Two-thirds of all fractures are not attributable to osteoporosis and advancing age: implication for fracture prevention.

Mai, HT; Tran, TS; Ho-Le, TP; Center, JR; Eisman, JA; Nguyen, TV

Two-thirds of all fractures are not attributable to osteoporosis and advancing age: implication for fracture prevention.

Mai, HT Tran, TS Ho-Le, TP Center, JR Eisman, JA Nguyen, TV

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Publisher:: ENDOCRINE SOC
Publication Type:: Journal Article
Citation:: The Journal of clinical endocrinology and metabolism, 2019, 104, (8), pp. 3514-3520
Issue Date:: 2019-04-05

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Field	Value	Language
dc.contributor.author	Mai, HT
dc.contributor.author	Tran, TS
dc.contributor.author	Ho-Le, TP
dc.contributor.author	Center, JR
dc.contributor.author	Eisman, JA
dc.contributor.author	Nguyen, TV
dc.date.accessioned	2020-05-18T03:48:39Z
dc.date.available	2019-04-01
dc.date.available	2020-05-18T03:48:39Z
dc.date.issued	2019-04-05
dc.identifier.citation	The Journal of clinical endocrinology and metabolism, 2019, 104, (8), pp. 3514-3520
dc.identifier.issn	0021-972X
dc.identifier.issn	1945-7197
dc.identifier.uri	http://hdl.handle.net/10453/140771
dc.description.abstract	CONTEXT:Although bone mineral density (BMD) is strongly associated with fracture and post-fracture mortality, the burden of fractures attributable to low BMD has not been investigated. OBJECTIVES:We sought to estimate the population attributable fraction (PAF) of fractures and fracture-related mortality that can be attributed to low BMD. DESIGN AND SETTING:This study is a part of an ongoing population-based prospective cohort study, Dubbo Osteoporosis Epidemiology study. In total, 3700 participants aged from 50 years and older had participated in the study. Low-trauma fracture was ascertained by X-ray reports, and mortality was ascertain from the Birth, Death and Marriage Registry. RESULTS:Overall, 21% of women and 11% of men had osteoporotic BMD. In univariable analysis, 21% and 16% of total fractures in women and men, respectively, were attributable to osteoporosis. Osteoporosis combined with advancing age (>70 yrs) accounted for 34% and 35% of fractures in women and men, respectively. However, these two factors accounted for ∼60% of hip fractures. About 99% and 66% of postfracture mortality in women and men, respectively, were attributable to advancing age, osteoporosis and fracture; however, most of the attributable proportion was accounted for advancing age. CONCLUSIONS:A substantial health care burden of fracture is on individuals aged <70 years and/or non-osteoporosis, suggesting that treatment of individuals with osteoporosis is unlikely to reduce a large number of fractures in the general population.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ENDOCRINE SOC
dc.relation.ispartof	The Journal of clinical endocrinology and metabolism
dc.relation.isbasedon	10.1210/jc.2018-02614
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine
dc.subject.classification	Endocrinology & Metabolism
dc.title	Two-thirds of all fractures are not attributable to osteoporosis and advancing age: implication for fracture prevention.
dc.type	Journal Article
utslib.citation.volume	104
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1114 Paediatrics and Reproductive Medicine
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2020-05-18T03:48:34Z
pubs.issue	8
pubs.publication-status	Published
pubs.volume	104
utslib.start-page	3514
utslib.citation.issue	8

Abstract:

CONTEXT:Although bone mineral density (BMD) is strongly associated with fracture and post-fracture mortality, the burden of fractures attributable to low BMD has not been investigated. OBJECTIVES:We sought to estimate the population attributable fraction (PAF) of fractures and fracture-related mortality that can be attributed to low BMD. DESIGN AND SETTING:This study is a part of an ongoing population-based prospective cohort study, Dubbo Osteoporosis Epidemiology study. In total, 3700 participants aged from 50 years and older had participated in the study. Low-trauma fracture was ascertained by X-ray reports, and mortality was ascertain from the Birth, Death and Marriage Registry. RESULTS:Overall, 21% of women and 11% of men had osteoporotic BMD. In univariable analysis, 21% and 16% of total fractures in women and men, respectively, were attributable to osteoporosis. Osteoporosis combined with advancing age (>70 yrs) accounted for 34% and 35% of fractures in women and men, respectively. However, these two factors accounted for ∼60% of hip fractures. About 99% and 66% of postfracture mortality in women and men, respectively, were attributable to advancing age, osteoporosis and fracture; however, most of the attributable proportion was accounted for advancing age. CONCLUSIONS:A substantial health care burden of fracture is on individuals aged <70 years and/or non-osteoporosis, suggesting that treatment of individuals with osteoporosis is unlikely to reduce a large number of fractures in the general population.

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http://hdl.handle.net/10453/140771