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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #411909

Research Project: Nutrient Metabolism and Musculoskeletal Health in Older Adults

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX

item KANIS, JOHN - University Of Sheffield Medical School
item JOHANSSON, HELENA - Australian Catholic University
item MCKLOSKEY, EUGENE - University Of Sheffield
item LIU, ENWU - Australian Catholic University
item AKESSON, KRISTINA - Lund University
item ANDERSON, FRED - University Of Massachusetts
item AXAGRA, RAFAEL - University Of Barcelona
item BAGER, CECILIE - Nordic Bioscience As
item BEAUDART, CHARLOTTE - University Of Liege
item BISCHOFF-FERRARI, HEIKE - University Of Zurich
item BIVER, EMMANUEL - Geneva University Hospital
item BRUYERE, OLIVIER - University Of Liege
item CAULEY, JANE - University Of Pittsburgh
item CENTER, JACQUELINE - Garvan Institute Of Medical Research
item CHAPURLAT, ROLAND - Institut National De La Sante Et De La Recherche Medicale (INSERM)
item CHRISTIANSEN, CLAUS - Nordic Bioscience As
item COOPER, CYRUS - University Of Southampton
item CRANDALL, CAROLYN - University Of California (UCLA)
item CUMMINGS, STEVEN - California Pacific Medical Center Research Institute
item DA SILVA, JOSE - University Of Coimbra
item DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item DIEZ-PEREZ, ADOLFO - Autonomous University Of Barcelona
item DUFOUR, ALYSSA - Harvard Medical School
item EISMAN, JOHN - Garvan Institute Of Medical Research
item ELDERS, PETRA - Amsterdam Public Health Research Institute
item FERRARI, SERGE - Amsterdam Public Health Research Institute
item FUJITA, YUSUKE - Kindai University
item FUJIWARA, SHIN-ICHIRO - Yasuda Women'S University
item GLUER, CLAUS - University Of Kiel
item GOLDSHTEIN, ITAY - Maccabi Healthcare Services
item GOLTZMAN, DAVID - McGill University - Canada
item GUDNASON, VILMUNDUR - Icelandic Heart Association
item HALL, JILL - University Of Edinburgh
item HANS, DIDIER - Lausanne University Hospital
item HOFF, MARI - Norwegian University Of Science And Technology
item HOLLICK, ROSEMARY - University Of Aberdeen
item HUISMAN, MARTIJIM - Vu University Medical Center
item IKI, MASAYUKI - Kindai University
item ISH-SHALOM, SOPHIA - Elisha Hospital
item JOENS, GRAEME - University Of Tasmania
item KARLSSON, MAGNUS - Lund University
item KHOSLA, SUNDEEP - Mayo Clinic
item KIEL, DOUGLAS - Harvard Medical School
item KOH, WOON-PUAY - National University Of Singapore
item KOROMANI, F JORDA - Erasmus University
item KOTOWICZ, MARK - Deakin University
item KROGER, HELMUT - Kuopio University Hospital
item KWOK, TIMOTHY - The Chinese University Of Hong Kong (CUHK)
item LAMY, OLIVIER - Lausanne University Hospital
item LANGHAMMER, A - Norwegian University Of Science And Technology
item LARIJANI, BAGHER - Tehran University Of Medical Sciences
item LIPPUNER, KURT - University Of Bern
item MELLSTROM, DAN - University Of Gothenburg
item MERLIJN, THOMAS - Amsterdam Public Health Research Institute
item NORDSTROM, ANNA - The Arctic University Of Norway (UIT)
item NORDSTROM, PETER - Uppsala University
item O'NEILL, TERENCE - Manchester Academic Health Science Centre
item OBERMAYER-PIETSCH, BARBARA - Medical University Of Graz
item OHLSSON, CLAES - University Of Gothenburg
item ORWOLL, ERIC - Oregon Health & Science University
item PASCO, JULIE - Deakin University
item RIVADENEIRA, FERNANDO - Erasmus Medical Center
item SCHOTT, ANNE - University Of Lyon
item SHIROMA, ERIC - National Institute On Aging (NIA, NIH)
item SIGGEIRSDOTTIR, KRISTIN - Icelandic Heart Association
item SIMONSICK, E - National Institute On Aging (NIA, NIH)
item SORNAY-RENDU, ELISABETH - University Of Lyon
item SUND, REIJO - University Of Eastern Finland
item SWART, KARIN - Amsterdam Public Health Research Institute
item SZULC, PAWEL - University Of Lyon
item TAMAKI, J - Educational Foundation Of Osaka Medical And Pharmaceutical University
item TORGERSON, DAVID - University Of York
item VAN SCHOOR, NATASJA - Amsterdam Public Health Research Institute
item VAN STAA, TJEERD - University Of Manchester
item VILA, JEREMY - Hospital Del Mar Medical Research Institute
item WAREHAM, NICK - University Of Cambridge
item WRIGHT, NICOLE - University Of Alabama At Birmingham
item YOSHIMURA, NAOYA - University Of Tokyo
item ZILLIKENS, MARIA - Erasmus University
item ZWART, MARTA - Preciosa-Fundacion Para La Investigacion
item VANDENPUT, LIESBETH - Australian Catholic University
item HARVEY, NICOLAS - University Of Southampton
item LORENTZON, MATTIAS - University Of Gothenburg
item LESLIE, WILLIAM - University Of Manitoba

