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Previous fractures at multiple sites increase the risk for subsequent fractures: the global longitudinal study of osteoporosis in women

Record type: Article

Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women aged ?55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ?3 fractures, respectively, since age 45 years. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no previous fractures, women with 1, 2, or ?3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ?3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio [HR]?=?7.3) and hip (HR?=?3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, and previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture. Women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development.

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Citation

Gelhbach, Stephen, Saag, Kenneth .G., Adachi, Jonathan D., Hooven, Fred H., Flahvie, Julie, Boonen, Steven, Chapurlat, Roland D., Compston, Juliet E., Cooper, Cyrus, Diez-Perez, Adolfo, Greenspan, Susan L., LaCroix, Andrea Z., Netelenbos, J. Coen, Pfeilschifter, Johannes, Rossini, Maurizio, Roux, Christian, Sambrook, Philip N., Silverman, Stuart, Siris, Ethel S., Watts, Nelson B. and Lindsay, Robert (2012) Previous fractures at multiple sites increase the risk for subsequent fractures: the global longitudinal study of osteoporosis in women Journal of Bone and Mineral Research, 27, (3), pp. 645-653. (doi:10.1002/jbmr.1476). (PMID:22113888).

More information

e-pub ahead of print date: 21 February 2012
Published date: March 2012
Keywords: women, fracture, osteoporosis, predictor
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 340467
URI: http://eprints.soton.ac.uk/id/eprint/340467
ISSN: 0884-0431
PURE UUID: 33c3ea6f-0bc5-4eda-b2e0-e8c381ac9e4f

Catalogue record

Date deposited: 22 Jun 2012 11:02
Last modified: 18 Jul 2017 05:44

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Contributors

Author: Stephen Gelhbach
Author: Kenneth .G. Saag
Author: Jonathan D. Adachi
Author: Fred H. Hooven
Author: Julie Flahvie
Author: Steven Boonen
Author: Roland D. Chapurlat
Author: Juliet E. Compston
Author: Cyrus Cooper
Author: Adolfo Diez-Perez
Author: Susan L. Greenspan
Author: Andrea Z. LaCroix
Author: J. Coen Netelenbos
Author: Johannes Pfeilschifter
Author: Maurizio Rossini
Author: Christian Roux
Author: Philip N. Sambrook
Author: Stuart Silverman
Author: Ethel S. Siris
Author: Nelson B. Watts
Author: Robert Lindsay

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