title: Lifestyle and other factors predict ankle fractures in perimenopausal women: a population-based prospective cohort study.
abstract: The Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study examines the risk factors for fractures and low bone density in middle-aged women. In the present study we investigated lifestyle and other risk factors for ankle fracture. The study population consisted of 11,798 women, aged 47-56 years at baseline. During the 5 year follow-up, these women sustained 194 validated malleolar fractures, giving an incidence of 3.4 fractures/1000 person-years. Four independent predictors for malleolar fracture were detected: smoking; multipharmacy; fracture history; and overweight status. The hazard ratio (HR) for positive fracture history was 1.63 (p = 0.005). In women with a body mass index (BMI) of 25-30 kg/m(2) vs. those with a BMI <25 kg/m(2), HR was 1.69 (p = 0.003). Those who used three or more prescribed drugs had an HR of 2.03 (p = 0.0003) vs. those who used no drugs. Smoking had a dose-response effect, with HRs of 1.73 (p = 0.016) in those smoking 1-19 cigarettes/day, and 2.94 (p = 0.001) in those smoking > or =20 cigarettes/day. Lifestyle factors and fracture history appear to be important predictors of ankle fracture.
authors.affiliation: Department of Surgery, University Central Hospital of Kuopio, Kuopio, Finland. antti.valtola@pp.inet.fi
authors.forename: A
authors.initials: A
authors.lastname: Valtola
authors.forename: R
authors.initials: R
authors.lastname: Honkanen
authors.forename: H
authors.initials: H
authors.lastname: Kröger
authors.forename: M
authors.initials: M
authors.lastname: Tuppurainen
authors.forename: S
authors.initials: S
authors.lastname: Saarikoski
authors.forename: E
authors.initials: E
authors.lastname: Alhava
mesh_terms: D016512:Ankle Injuries / Q000453:epidemiology / Q000209:etiology*; D015992:Body Mass Index; D015331:Cohort Studies; D011307:Drug Prescriptions; D015981:Epidemiologic Factors; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects