Determinants of incidence of osteoporotic fractures in the female Spanish population older than 50

Abstract

It is well known that the adoption of preventive measures for osteoporosis may contribute to minimizing its impact as a result of bone fractures. However, there are well-recognized risk factors involved in the onset of osteoporosis that are not possible to modify. Better knowledge of these non-modifiable factors could aid prevention in subjects at high risk of fractures. The aim of this study was to evaluate the likely association between gynecological, reproductive and family history of hip fracture with the incidence of vertebral and nonvertebral osteoporotic fractures in women older than 50. We studied 255 women aged 50 and over, randomly selected from a Spanish population that had participated in a study of prevalence of vertebral fractures (EVOS study). This cohort was prospectively followed for 8 years by means of four postal questionnaires, in order to find out the incidence of nonvertebral fractures. Concerning the incidence of vertebral fractures, participants were invited to repeat the lumbar spine X-rays 4 years after the initial study. A total of 31 women had incident osteoporotic fractures. The analysis of gynecological variables showed that an increase in the age at menarche was a risk factor for all incident osteoporotic fractures [OR=1.57 (1.04-2.37)]. The presence of amenorrhea at any age during the fertile period was associated with higher incidence of all osteoporotic fractures [OR=6.30 (1.61-24.70)]. Among all the reproductive variables analyzed (pregnancy, number of live births and breast-feeding) only pregnancy was an important protective factor in preventing incident Colles fracture [OR=0.15 (0.03-0.62)]. A family history of hip fracture was associated with a higher incidence of all osteoporotic fractures [OR=3.59 (1.01-12.79)]. In summary, a late age at menarche, the presence of amenorrhea and having close relatives with hip fracture were all risk factors which, independently of bone mineral density (BMD) and age, were associated with higher incidence of all osteoporotic fractures. Pregnancy was an important protective factor for the incidence of Colles fractures.

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

“…However, over five dozen epidemiologic studies of pre-, peri-, and postmenopausal women have found a neutral effect (16,38,63,158,203,214,215,290,292,299,341,356,368,379,383,397,444,445,448,463,481,506,509,541,547,611,619,625,636,648,683,700,761,828,845,846,861,864,865,869,879,934,935,944,951,969,1020) or a protective effect (25,27,71,…”

Epigenetics: A New Player in the Regulation of Mammalian Puberty

“…For example, early age at menarche (AAM) is a risk factor for breast cancer [2][3][4] , cardiovascular disease [5] , depression [6] , eating disorders [7] , conduct and behavioral disorders [8] , diabetes [9] and increased all-cause mortality [10] . Conversely, late AAM is associated with a decreased risk of ischemic heart disease [11] but an increased risk of osteoporotic fracture [12,13] . Boys are also affected by alterations in pubertal timing, with delayed puberty being a cause of bullying, poor self-esteem and psychosocial distress, while early puberty is a risk factor for testicular cancer [8] .…”

Association between Age at Menarche and Cardiovascular Disease Risk Factors in China: A Large Population-Based Investigation

“…The timing of menarche is determined by both genetic and environmental factors [1,2] . Results from previous studies have shown that a female's AAM affects her health later in life and has been identified as a risk factor for several traits including breast cancer [3,4] , osteoporotic fracture [5] , abnormal lung function [6] and depression [7,8] . Moreover, recent researches mentioned that earlier menarche has also been associated with obesity [9] , type 2 diabetes [10][11][12] as well as increased metabolic syndrome [13,14] , and all these confer an increased risk of cardiovascular disease (CVD).…”