Repeat low-trauma fractures occur frequently among men and women who have osteopenic BMD

Lisa Langsetmo, David Goltzman, Christopher S. Kovacs, Jonathan D. Adachi, David A. Hanley, Nancy Kreiger, Robert Josse, Alexandra Papaioannou, Wojciech P. Olszynski, Sophie A. Jamal, Alan Tenenhouse, Suzette Poliquin, Suzanne Godmaire, Claudie Berger, Carol Joyce, Emma Sheppard, Susan Kirkland, Stephanie Kaiser, Barbara Stanfield, Jacques P. BrownLouis Bessette, Marc Gendreau, Tassos Anastassiades, Tanveer Towheed, Barbara Matthews, Bob Josse, Tim Murray, Barbara Gardner-Bray, Laura Pickard, K. Shawn Davison, Jola Thingvold, Jane Allan, Jerilynn C. Prior, Yvette Vigna, Brian C. Lentle

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

Fracture risk assessment based solely on BMD has limitations. Additional risk factors include the presence of a previous low-trauma fracture. We sought to quantify the fracture burden attributable to first versus repeat fracture. We studied 2179 men and 5269 women, 50-90 yr of age, participating in the Canadian Multicentre Osteoporosis Study (CaMos). We included all low-trauma fractures that occurred over 8 yr of follow-up and classified these as either first or repeat clinical low-trauma fracture based on lifetime fracture history. Analyses were further stratified by sex, age, BMD risk categories (normal, osteopenia, osteoporosis), and vertebral deformity status. There were 128 fractures in men and 577 fractures in women. About 25% of fractures in men and 40% in women were repeat fractures. Just over one half of first fractures occurred in those with osteopenic BMD (58% in men, 54% in women). Just under one half of repeat fractures also occurred in those with osteopenic BMD (42% in men, 47% in women). The incidence of repeat fracture was, in most cases, nearly double, but sometimes nearly quadruple, the incidence of first fracture within a given BMD risk category in both men and women. Repeat fractures contribute substantially to overall fracture burden, and the contribution is independent of BMD. Furthermore, those with a combination of prior low-trauma fracture and another risk factor were at especially high risk of future fracture.

Original languageEnglish (US)
Pages (from-to)1515-1522
Number of pages8
JournalJournal of Bone and Mineral Research
Volume24
Issue number9
DOIs
StatePublished - 2009

Keywords

  • Age
  • BMD
  • Canada
  • Distribution
  • Epidemiology
  • Fracture
  • Low-trauma fracture
  • Men
  • Osteoporosis
  • Women

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