How Hip and Whole-Body Bone Mineral Density Predict Hip Fracture in Elderly Women: The EPIDOS Prospective Study

Schott, Anne-Marie; Cormier, Catherine; Hans, Didier; Favier, F.; Hausherr, E.; Dargent-Molina, Patricia; Delmas, Pierre D.; Ribot, C.; Sébert, J. L.; Breart, Gérard; Meunier, Pierre J.

doi:10.1007/s001980050061

Cited by 320 publications

(189 citation statements)

References 24 publications

(23 reference statements)

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“…As in previous studies, individuals with a fracture had, on average, lower BMD than those without a fracture. (35)(36)(37)(38) Moreover, individuals with a fracture were older, more likely to have a preexisting fracture, and more likely to have had at least one fall during the 12 months prior to the fracture event.…”

Section: Resultsmentioning

confidence: 99%

Genetic profiling and individualized prognosis of fracture

Tran

Nguyen

et al. 2010

Journal of Bone and Mineral Research

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Fragility fracture is a serious public health problem in the world. The risk of fracture is determined by genetic and nongenetic clinical risk factors. This study sought to quantify the contribution of genetic profiling to fracture prognosis. The study was built on the ongoing Dubbo Osteoporosis Epidemiology Study, in which fracture and risk factors of 858 men and 1358 women had been monitored continuously from 1989 and 2008. Fragility fracture was ascertained by radiologic reports. Bone mineral density at the femoral neck was measured by dual-energy X-ray absorptiometry (DXA). Fifty independent genes with allele frequencies ranging from 0.01 to 0.60 and relative risks (RRs) ranging from 1.01 to 3.0 were simulated. Three predictive models were fitted to the data in which fracture was a function of (1) clinical risk factors only, (2) genes only, and (3) clinical risk factors and 50 genes. The area under the curve (AUC) for model 1 was 0.77, which was lower than that of model II (AUC ¼ 0.82). Adding genes into the clinical risk factors model (model 3) increased the AUC to 0.88 and improved the accuracy of fracture classification by 45%, with most (41%) improvement in specificity. In the presence of clinical risk factors, the number of genes required to achieve an AUC of 0.85 was around 25. These results suggest that genetic profiling could enhance the predictive accuracy of fracture prognosis and help to identify high-risk individuals for appropriate management of osteoporosis or intervention. ß

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Section: Resultsmentioning

confidence: 99%

Genetic profiling and individualized prognosis of fracture

Tran

Nguyen

et al. 2010

Journal of Bone and Mineral Research

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“…(28) In women age 75 and older, lower fat mass, but not lean mass, was associated with greater risk of hip fracture; however, linearity of the fat mass association was assumed, and evidence of independence from BMD was not presented. (29) How these components of body size individually contribute to the associations of BMI with skeletal outcomes remains uncertain but is of great interest.…”

Section: Introductionmentioning

confidence: 99%

Obesity and fracture in men and women: An epidemiologic perspective

Nielson

Srikanth

Orwoll

2011

Journal of Bone and Mineral Research

220

137

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In Western societies, mean body weight has increased dramatically in older people, and a similar trend exists in Asia. Yet insufficient attention has been directed to the problem of osteoporotic fractures in the overweight and obese. Many, if not most, osteoporotic fractures occur in overweight or obese people, and obese men may be particularly susceptible. We discuss the potential implications of these findings, including the challenge of identifying individuals at highest risk, screening and treatment strategies, and future research directions. ß

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“…[10][11][12][13] Furthermore, multiple myeloma is associated with systemic osteoporosis as a result of increased osteoclastic activity. 14 ABMT patients also may have general risk factors for osteoporosis that include older age, 15 thin body habitus, 16,17 a family history of osteoporosis, 18 smoking, 19,20 and physical inactivity. 16 While survivors of ABMT have significant risks for decreased BMD, little is known about the incidence or predictive variables for osteopenia and osteoporosis in this population.…”

mentioning

confidence: 99%

Decreased bone mineral density is common after autologous blood or marrow transplantation

Schimmer

Mah

Bordeleau

et al. 2001

Bone Marrow Transplant

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Summary:Survivors of autologous blood or marrow transplantation (ABMT) are predisposed to decreased bone mineral density (BMD), but data are lacking on the incidence and risk factors for this condition. Therefore, we measured BMD in 64 of 68 consecutive ABMT survivors (35 men and 29 women) attending the University of Toronto ABMT long-term follow-up clinic. Patients were evaluated a median of 4.2 years (range: 4.9 months-11.4 years) after ABMT. Median age at evaluation was 49.6 years (range: 23.5-68.2 years). At the L1-L4 vertebrae, 17 (26%) patients (eight men and nine women) had osteopenia and one male (2%) had osteoporosis. Mean BMD at L1-L4 did not differ from healthy young adults or age and sex matched controls. At the femoral neck, 30 patients (46%) (18 men and 12 women) had osteopenia and five (8%) (two men and three women) had osteoporosis. Mean BMD at the femoral neck was significantly lower than in healthy young adults and age-and sex-matched controls. By regression analysis, patients with decreased BMD were older than those with normal BMD (P = 0.02). Gender, body mass index, time from BMT to evaluation and presence of hypogonadism were not associated with decreased BMD. Treatment of decreased bone density was instituted and follow-up data were obtained 1 year after treatment in 22 of 39 patients with reduced BMD. Nineteen (86%) patients had stabilization or improvement of their bone density at follow-up. We conclude that, after ABMT, over half of the patients have evidence of osteopenia or osteoporosis. Men and women were equally affected. In our study, only older age at evaluation was predictive for loss of BMD. We recommend the measurement of BMD as an integral component to the follow-up of ABMT patients. Bone Marrow Transplantation (2001) As the number of long-term survivors of autologous blood or marrow transplantation (ABMT) increases, greater attention is turning to the late complications of this procedure. One such complication is decreased bone mineral densityosteopenia and osteoporosis. Osteopenia is a systemic condition characterized by reduced bone mass and increased susceptibility to bone fracture. Osteoporosis is a more severe reduction in bone mass and a greater susceptibility to bone fracture.In the short term, osteoporosis seems trivial compared with a diagnosis of cancer, but for those cured of their disease, decreased bone mineral density contributes to chronic morbidity and mortality in the form of bone fractures. For example, 50% of patients who sustain an osteoporosisrelated hip fracture require assistance with activities of daily living 1 and elderly patients who suffer an osteoporosis-related hip fracture have an increased 1-year mortality of 12-37%. 2 ABMT predisposes to decreased BMD through early and late acting mechanisms. ABMT is associated with an acute increase in bone turnover due to the high-dose chemotherapy, marrow reinfusion and G-CSF administration, but effects on long-term bone density are unknown. [3][4][5] The late effects of ABMT on BMD are primarily due to t...

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How Hip and Whole-Body Bone Mineral Density Predict Hip Fracture in Elderly Women: The EPIDOS Prospective Study

Cited by 320 publications

References 24 publications

Genetic profiling and individualized prognosis of fracture

Genetic profiling and individualized prognosis of fracture

Obesity and fracture in men and women: An epidemiologic perspective

Decreased bone mineral density is common after autologous blood or marrow transplantation

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