Risk factors for hip fracture in european women: The MEDOS study

Abstract

The aims of this study were to determine common international risk factors for hip fracture in women aged 50 years or more. We studied women aged 50 years or more who sustained a hip fracture in 14 centers from Portugal, Spain, France, Italy, Greece, and Turkey over a 1-year period. Women aged 50 years or more selected from the neighborhood or population registers served as controls. Cases and controls were interviewed using a structured questionnaire on work, physical activity, exposure to sunlight, reproductive, history and gynecologic status, height, weight, mental score, and consumption of tobacco, alcohol, calcium, coffee, and tea. Significant risk factors identified by univariate analysis included low body mass index (BMI), short fertile period, low physical activity. lack of sunlight exposure, low milk consumption, no consumption of tea, and a poor mental score. No significant adverse effects of coffee or smoking were observed. Moderate intake of spirits was a protective factor in young adulthood, but otherwise no significant effect of alcohol intake was observed. For some risks, a threshold effect was observed. A low BMI and milk consumption were significant risks only in the lowest 50% and 10% of the population, respectively. A late menarche, poor mental score, low BMI and physical activity, low exposure to sunlight, and a low consumption of calcium and tea remained independent risk factors after multivariate analysis, accounting for 70% of hip fractures. Excluding mental score and age at menarche (not potentially reversible), the attributable risk was 56%. Thus, about half of the hip fractures could be explained on the basis of the potentially reversible risk factors sought. In contrast, the use of risk factors to "predict" hip fractures had moderate sensitivity and specificity. We conclude that variations in lifestyle factors are associated with significant differences in the risk of hip fracture, account for a large component of the total risk, and may be of some value in selecting individuals at high risk.

Catch up in bone acquisition in young adult men with late normal puberty

“…2). Men with late puberty also lost less in aBMD of the total hip and femoral neck (À0.01 AE 0.07 g/cm 2 versus À0.03 AE 0.05 g/cm 2 and À0.02 AE 0.07 g/cm 2 versus À0.05 AE 0.06 g/cm 2 , respectively, p < 0.001) than men with early puberty (Fig. 2).…”

“…Cross-calibration between the two Lunar Prodigy DXA machines was performed at the time of follow-up. Phantom measurements (phantom number 9397) were made regularly with the original Lunar Prodigy DXA, and were stable over time (1.270 g/cm 2 at the time of the original study and 1.268 g/cm 2 at the time of the follow-up study). In the cross-calibration, 24 young men, 24.7 AE 1.7 years of age, were measured with both Lunar Prodigy DXA devices within a period of 4 days.…”

“…Late menarche has been associated with low BMD and higher fracture risk at several sites in postmenopausal women, (1)(2)(3)(4)(5) and in premenopausal women early menarche has been associated with high BMD. (24,25) In the present study, no significant differences in aBMD or BMC of the lumbar spine, femoral neck, or total body between men with early, middle, or late puberty at 24 years of age were ascertained.…”

“…In postmenopausal women, late menarche has been associated with lower BMD as well as an increased risk of fractures of the forearm, vertebrae, and hip. (1)(2)(3)(4)(5) More recent studies have shown an association between late menarche and lower BMD in young adulthood and in premenopausal women. (6,7) The influence of pubertal timing on adult BMD in men is not clear.…”

Associations between dietary flavonoid intakes and bone health in a scottish population

“…Human studies on dietary flavonoids and bone health have focused on tea because tea has been reported to protect against hip fracture. (11,12) Cellular models and animal studies have found associations between bone health and flavonoids (13)(14)(15) ; therefore, the aim of this study was to examine whether dietary flavonoids (ie, flavonols, flavones, flavanones, catechins, and procyanidins) were associated with markers of bone health in a large cohort of Scottish women. aged 45 to 54 years who first visited our unit between 1990 and 1994.…”