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Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: a population-based case-control study.
Bone. 2009 Oct; 45(4):789-93.BONE

Abstract

OBJECTIVE

We used dual X-ray absorptiometry (DXA) to measure calcaneal bone mineral density (BMD) and estimate the prevalence of osteoporosis in a population with distal forearm fracture and a normative cohort.

METHODS

Patients 20 to 80 years of age with distal forearm fracture treated at one emergency hospital during two consecutive years were invited to calcaneal BMD measurement; 270 women (81%) and 64 men (73%) participated. A DXA heel scanner estimated BMD (g/cm(2)) and T-scores. Osteoporosis was defined as T-score< or =-2.5 SD. Of the fracture cohort, 254 women aged 40-80 years and 27 men aged 60-80 years were compared with population-based control cohorts comprising 171 women in the age groups 50, 60, 70 and 80 years and 75 men in the age groups 60, 70, and 80 years.

RESULTS

In the fracture population no woman below 40 years or man below 60 years of age had osteoporosis. In women aged 40-80 years the prevalence of osteoporosis in the distal forearm fracture cohort was 34% and in the population-based controls was 25%; the age-adjusted prevalence ratio (PR) was 1.32 (95% CI 1.00-1.76). In the subgroup of women aged 60-80 years the age-adjusted prevalence ratio of osteoporosis was 1.28 (95% CI 0.95-1.71). In men aged 60-80 years the prevalence of osteoporosis in the fracture cohort was 44% and in the population-based controls was 8% (PR 6.31, 95% CI 2.78-14.4). The age-adjusted odds ratio for fracture associated with a 1-SD reduction in calcaneal BMD was in women aged 40-80 years 1.4 (95% CI 1.1-1.8), in the subgroup of women aged 60-80 years 1.2 (95% CI 0.95-1.6), and in men aged 60-80 years 2.6 (95% CI 1.7-4.1). Among those aged 60-80 years the area under the ROC curve was in women 0.56 (95% CI 0.49-0.63) and in men 0.80 (95% CI 0.70-0.80).

CONCLUSIONS

The age-adjusted prevalence of osteoporosis based on calcaneal BMD is higher in individuals with distal forearm fracture than in population-based controls. BMD impairment is associated with increased odds ratio for forearm fracture in both women and men but the differences between cases and controls are more pronounced in men than in women, which may have implications in fracture prevention.

Authors+Show Affiliations

Department of Clinical Sciences, Lund University, Lund, Sweden. Isam.Atroshi@skane.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19539795

Citation

Atroshi, Isam, et al. "Low Calcaneal Bone Mineral Density and the Risk of Distal Forearm Fracture in Women and Men: a Population-based Case-control Study." Bone, vol. 45, no. 4, 2009, pp. 789-93.
Atroshi I, Ahlander F, Billsten M, et al. Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: a population-based case-control study. Bone. 2009;45(4):789-93.
Atroshi, I., Ahlander, F., Billsten, M., Ahlborg, H. G., Mellström, D., Ohlsson, C., Ljunggren, O., & Karlsson, M. K. (2009). Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: a population-based case-control study. Bone, 45(4), 789-93. https://doi.org/10.1016/j.bone.2009.06.008
Atroshi I, et al. Low Calcaneal Bone Mineral Density and the Risk of Distal Forearm Fracture in Women and Men: a Population-based Case-control Study. Bone. 2009;45(4):789-93. PubMed PMID: 19539795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: a population-based case-control study. AU - Atroshi,Isam, AU - Ahlander,Fredrik, AU - Billsten,Mats, AU - Ahlborg,Henrik G, AU - Mellström,Dan, AU - Ohlsson,Claes, AU - Ljunggren,Osten, AU - Karlsson,Magnus K, Y1 - 2009/06/17/ PY - 2009/02/19/received PY - 2009/06/05/revised PY - 2009/06/10/accepted PY - 2009/6/23/entrez PY - 2009/6/23/pubmed PY - 2009/12/16/medline SP - 789 EP - 93 JF - Bone JO - Bone VL - 45 IS - 4 N2 - OBJECTIVE: We used dual X-ray absorptiometry (DXA) to measure calcaneal bone mineral density (BMD) and estimate the prevalence of osteoporosis in a population with distal forearm fracture and a normative cohort. METHODS: Patients 20 to 80 years of age with distal forearm fracture treated at one emergency hospital during two consecutive years were invited to calcaneal BMD measurement; 270 women (81%) and 64 men (73%) participated. A DXA heel scanner estimated BMD (g/cm(2)) and T-scores. Osteoporosis was defined as T-score< or =-2.5 SD. Of the fracture cohort, 254 women aged 40-80 years and 27 men aged 60-80 years were compared with population-based control cohorts comprising 171 women in the age groups 50, 60, 70 and 80 years and 75 men in the age groups 60, 70, and 80 years. RESULTS: In the fracture population no woman below 40 years or man below 60 years of age had osteoporosis. In women aged 40-80 years the prevalence of osteoporosis in the distal forearm fracture cohort was 34% and in the population-based controls was 25%; the age-adjusted prevalence ratio (PR) was 1.32 (95% CI 1.00-1.76). In the subgroup of women aged 60-80 years the age-adjusted prevalence ratio of osteoporosis was 1.28 (95% CI 0.95-1.71). In men aged 60-80 years the prevalence of osteoporosis in the fracture cohort was 44% and in the population-based controls was 8% (PR 6.31, 95% CI 2.78-14.4). The age-adjusted odds ratio for fracture associated with a 1-SD reduction in calcaneal BMD was in women aged 40-80 years 1.4 (95% CI 1.1-1.8), in the subgroup of women aged 60-80 years 1.2 (95% CI 0.95-1.6), and in men aged 60-80 years 2.6 (95% CI 1.7-4.1). Among those aged 60-80 years the area under the ROC curve was in women 0.56 (95% CI 0.49-0.63) and in men 0.80 (95% CI 0.70-0.80). CONCLUSIONS: The age-adjusted prevalence of osteoporosis based on calcaneal BMD is higher in individuals with distal forearm fracture than in population-based controls. BMD impairment is associated with increased odds ratio for forearm fracture in both women and men but the differences between cases and controls are more pronounced in men than in women, which may have implications in fracture prevention. SN - 1873-2763 UR - https://www.unboundmedicine.com/medline/citation/19539795/Low_calcaneal_bone_mineral_density_and_the_risk_of_distal_forearm_fracture_in_women_and_men:_a_population_based_case_control_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756-3282(09)01658-5 DB - PRIME DP - Unbound Medicine ER -