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Risk faktors for fracture in middle-aged men and women

Holmberg, Anna H LU (2006) In 2006:67
Abstract
The number of fractures is increasing worldwide, and fractures frequently cause long-term disability, impaired quality of life and sometimes death. The Malmö Preventive Project, a population-based, prospective study, consisting of 22 444 men, mean age 44 and 10 902 women, mean age 50 years, provides data for evaluation of common public health conditions, such as fracture and diabetes. The follow-up was 19 and 15 years for men and women, respectively. Multiple risk factors for fracture were identified.



In women, the most important risk factors were advancing age (relative risk RR 1.56, Confidence Interval 95% 1.45-1.68), previous fracture (RR 2.00, CI 95% 1.56-2.58) and diabetes (RR 1.87, CI 95% 1.26-2,79). In men,... (More)
The number of fractures is increasing worldwide, and fractures frequently cause long-term disability, impaired quality of life and sometimes death. The Malmö Preventive Project, a population-based, prospective study, consisting of 22 444 men, mean age 44 and 10 902 women, mean age 50 years, provides data for evaluation of common public health conditions, such as fracture and diabetes. The follow-up was 19 and 15 years for men and women, respectively. Multiple risk factors for fracture were identified.



In women, the most important risk factors were advancing age (relative risk RR 1.56, Confidence Interval 95% 1.45-1.68), previous fracture (RR 2.00, CI 95% 1.56-2.58) and diabetes (RR 1.87, CI 95% 1.26-2,79). In men, advancing age (RR 1.19, CI 95% 1.12-1.26), mental health problems (RR 1.92, CI 95% 1.47-2.51), increased levels of ? glutamyl transferase (RR 1.24, CI 95% 1.18-1.31) and diabetes (RR 2.38, CI 95% 1.65-3.42) were major risk contributors.



Impaired glucose tolerance, evaluated through an oral glucose tolerance test, was in both genders associated with a substantially decreased risk of fractures, independent of age, BMI and smoking.



This thesis has identified multiple risk factors for low-energy fracture, in both men and women, highlighting diabetes and mental health problems as major contributors in this age group. Current management strategies and therapeutic guidelines are not addressing a number of the identified risk factors. Subsequently, risk assessment can be substantially improved by adding these risk factors to intervention algorithms for middle-aged individuals. (Less)
Abstract (Swedish)
Popular Abstract in Swedish

Sedan årtionden ökar antalet frakturer över hela världen, och i alla ålderskategorier. Frakturer leder ofta till längre tids funktionsinskränkning, sämre livskvalitet och ibland till döden. Projektet ?Malmö Förebyggande Medicin?, an populationsbaserad, prospektiv studie av 22 444 män, medelålder 44 år, och 10 902 kvinnor, medelålder 50 år, är väl lämpad för studier av vanliga folkhälsoproblem som t.ex. fraktur och diabetes. Uppföljningstiden var 19 och 15 år för män och kvinnor. Multipla riskfaktorer för fraktur kunde identifieras.



De viktigaste riskfaktorerna för kvinnor var stigande ålder (relativ risk RR 1.56, konfidensintervall CI 95% 1.45-1.68), tidigare fraktur(RR 2.00,... (More)
Popular Abstract in Swedish

Sedan årtionden ökar antalet frakturer över hela världen, och i alla ålderskategorier. Frakturer leder ofta till längre tids funktionsinskränkning, sämre livskvalitet och ibland till döden. Projektet ?Malmö Förebyggande Medicin?, an populationsbaserad, prospektiv studie av 22 444 män, medelålder 44 år, och 10 902 kvinnor, medelålder 50 år, är väl lämpad för studier av vanliga folkhälsoproblem som t.ex. fraktur och diabetes. Uppföljningstiden var 19 och 15 år för män och kvinnor. Multipla riskfaktorer för fraktur kunde identifieras.



De viktigaste riskfaktorerna för kvinnor var stigande ålder (relativ risk RR 1.56, konfidensintervall CI 95% 1.45-1.68), tidigare fraktur(RR 2.00, CI 95% 1.56-2.58) och diabetes (RR 1.87, CI 95% 1.26-2,79). De viktigaste riskfaktorerna för män var stigande ålder (RR 1.19, CI 95% 1.12-1.26), mental ohälsa (RR 1.92, CI 95% 1.47-2.51), förhöjt ?-glutamyl transferas, GT (RR 1.24, CI 95% 1.18-1.31) och diabetes (RR 2.38, CI 95% 1.65-3.42).



Sänkt glukostolerans, utvärderad med hjälp av ett oralt glukostoleranstest, var., hos både män och kvinnor, associerad med minskad risk för fraktur, oberoende av ålder, BMI och rökning.



