Asking about lifestyle risk factors for osteoporosis in a busy clinic — is it worth it?

Abstract

Objectives: Earlier fracture is a strong risk factor for subsequent fracture. Vertebral fractures give loss in body height, and height loss will be a sum of spinal degeneration. We hypothesize that heightj loss predicts subsequent fractures of all types. Material and methods: All males born 1925-59 and all females born 1930-59 and living in the city of Troms@ were invited to surveys in 1979/80 and 1986/87 (Troms~ Heart Study). Of 18707 invited, 12270 met twice (66%). Height was measured without shoes by stadlometer. All types of fractures in the period 1988-1995 (n=826) except vertebral fractures, have been recorded and verified by X-ray in the only hospital in the area. Fractures have been coded as low-traumatic or not from information in the referrals. Results: Those with a height loss compared to those with no height loss suffered more fractures of all types (RR=I,23 CI 1,05-1,44, p=0,009). The relative risk was higher for women (RR=I,54 CI 1,22-1,95, p=0,00013), especially with respect to wrist fractures (RR=I,64 CI 1,14-2,38, p=0,007), but the estimates were similar for ankle fractures (RR=I,64 CI 0,85, p=0,08). Exluding hlgh-tratunatic fractures did not change the point estimates significantly. When adjusting for age among women, the odds ratio for fractures decreased (RR=l,26 CI 1,00-1,51 p=0,07). Among men there were interaction with age (p=0,014), thus height loss among older men was predictive of fractures, but not among young men. When including an interaction term in the regression model, height loss was predictive of fractures among men(p=0,02). Conclusion: Height loss is a predictor of fractures, even in such a young population. There is a need for further studies on the subject in older populations, but this result suggests that proper measurement of height loss could be part of follow-up studies of osteoporosis.