title: High serum total cholesterol is a long-term cause of osteoporotic fracture.
abstract: CONCLUSIONS
  Risk factors for osteoporotic fractures were evaluated in 1,396 men and women for a period of 20 years. Serum total cholesterol was found to be an independent osteoporotic fracture risk factor whose predictive power improves with time.
  
  
  BACKGROUND
  The purpose of this study was to evaluate long-term risk factors for osteoporotic fracture.
  
  
  METHODS
  A population random sample of men and women aged 25-64 years (the Gothenburg WHO MONICA project, N = 1,396, 53% women) was studied prospectively. The 1985 baseline examination recorded physical activity at work and during leisure time, psychological stress, smoking habits, coffee consumption, BMI, waist/hip ratio, blood pressure, total, HDL and LDL cholesterol, triglycerides, and fibrinogen. Osteoporotic fractures over a period of 20 years were retrieved from the Gothenburg hospital registers. Poisson regression was used to analyze the predictive power for osteoporotic fracture of each risk factor.
  
  
  RESULTS
  A total number of 258 osteoporotic fractures occurred in 143 participants (10.2%). As expected, we found that previous fracture, smoking, coffee consumption, and lower BMI each increase the risk for osteoporotic fracture independently of age and sex. More unexpectedly, we found that the gradient of risk of serum total cholesterol to predict osteoporotic fracture significantly increases over time (p = 0.0377).
  
  
  CONCLUSIONS
  Serum total cholesterol is an independent osteoporotic fracture risk factor whose predictive power improves with time. High serum total cholesterol is a long-term cause of osteoporotic fracture.
authors.affiliation: Section for Endocrinology, Institution of Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden. pinelopi.trimpou@vgregion.se
authors.forename: P
authors.initials: P
authors.lastname: Trimpou
authors.forename: A
authors.initials: A
authors.lastname: Odén
authors.forename: T
authors.initials: T
authors.lastname: Simonsson
authors.forename: L
authors.initials: L
authors.lastname: Wilhelmsen
authors.forename: K
authors.initials: K
authors.lastname: Landin-Wilhelmsen
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods; D002784:Cholesterol / Q000097:blood*; D003069:Coffee / Q000009:adverse effects; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D058866:Osteoporotic Fractures / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D003069:Coffee; D002784:Cholesterol
references.citation: Circulation. 1968 Dec;38(6):1104-15
references.pmid: 5721960
references.citation: Bone. 2003 May;32(5):468-73
references.pmid: 12753862
references.citation: IARC Sci Publ. 1987;(82):1-406
references.pmid: 3329634
references.citation: Lancet. 1999 Mar 13;353(9156):878-82
references.pmid: 10093980
references.citation: BMJ. 1996 May 18;312(7041):1254-9
references.pmid: 8634613
references.citation: J Bone Miner Res. 2009 Jun;24(6):1103-9
references.pmid: 19113906
references.citation: Osteoporos Int. 2007 Apr;18(4):505-12
references.pmid: 17109061
references.citation: Osteoporos Int. 2004 Jun;15(6):452-8
references.pmid: 15205716
references.citation: Adv Cardiol. 1976;18(0):217-30
references.pmid: 983849
references.citation: J Intern Med. 1997 Sep;242(3):199-211
references.pmid: 9350164
references.citation: Endocr J. 2002 Apr;49(2):211-7
references.pmid: 12081241
references.citation: Osteoporos Int. 2006;17(3):426-32
references.pmid: 16437192
references.citation: Osteoporos Int. 2010 Mar;21(3):409-16
references.pmid: 19475474
references.citation: Osteoporos Int. 2010 Mar;21(3):425-31
references.pmid: 19565174
references.citation: Bone. 2003 Jan;32(1):8-14
references.pmid: 12584030
references.citation: Arch Intern Med. 2004 Jan 26;164(2):146-52
references.pmid: 14744837
references.citation: Am J Med. 2005 Dec;118(12):1414
references.pmid: 16378789
references.citation: Am J Clin Nutr. 2006 Jan;83(1):146-54
references.pmid: 16400063