Baseline measurement of bone mass predicts fracture in white women

Siu Hui, C. W. Slemenda, C. C. Johnston

Research output: Contribution to journalArticle

486 Citations (Scopus)

Abstract

Study Objective: To determine if a single bone mass measurement of the radius is predictive of future fractures at any site. Design: Observational study of a cohort of free-living subjects and a cohort of retirement-home residents with an average follow-up of 6.7 years and 5.5 years, respectively (range, 1 to 15 years for both cohorts). Setting: General community and a retirement home. Subjects: Volunteer sample of white women (386 free-living and 135 living in a retirement home) who were free of disease and were not receiving medication known to affect bone metabolism. In terms of physical condition subjects ranged from the totally independent to the wheelchair-bound. Measurements and Main Results: A radial bone mass measurement was done at the initial visit. Subsequent nonspine fractures were reported by the subjects at follow-up visits, which were less than a year apart in most cases, and verified with medical records. Cox regression was used to model time to first fracture as a function of age and bone mass. These analyses showed that for every 0.1 g/cm decrement in bone mass, the relative risk of fracture was 2.2 (CI, 1.7 to 2.8) for the free-living and 1.5 (CI, 1.2 to 1.9) for the retirement-home residents. Baseline age did not predict the risk of fracture in either cohort, and controlling for baseline age did not reduce the relative-risk estimates of bone mass. Similar analyses also showed that bone mass was a statistically significant predictor for first hip fractures (n = 30) among the nursing-home residents (relative risk, 1.9; CI, 1.4 to 2.7) and first forearm fractures (n = 10) among the free living (relative risk, 3.6; CI, 1.9 to 6.8). For both cohorts, the 8-year probability of any nonspine fracture was about 80% for subjects with initial bone mass less than 0.6 g/cm and was less than 10% for subjects with initial bone mass greater than 0.8 g/cm. Similarly, those in the retirement home with bone mass below 0.6 g/cm had a 6-year probability of hip fracture of 43%, compared with a 17% risk for those with greater bone mass. Conclusion: A single bone mass measurement of the radius is predictive of future nonspine fractures at all sites, and at both the forearm and the hip. Baseline age was not a significant predictor of fracture within either cohort. Relative-risk estimates were not dissimilar across fracture sites.

Original languageEnglish
Pages (from-to)355-361
Number of pages7
JournalAnnals of Internal Medicine
Volume111
Issue number5
StatePublished - 1989

Fingerprint

Bone and Bones
Retirement
Hip Fractures
Forearm
Wheelchairs
Nursing Homes
Medical Records
Observational Studies
Hip
Volunteers

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Baseline measurement of bone mass predicts fracture in white women. / Hui, Siu; Slemenda, C. W.; Johnston, C. C.

In: Annals of Internal Medicine, Vol. 111, No. 5, 1989, p. 355-361.

Research output: Contribution to journalArticle

Hui, S, Slemenda, CW & Johnston, CC 1989, 'Baseline measurement of bone mass predicts fracture in white women', Annals of Internal Medicine, vol. 111, no. 5, pp. 355-361.
Hui, Siu ; Slemenda, C. W. ; Johnston, C. C. / Baseline measurement of bone mass predicts fracture in white women. In: Annals of Internal Medicine. 1989 ; Vol. 111, No. 5. pp. 355-361.
@article{0a5243473d2647f6b2d22ba600aa4097,
title = "Baseline measurement of bone mass predicts fracture in white women",
abstract = "Study Objective: To determine if a single bone mass measurement of the radius is predictive of future fractures at any site. Design: Observational study of a cohort of free-living subjects and a cohort of retirement-home residents with an average follow-up of 6.7 years and 5.5 years, respectively (range, 1 to 15 years for both cohorts). Setting: General community and a retirement home. Subjects: Volunteer sample of white women (386 free-living and 135 living in a retirement home) who were free of disease and were not receiving medication known to affect bone metabolism. In terms of physical condition subjects ranged from the totally independent to the wheelchair-bound. Measurements and Main Results: A radial bone mass measurement was done at the initial visit. Subsequent nonspine fractures were reported by the subjects at follow-up visits, which were less than a year apart in most cases, and verified with medical records. Cox regression was used to model time to first fracture as a function of age and bone mass. These analyses showed that for every 0.1 g/cm decrement in bone mass, the relative risk of fracture was 2.2 (CI, 1.7 to 2.8) for the free-living and 1.5 (CI, 1.2 to 1.9) for the retirement-home residents. Baseline age did not predict the risk of fracture in either cohort, and controlling for baseline age did not reduce the relative-risk estimates of bone mass. Similar analyses also showed that bone mass was a statistically significant predictor for first hip fractures (n = 30) among the nursing-home residents (relative risk, 1.9; CI, 1.4 to 2.7) and first forearm fractures (n = 10) among the free living (relative risk, 3.6; CI, 1.9 to 6.8). For both cohorts, the 8-year probability of any nonspine fracture was about 80{\%} for subjects with initial bone mass less than 0.6 g/cm and was less than 10{\%} for subjects with initial bone mass greater than 0.8 g/cm. Similarly, those in the retirement home with bone mass below 0.6 g/cm had a 6-year probability of hip fracture of 43{\%}, compared with a 17{\%} risk for those with greater bone mass. Conclusion: A single bone mass measurement of the radius is predictive of future nonspine fractures at all sites, and at both the forearm and the hip. Baseline age was not a significant predictor of fracture within either cohort. Relative-risk estimates were not dissimilar across fracture sites.",
author = "Siu Hui and Slemenda, {C. W.} and Johnston, {C. C.}",
year = "1989",
language = "English",
volume = "111",
pages = "355--361",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "5",

}

TY - JOUR

T1 - Baseline measurement of bone mass predicts fracture in white women

AU - Hui, Siu

AU - Slemenda, C. W.

