title: Risk factors for nonvertebral fracture in obese older women.
abstract: BACKGROUND
  A high prevalence of obesity has recently been reported in postmenopausal women with low trauma fracture, suggesting that higher bone mineral density (BMD) in obese individuals may not be protective against fracture.
  
  
  OBJECTIVE
  The aim of this study was to compare BMD and other risk factors for nonvertebral fracture in 1377 obese postmenopausal women.
  
  
  METHODS
  Characteristics of obese women with and without incident nonvertebral fracture were investigated among the prospective cohort in the Study of Osteoporotic Fractures.
  
  
  METHODS
  The Study of Osteoporotic Fractures is a multicenter study of 9704 women (>99% Caucasian) aged 65 yr and over who were recruited between September 1986 and October 1988 from population-based listings at four U.S. clinical centers.
  
  
  METHODS
  The main outcome measure was nonvertebral fracture.
  
  
  RESULTS
  BMD T-scores in the spine, femoral neck, and total hip were significantly lower in obese women who experienced fractures than in obese women without fracture: mean differences, -0.56 [95% confidence interval (CI) = -0.73 to -0.39], -0.46 (95% CI = -0.57 to -0.36), and -0.51 (95% CI = -0.62 to -0.39), respectively (P < 0.0001 for all). A previous history of fracture [odds ratio = 1.69 (95% CI = 1.33-2.14); P < 0.0001] and femoral neck BMD [1.62 (95% CI = 1.42-1.85) per sd decrease in BMD; P < 0.0001] were independently associated with incident nonvertebral fracture.
  
  
  CONCLUSIONS
  Obese postmenopausal women who sustain nonvertebral fractures have significantly lower BMD on average than obese women without fracture and are more likely to have a past history of fracture. Fractures in obese postmenopausal women thus exhibit some characteristics of fragility fractures.
authors.affiliation: Department of Clinical Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul 97105-900, Brazil. mopremaor@bol.com.br
authors.forename: M O
authors.initials: MO
authors.lastname: Premaor
authors.forename: K
authors.initials: K
authors.lastname: Ensrud
authors.forename: L
authors.initials: L
authors.lastname: Lui
authors.forename: R A
authors.initials: RA
authors.lastname: Parker
authors.forename: J
authors.initials: J
authors.lastname: Cauley
authors.forename: T A
authors.initials: TA
authors.lastname: Hillier
authors.forename: S
authors.initials: S
authors.lastname: Cummings
authors.forename: J E
authors.initials: JE
authors.lastname: Compston
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D009765:Obesity / Q000453:epidemiology*; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014954:Wrist Injuries / Q000453:epidemiology*