. S. Siris
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  4. P. D. Miller
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  5. Y.-T. Chen
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  6. L. E. Markson
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Corresponding author

Correspondence to E. Barrett-Connor.

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Barrett-Connor, E., Sajjan, S.G., Siris, E.S. et al. Wrist fracture as a predictor of future fractures in younger versus older postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 19, 607–613 (2008). https://doi.org/10.1007/s00198-007-0508-8

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  • DOI: https://doi.org/10.1007/s00198-007-0508-8

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