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Increase in Fracture Risk Following Unintentional Weight Loss in Postmenopausal Women: The Global Longitudinal Study of Osteoporosis in Women
Author(s) -
Compston Juliet E,
Wyman Allison,
FitzGerald Gordon,
Adachi Jonathan D,
Chapurlat Roland D,
Cooper Cyrus,
DíezPérez Adolfo,
Gehlbach Stephen H,
Greenspan Susan L,
Hooven Frederick H,
LaCroix Andrea Z,
March Lyn,
Netelenbos J Coen,
Nieves Jeri W,
Pfeilschifter Johannes,
Rossini Maurizio,
Roux Christian,
Saag Kenneth G,
Siris Ethel S,
Silverman Stuart,
Watts Nelson B,
Anderson Frederick A
Publication year - 2016
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.2810
Subject(s) - medicine , weight loss , osteoporosis , hazard ratio , hip fracture , proportional hazards model , confidence interval , obesity
Increased fracture risk has been associated with weight loss in postmenopausal women, but the time course over which this occurs has not been established. The aim of this study was to examine the effects of unintentional weight loss of ≥10 lb (4.5 kg) in postmenopausal women on fracture risk at multiple sites up to 5 years after weight loss. Using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), we analyzed the relationships between self‐reported unintentional weight loss of ≥10 lb at baseline, year 2, or year 3 and incident clinical fracture in the years after weight loss. Complete data were available in 40,179 women (mean age ± SD 68 ± 8.3 years). Five‐year cumulative fracture rate was estimated using the Kaplan‐Meier method, and adjusted hazard ratios for weight loss as a time‐varying covariate were calculated from Cox multiple regression models. Unintentional weight loss at baseline was associated with a significantly increased risk of fracture of the clavicle, wrist, spine, rib, hip, and pelvis for up to 5 years after weight loss. Adjusted hazard ratios showed a significant association between unintentional weight loss and fracture of the hip, spine, and clavicle within 1 year of weight loss, and these associations were still present at 5 years. These findings demonstrate increased fracture risk at several sites after unintentional weight loss in postmenopausal women. This increase is found as early as 1 year after weight loss, emphasizing the need for prompt fracture risk assessment and appropriate management to reduce fracture risk in this population. © 2016 American Society for Bone and Mineral Research.