title: Prediction of perimenopausal fractures by bone mineral density and other risk factors.
abstract: In a prospective population-based cohort study, we assessed whether bone mineral density (BMD) measurements of perimenopausal women and other risk factors for osteoporosis are predictive of subsequent fracture. Women aged 47-51 years chosen randomly from a population register who underwent a bone density measurement 2 years previously were followed up by questionnaire to assess the 2-year incidence of any self-reported fractures. We found that 44 women, out of 1857 who completed the questionnaire, sustained at least one fracture within a 2-year follow-up period. After adjustment for covariates, the odds ratio of sustaining a fracture was 1.6 (95% confidence interval [CI] 1.16-2.34) for every standard deviation reduction in BMD at the spine, for women with a prior history of fracture the odds ratio of a subsequent fracture was approximately 2 (95% CI 1.31-3.03), a family history of hip fracture (maternal grandmother) carried an odds ratio of 3.7 (95% CI 1.55-8.85), while being postmenopausal or having a hysterectomy resulted in an odds ratio of 1.98 (1.02-3.56). This study has shown that BMD measurements at the hip and spine and other risk factors predict any nonhip and nonspine perimenopausal fractures. Further follow-up is required to assess the predictive performance of BMD measurements and other risk factors for hip and spine fractures.
authors.affiliation: Health Economics Research Unit (HERU), University of Aberdeen, United Kingdom.
authors.forename: D J
authors.initials: DJ
authors.lastname: Torgerson
authors.forename: M K
authors.initials: MK
authors.lastname: Campbell
authors.forename: R E
authors.initials: RE
authors.lastname: Thomas
authors.forename: D M
authors.initials: DM
authors.lastname: Reid
mesh_terms: D015519:Bone Density / Q000502:physiology*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control*; D011237:Predictive Value of Tests; D017697:Premenopause / Q000502:physiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires