title: Increase in Fracture Risk Following Unintentional Weight Loss in Postmenopausal Women: The Global Longitudinal Study of Osteoporosis in Women.
abstract: Increased fracture risk has been associated with weight loss in postmenopausal women, but the time course over which this occurs has not been established. The aim of this study was to examine the effects of unintentional weight loss of ≥10 lb (4.5 kg) in postmenopausal women on fracture risk at multiple sites up to 5 years after weight loss. Using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), we analyzed the relationships between self-reported unintentional weight loss of ≥10 lb at baseline, year 2, or year 3 and incident clinical fracture in the years after weight loss. Complete data were available in 40,179 women (mean age ± SD 68 ± 8.3 years). Five-year cumulative fracture rate was estimated using the Kaplan-Meier method, and adjusted hazard ratios for weight loss as a time-varying covariate were calculated from Cox multiple regression models. Unintentional weight loss at baseline was associated with a significantly increased risk of fracture of the clavicle, wrist, spine, rib, hip, and pelvis for up to 5 years after weight loss. Adjusted hazard ratios showed a significant association between unintentional weight loss and fracture of the hip, spine, and clavicle within 1 year of weight loss, and these associations were still present at 5 years. These findings demonstrate increased fracture risk at several sites after unintentional weight loss in postmenopausal women. This increase is found as early as 1 year after weight loss, emphasizing the need for prompt fracture risk assessment and appropriate management to reduce fracture risk in this population. © 2016 American Society for Bone and Mineral Research.
authors: Cambridge Biomedical Campus, Cambridge, UK.
authors: Juliet E
authors: JE
authors: Compston
authors: Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
authors: Allison
authors: A
authors: Wyman
authors: Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
authors: Gordon
authors: G
authors: FitzGerald
authors: St Joseph's Healthcare, McMaster University, Hamilton, Canada.
authors: Jonathan D
authors: JD
authors: Adachi
authors: Division of Rheumatology, INSERM U1033, Université de Lyon, Hôpital E Herriot, Lyon, France.
authors: Roland D
authors: RD
authors: Chapurlat
authors: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors: Cyrus
authors: C
authors: Cooper
authors: Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona, Spain.|RETICEF, Instituto Carlos III, Madrid, Spain.
authors: Adolfo
authors: A
authors: Díez-Pérez
authors: Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
authors: Stephen H
authors: SH
authors: Gehlbach
authors: University of Pittsburgh, Pittsburgh, PA, USA.
authors: Susan L
authors: SL
authors: Greenspan
authors: University of Massachusetts Medical School, Worcester, MA, USA.
authors: Frederick H
authors: FH
authors: Hooven
authors: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Andrea Z
authors: AZ
authors: LaCroix
authors: University of Sydney Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia.
authors: Lyn
authors: L
authors: March
authors: Department of Endocrinology, VU University Medical Center, Amsterdam, Netherlands.
authors: J Coen
authors: JC
authors: Netelenbos
authors: Helen Hayes Hospital and Columbia University, West Haverstraw, NY, USA.
authors: Jeri W
authors: JW
authors: Nieves
authors: Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany.
authors: Johannes
authors: J
authors: Pfeilschifter
authors: Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy.
authors: Maurizio
authors: M
authors: Rossini
authors: Paris Descartes University, Cochin Hospital, Paris, France.
authors: Christian
authors: C
authors: Roux
authors: Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: Kenneth G
authors: KG
authors: Saag
authors: Columbia University Medical Center, New York, NY, USA.
authors: Ethel S
authors: ES
authors: Siris
authors: Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Stuart
authors: S
authors: Silverman
authors: Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA.
authors: Nelson B
authors: NB
authors: Watts
authors: Cambridge Biomedical Campus, Cambridge, UK.
authors: Frederick A
authors: FA
authors: Anderson
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017698:Postmenopause; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015431:Weight Loss
keywords: FRACTURE; POSTMENOPAUSAL WOMEN; WEIGHT LOSS