The population burden of fractures originates in women with osteopenia, not osteoporosis

Pasco, J. A., Seeman, E., Henry, M. J., Merriman, E. N., Nicholson, G. C. and Kotowicz, M. A. 2006, The population burden of fractures originates in women with osteopenia, not osteoporosis, Osteoporosis International, vol. 17, no. 9, pp. 1404-1409, doi: 10.1007/s00198-006-0135-9.

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Title The population burden of fractures originates in women with osteopenia, not osteoporosis
Author(s) Pasco, J. A.ORCID iD for Pasco, J. A.
Seeman, E.
Henry, M. J.
Merriman, E. N.
Nicholson, G. C.
Kotowicz, M. A.ORCID iD for Kotowicz, M. A.
Journal name Osteoporosis International
Volume number 17
Issue number 9
Start page 1404
End page 1409
Total pages 6
Publisher Springer U. K.
Place of publication Surrey, England
Publication date 2006-09
ISSN 0937-941X
Keyword(s) bone mineral density
fracture risk
population study
Summary Introduction : Osteoporosis is associated with increased risk for fracture. However, most postmenopausal women have bone mineral density (BMD) within the normal or osteopenic range. The aim of this study was to determine the proportion of the population burden of fragility fractures arising from women at modest risk for fracture.

Methods : We measured baseline BMD in a population-based random sample of 616 postmenopausal women aged 60–94 years and followed these individuals for a median of 5.6 years (IQR 3.9–6.5) to determine the incidence of fractures according to age, BMD and the presence of a prior fracture.

Results : Based on WHO criteria, 37.6% of the women had normal total hip BMD, 48.0% had osteopenia and 14.5% had osteoporosis. The incidence of fracture during follow-up was highest in women with osteoporosis, but only 26.9% of all fractures arose from this group; 73.1% occurred in women without osteoporosis (56.5% in women with osteopenia, 16.6% in women with normal BMD). Decreasing BMD, increasing age and prior fracture contributed independently to increased fracture risk; in a multivariate model, the relative risk for fracture increased 65% for each SD decrease in BMD (RR=1.65, 95%CI 1.32–2.05), increased 3% for every year of age (RR=1.03, 95%CI 1.01–1.06) and doubled with prevalent fracture (RR=2.01, 95% CI 1.40–2.88). A prevalent fracture increased the risk for fractures such that women with osteopenia and prevalent fracture had the same, if not greater, risk as women with osteoporosis alone.
Language eng
DOI 10.1007/s00198-006-0135-9
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2006, International Osteoporosis Foundation and National Osteoporosis Foundation
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Document type: Journal Article
Collection: School of Medicine
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