title: Self-reported diseases and the risk of non-vertebral fractures: the Tromsø study.
abstract: We wanted to estimate the independent fracture risk associated with chronic diseases for men and women separately, adjusting for other known risk factors. This is a population-based study of all those who attended the fourth survey (1994-1995) in the Tromsø Study (n=27,159) who were followed until 31 December 2000 with respect to non-vertebral fractures. At baseline the age range was 25-98 years. Chronic disease cases were defined by self-report in questionnaires. All non-vertebral fractures were registered by computerized search in radiographic archives in the sole provider of radiographic service in the area. A total of 446 and 803 non-vertebral fractures were registered among men and women, respectively. Self-reported diabetes mellitus, stroke, asthma, hypo- and hyperthyroidism and psychiatric disorders were associated with increased fracture risk. Multivariate analyses showed an independent risk of fractures associated with self-reported diabetes mellitus, hypothyroidism and psychiatric disorders among men. Among women the independent risk was associated with self-reported asthma, hypo- and hyperthyroidism and psychiatric disorders. Self-reported heart disease had a protective effect on wrist fracture, especially in women. Increased burden of chronic diseases increase the risk of all non-vertebral (P<0.0001), wrist (P=0.005), proximal humerus (P=0.0004) and hip fracture (P=0.0002) in men, and for the proximal humerus (P=0.003) and hip fracture (P=0.04) in women. There was an independent fracture risk associated with self-reported diabetes mellitus, asthma, hypo- and hyperthyroidism and psychiatric disorders in men and women. Increasing burden of disease increased fracture risk in both men and women.
authors.affiliation: Institute of Community Medicine, University of Tromsø, 9037, Tromsø, Norway. Luai.Awad@ism.uit.no
authors.forename: Luai A
authors.initials: LA
authors.lastname: Ahmed
authors.forename: Henrik
authors.initials: H
authors.lastname: Schirmer
authors.forename: Gro K
authors.initials: GK
authors.lastname: Berntsen
authors.forename: Vinjar
authors.initials: V
authors.lastname: Fønnebø
authors.forename: Ragnar M
authors.initials: RM
authors.lastname: Joakimsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D048909:Diabetes Complications / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology; D012650:Self Disclosure; D012737:Sex Factors; D012784:Shoulder Fractures / Q000453:epidemiology / Q000209:etiology; D013959:Thyroid Diseases / Q000150:complications / Q000453:epidemiology