| Title: | Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX |
| Journal: | Osteoporosis International |
| Published: | 11 Aug 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/37566158/ |
| DOI: | https://doi.org/10.1007/s00198-023-06870-z |
| URL: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7615305 |
Publication 9762
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Abstract
A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX.IntroductionThe aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD).MethodsWe studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients.ResultsA previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination.ConclusionA previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.</p>
84 Authors
- J.A. Kanis
- H. Johansson
- E.V. McCloskey
- E. Liu
- K.E. Åkesson
- F.A. Anderson
- R. Azagra
- C.L. Bager
- C. Beaudart
- H.A. Bischoff-Ferrari
- E. Biver
- O. Bruyère
- J.A. Cauley
- J.R. Center
- R. Chapurlat
- C. Christiansen
- C. Cooper
- C.J. Crandall
- S.R. Cummings
- J.A.P. da Silva
- B. Dawson-Hughes
- A. Diez-Perez
- A.B. Dufour
- J.A. Eisman
- P.J.M. Elders
- S. Ferrari
- Y. Fujita
- S. Fujiwara
- C.-C. Glüer
- I. Goldshtein
- D. Goltzman
- V. Gudnason
- J. Hall
- D. Hans
- M. Hoff
- R.J. Hollick
- M. Huisman
- M. Iki
- S. Ish-Shalom
- G. Jones
- M.K. Karlsson
- S. Khosla
- D.P. Kiel
- W.-P. Koh
- F. Koromani
- M.A. Kotowicz
- H. Kröger
- T. Kwok
- O. Lamy
- A. Langhammer
- B. Larijani
- K. Lippuner
- D. Mellström
- T. Merlijn
- A. Nordström
- P. Nordström
- T.W. O'Neill
- B. Obermayer-Pietsch
- C. Ohlsson
- E.S. Orwoll
- J.A. Pasco
- F. Rivadeneira
- A.-M. Schott
- E.J. Shiroma
- K. Siggeirsdottir
- E.M. Simonsick
- E. Sornay-Rendu
- R. Sund
- K.M.A. Swart
- P. Szulc
- J. Tamaki
- D.J. Torgerson
- N.M. van Schoor
- T.P. van Staa
- J. Vila
- N.J. Wareham
- N.C. Wright
- N. Yoshimura
- M.C. Zillikens
- M. Zwart
- L. Vandenput
- N.C. Harvey
- M. Lorentzon
- W.D. Leslie
1 Application
| Application ID | Title |
|---|---|
| 3593 | Osteoporosis, fractures and cardiovascular risk |
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