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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Body Size and the Risk for Fractures in Older Women
18 July 2000 | Volume 133 Issue 2 | Page 123
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full report titled "Body Size and Risk for Clinical Fractures in Older Women." It is in the 18 July 2000 issue of Annals of Internal Medicine (volume 133, pages 123-127). The authors are K.L. Margolis, K.E. Ensrud, P.J. Schreiner, and H.K. Tabor, for the Study of Osteoporotic Fractures Research Group.
What is the problem and what is known about it so far?
Broken bones (fractures) are a significant health problem for older women. Previous studies have shown that small women are at higher risk for hip fractures than larger women. Small women are also more likely than large women to have thinning of the bones (osteoporosis). It has not been known, however, whether small women are also at greater risk for fractures of places other than the hip, such as the pelvis, ankle, or wrist.
Why did the researchers do this particular study?
To find out whether small body size puts women at risk for fractures of the pelvis, ribs, arm, elbow, ankle, wrist, and foot.
Who was studied?
The study included 8059 nonblack women age 65 and older who were participating in a larger study of osteoporosis. Black women were not included in the study because osteoporosis is uncommon in black women.
How was the study done?
The researchers collected information from the study participants about current weight, weight change since age 25, body mass index (a measure of overall body size that accounts for height and weight), body fat content, and bone density (a measure of how heavy the bones are). During a follow-up period that took place after the initial measurements were made, the researchers also determined how many women had fractures of the hip, pelvis, ribs, arm, elbow, ankle, wrist, or foot. The researchers then compared the risk for fractures at each site in smaller women with the risk in larger women.
What did the researchers find?
Compared to women who weighed more than 73.3 kilograms (161 pounds), women who weighed less than 57.8 kilograms (127 pounds) were about 2 times more likely to have fractures of the hip, pelvis, and ribs. These differences appeared to be related to lower bone density in small women rather than to body size itself. Smaller body size did not appear to put women at a higher risk for fractures of the arm, elbow, wrist, ankle, or foot.
What were the limitations of the study?
Although small body size could contribute to a woman's risk for fractures in several ways, the only risk factor that this study could identify in smaller women was low bone density. This study did not examine spine fractures, a common and disabling type of fracture in women with osteoporosis.
What are the implications of the study?
When bone density measurements are not available, total body weight can be a useful way to identify women who are at higher than average risk for fractures of the hip, pelvis, and ribs.
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