Risk factors associated with incident clinical vertebral and nonvertebral fractures in postmenopausal women: the Canadian Multicentre Osteoporosis Study (CaMos)

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 16(5), 568-578

DOI 10.1007/s00198-004-1735-x PMID 15517191

Abstract

Utilizing data from the Canadian Multicentre Osteoporosis Study (CaMos), we examined the association between potential risk factors and incident vertebral and nonvertebral fractures. A total of 5,143 postmenopausal women were enrolled. Information collected during the study included data from the CaMos baseline and annually mailed fracture questionnaires, the Short Form 36 (SF-36), the Health Utilities Index, and physical measurements. Participants were followed for 3 years. Postmenopausal women were classified into four groups according to their incident fracture status since baseline: those without a new fracture; those with a new clinically recognized vertebral fracture; those with an incident nonvertebral fracture at the wrist, hip, humerus, pelvis, or ribs (main nonvertebral fracture group); and those with any new nonvertebral fracture (any-nonvertebral-fracture group). We performed multivariate Cox proportional hazard analysis using all possible risk factors to determine the association between risk factors and the time to the first minimal trauma fracture. Best predictive models were also determined using variables that were included in the full models. The Bayesian information criterion was used for model selection. For all analyses, relative risks and associated 95% confidence intervals were calculated. During the follow-up period, 34, 163, and 280 women developed a vertebral, a main nonvertebral, or any nonvertebral fracture, respectively. The best predictive models indicated that a five point lower quality of life as measured by the SF-36 physical component summary score was associated with relative risks of 1.21 (95% CI, 1.02 to 1.44), 1.17 (95% CI, 1.07 to 1.28), and 1.19 (95% CI, 1.11 to 1.27) for incident vertebral, main nonvertebral, and all nonvertebral fractures, respectively. In addition, for a one standard deviation (SD=0.12) lower femoral neck BMD, the relative risks for incident vertebral, main nonvertebral, and any nonvertebral fractures increased by 2.73 (95% CI, 1.74 to 4.28), 1.39 (95% CI, 1.06 to 1.82), and 1.34 (95% CI, 1.09 to 1.65), respectively. Furthermore, various anthropometric measures, disease conditions, and medications are associated with a new fracture. Identifying postmenopausal women at risk is important given that fracture prevention therapies are now available.

Topics

postmenopausal fracture risk factors CaMos prospective study, vertebral nonvertebral fracture bone mineral density quality of life, Canadian Multicentre Osteoporosis Study incident fracture women, Prior Papaioannou postmenopausal fracture risk factors, femoral neck BMD vertebral fracture risk Cox proportional hazard, SF-36 physical component fracture prediction postmenopausal, postmenopausal osteoporosis anthropometric measures medication risk, incident clinical vertebral fracture Bayesian model selection, minimal trauma fracture risk postmenopausal women prospective cohort, fracture prevention risk identification postmenopausal women
PMID 15517191 15517191 DOI 10.1007/s00198-004-1735-x 10.1007/s00198-004-1735-x

Cite this article

Alexandra Papaioannou, Lawrence Joseph, George Ioannidis, Claudie Berger, Tassos Anastassiades, Jacques P Brown, David A Hanley, Wilma Hopman, Robert G Josse, Susan Kirkland, Timothy M Murray, Wojciech P Olszynski, Laura Pickard, Jerilynn C Prior, Kerry Siminoski, & Jonathan D Adachi (2005). Risk factors associated with incident clinical vertebral and nonvertebral fractures in postmenopausal women: the Canadian Multicentre Osteoporosis Study (CaMos). *Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA*, *16*(5), 568-578. https://doi.org/10.1007/s00198-004-1735-x

Related articles