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- Holmberg, Anna H, et al.
(författare)
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Risk factors for hip fractures in a middle-aged population: a study of 33,000 men and women.
- 2005
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 16:Sep22, s. 2185-2194
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge about subjects who sustain hip fractures in middle age is poor. This study prospectively investigated risk factors for hip fracture in middle age and compared risk factors for cervical and trochanteric hip fractures. The Malmo Preventive Project consists of 22,444 men, mean age 44 years, and 10,902 women, mean age 50 years at inclusion. Baseline assessment included multiple examinations and lifestyle information. Follow-up was up to 16 years with regard to occurrence of fracture. One hundred thirty-five women had one low-energy hip fracture each, 93 of which were cervical and 42 trochanteric. One hundred sixty-three men had 166 hip fractures, of which 81 were cervical and 85 trochanteric. In the final Cox regression model for women, the risk factors with the strongest associations with hip fracture were diabetes (risk ratio (RR) 3.89, 95% confidence interval (CI) 1.69-8.93, p=0.001) and poor self-rated health (RR 1.74, 95% CI 1.22-2.48, p=0.002). A history of previous fracture (RR 4.76, 95%CI 2.74-8.26, p=0.0001) was also a significant risk factor. In men, diabetes had the strongest association with hip fracture (RR 6.13, 95%CI 3.19-11.8, p=0.001). Smoking (RR 2.20, 95%CI 1.54-3.15, p=0.001), high serum gamma-glutamyl transferase (RR 1.84, 95%CI 1.50-2.26, p=0.001), poor self-rated health (RR 1.49, 95%CI 1.06-2.10, p=0.02) and reported sleep disturbances (RR 1.52, 95%CI 1.03-2.27, p=0.04) were other significant risk factors. The strongest risk factor for hip fracture for both women and men in middle age was diabetes. Many risk factors were similar for men and women, although the risk ratio differed. The risk factor pattern for cervical versus trochanteric fractures differed in both men and women. The findings indicate that those suffering a hip fracture before the age of 75 have a shorter life expectancy, suggesting that hip fractures affect the less healthy segment of the population.
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- Karlsson, Magnus K., et al.
(författare)
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Bone mineral normative data in Malmö, Sweden : Comparison with reference data and hip fracture incidence in other ethnic groups
- 1993
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 64:2, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- The bone mineral mass was measured in 324 residents of the city of Malmö Sweden, by dual energy roentgen absorptiometry (DEXA) using the Lunar DPX equipment - total body, hip, and lumbar vertebrae. the bone mineral content of the wrist was also measured with single photon absorptiometry (SPA) in 88 of the individuals. Weight, height, and vertebral height, as well as body fat, lean body mass, menarcheal age, menopausal age, and hand grip strength were determined. Measurements were compared with reference bone mineral content values from the United States, Japan, and France - also hip fracture incidence was compared. All bone mineral values decreased with age. A good correlation was found between the DEXA technique of total body bone mineral and the forearm SPA values. the bone mineral content was correlated with lean body mass and weight. the Malmö bone mineral content was on the same level as in the United States, but higher than in Japan and France. the comparatively high risk of fragility fractures in the Scandinavian countries compared with most other settings cannot be explained by low bone mass.
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- Åkesson, Kristina, et al.
(författare)
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Assessment of biochemical markers of bone metabolism in relation to the occurrence of fracture : a retrospective and prospective population-based study of women
- 1995
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Ingår i: Journal of Bone and Mineral Research. - : Wiley. - 0884-0431 .- 1523-4681. ; 10:11, s. 1823-1829
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Tidskriftsartikel (refereegranskat)abstract
- We have in a population-based setting evaluated biochemical markers of bone metabolism in 328 women, aged 40-80 years, and related it to contents of bone mineral measurements and the retrospective and prospective presence of fracture. The participants were recruited from the city population files. Serum samples for analysis of osteocalcin (Oc), procollagen I carboxy-terminal extension peptide (PICP), and carboxy-terminal telopeptide of type I collagen (ICTP) were taken, and forearm bone mineral content (BMC) was measured by single photon absorptiometry (SPA). Fracture history was recorded, and the information was verified and supplemented from both radiologic and orthopedic files. Five years later the registration of fractures was repeated. At the initial investigation, Oc was 23% lower in women who had sustained a fracture (n = 37) within 6 years before measurement (6.3 +/- 3.6 microgram/l vs 8.2 +/- 4.2 microgram/l (p = 0.006)), after adjusting for age and BMC difference. PICP and ICTP were not different from values in the women without fracture. However, in women aged 70-80 years with a fracture sustained during the previous 6 years, PICP was lower (128 +/- 32 microgram/l vs 144 +/- 34 microgram/l, p = 0.046). Oc and ICTP were significantly correlated to age and BMC (Oc-age r = 0.36, Oc-BMC r = -0.31, ICTP-age r = 0.44, ICTP-BMC r = -0.24). The correlations of PICP were weaker. Prospectively, logistic regression gave an odds ratio (OR) of 1.8 (p = 0.015) for a low PICP and fracture susceptibility, at a change of 1 SD, independent of age and BMC. In the age bracket 70-80, the odds ratio was 2.4 (p = 0.036). The odds ratio for ICTP, independent of age and BMC, was 1.9 (P = 0.043) for 1 SD decrease and subsequent fracture risk. We concluded that women who had sustained at least one recent fracture had an altered bone turnover with decreased bone formation but an unaltered resorption. Women with retrospectively registered fractures also sustained subsequent fractures. A decrease from the mean of the collagen markers PICP and ICTP was associated with an increased risk for future fracture. Utilizing these biochemical markers of bone metabolism in a female population, PICP and ICTP had a similar influence on the risk of future fracture as forearm BMC (OR = 1.6, p = 0.03).
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