Predicting various fragility fractures in women by forearm bone densitometry: a follow-up study.
This is a follow-up of a previous study on the predictive power of bone mineral measurements; two more observation years have been added. A group of women (n = 1076) had their forearm bone mineral content (BMC) measured from 1970-1976. All fractures that occurred in 1975-1987 (13 years) were recorded. Four hundred sixty-nine fragility fractures occurred during the collection period. Again, it was found that BMC at the distal end of the forearm is a good predictor of future fracture before the age of 70. The measurement at the proximal site (forearm shafts), however, in contrast to our previous study, has a capacity of predicting fracture also in the age group 70-80. BMC measurements were good predictors of vertebral crush fractures and trochanteric hip fracture but lesser predictors of fractures of the distal end of the forearm. In age groups 40-70, BMC was a stronger predictor of fracture than age, and the risk associated with a 1 SD decrease of BMC 6 was 3.2 for a hip fracture as compared with those without any fragility fracture, even when adjusted for age. In addition to BMC, low body weight was a fracture predictor. Body weight 5 kg below age-adjusted mean increased the risk of a trochanteric hip fracture by 30%. The data are used in hypothetical calculations of the effects of screening.
Gärdsell
P
P
Department of Orthopaedics, Malmö General Hospital, Lund University, Sweden.
Johnell
O
O
Nilsson
B E
BE
Gullberg
B
B
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001835:Body Weight; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm; D050723:Fractures, Bone / Q000209:etiology*; D006620:Hip Fractures / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors