The association between alcohol consumption and risk of hip fracture differs by age and gender in Cohort of Norway: a NOREPOS study
The association between alcohol consumption and hip fracture differed by gender: Men aged 30–59 years drinking frequently or 14+ gl/week had higher risk than moderate drinkers. No significant association was seen in older men. Women not drinking alcohol had higher risk than those drinking moderately both regarding frequency and amount.
We aimed to examine alcohol consumption and risk of hip fracture according to age and gender in the population-based Cohort of Norway (1994–2003).
Socio-demographics, lifestyle, and health were self-reported and weight and height were measured in 70,568 men and 71,357 women ≥ 30 years. Information on subsequent hip fractures was retrieved from hospitals’ electronic patient registries during 1994–2013. Frequency of alcohol consumption was categorized: never/seldom, moderate (≤ 2–3 times/week), or frequent (≥ 4 times/week), and amount as number of glasses per week: 0, 1–6, 7–13, 14–27, and 28+. Type of alcohol (wine vs. beer/hard liquor) was also examined. Cox’s proportional hazards regression was used to estimate hazard ratios (HRs) stratified on gender and baseline age < 60 and ≥ 60 years.
During median 15-year follow-up, 1558 men and 2511 women suffered a hip fracture. Using moderate drinkers as reference, men < 60 years drinking frequently had multivariable adjusted HR = 1.73 (CI 1.02–2.96) for hip fracture and more than 2.5 times higher risk if they consumed 14+ glasses compared to 1–6 glasses per week. In other groups of age and gender, no statistically significant increased risk was found in those consuming the highest levels of alcohol. Compared to women with moderate or frequent alcohol use, never/seldom-drinking women had the highest fracture risk. In women, use of wine was associated with lower fracture risk than other types of alcohol.
Risk of hip fracture was highest in men < 60 years with the highest frequency and amount of alcohol consumption and in non-drinking women.
KeywordsAge Alcohol consumption Amount Frequency Gender Hip fracture
The authors wish to acknowledge the services of CONOR and the contributing research centers delivering data to CONOR. The authors are deeply grateful to Tomislav Dimoski (Norwegian Institute of Public Health (NIPH), the Statistics Norway, the Norwegian Patient Register, and the staff at the Department of Pharmacoepidemiology (Norwegian Institute of Public Health—NIPH) contributing to the collection and encryption of the hip fracture data. Professor Aage Tverdal (NIPH) has generously managed the original project. Sincere thanks also to senior scientist Ståle Østhus (NIPH) for valuable guiding into the practical methods of calculating amount of alcohol consumption. We also want to acknowledge the other members of NOREPOS Research Group: Professor Nina Emaus, Consultant and Associate professor Guri Grimnes, Professor Berit Schei, Professor Siri Forsmo, Consultant Ellen Apalset, and Post doc Cecilie Dahl.
Compliance with ethical standards
Cohort of Norway and linkages between the data sources were approved by the Regional Committee for Medical and Health Research Ethics (region South-East) and the Norwegian Data Protection Authority. All participants in the CONOR study gave their written informed consent. The CONOR steering committee approved the project. The study has been conducted in full accordance with the Declaration of Helsinki of the World Medical Association
Conflicts of interest
- 2.Omsland TK, Holvik K, Meyer HE, Center JR, Emaus N, Tell GS, Schei B, Tverdal A, Gjesdal CG, Grimnes G, Forsmo S, Eisman JA, Søgaard AJ (2012) Hip fractures in Norway 1999-2008: time trends in total incidence and second hip fracture rates: a NOREPOS study. Eur J Epidemiol 27:807–814. https://doi.org/10.1007/s10654-012-9711-9 CrossRefPubMedGoogle Scholar
- 5.Omsland TK, Emaus N, Magnus JH, Ahmed LA, Holvik K, Center J, Forsmo S, Gjesdal CG, Schei B, Vestergaard P, Eisman JA, Falch JA, Tverdal A, Søgaard AJ, Meyer HE (2014) Mortality following the first hip fracture in Norwegian women and men (1999-2008). A NOREPOS study. Bone 63:81–86CrossRefGoogle Scholar
- 6.Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, IOF CSA Working Group on Fracture Epidemiology (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288. https://doi.org/10.1007/s00198-011-1601-6 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Huijts T, Stornes P, Eikemo TA, Bambra C, HiNews Consortium (2017) The social and behavioural determinants of health in Europe: findings from the European Social Survey (2014) special module on the social determinants of health. Eur J Pub Health 27(suppl 1):55–62. https://doi.org/10.1093/eurpub/ckw231 CrossRefGoogle Scholar
- 23.Rehm J (1998) Measuring quantity, frequency, and volume of drinking. Alcohol Clin Exp Res 22(Suppl):4–14. https://doi.org/10.1111/j.1530-0277.1998.tb04368.x CrossRefGoogle Scholar
- 26.Aamodt G, Søgaard AJ, Næss Ø, Beckstrøm AC, Samuelsen SO, the CONOR steering group (2012) Cohort of Norway (CONOR): Potential for research, design and representativeness (in Norwegian). Oslo, Norway, Norwegian Institute of Public Health. https://www.fhi.no/globalassets/dokumenterfiler/conor.pdf. Accessed April 2018
- 36.Waite L, Gallagher M (2002) The case for marriage: why married people are happier, healthier and better off financially. Random House LLC, New YorkGoogle Scholar
- 39.Horverak Ø, Bye EK (2007). Det norske drikkemønsteret (in Norwegian). SIRUS-rapport nr. 2/2007. Statens institutt for rusmiddelforskning, Oslo, Norway. https://www.fhi.no/globalassets/dokumenterfiler/rapporter/sirusrap.2.07.pd.pdf
- 44.Bye EK, Amundsen EJ, Lund M (2013) Bruk av tobakk, rusmidler og vanedannende legemidler i Norge – hovedfunn fra SIRUS’ befolkningsundersøkelse i 2012 (in Norwegian). SIRUS-rapport 6/2013. Statens institutt for rusmiddelforskning, Oslo, Norway. https://www.fhi.no/globalassets/dokumenterfiler/rapporter/sirusrap.6.13.pdf