Gender differences in the incidence of and risk factors for hip fracture: A 16-year longitudinal study in a southern European population

Lobo, Elena; Marcos, Guillermo; Santabárbara, Javier; Salvador-Rosés, Helena; Lobo-Escolar, Luis; Cámara, Concepción de la; Aso, Alberto; Lobo-Escolar, Antonio

doi:10.1016/j.maturitas.2016.12.009

Cited by 35 publications

(48 citation statements)

References 30 publications

(37 reference statements)

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“…We did find a positive gradient in the association between smoking and fracture risk, with a 17% to 44% increased hazard of fracture among those men who reported smoking at least 6 and 21+ cigarettes per day, respectively, which is in accordance to what has been previously published . Our baseline data were collected among young adults, mostly aged 18, and therefore while bone is still building up.…”

Section: Discussionsupporting

confidence: 89%

“…(20) Afterwards, evidence has been piling up linking smoking with fractures in men. (18,19,21) The association with alcohol is less consistent; although hip fracture risk appears to decrease among those consuming up to one drink per day compared with abstainers and with heavy drinkers, the same is not reported for other fracture sites. Moreover, the association between alcohol and bone mineral density differs by sex.…”

Section: Introductionmentioning

confidence: 99%

“…In 2005, a meta‐analysis found that smoking conferred and increased risk of fracture, which was more pronounced in men . Afterwards, evidence has been piling up linking smoking with fractures in men . The association with alcohol is less consistent; although hip fracture risk appears to decrease among those consuming up to one drink per day compared with abstainers and with heavy drinkers, the same is not reported for other fracture sites.…”

Section: Introductionmentioning

confidence: 99%

“…In parallel, evidence suggests that smoking and alcohol use could contribute to an increased fracture risk (17) through a lower bone mineral density for smokers (18) and a higher risk for falls and traumas for heavy alcohol drinkers. (19) In 2005, a meta-analysis found that smoking conferred and increased risk of fracture, which was more pronounced in men. (20) Afterwards, evidence has been piling up linking smoking with fractures in men.…”

Section: Introductionmentioning

confidence: 99%

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Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry

Prieto-Alhambra

Turkiewicz

Reyes

et al. 2019

Journal of Bone and Mineral Research

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We aimed to determine the relationship between handgrip strength, smoking, and alcohol consumption in young men and fracture risk at middle age. Thus, we carried out a cohort study including young men undergoing conscription examination in Sweden from September 1969 to May 1970 at a typical age of 18 years. Data on muscle strength, height, weight, and lifestyle factors were linked to the National Patient Register 1987–2010. Handgrip strength was considered the main exposure and smoking and alcohol consumption as secondary exposures. Outcomes were all fractures (except face, skull, digits), major osteoporotic fractures (thoracic/lumbar spine, proximal humerus, distal forearm or hip), and major traumatic fractures (shaft of humerus, forearm, femur, or lower leg) based on ICD‐9 and ‐10 codes. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) according to handgrip strength as a continuous variable (per 1 SD), after adjustment for weight, height, parental education, smoking, and alcohol consumption. A total of 40,112 men were included, contributing 892,572 person‐years. Overall, 3974 men fractured in middle age with the incidence rate (95% CI) of 44.5 (43.2–45.9) per 1000 person‐years. The corresponding rates were12.2 and 5.6 per 1000 person‐years for major osteoporotic and traumatic fractures, respectively. Handgrip strength‐adjusted HR (95% CI) was 1.01 (0.98–1.05), 0.94 (0.88–1.00), and 0.98 (0.88–1.08) per SD for all, major osteoporotic, and major traumatic fractures, respectively. Adjusted HR (95% CI) for smokers (>21 cigarettes/d) was 1.44 (1.21, 1.71) for all fractures, while the association between alcohol consumption and hazards of fracture was J‐shaped. Therefore, young adult handgrip strength was not associated with fracture risk in middle‐age men, although smoking and high alcohol consumption did confer an increased risk. © 2019 American Society for Bone and Mineral Research. © 2019 American Society for Bone and Mineral Research.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry

Prieto-Alhambra

Turkiewicz

Reyes

et al. 2019

Journal of Bone and Mineral Research

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“…16, 108 109 Men´s health seem to be more likely to be affected by "risky" behaviour such as smoking or drinking alcohol, 83,110,111 whereas women´s health is influenced by more structural and psychosocial factors. 112,113 However, sex discrimination in health-care expenditure with a consequent survival advantage for men is well-known in some countries, 67, 114 so much so that female patients assess the quality of their hospital care significantly worse than do male patients, and call for better nursing care and better management of their pain. 115 A recent Swedish study has shown that male patients with trauma were more likely than women to obtain the highest prehospital priority, and to be transported directly to a designated trauma centre, 116 despite the fact that Sweden is at the forefront of promoting equity between the sexes.…”

Section: Medical Interventionsmentioning

confidence: 99%

Outcome of burn care : the mortality perspective

Pompermaier¹

2017

Linköping University Medical Dissertations

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Physical Activity and Psychosocial Factors Associated With Risk of Future Fractures in Middle-Aged Men and Women

Rogmark

Fedorowski

Hamrefors

2020

Journal of Bone and Mineral Research

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Identification of risk factors for fractures is important for improving public health. We aimed to identify which factors related to physical activity and psychosocial situation were associated with incident fractures among 30,446 middle-aged women and men, followed from 1991-1996 to 2016, in a prospective population-based cohort study. The association between the baseline variables and first incident fracture was assessed by Cox regression models, and significant risk factors were summed into fracture risk scores. Any first incident fracture affecting spine, thoracic cage, arms, shoulders, hands, pelvis, hips, or legs was obtained from the National Patient Register, using the unique personal identity number of each citizen. A total of 8240 subjects (27%) had at least one fracture during the follow-up of median 20.7 years. Age, female sex, body mass index, previous fracture, reported family history of fracture >50 years (all p < .001), low leisure-time physical activity (p = .018), heavy work (p = .024), living alone (p = .002), smoking (p < .001), and no or high alcohol consumption (p = .005) were factors independently associated with incident fracture. The fracture risk score (0-9 points) was strongly associated with incident fracture (p for trend <.001). Among men without risk factors, the incidence rate was 5.3/1000 person-years compared with 23.2 in men with six or more risk factors (hazard ratio [HR] = 5.5; 95% confidence interval [CI] 3.7-8.2). Among women with no risk factors, the incidence rate was 10.7 compared with 28.4 in women with six or more risk factors (HR = 3.1; 95% CI 2.4-4.0). Even moderate levels of leisure-time physical activity in middle age are associated with lower risk of future fractures. In contrast, heavy work, living alone, smoking, and no or high alcohol consumption increase the risk of fracture. Our results emphasize the importance of these factors in public health initiatives for fracture prevention.

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Gender differences in the incidence of and risk factors for hip fracture: A 16-year longitudinal study in a southern European population

Abstract: The IR of hip fractures was three times higher among women. Illiteracy and clinically significant depression among women and active smoking and disability (HR=3.14) among men independently increased the risk, but dementia did not.

Cited by 35 publications

References 30 publications

Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry

Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry

Outcome of burn care : the mortality perspective

Physical Activity and Psychosocial Factors Associated With Risk of Future Fractures in Middle-Aged Men and Women

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