Predictors of fragility fracture and low bone mineral density in patients with a history of parental fracture

Abstract

Objectives Bone mineral density (BMD) and fragility fracture (FF) have high heritability, but few data exist on impact of other factors on families with fracture history. We aimed to evaluate predictors of FF and low BMD, in patients with family history of FF. Methods This was a retrospective study on patients undergoing dual energy X-ray absorptiometry at a district general hospital (DGH), 2004–2016. Parameters recorded (in addition to standard dual energy X-ray absorptiometry parameters): age, smoking, alcohol, corticosteroids, aromatase inhibitors, Depo-Provera, hormone replacement therapy, rheumatoid arthritis, polymyalgia rheumatica, breast or prostate cancer, coeliac disease, and fracture site. Logistic regression was used to model fracture risk and site, and linear regression for impact of factors on L1–4 and femoral BMD. Factor analyses with polychoric correlation matrices and calculation of Eigenvalues were applied to determine association between fracture sites and associated risk factors. Results A total of 6053 patients were included, 91.1% female. 2094 had sustained at least one FF. Smoking, alcoholism, increased age, height, and fat mass increased FF risk. Sites analysed: femur, tibia/fibula, humerus, forearm, ribs, and vertebrae. Alcoholism, and increasing tissue thickness and fat mass significantly increased FF risk. Decreased right femoral and vertebral BMD increased overall FF risk. Conclusions Our study confirms the effect of certain factors on vertebral BMD, but suggests a differential effect on the upper and lower spine, as well as in the dominant and nondominant hip. Different sites of fracture are associated with different risk factors, the most common sites of fracture being the peripheral long bones and vertebrae.

Correlates of bone resorption marker C-Telopeptide of type-I collagen for rural postmenopausal women in Zuturung, Kaduna State, Nigeria

“…This is similar to what is reported in another study. 31 In our study it was however not statistically significant (p>0.05). The waist circumference demonstrated a positive correlation with mean serum PINP (Table 3).…”

Quantitative Ultrasound - An Epidemiological Tool to Uncover the Influence of Lifestyle Factors & its Associated Co Morbidities on Bone Density

“…Most of the associations found in our study, except with diabetes, were similar to those consistently associated with BMD as measured with DEXA scans. [6][7][8][9][10][11][12][13][14][15] Diabetes and bone strength depends on the type of diabetes, T1DM presenting with decreased BMD while patients with T2DM presenting with normal to increased BMD. 22,23 Our study, which included T1DM and T2DM in a single group, showed decrease in BMD as an association to diabetes.…”

The effect of table olive wastewater extract administration on the adult ovariectomised rat model of osteoporosis

“…It is estimated that one out of two women and one out of four men at the age of 50 years and older will face at least one osteoporotic fracture (2) . Among the factors which seem to lead to lower bone mineral density (BMD) and increased risk of fracture are genetic background, lack of exercise, high body fat mass, smoking, high alcohol intake and prolonged use of glucocorticoids (3)(4)(5) . On the other hand, physical exercise (in particular weight-bearing exercise and walking), starting early before menopause onset, seems to be beneficial for the maintenance or increase of BMD (6,7) .…”