Body Size and the Risk for Fractures in Older Women. Ann Intern Med. 2000;133:123. doi: 10.7326/0003-4819-133-2-200007180-00025
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Published: Ann Intern Med. 2000;133(2):123.
Broken bones (fractures) are a significant health problem for older women. Previous studies have shown that small women are at higher risk for hip fractures than larger women. Small women are also more likely than large women to have thinning of the bones (osteoporosis). It has not been known, however, whether small women are also at greater risk for fractures of places other than the hip, such as the pelvis, ankle, or wrist.
To find out whether small body size puts women at risk for fractures of the pelvis, ribs, arm, elbow, ankle, wrist, and foot.
The study included 8059 nonblack women age 65 and older who were participating in a larger study of osteoporosis. Black women were not included in the study because osteoporosis is uncommon in black women.
The researchers collected information from the study participants about current weight, weight change since age 25, body mass index (a measure of overall body size that accounts for height and weight), body fat content, and bone density (a measure of how heavy the bones are). During a follow-up period that took place after the initial measurements were made, the researchers also determined how many women had fractures of the hip, pelvis, ribs, arm, elbow, ankle, wrist, or foot. The researchers then compared the risk for fractures at each site in smaller women with the risk in larger women.
Compared to women who weighed more than 73.3 kilograms (161 pounds), women who weighed less than 57.8 kilograms (127 pounds) were about 2 times more likely to have fractures of the hip, pelvis, and ribs. These differences appeared to be related to lower bone density in small women rather than to body size itself. Smaller body size did not appear to put women at a higher risk for fractures of the arm, elbow, wrist, ankle, or foot.
Although small body size could contribute to a woman's risk for fractures in several ways, the only risk factor that this study could identify in smaller women was low bone density. This study did not examine spine fractures, a common and disabling type of fracture in women with osteoporosis.
When bone density measurements are not available, total body weight can be a useful way to identify women who are at higher than average risk for fractures of the hip, pelvis, and ribs.
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The summary below is from the full report titled “Body Size and Risk for Clinical Fractures in Older Women.” It is in the 18 July 2000 issue of Annals of Internal Medicine (volume 133, pages 123-127). The authors are K.L. Margolis, K.E. Ensrud, P.J. Schreiner, and H.K. Tabor, for the Study of Osteoporotic Fractures Research Group.
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