AU - Johnston, C. C.

PY - 1989

Y1 - 1989

N2 - Study Objective: To determine if a single bone mass measurement of the radius is predictive of future fractures at any site. Design: Observational study of a cohort of free-living subjects and a cohort of retirement-home residents with an average follow-up of 6.7 years and 5.5 years, respectively (range, 1 to 15 years for both cohorts). Setting: General community and a retirement home. Subjects: Volunteer sample of white women (386 free-living and 135 living in a retirement home) who were free of disease and were not receiving medication known to affect bone metabolism. In terms of physical condition subjects ranged from the totally independent to the wheelchair-bound. Measurements and Main Results: A radial bone mass measurement was done at the initial visit. Subsequent nonspine fractures were reported by the subjects at follow-up visits, which were less than a year apart in most cases, and verified with medical records. Cox regression was used to model time to first fracture as a function of age and bone mass. These analyses showed that for every 0.1 g/cm decrement in bone mass, the relative risk of fracture was 2.2 (CI, 1.7 to 2.8) for the free-living and 1.5 (CI, 1.2 to 1.9) for the retirement-home residents. Baseline age did not predict the risk of fracture in either cohort, and controlling for baseline age did not reduce the relative-risk estimates of bone mass. Similar analyses also showed that bone mass was a statistically significant predictor for first hip fractures (n = 30) among the nursing-home residents (relative risk, 1.9; CI, 1.4 to 2.7) and first forearm fractures (n = 10) among the free living (relative risk, 3.6; CI, 1.9 to 6.8). For both cohorts, the 8-year probability of any nonspine fracture was about 80% for subjects with initial bone mass less than 0.6 g/cm and was less than 10% for subjects with initial bone mass greater than 0.8 g/cm. Similarly, those in the retirement home with bone mass below 0.6 g/cm had a 6-year probability of hip fracture of 43%, compared with a 17% risk for those with greater bone mass. Conclusion: A single bone mass measurement of the radius is predictive of future nonspine fractures at all sites, and at both the forearm and the hip. Baseline age was not a significant predictor of fracture within either cohort. Relative-risk estimates were not dissimilar across fracture sites.

AB - Study Objective: To determine if a single bone mass measurement of the radius is predictive of future fractures at any site. Design: Observational study of a cohort of free-living subjects and a cohort of retirement-home residents with an average follow-up of 6.7 years and 5.5 years, respectively (range, 1 to 15 years for both cohorts). Setting: General community and a retirement home. Subjects: Volunteer sample of white women (386 free-living and 135 living in a retirement home) who were free of disease and were not receiving medication known to affect bone metabolism. In terms of physical condition subjects ranged from the totally independent to the wheelchair-bound. Measurements and Main Results: A radial bone mass measurement was done at the initial visit. Subsequent nonspine fractures were reported by the subjects at follow-up visits, which were less than a year apart in most cases, and verified with medical records. Cox regression was used to model time to first fracture as a function of age and bone mass. These analyses showed that for every 0.1 g/cm decrement in bone mass, the relative risk of fracture was 2.2 (CI, 1.7 to 2.8) for the free-living and 1.5 (CI, 1.2 to 1.9) for the retirement-home residents. Baseline age did not predict the risk of fracture in either cohort, and controlling for baseline age did not reduce the relative-risk estimates of bone mass. Similar analyses also showed that bone mass was a statistically significant predictor for first hip fractures (n = 30) among the nursing-home residents (relative risk, 1.9; CI, 1.4 to 2.7) and first forearm fractures (n = 10) among the free living (relative risk, 3.6; CI, 1.9 to 6.8). For both cohorts, the 8-year probability of any nonspine fracture was about 80% for subjects with initial bone mass less than 0.6 g/cm and was less than 10% for subjects with initial bone mass greater than 0.8 g/cm. Similarly, those in the retirement home with bone mass below 0.6 g/cm had a 6-year probability of hip fracture of 43%, compared with a 17% risk for those with greater bone mass. Conclusion: A single bone mass measurement of the radius is predictive of future nonspine fractures at all sites, and at both the forearm and the hip. Baseline age was not a significant predictor of fracture within either cohort. Relative-risk estimates were not dissimilar across fracture sites.

UR - http://www.scopus.com/inward/record.url?scp=0024458249&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024458249&partnerID=8YFLogxK

M3 - Article

C2 - 2764403

AN - SCOPUS:0024458249

VL - 111

SP - 355

EP - 361

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 5

ER -