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Early menopause and weight loss are significant factors associated with risk of future fracture in middle-aged women

Moberg, Louise LU ; Hamrefors, Viktor LU orcid ; Fedorowski, Artur LU orcid and Rogmark, Cecilia LU (2022) In BMC Musculoskeletal Disorders 23(1).
Abstract

BACKGROUND: To identify factors related to reproductive history and weight change associated with first incident fracture in middle-aged women.

METHODS: In total, 18,326 women from the Malmö Diet and Cancer study were included in this prospective population-based cohort study. Participants were included 1991-1996 and followed to 2016. Using data from the National Patient Registry, linked with every participants' unique personal identification number, any first fracture affecting spine, thoracic cage, upper and lower extremities was identified. The association of baseline factors with incident fracture risk was analyzed using Cox regression models.

RESULTS: For participating women, median age 56.0 years, the multivariable Cox... (More)

BACKGROUND: To identify factors related to reproductive history and weight change associated with first incident fracture in middle-aged women.

METHODS: In total, 18,326 women from the Malmö Diet and Cancer study were included in this prospective population-based cohort study. Participants were included 1991-1996 and followed to 2016. Using data from the National Patient Registry, linked with every participants' unique personal identification number, any first fracture affecting spine, thoracic cage, upper and lower extremities was identified. The association of baseline factors with incident fracture risk was analyzed using Cox regression models.

RESULTS: For participating women, median age 56.0 years, the multivariable Cox regression analysis observed that early menopause (40-44 years) (hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.03-1.27) but not premature menopause < 40 years (HR 1.06, 95% CI 0.91-1.24) was associated with future fracture risk. Self-reported weight loss since age 20 was also associated with future fracture risk (HR 1.39, 95% CI 1.17-1.65) whereas a daily alcohol consumption in the third quartile (5.36-11.42 g/day) compared to the lowest quartile (0-0.80 g/day) was associated with decreased future fracture risk (HR 0.88, 95% CI 0.81-0.96). The multivariable Cox regression analysis also observed that increasing age and weight at baseline, current smoking, a positive history of previous fracture and family history of fractures were associated with increased fracture risk whereas an increasing BMI was associated with a decreased fracture risk. No association to parity or period of lactation was observed nor ever-use of oral contraceptives and menopausal hormone therapy.

CONCLUSION: This study shows that early menopause between 40 to 45 years and self-reported weight loss since age of 20 are relevant factors associated with increased fracture risk in middle-aged women. These factors were independent of traditional predictors of fracture risk among women and may be considered in preventive initiatives.

TRIAL REGISTRATION: Clinicaltrials.gov with identifier: NCT04151732, since Nov 5th 2018.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Cohort Studies, Female, Fractures, Bone/epidemiology, Humans, Menopause, Middle Aged, Pregnancy, Prospective Studies, Risk Factors, Weight Loss, Young Adult
in
BMC Musculoskeletal Disorders
volume
23
issue
1
article number
779
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85135911050
  • pmid:35974320
ISSN
1471-2474
DOI
10.1186/s12891-022-05744-5
language
English
LU publication?
yes
additional info
© 2022. The Author(s).
id
eae436d7-7bce-4623-b2a1-275115fea0e7
date added to LUP
2022-08-19 22:24:46
date last changed
2024-04-04 07:48:16
@article{eae436d7-7bce-4623-b2a1-275115fea0e7,
  abstract     = {{<p>BACKGROUND: To identify factors related to reproductive history and weight change associated with first incident fracture in middle-aged women.</p><p>METHODS: In total, 18,326 women from the Malmö Diet and Cancer study were included in this prospective population-based cohort study. Participants were included 1991-1996 and followed to 2016. Using data from the National Patient Registry, linked with every participants' unique personal identification number, any first fracture affecting spine, thoracic cage, upper and lower extremities was identified. The association of baseline factors with incident fracture risk was analyzed using Cox regression models.</p><p>RESULTS: For participating women, median age 56.0 years, the multivariable Cox regression analysis observed that early menopause (40-44 years) (hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.03-1.27) but not premature menopause &lt; 40 years (HR 1.06, 95% CI 0.91-1.24) was associated with future fracture risk. Self-reported weight loss since age 20 was also associated with future fracture risk (HR 1.39, 95% CI 1.17-1.65) whereas a daily alcohol consumption in the third quartile (5.36-11.42 g/day) compared to the lowest quartile (0-0.80 g/day) was associated with decreased future fracture risk (HR 0.88, 95% CI 0.81-0.96). The multivariable Cox regression analysis also observed that increasing age and weight at baseline, current smoking, a positive history of previous fracture and family history of fractures were associated with increased fracture risk whereas an increasing BMI was associated with a decreased fracture risk. No association to parity or period of lactation was observed nor ever-use of oral contraceptives and menopausal hormone therapy.</p><p>CONCLUSION: This study shows that early menopause between 40 to 45 years and self-reported weight loss since age of 20 are relevant factors associated with increased fracture risk in middle-aged women. These factors were independent of traditional predictors of fracture risk among women and may be considered in preventive initiatives.</p><p>TRIAL REGISTRATION: Clinicaltrials.gov with identifier: NCT04151732, since Nov 5th 2018.</p>}},
  author       = {{Moberg, Louise and Hamrefors, Viktor and Fedorowski, Artur and Rogmark, Cecilia}},
  issn         = {{1471-2474}},
  keywords     = {{Adult; Cohort Studies; Female; Fractures, Bone/epidemiology; Humans; Menopause; Middle Aged; Pregnancy; Prospective Studies; Risk Factors; Weight Loss; Young Adult}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{Early menopause and weight loss are significant factors associated with risk of future fracture in middle-aged women}},
  url          = {{http://dx.doi.org/10.1186/s12891-022-05744-5}},
  doi          = {{10.1186/s12891-022-05744-5}},
  volume       = {{23}},
  year         = {{2022}},
}