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

L. A. Ahmed, N. Emaus, G. K. Berntsen, Å Bjørnerem, V. Fønnebø, L. Jørgensen, H. Schirmer, J. Størmer, R. M. Joakimsen

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32 Citations (Scopus)

Abstract

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 nonvertebral 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.

Original languageEnglish
Pages (from-to)1503-1511
Number of pages9
JournalOsteoporosis International
Volume21
Issue number9
DOIs
Publication statusPublished - Sep 2010
Externally publishedYes

Keywords

  • Bone loss
  • Bone mineral density
  • Fracture risk
  • Non-vertebral fractures
  • Osteoporotic fractures
  • Postmenopausal women

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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