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Body Size and Risk for Clinical Fractures in Older Women
- Karen L. Margolis, MD, MPH;
- Kristine E. Ensrud, MD, MPH;
- Pamela J. Schreiner, PhD;
- Holly K. Tabor, PhD; and
- for the Study of Osteoporotic Fractures Research Group*
- 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.
Abstract
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.
Article and Author Information
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Presented in part at the annual meeting of the Society of General Internal Medicine, Chicago, Illinois, 25 April 1998.
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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.
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Grant Support: By grant 5-R01-AG-05395 from the National Institute on Aging.
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Requests for Single Reprints: Karen Margolis, MD, MPH, Division of Clinical Epidemiology, Hennepin County Medical Center (865B), 701 Park Avenue, Minneapolis, MN 55415.
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Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.
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Current Author Addresses: Dr. Margolis: Division of Clinical Epidemiology, Hennepin County Medical Center (865B), 701 Park Avenue, Minneapolis, MN 55415.
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Dr. Ensrud: Section of General Medicine (1110), Minneapolis Veterans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417.
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Dr. Schreiner: Division of Epidemiology, University of Minnesota School of Public Health, 1300 South Second Street, Suite 300, Minneapolis, MN 55454.
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Dr. Tabor: Department of Genetics, Stanford University School of Medicine, 300 Pasteur Drive, Room M-310, Stanford, CA 94305-5120.
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Author Contributions: Conception and design: K. Margolis, K.E. Ensrud.
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Analysis and interpretation of the data: K. Margolis, K.E. Ensrud, P.J. Schreiner, H.K. Tabor.
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Drafting of the article: K. Margolis, K.E. Ensrud.
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Critical revision of the article for important intellectual content: K. Margolis, K.E. Ensrud, P.J. Schreiner, H.K. Tabor.
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Final approval of the article: K. Margolis, K.E. Ensrud, P.J. Schreiner.
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Provision of study materials or patients: K.E. Ensrud.
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Statistical expertise: K.E. Ensrud, H.K. Tabor.
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Obtaining of funding: K.E. Ensrud.
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Collection and assembly of data: K.E. Ensrud.
- Copyright ©2004 by the American College of Physicians
