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Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women

Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women
Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women
Low body mass index (BMI) is a well-established risk factor for fracture in postmenopausal women. Height and obesity have also been associated with increased fracture risk at some sites. We investigated the relationships of weight, BMI, and height with incident clinical fracture in a practice-based cohort of postmenopausal women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). Data were collected at baseline and at 1, 2, and 3 years. For hip, spine, wrist, pelvis, rib, upper arm/shoulder, clavicle, ankle, lower leg, and upper leg fractures, we modeled the time to incident self-reported fracture over a 3-year period using the Cox proportional hazards model and fitted the best linear or nonlinear models containing height, weight, and BMI. Of 52,939 women, 3628 (6.9%) reported an incident clinical fracture during the 3-year follow-up period. Linear BMI showed a significant inverse association with hip, clinical spine, and wrist fractures: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) per increase of 5?kg/m2 were 0.80 (0.71–0.90), 0.83 (0.76–0.92), and 0.88 (0.83–0.94), respectively (all p?<?0.001). For ankle fractures, linear weight showed a significant positive association: adjusted HR per 5-kg increase 1.05 (1.02–1.07) (p?<?0.001). For upper arm/shoulder and clavicle fractures, only linear height was significantly associated: adjusted HRs per 10-cm increase were 0.85 (0.75–0.97) (p?=?0.02) and 0.73 (0.57–0.92) (p?=?0.009), respectively. For pelvic and rib fractures, the best models were for nonlinear BMI or weight (p?=?0.05 and 0.03, respectively), with inverse associations at low BMI/body weight and positive associations at high values. These data demonstrate that the relationships between fracture and weight, BMI, and height are site-specific. The different associations may be mediated, at least in part, by effects on bone mineral density, bone structure and geometry, and patterns of falling
0884-0431
487-493
Compston, J.E.
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Flahive, J.
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Hosmer, D.W.
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Watts, N.B.
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Siris, E.S.
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Silverman, S.
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Saag, K.G.
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Roux, C.
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Rossini, M.
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Pfeilschifter, J.
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Nieves, J.W.
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Netelenbos, J.C.
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March, L.
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LaCroix, A.Z.
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Hooven, F.H.
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Greenspan, S.L.
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Gehlbach, S.H.
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Diez-Perez, A.
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Cooper, C.
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Chapurlat, R.D.
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Boonen, S.
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Anderson, F.A.
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Adami, S.
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Adachi, J.
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Compston, J.E.
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Flahive, J.
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Hosmer, D.W.
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Watts, N.B.
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Siris, E.S.
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Silverman, S.
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Saag, K.G.
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Roux, C.
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Rossini, M.
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Pfeilschifter, J.
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Nieves, J.W.
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Netelenbos, J.C.
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March, L.
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LaCroix, A.Z.
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Hooven, F.H.
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Greenspan, S.L.
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Gehlbach, S.H.
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Diez-Perez, A.
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Cooper, C.
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Chapurlat, R.D.
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Boonen, S.
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Anderson, F.A.
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Adami, S.
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Adachi, J.
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Compston, J.E., Flahive, J., Hosmer, D.W., Watts, N.B., Siris, E.S., Silverman, S., Saag, K.G., Roux, C., Rossini, M., Pfeilschifter, J., Nieves, J.W., Netelenbos, J.C., March, L., LaCroix, A.Z., Hooven, F.H., Greenspan, S.L., Gehlbach, S.H., Diez-Perez, A., Cooper, C., Chapurlat, R.D., Boonen, S., Anderson, F.A., Adami, S. and Adachi, J. (2014) Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women. Journal of Bone and Mineral Research, 29 (2), 487-493. (doi:10.1002/jbmr.2051). (PMID:23873741)

Record type: Article

Abstract

Low body mass index (BMI) is a well-established risk factor for fracture in postmenopausal women. Height and obesity have also been associated with increased fracture risk at some sites. We investigated the relationships of weight, BMI, and height with incident clinical fracture in a practice-based cohort of postmenopausal women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). Data were collected at baseline and at 1, 2, and 3 years. For hip, spine, wrist, pelvis, rib, upper arm/shoulder, clavicle, ankle, lower leg, and upper leg fractures, we modeled the time to incident self-reported fracture over a 3-year period using the Cox proportional hazards model and fitted the best linear or nonlinear models containing height, weight, and BMI. Of 52,939 women, 3628 (6.9%) reported an incident clinical fracture during the 3-year follow-up period. Linear BMI showed a significant inverse association with hip, clinical spine, and wrist fractures: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) per increase of 5?kg/m2 were 0.80 (0.71–0.90), 0.83 (0.76–0.92), and 0.88 (0.83–0.94), respectively (all p?<?0.001). For ankle fractures, linear weight showed a significant positive association: adjusted HR per 5-kg increase 1.05 (1.02–1.07) (p?<?0.001). For upper arm/shoulder and clavicle fractures, only linear height was significantly associated: adjusted HRs per 10-cm increase were 0.85 (0.75–0.97) (p?=?0.02) and 0.73 (0.57–0.92) (p?=?0.009), respectively. For pelvic and rib fractures, the best models were for nonlinear BMI or weight (p?=?0.05 and 0.03, respectively), with inverse associations at low BMI/body weight and positive associations at high values. These data demonstrate that the relationships between fracture and weight, BMI, and height are site-specific. The different associations may be mediated, at least in part, by effects on bone mineral density, bone structure and geometry, and patterns of falling

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Published date: February 2014
Organisations: Human Development & Health

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Local EPrints ID: 362787
URI: http://eprints.soton.ac.uk/id/eprint/362787
ISSN: 0884-0431
PURE UUID: 2500c33e-48e5-4604-8daa-bf655f27af82
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 10 Mar 2014 11:44
Last modified: 18 Mar 2024 02:45

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Contributors

Author: J.E. Compston
Author: J. Flahive
Author: D.W. Hosmer
Author: N.B. Watts
Author: E.S. Siris
Author: S. Silverman
Author: K.G. Saag
Author: C. Roux
Author: M. Rossini
Author: J. Pfeilschifter
Author: J.W. Nieves
Author: J.C. Netelenbos
Author: L. March
Author: A.Z. LaCroix
Author: F.H. Hooven
Author: S.L. Greenspan
Author: S.H. Gehlbach
Author: A. Diez-Perez
Author: C. Cooper ORCID iD
Author: R.D. Chapurlat
Author: S. Boonen
Author: F.A. Anderson
Author: S. Adami
Author: J. Adachi

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