title: Predictors of non-vertebral fracture in older Chinese males and females: Mr. OS and Ms. OS (Hong Kong).
abstract: Clinical risk factors to predict fracture are useful in guiding management of patients with osteoporosis or falls. Clinical predictors may however be population specific because of differences in lifestyle, environment and ethnicity. Four thousand community-dwelling Chinese males and females with average ages of 72.4 and 72.6 years were followed up for incident fractures, with an average of 6.5 and 8.8 years, respectively. Clinical information was collected, and bone mineral density (BMD) measurements were carried out at baseline. Stepwise Cox regression models were used to identify risk factors of nonvertebral fractures, with BMD as covariate. Areas under the receiver-operating characteristic (ROC) curve (AUC) were compared among different risk models. The incidence rates of nonvertebral fractures were 10.3 and 20.5 per 1000 person years in males and females, respectively. In males, age ≥80, history of a fall in the past year, fracture history, chronic obstructive pulmonary disease, impaired visual depth perception and low physical health-related quality of life were significant fracture risk factors, independent of BMD. In females, the significant factors were fracture history, low visual acuity and slow narrow walking speed. The clinical risk factors had a significant influence on fracture risk irrespective of osteoporosis status, even having a better risk discrimination than BMD alone, especially in males. The best risk prediction model consisted both BMD and clinical risk factors. Clinical risk factors have additive value to hip BMD in predicting nonvertebral fractures in older Chinese people and may predict them better than BMD alone in older Chinese males.
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. tkwok@cuhk.edu.hk.|Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China. tkwok@cuhk.edu.hk.
authors.forename: Timothy Chi Yui
authors.initials: TCY
authors.lastname: Kwok
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.|Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
authors.forename: Chyi Chyi
authors.initials: CC
authors.lastname: Khoo
authors.affiliation: Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors.forename: Jason
authors.initials: J
authors.lastname: Leung
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kwok
authors.affiliation: Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Orwoll
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
authors.affiliation: Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors.forename: Ping Chung
authors.initials: PC
authors.lastname: Leung
mesh_terms: D000368:Aged; D019540:Area Under Curve; D044466:Asian People; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D016016:Proportional Hazards Models; D011788:Quality of Life; D012307:Risk Factors
keywords: Aged; Asian continental ancestry group; Bone; Fracture; Risk factors