Submitted to: Osteoporosis International
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/22/2023
Publication Date: 8/11/2023
Citation: Kanis, J.A., Johansson, H., McKloskey, E.V., Liu, E., Akesson, K., Anderson, F.A., Axagra, R., Bager, C.L., Beaudart, C., Bischoff-Ferrari, H.A., Biver, E., Bruyere, O., Cauley, J.A., Center, J.R., Chapurlat, R., Christiansen, C., Cooper, C., Crandall, C.J., Cummings, S.R., da Silva, J.A., Dawson-Hughes, B., Diez-Perez, A., Dufour, A.B., Eisman, J.A., Elders, P.J., Ferrari, S.J., Fujita, Y., Fujiwara, S., Gluer, C.C., Goldshtein, I., Goltzman, D., Gudnason, V., Hall, J., Hans, D., Hoff, M., Hollick, R.J., Huisman, M., Iki, M., Ish-Shalom, S., Joens, G., Karlsson, M.K., Khosla, S., Kiel, D., Koh, W.P., Koromani, F., Kotowicz, M.A., Kroger, H., Kwok, T., Lamy, O., Langhammer, A., Larijani, B., Lippuner, K., Mellstrom, D., Merlijn, T., Nordstrom, A., Nordstrom, P., O'Neill, T.W., Obermayer-Pietsch, B., Ohlsson, C., Orwoll, E.S., Pasco, J., Rivadeneira, F., Schott, A., Shiroma, E.J., Siggeirsdottir, K., Simonsick, E., Sornay-Rendu, E., Sund, R., Swart, K., Szulc, P., Tamaki, J., Torgerson, D.J., Van Schoor, N.M., Van Staa, T.P., Vila, J., Wareham, N.J., Wright, N.C., Yoshimura, N., Zillikens, M.C., Zwart, M., Vandenput, L., Harvey, N.C., Lorentzon, M., Leslie, W.D. 2023. Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX. Osteoporosis International.

Interpretive Summary: The relationship between self-reported falls and fracture risk was estimated in an analysis of 906,532 individuals from 46 cohorts around the globe, including the STOP IT study conducted at the USDA HNRCA. Twenty-three percent of the 906,532 participants reported falling in the past year. Having a fall in the last year was associated with a 41% increase in having a fracture in the women and a 41% increase in the men. This analysis establishes the importance of a prior fall as a risk factor for fracture and provides the justification for including a fall in the last year as a risk factor in the FRAX algorithm that is used globally to assess fracture risk.

Technical Abstract: Summary A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX. Introduction The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD). Methods We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted B-coefficients. Results A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination. Conclusion A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.