0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Factors Associated with Appendicular Bone Mass in Older Women

Douglas C. Bauer, MD; Warren S. Browner, MD, MPH; Jane A. Cauley, DrPH; Eric S. Orwoll, MD; Jean C. Scott, DrPH; Dennis M. Black, PhD; Jo L. Tao, MPH; Steven R. Cummings, MD, Study of Osteoporotic Fractures Research Group*
[+] Article and Author Information

Requests for Reprints: Douglas C. Bauer, MD, Prevention Sciences Group, University of California, San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105. Grant Support: By Public Health Service Grants AG05394, AR35582, AR35583, and AR35584.


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;118(9):657-665. doi:10.7326/0003-4819-118-9-199305010-00001
Text Size: A A A

Objective: To determine the factors associated with appendicular bone mass in older women.

Design: Cross-sectional analysis of baseline data collected for a multicenter, prospective study of osteoporotic fractures.

Setting: Four clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela valley, Pennsylvania.

Patients: A total of 9704 ambulatory, nonblack women, ages 65 years or older, recruited from population-based listings.

Measurements: Demographic and historical information and anthropometric measurements were obtained from a baseline questionnaire, interview, and examination. Single-photon absorptiometry scans were obtained at three sites: the distal radius, midradius, and calcaneus. Multivariate associations with bone mass were first examined in a randomly selected half of the cohort (training group) and were then tested on the other half of the cohort (validation group).

Results: In order of decreasing strength of association, estrogen use, non–insulin-dependent diabetes, thiazide use, increased weight, greater muscle strength, later age at menopause, and greater height were independently associated with higher bone mass. Gastric surgery, age, history of maternal fracture, smoking, and caffeine intake were associated with lower bone mass (all P < 0.05). For example, we found that 2 or more years of estrogen use was associated with a 7.2% increase in distal radius bone mass, whereas gastrectomy was associated with an 8.2% decrease in bone mass. The associations between bone mass and dietary calcium intake and rheumatoid arthritis were inconsistent. Alcohol use, physical activity, use of calcium supplements, pregnancy, breast-feeding, parental nationality, and hair color were among the many variables not associated with bone mass. Multivariate models accounted for 20% to 35% of the total variance of bone mass.

Conclusions: A large number of factors influence the bone mass of elderly women; however, age, weight, muscle strength, and estrogen use are the most important factors.

*For a list of the investigators in the Study of Osteoporotic Fractures Research Group, see the Appendix. For current author affiliations, see end of text.

Figures

Grahic Jump Location
Figure 1.
Current weight compared with distal radius bone mass, adjusted for age.

BMD = bone mineral density.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Current dietary calcium compared with distal radius bone mass, adjusted for age.

BMD = bone mineral density.

Grahic Jump Location
Grahic Jump Location
Figure 3.
Current postmenopausal hormone use and distal radius bone mass, adjusted for age and duration of estrogen use.PP

BMD = bone mineral density. * = 0.02; = 0.0001.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)