W D Leslie1, J T Schousboe2,3, S N Morin4, P Martineau5, L M Lix5, H Johansson6,7, E V McCloskey6,8, N C Harvey9,10, J A Kanis6,7. 1. Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, Canada. bleslie@sbgh.mb.ca. 2. Park Nicollet Clinic & HealthPartners Institute, Minneapolis, MN, USA. 3. University of Minnesota, Minneapolis, MN, USA. 4. McGill University, Montreal, Canada. 5. Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, Canada. 6. Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, Beech Hill Rd, Sheffield, S10 2RX, UK. 7. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. 8. Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK. 9. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 10. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Abstract
During median follow-up 6.0 years in 11,495 individuals, prior absolute and annualized measured height loss was significantly greater in those with subsequent incident fracture compared with those without incident fracture. PURPOSE: FRAX® accepts baseline height and weight as input variables, but does not consider change in these parameters over time. AIM: To evaluate the association between measured height or weight loss on subsequent fracture risk adjusted for FRAX scores, risk factors, and competing mortality. METHODS: Using a dual-energy x-ray absorptiometry (DXA) registry for the Province of Manitoba, Canada, we identified women and men age 40 years or older with height and weight measured at the time of two DXA scans. Cox regression analyses were performed to test for a covariate-adjusted association between prior height and weight loss with incident fractures occurring after the second scan using linked population-based healthcare data. RESULTS: The study population consisted of 11,495 individuals (average age 68.0 ± 9.9 years, 94.6% women). During median follow-up 6.0 years, records demonstrated incident major osteoporotic fracture (MOF) in 869 individuals, hip fractures in 265, clinical vertebral fractures in 207, and any fracture in 1203. Prior height loss was significantly greater in individuals with fracture compared with those without fracture, regardless of fracture site. Mortality was greater in those with prior height loss (HR per SD 1.11, 95% CI 1.06-1.17) or weight loss (HR per SD 1.26, 95% CI 1.19-1.32). Each SD in height loss was associated with increased fracture risk (MOF 12-17%, hip 8-19%, clinical vertebral 28-37%, any fracture 14-19%). Prior weight loss was associated with 21-30% increased risk for hip fracture, but did not increase risk for other fractures. Height loss of 3.0 cm or greater more than doubled the risk for subsequent fracture. CONCLUSIONS: Prior height loss is associated with a small but significant increase in risk of incident fracture at all skeletal sites independent of other clinical risk factors and competing mortality as considered by FRAX. Prior weight loss only increases risk for subsequent hip fracture.
During median follow-up 6.0 years in 11,495 individuals, prior absolute and annualized measured height loss was significantly greater in those with subsequent incident fracture compared with those without incident fracture. PURPOSE: FRAX® accepts baseline height and weight as input variables, but does not consider change in these parameters over time. AIM: To evaluate the association between measured height or weight loss on subsequent fracture risk adjusted for FRAX scores, risk factors, and competing mortality. METHODS: Using a dual-energy x-ray absorptiometry (DXA) registry for the Province of Manitoba, Canada, we identified women and men age 40 years or older with height and weight measured at the time of two DXA scans. Cox regression analyses were performed to test for a covariate-adjusted association between prior height and weight loss with incident fractures occurring after the second scan using linked population-based healthcare data. RESULTS: The study population consisted of 11,495 individuals (average age 68.0 ± 9.9 years, 94.6% women). During median follow-up 6.0 years, records demonstrated incident major osteoporotic fracture (MOF) in 869 individuals, hip fractures in 265, clinical vertebral fractures in 207, and any fracture in 1203. Prior height loss was significantly greater in individuals with fracture compared with those without fracture, regardless of fracture site. Mortality was greater in those with prior height loss (HR per SD 1.11, 95% CI 1.06-1.17) or weight loss (HR per SD 1.26, 95% CI 1.19-1.32). Each SD in height loss was associated with increased fracture risk (MOF 12-17%, hip 8-19%, clinical vertebral 28-37%, any fracture 14-19%). Prior weight loss was associated with 21-30% increased risk for hip fracture, but did not increase risk for other fractures. Height loss of 3.0 cm or greater more than doubled the risk for subsequent fracture. CONCLUSIONS: Prior height loss is associated with a small but significant increase in risk of incident fracture at all skeletal sites independent of other clinical risk factors and competing mortality as considered by FRAX. Prior weight loss only increases risk for subsequent hip fracture.
Authors: Sören Möller; Michael K Skjødt; Lin Yan; Bo Abrahamsen; Lisa M Lix; Eugene V McCloskey; Helena Johansson; Nicholas C Harvey; John A Kanis; Katrine Hass Rubin; William D Leslie Journal: Osteoporos Int Date: 2021-10-01 Impact factor: 4.507
Authors: William D Leslie; John T Schousboe; Suzanne N Morin; Patrick Martineau; Lisa M Lix; Helena Johansson; Eugene V McCloskey; Nicholas C Harvey; John A Kanis Journal: Arch Osteoporos Date: 2020-06-25 Impact factor: 2.617
Authors: Kristine E Ensrud; John T Schousboe; Allyson M Kats; Tien N Vo; Brent C Taylor; Peggy M Cawthon; Jane A Cauley; Nancy E Lane; Andrew R Hoffman; Lisa Langsetmo Journal: J Bone Miner Res Date: 2021-03-19 Impact factor: 6.390