Summary

During median follow-up 6.0 years in 11,495 individuals, prior absolute and annualized measured height loss was significantly greater in those with subsequent incident fracture compared with those without incident fracture.

Purpose

FRAX® accepts baseline height and weight as input variables, but does not consider change in these parameters over time.

Aim

To evaluate the association between measured height or weight loss on subsequent fracture risk adjusted for FRAX scores, risk factors, and competing mortality.

Methods

Using a dual-energy x-ray absorptiometry (DXA) registry for the Province of Manitoba, Canada, we identified women and men age 40 years or older with height and weight measured at the time of two DXA scans. Cox regression analyses were performed to test for a covariate-adjusted association between prior height and weight loss with incident fractures occurring after the second scan using linked population-based healthcare data.

Results

The study population consisted of 11,495 individuals (average age 68.0 ± 9.9 years, 94.6% women). During median follow-up 6.0 years, records demonstrated incident major osteoporotic fracture (MOF) in 869 individuals, hip fractures in 265, clinical vertebral fractures in 207, and any fracture in 1203. Prior height loss was significantly greater in individuals with fracture compared with those without fracture, regardless of fracture site. Mortality was greater in those with prior height loss (HR per SD 1.11, 95% CI 1.06–1.17) or weight loss (HR per SD 1.26, 95% CI 1.19–1.32). Each SD in height loss was associated with increased fracture risk (MOF 12–17%, hip 8–19%, clinical vertebral 28–37%, any fracture 14–19%). Prior weight loss was associated with 21–30% increased risk for hip fracture, but did not increase risk for other fractures. Height loss of 3.0 cm or greater more than doubled the risk for subsequent fracture.

Conclusions

Prior height loss is associated with a small but significant increase in risk of incident fracture at all skeletal sites independent of other clinical risk factors and competing mortality as considered by FRAX. Prior weight loss only increases risk for subsequent hip fracture.

中文翻译：

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一项基于注册表的队列研究表明，测得的身高损失可以独立于FRAX预测临床骨折的发生

概要

在11495位患者的中位随访6.0年中，发生后续骨折的患者与未发生骨折的患者相比，先前的绝对和年度测得的身高损失明显更大。

目的

FRAX®接受基线身高和体重作为输入变量，但不考虑这些参数随时间的变化。

目标

为了评估身高或体重减轻与随后因FRAX评分，危险因素和竞争性死亡率而调整的骨折风险之间的关联。

方法

使用加拿大曼尼托巴省的双能X射线骨密度仪（DXA）登记册，我们确定了40岁以上的男女，在两次DXA扫描时测量了身高和体重。使用链接的基于人口的医疗数据，进行了Cox回归分析，以测试先前身高和体重减轻与第二次扫描后发生的意外骨折之间的协变量校正关联。

结果

研究人群包括11,495人（平均年龄68.0±9.9岁，女性94.6％）。在中位随访6.0年中，记录显示有869人发生严重骨质疏松性骨折（MOF），265例发生髋部骨折，207例发生临床椎体骨折以及1203例发生任何骨折。那些没有骨折的人，不考虑骨折部位。先前身高下降（HR根据SD 1.11，95％CI 1.06–1.17）或体重减轻（HR根据SD 1.26，95％CI 1.19-1.32）的患者死亡率更高。每个身高降低的SD与增加的骨折风险相关（MOF为12–17％，髋部为8–19％，临床椎骨为28–37％，任何骨折为14–19％）。先前的体重减轻与髋部骨折风险增加21％至30％有关，但并未增加其他骨折的风险。

结论

先前的身高降低与所有骨骼部位发生骨折的风险小而显着增加相关，而不受其他临床风险因素和竞争性死亡率的影响，FRAX认为。先前的体重减轻只会增加随后发生髋部骨折的风险。