Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study

Schuit, Stephanie C. E.; Klift, Marjolein van der; Weel, A.; Laet, Chris De; Burger, Huibert; Seeman, Ego; Hofman, Albert; Uitterlinden, André G.; Leeuwen, Johannes P.T.M. van; Pols, Huibert A. P.

doi:10.1016/j.bone.2003.10.001

Cited by 1,403 publications

(884 citation statements)

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“…Three studies suggest the relationship between hip BMD and nonspine fracture risk is similar in men and women [18,29,34]. The association between hip areal BMD and fracture risk may be stronger in men, although this gender difference becomes less pronounced with advancing age [6].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

Gender Differences in Osteoporosis and Fractures

Cawthon

2011

Clinical Orthopaedics &Amp; Related Research

249

153

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Background Osteoporosis is generally thought of as a ''woman's disease'' because the prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older men. However, the absolute number of men affected by osteoporosis and fractures is large, as at least 2.8 million men in the United States are thought to have osteoporosis. Questions/purposes The purposes of this review are to (1) highlight gender differences in osteoporosis and fracture risk, (2) describe disparities in treatment and outcomes after fractures between men and women, and (3) propose solutions to reducing disparities in treatment and prevention. Methods A literature survey was conducted using MEDLINE with a variety of search terms and using references from the author's personal collection of articles. A formal search strategy and exclusion criteria were not employed and the review is therefore selective. Where are we now? Postmenopausal women have a higher prevalence of osteoporosis and greater incidence of fracture than older men. Despite the higher fracture risk in postmenopausal women, older men tend to have worse outcomes after fracture and poorer treatment rates, although less is known about the disease course in men.Multifaceted interventions to improve the screening and treatment for osteoporosis were recently developed. Where do we need to go? Improvement in treatment rates of those at risk, regardless of gender, is an important goal in osteoporosis management. How do we get there? Further development and evaluation of cost-effective, multifaceted interventions for screening and treatment of osteoporosis and fractures are needed; such interventions will likely improve the primary prevention of fractures.

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Section: Search Strategy and Criteriamentioning

confidence: 99%

Gender Differences in Osteoporosis and Fractures

Cawthon

2011

Clinical Orthopaedics &Amp; Related Research

249

153

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“…However, this score identifies only half of the future osteoporotic fractures that will occur in postmenopausal women. (2,3) In men, this predictive value is even smaller because only 20% of fractures in elderly men are observed among those with a low T-score. (4) During the last decade, others aspects of bone quality have been investigated with various techniques in order to better understand the pathophysiology of osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in men

Vilayphiou

Boutroy

Szulc

et al. 2010

Journal of Bone and Mineral Research

126

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Few studies have investigated bone microarchitecture and biomechanical properties in men. This study assessed in vivo both aspects in a population of 185 men (aged 71 AE 10 years) with prevalent fragility fractures, compared to 185 controls matched for age, height, and weight, from the Structure of the Aging Men's Bones (STRAMBO) cohort.In this case-control study, areal BMD (aBMD) was measured by DXA, bone microarchitecture was assessed by high resolution (HR)-pQCT, and finite element (mFE) analysis was based on HR-pQCT images of distal radius and tibia. A principal component (PC) analysis (PCA) was used to study the association of synthetic PCs with fracture by computing their odds ratio (OR [95%CI]) per SD change. Specific associations with vertebral fracture (n ¼ 100), and nonvertebral fracture (n ¼ 85) were also computed.At both sites, areal and volumetric BMD, cortical thickness and trabecular number, separation, and distribution were significantly worse in cases than in controls, with differences ranging from À6% to 15%. mFE-derived stiffness and failure load were 8% to 9% lower in fractures ( p < .01). No difference in load distribution was found between the two groups. After adjustment for aBMD, only differences of mFE-derived stresses, stiffness, and failure load at the tibia remained significant ( p < .05).PCA resulted in defining 4 independent PCs, explaining 83% of the total variability of bone characteristics. Nonvertebral fractures were associated with PC1, reflecting bone quantity and strength at the radius (tibia) with OR ¼

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“…Values in bold font indicate p < 0.05 vBMD volumetric bone mineral density, aBMD areal BMD, CSA cross-sectional area, CI confidence interval Values are presented as adjusted means ± standard errors (adjusted for sex, average portion size, dietary protein content, cross-sectional muscle area measured by pQCT, smoking, and physical activity) MG milk group (milk only, no fermented dairy products), FDG fermented dairy group (fermented dairy products only, no milk), ADG all dairy group (milk and fermented dairy products), NDG no dairy group (no milk or fermented dairy products), vBMD volumetric bone mineral density, CSA cross-sectional area, aBMD areal bone mineral density indication of a negative effect of dairy product consumption on any investigated bone measurement. The mineralization of the skeleton undeniably decreases with age [22], and low BMD has been linked to an increased risk of fracture in elderly men and women [23][24][25][26][27][28][29], as well as in very elderly women [30,31]. Calcium supplementation has been shown to reduce the loss of bone [32], and increased consumption of calcium-rich dairy products (e.g., milk) has been found to provide an adequate source of dietary calcium, comparable to the results of other calcium supplementation strategies [33].…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, we used pQCT together with the more commonly employed DXA, to evaluate different aspects of the bone [24,25,28,30]. pQCT enables measurement of cortical and trabecular bone, as well as CSAs, thereby enabling more in-depth examination of bone properties.…”

Section: Discussionmentioning

confidence: 99%

Dairy product intake and bone properties in 70-year-old men and women

et al. 2018

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Summary In the present population-based study including 70-year-old men and women, total dairy product intake was associated with a weak positive association with tibia trabecular and cortical cross-sectional areas. Purpose Milk consumption has recently been suggested to increase fracture risk. Therefore, we aimed to investigate associations between dairy product consumption and peripheral bone properties. Furthermore, we explored whether consumption of milk and fermented dairy products affected bone properties differently. Methods The Healthy Aging Initiative is a population-based, cross-sectional study investigating the health of 70-year-old men and women. Out of the 2904 individuals who met the inclusion criteria, data on self-reported daily dairy product consumption (dl/ day), peripheral quantitative computed tomography (pQCT) examinations at the 4 and 66% scan sites of the tibia and radius, and dual-energy X-ray absorptiometry (DXA) scans were collected from 2040 participants. Associations between dairy product consumption and bone properties were examined using multiple linear regression models adjusted for sex, muscle area, meal size, dietary protein proportion, current smoking status, and objectively measured physical activity. Results Total dairy product intake was associated with larger trabecular (2.296 (95% CI, 0.552-4.039) mm 2 , per dl/day increase, p = 0.01) and cortical cross-sectional areas (CSAs) in the tibia (1.757 (95% CI, 0.683-2.830 mm 2 , p = 0.001) as measured by pQCT and higher areal bone mineral density (aBMD) of the radius (3.231 (95% CI, 0.764-5.698) mg/cm 2 , p = 0.01) as measured by DXA. No other measurement in the tibia, radius, femoral neck, or lower spine was associated significantly with dairy product intake. Bone properties did not differ according to the type of dairy product consumed. Conclusion No evidence of a negative association between dairy product consumption and bone health was found. Furthermore, total dairy product consumption was associated with increased CSAs in the tibia, regardless of dairy product type. Collectively, our findings indicate the existence of a weak but significant positive association between dairy product consumption bone properties in older adults.

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Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study

Cited by 1,403 publications

References 35 publications

Gender Differences in Osteoporosis and Fractures

Gender Differences in Osteoporosis and Fractures

Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in men

Dairy product intake and bone properties in 70-year-old men and women

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