Denna avhandling har identifierat multipla riskfaktorer för lågenergifrakturer hos män och kvinnor, med diabetes och mental ohälsa som extra starka faktorer i denna åldersgrupp. Nuvarande behandlingsstrategier och läkemedelsrekommendationer inkluderar inte flera av de nu identifierade riskfaktorerna. Man bör, för att förbättra bedömningen av frakturrisk, addera dessa riskfaktorer till de interventionsalgoritmer som används i medelåldern. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Docent Mallmin, Hans, Enheten för ortopedisk kirurgi, Universtitetssjukhuset, Uppsala
organization
publishing date
type
Thesis
publication status
published
subject
keywords
risk factors, women, men, middle age, low-energy fracture, diabetes, mental health, hyperglycaemia, Public health, Folkhälsa, epidemiology, Prospective cohort study, epidemiologi
in
2006:67
pages
103 pages
publisher
Clinical and Molecular Osteoporosis Research Unit, Clinical Sciences, Malmö.
defense location
Universitetsklinikernas aula, Ingång 35, Universitetssjukhuset MAS, MALMÖ
defense date
2006-05-26 09:00:00
ISSN
1652-8220
ISBN
91-85481-92-0
language
English
LU publication?
yes
additional info
Anna Holmberg, Olof Johnell, Kristina Åkesson, Peter M Nilsson, Jan-Åke Nilsson and Göran Berglund. 2004. Forearm bone mineral density in 1 294 middle-aged women – a strong predictor of fragility fractures. Journal of Clinical Densitometry, vol 7 pp 419-23.
Anna H Holmberg, Olof Johnell, Peter M Nilsson, Jan-Åke Nilsson, Göran Berglund and Kristina Åkesson. 2005. Risk factors for hip fractures in a middle-aged population– a study of 33 000 men and women. Osteoporosis International, vol 16 pp 2185-94.
Anna H Holmberg, Olof Johnell, Peter M Nilsson, Jan-Åke Nilsson, Göran Berglund and Kristina Åkesson. . Risk factors for fragility fractures in middle age. A prospective population-based study of 33 000 men and women. Osteoporosis International, (accepted)
Anna H Holmberg, Peter M Nilsson, Olof Johnell, Jan-Åke Nilsson and Kristina Åkesson. . The Association Between Hyperglycaemia, Diabetes and Early Fracture Risk in Middle-Age. A prospective, population-based study of 22 444 men and 10 902 women. (manuscript)
id
3fa2dbaf-9259-4207-875b-7b16808a7562 (old id 546777)
date added to LUP
2016-04-01 16:25:03
date last changed
2023-04-18 19:35:26
@phdthesis{3fa2dbaf-9259-4207-875b-7b16808a7562,
  abstract     = {{The number of fractures is increasing worldwide, and fractures frequently cause long-term disability, impaired quality of life and sometimes death. The Malmö Preventive Project, a population-based, prospective study, consisting of 22 444 men, mean age 44 and 10 902 women, mean age 50 years, provides data for evaluation of common public health conditions, such as fracture and diabetes. The follow-up was 19 and 15 years for men and women, respectively. Multiple risk factors for fracture were identified.<br/><br>
<br/><br>
In women, the most important risk factors were advancing age (relative risk RR 1.56, Confidence Interval 95% 1.45-1.68), previous fracture (RR 2.00, CI 95% 1.56-2.58) and diabetes (RR 1.87, CI 95% 1.26-2,79). In men, advancing age (RR 1.19, CI 95% 1.12-1.26), mental health problems (RR 1.92, CI 95% 1.47-2.51), increased levels of ? glutamyl transferase (RR 1.24, CI 95% 1.18-1.31) and diabetes (RR 2.38, CI 95% 1.65-3.42) were major risk contributors.<br/><br>
<br/><br>
Impaired glucose tolerance, evaluated through an oral glucose tolerance test, was in both genders associated with a substantially decreased risk of fractures, independent of age, BMI and smoking.<br/><br>
<br/><br>
This thesis has identified multiple risk factors for low-energy fracture, in both men and women, highlighting diabetes and mental health problems as major contributors in this age group. Current management strategies and therapeutic guidelines are not addressing a number of the identified risk factors. Subsequently, risk assessment can be substantially improved by adding these risk factors to intervention algorithms for middle-aged individuals.}},
  author       = {{Holmberg, Anna H}},
  isbn         = {{91-85481-92-0}},
  issn         = {{1652-8220}},
  keywords     = {{risk factors; women; men; middle age; low-energy fracture; diabetes; mental health; hyperglycaemia; Public health; Folkhälsa; epidemiology; Prospective cohort study; epidemiologi}},
  language     = {{eng}},
  publisher    = {{Clinical and Molecular Osteoporosis Research Unit, Clinical Sciences, Malmö.}},
  school       = {{Lund University}},
  series       = {{2006:67}},
  title        = {{Risk faktors for fracture in middle-aged men and women}},
  url          = {{https://lup.lub.lu.se/search/files/4666457/546778.pdf}},
  year         = {{2006}},
}