title: Features of the metabolic syndrome and the risk of non-vertebral fractures: the Tromsø study.
abstract: BACKGROUND
  We wanted to examine whether the features of the metabolic syndrome carried an increased risk of non-vertebral fracture.
  
  
  METHODS
  This is a population-based, 6-year follow-up of 27,159 subjects from the municipality of Tromsø, followed from 1994 until 2001. Age range was 25-98 years. Non-fasting serum levels of high-density lipoprotein (HDL), triglycerides and glucose, blood pressure (BP), weight and height were measured at baseline. All non-vertebral fractures were registered by computerised search in radiographic archives.
  
  
  RESULTS
  A total of 1,249 non-vertebral fractures were registered. Increasing number of metabolic syndrome features was associated with significantly reduced fracture risk in both men and women, p= 0.004 and p<0.0001, respectively. High BP was protective against fracture in men [relative risk (RR) 0.89; 95% confidence interval (CI) 0.8-0.99)] while increased body mass index (BMI) was protective in women (RR 0.91; 95% CI 0.84-0.98). Increasing non-fasting serum levels of HDL increased fracture risk in women (RR 1.12; 95% CI 1.05-1.21). BMI modified the effect of HDL in men. Accordingly, high HDL increased fracture risk in men with high BMI (RR 1.51; 95% CI 1.2-1.9).
  
  
  CONCLUSIONS
  Increasing burden of metabolic syndrome features protects against non-vertebral fractures. Reduced non-vertebral fracture risk was associated with high BP in men and increased body mass in women. Lower non-fasting serum levels of HDL protect against fractures in women and obese men.
authors.affiliation: Institute of Community Medicine, University of Tromsø, 9037 Tromsø, Norway. Luai.Awad@ism.uit.no
authors.forename: L A
authors.initials: LA
authors.lastname: Ahmed
authors.forename: H
authors.initials: H
authors.lastname: Schirmer
authors.forename: G K
authors.initials: GK
authors.lastname: Berntsen
authors.forename: V
authors.initials: V
authors.lastname: Fønnebø
authors.forename: R M
authors.initials: RM
authors.lastname: Joakimsen
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D009664:Norway; D012042:Registries; D012306:Risk; D014280:Triglycerides / Q000097:blood
chemical_list: D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol