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    Differing risk profiles for individual fracture sites: Evidence from the global longitudinal study of osteoporosis in women (GLOW)

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    Authors
    FitzGerald, Gordon
    Boonen, Steven
    Compston, Juliet E.
    Pfeilschifter, Johannes
    LaCroix, Andrea Z.
    Hooven, Frederick H.
    Gehlbach, Stephen H.
    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2012-09-01
    Keywords
    Osteoporosis
    Osteoporosis, Postmenopausal
    Osteoporotic Fractures
    Fractures, Bone
    Health Services Research
    Musculoskeletal Diseases
    
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    Link to Full Text
    http://dx.doi.org/10.1002/jbmr.1652
    Abstract
    The purposes of this study were to examine fracture risk profiles at specific bone sites, and to understand why model discrimination using clinical risk factors is generally better in hip fracture models than in models that combine hip with other bones. Using 3-year data from the GLOW study (54,229 women with more than 4400 total fractures), we present Cox regression model results for 10 individual fracture sites, for both any and first-time fracture, among women aged >/=55 years. Advanced age is the strongest risk factor in hip (hazard ratio [HR] = 2.3 per 10-year increase), pelvis (HR = 1.8), upper leg (HR = 1.8), and clavicle (HR = 1.7) models. Age has a weaker association with wrist (HR = 1.1), rib (HR = 1.2), lower leg (not statistically significant), and ankle (HR = 0.81) fractures. Greater weight is associated with reduced risk for hip, pelvis, spine, and wrist, but higher risk for first lower leg and ankle fractures. Prior fracture of the same bone, although significant in nine of 10 models, is most strongly associated with spine (HR = 6.6) and rib (HR = 4.8) fractures. Past falls are important in all but spine models. Model c indices are >/=0.71 for hip, pelvis, upper leg, spine, clavicle, and rib, but
    Source
    J Bone Miner Res. 2012 Sep;27(9):1907-1915. doi: 10.1002/jbmr.1652. Link to article on publisher's site
    DOI
    10.1002/jbmr.1652
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27166
    PubMed ID
    22550021
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/jbmr.1652
    Scopus Count
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    GLOW Publications

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