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18 July 2000 | Volume 133 Issue 2 | Pages 123-127
Background: Small body size predicts hip fractures in older women.
Objective: To test the hypothesis that small body size predicts the risk for other clinical fractures.
Design: Prospective cohort study.
Setting: Population-based listings in four areas of the United States.
Patients: 8059 ambulatory nonblack women 65 years of age or older.
Measurements: Weight, weight change since 25 years of age, body mass index, lean body mass and percent body fat, and nonspine fractures during 6.4 years of follow-up.
Results: Compared with women in the highest quartile of weight, women in the lowest quartile had relative risks of 2.0 (95% CI, 1.5 to 2.8) for hip fractures, 2.3 (CI, 1.1 to 4.7) for pelvis fractures, and 2.4 (CI, 1.5 to 3.9) for rib fractures. Adjustment for total-hip bone mineral density eliminated the elevated risk. Results were similar for other body size measures. Smaller body size was not a risk factor for humerus, elbow, wrist, ankle, or foot fractures.
Conclusions: Total body weight is useful in the prediction of hip, pelvis, and rib fractures when bone mineral density has not been measured.
*For investigators in the Study of Osteoporotic Fractures Research Group, see Appendix.
Author and Article Information
From the Hennepin County Medical Center, Minneapolis Medical Research Foundation, Minneapolis Veterans Affairs Medical Center, and School of Public Health, University of Minnesota, Minneapolis, Minnesota; and University of California, San Francisco, San Francisco, California.
Presented in part at the annual meeting of the Society of General Internal Medicine, Chicago, Illinois, 25 April 1998.
Acknowledgments: The authors thank Katie Stone, PhD, for assistance with the analyses and Warren Browner, MD, and Jane Cauley, PhD, for comments on an earlier version of the manuscript.
Grant Support: By grant 5-R01-AG-05395 from the National Institute on Aging.
Requests for Single Reprints: Karen Margolis, MD, MPH, Division of Clinical Epidemiology, Hennepin County Medical Center (865B), 701 Park Avenue, Minneapolis, MN 55415.
Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.
Current Author Addresses: Dr. Margolis: Division of Clinical Epidemiology, Hennepin County Medical Center (865B), 701 Park Avenue, Minneapolis, MN 55415.
Dr. Ensrud: Section of General Medicine (1110), Minneapolis Veterans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417.
Dr. Schreiner: Division of Epidemiology, University of Minnesota School of Public Health, 1300 South Second Street, Suite 300, Minneapolis, MN 55454.
Dr. Tabor: Department of Genetics, Stanford University School of Medicine, 300 Pasteur Drive, Room M-310, Stanford, CA 94305-5120.
Author Contributions: Conception and design: K. Margolis, K.E. Ensrud.
Analysis and interpretation of the data: K. Margolis, K.E. Ensrud, P.J. Schreiner, H.K. Tabor.
Drafting of the article: K. Margolis, K.E. Ensrud.
Critical revision of the article for important intellectual content: K. Margolis, K.E. Ensrud, P.J. Schreiner, H.K. Tabor.
Final approval of the article: K. Margolis, K.E. Ensrud, P.J. Schreiner.
Provision of study materials or patients: K.E. Ensrud.
Statistical expertise: K.E. Ensrud, H.K. Tabor.
Obtaining of funding: K.E. Ensrud.
Collection and assembly of data: K.E. Ensrud. BRIEF COMMUNICATION
Body Size and Risk for Clinical Fractures in Older Women
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