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dc.contributor.authorDennison, Elaine M.
dc.contributor.authorCompston, Juliet E.
dc.contributor.authorFlahive, Julie
dc.contributor.authorSiris, Ethel S.
dc.contributor.authorGehlbach, Stephen H.
dc.contributor.authorBoonen, Steven
dc.contributor.authorChapurlat, Roland D.
dc.contributor.authorDiez-Perez, Adolfo
dc.contributor.authorAnderson, Frederick A. Jr.
dc.contributor.authorHooven, Frederick H.
dc.contributor.authorLaCroix, Andrea Z.
dc.contributor.authorLindsay, Robert
dc.contributor.authorNetelenbos, J. Coen
dc.contributor.authorPfeilschifter, Johannes
dc.contributor.authorRossini, Maurizio
dc.contributor.authorRoux, Christian
dc.contributor.authorSaag, Kenneth G.
dc.contributor.authorSambrook, Phillip N.
dc.contributor.authorSilverman, Stuart
dc.contributor.authorWatts, Nelson B.
dc.contributor.authorGreenspan, Susan L.
dc.contributor.authorPremaor, Melissa
dc.contributor.authorCooper, Cyrus
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:45Z
dc.date.available2022-08-23T15:43:45Z
dc.date.issued2012-06-01
dc.date.submitted2012-08-24
dc.identifier.citationBone. 2012 Jun;50(6):1288-93. Epub 2012 Mar 9. <a href="http://dx.doi.org/10.1016/j.bone.2012.02.639">Link to article on publisher's site</a>
dc.identifier.issn1873-2763 (Linking)
dc.identifier.doi10.1016/j.bone.2012.02.639
dc.identifier.pmid22426498
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27165
dc.description.abstractINTRODUCTION: Greater awareness of the relationship between co-morbidities and fracture risk may improve fracture-prediction algorithms such as FRAX. MATERIALS AND METHODS: We used a large, multinational cohort study (GLOW) to investigate the effect of co-morbidities on fracture risk. Women completed a baseline questionnaire detailing past medical history, including co-morbidity history and fracture. They were re-contacted annually to determine incident clinical fractures. A co-morbidity index, defined as number of baseline co-morbidities, was derived. The effect of adding the co-morbidity index to FRAX risk factors on fracture prevention was examined using chi-squared tests, the May-Hosmer test, c index and comparison of predicted versus observed fracture rates. RESULTS: Of 52,960 women with follow-up data, enrolled between October 2006 and February 2008, 3224 (6.1%) sustained an incident fracture over 2 years. All recorded co-morbidities were significantly associated with fracture, except for high cholesterol, hypertension, celiac disease, and cancer. The strongest association was seen with Parkinson's disease (age-adjusted hazard ratio [HR]: 2.2; 95% CI: 1.6-3.1; P<0.001). Co-morbidities that contributed most to fracture prediction in a Cox regression model with FRAX risk factors as additional predictors were: Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease, osteoarthritis, and heart disease. CONCLUSION: Co-morbidities, as captured in a co-morbidity index, contributed significantly to fracture risk in this study population. Parkinson's disease carried a particularly high risk of fracture; and increasing co-morbidity index was associated with increasing fracture risk. Addition of co-morbidity index to FRAX risk factors improved fracture prediction.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22426498&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.bone.2012.02.639
dc.subjectOsteoporosis
dc.subjectOsteoporosis, Postmenopausal
dc.subjectOsteoporotic Fractures
dc.subjectFractures, Bone
dc.subjectHealth Services Research
dc.subjectMusculoskeletal Diseases
dc.titleEffect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)
dc.typeJournal Article
dc.source.journaltitleBone
dc.source.volume50
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_glow/6
dc.identifier.contextkey3257190
html.description.abstract<p>INTRODUCTION: Greater awareness of the relationship between co-morbidities and fracture risk may improve fracture-prediction algorithms such as FRAX.</p> <p>MATERIALS AND METHODS: We used a large, multinational cohort study (GLOW) to investigate the effect of co-morbidities on fracture risk. Women completed a baseline questionnaire detailing past medical history, including co-morbidity history and fracture. They were re-contacted annually to determine incident clinical fractures. A co-morbidity index, defined as number of baseline co-morbidities, was derived. The effect of adding the co-morbidity index to FRAX risk factors on fracture prevention was examined using chi-squared tests, the May-Hosmer test, c index and comparison of predicted versus observed fracture rates.</p> <p>RESULTS: Of 52,960 women with follow-up data, enrolled between October 2006 and February 2008, 3224 (6.1%) sustained an incident fracture over 2 years. All recorded co-morbidities were significantly associated with fracture, except for high cholesterol, hypertension, celiac disease, and cancer. The strongest association was seen with Parkinson's disease (age-adjusted hazard ratio [HR]: 2.2; 95% CI: 1.6-3.1; P<0.001). Co-morbidities that contributed most to fracture prediction in a Cox regression model with FRAX risk factors as additional predictors were: Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease, osteoarthritis, and heart disease.</p> <p>CONCLUSION: Co-morbidities, as captured in a co-morbidity index, contributed significantly to fracture risk in this study population. Parkinson's disease carried a particularly high risk of fracture; and increasing co-morbidity index was associated with increasing fracture risk. Addition of co-morbidity index to FRAX risk factors improved fracture prediction.</p>
dc.identifier.submissionpathcor_glow/6
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages1288-93


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