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Bone loss and the risk of non-vertebral fractures in women and men: the Tromsø study

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Abstract

Summary

We assessed the association between the rate of forearm bone loss and non-vertebral fracture. Bone loss at the distal forearm predicted fractures, independently of baseline BMD, but not independently of follow-up BMD in women. The BMD level where an individual ends up is the significant predictor of fracture risk.

Introduction

Bone loss may predict fracture risk independently of baseline BMD. The influence of follow-up BMD on this prediction is unknown. The aim of this study was to assess the association between bone loss and fracture risk in both sexes in a prospective population-based study.

Methods

We included 1,208 postmenopausal women (50 to 74 years), and 1,336 men (55 to 74 years) from the Tromsø Study, who had repeated distal and ultra-distal forearm BMD measurements. Non-vertebral fractures were registered from 2001 to 2005.

Results

A total of 100 women and 46 men sustained fractures during the follow-up time. Independent of baseline BMD, the RR associated with distal site bone loss of 1 SD %/year was 1.23 (1.01-1.50) for low-trauma fractures (excluding hand, foot, skull & high-trauma) and 1.32 (1.07-1.62) for osteoporotic fractures (hip, wrist and shoulder). However, bone loss did not predict fracture after adjusting for follow-up BMD. The BMD level where an individual ends up became the significant predictor of fracture risk and not the rate of bone loss. Follow-up BMD at ultra-distal site was associated with low-trauma fractures in both sexes. While ultra-distal site BMD changes were not associated with fracture risk in both sexes.

Conclusion

Bone loss at the distal forearm predicted non-vertebral fractures, independently of baseline BMD, but not independently of follow-up BMD, in women. The BMD level where an individual ends up is the significant predictor of fracture risk and not the rate of bone loss.

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Abbreviations

BMD:

Bone mineral density

RR:

Relative risk

SD:

Standard deviation

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Acknowledgment

This work was supported by grant from the Centre for Research in the Elderly in Tromsø, the Northern Norway Regional Health Authority.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Institute of community medicine, University of Tromsø, 9037, Tromsø, Norway

    L. A. Ahmed, N. Emaus, Å. Bjørnerem, V. Fønnebø & L. Jørgensen

  2. SKDE, University Hospital of North Norway, Tromsø, Norway

    N. Emaus

  3. NST, University Hospital of North Norway, Tromsø, Norway

    G. K. Berntsen

  4. Department of Health and Care Sciences, University of Tromsø, Tromsø, Norway

    L. Jørgensen

  5. University Hospital of North Norway, Tromsø, Norway

    L. Jørgensen, H. Schirmer, J. Størmer & R. M. Joakimsen

  6. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway

    R. M. Joakimsen

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  1. L. A. Ahmed
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  2. N. Emaus
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Correspondence to L. A. Ahmed.

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Ahmed, L.A., Emaus, N., Berntsen, G.K. et al. Bone loss and the risk of non-vertebral fractures in women and men: the Tromsø study. Osteoporos Int 21, 1503–1511 (2010). https://doi.org/10.1007/s00198-009-1102-z

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  • DOI: https://doi.org/10.1007/s00198-009-1102-z

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