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Osteoporosis International

, Volume 11, Issue 3, pp 265–270 | Cite as

Risk Factors for Perimenopausal Distal Forearm Fracture

  • R. J. Honkanen
  • K. Honkanen
  • H. Kröger
  • E. Alhava
  • M. Tuppurainen
  • S. Saarikoski
Original Article

Abstract:

This prospective population-based cohort study investigated factors predicting distal forearm fracture (DFF) in perimenopausal women. The study population consisted of 11 798 women from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) Study in Finland. Mean baseline age of these women was 52.3 (SD 2.9) years (range 47–56 years) and 68% were postmenopausal. Three hundred and sixty-eight women (3.1%) had a validated DFF during the 5-year follow-up. Previous wrist fracture, postmenopausal state, age and nulliparity were independent predictors of DFF, while hormone replacement therapy (HRT), dairy calcium and overweight protected against it in multivariate Cox regression analysis: previous wrist fracture increased the DFF risk by 158% (p<0.0001), menopause by 69% (p= 0.002) and age by 6% per year (p= 0.010), whereas the continuous use of HRT decreased the risk by 63% (p= 0.0001), the use of dairy calcium at 1000–1499 mg/day (vs <500 mg/day) by 39% (p= 0.004), overweight (BMI >25 kg/m2) by 36% (p= 0.0002) and parity by 29% (p= 0.031). Combining dichotomous low weight, low use of calcium, non-use of HRT and previous wrist fracture into a risk score gave a dose–response effect by score level: the presence (vs absence) of all four risk factors resulted in a 12-fold DFF risk. Nevertheless, the sensitivity and specificity of the score for detecting DFF remained low. It was concluded that HRT, high nutritional calcium intake and overweight protect against but a history of wrist fracture predisposes to perimenopausal distal forearm fracture. A simple risk factor inquiry would help to identify perimenopausal women at high risk of distal forearm fracture.

Key words:Calcium – Forearm fracture – HRT – Osteoporosis – Risk factor 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2000

Authors and Affiliations

  • R. J. Honkanen
    • 1
  • K. Honkanen
    • 1
  • H. Kröger
    • 3
  • E. Alhava
    • 3
  • M. Tuppurainen
    • 2
  • S. Saarikoski
    • 2
  1. 1.Research Institute of Public Health, University of Kuopio, Kuopio, FinlandFI
  2. 2.Department of Gynecology, Kuopio University Hospital, Finland;FI
  3. 3.Department of Surgery, Kuopio University Hospital, FinlandFI

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