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Body Size and Risk for Clinical Fractures in Older Women

Karen L. Margolis, MD, MPH; Kristine E. Ensrud, MD, MPH; Pamela J. Schreiner, PhD; Holly K. Tabor, PhD, Study of Osteoporotic Fractures Research Group*
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 2000;133(2):123-127. doi:10.7326/0003-4819-133-2-200007180-00011
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Background: Small body size predicts hip fractures in older women.

Objective: To test the hypothesis that small body size predicts the risk for other clinical fractures.

Design: Prospective cohort study.

Setting: Population-based listings in four areas of the United States.

Patients: 8059 ambulatory nonblack women 65 years of age or older.

Measurements: Weight, weight change since 25 years of age, body mass index, lean body mass and percent body fat, and nonspine fractures during 6.4 years of follow-up.

Results: Compared with women in the highest quartile of weight, women in the lowest quartile had relative risks of 2.0 (95% CI, 1.5 to 2.8) for hip fractures, 2.3 (CI, 1.1 to 4.7) for pelvis fractures, and 2.4 (CI, 1.5 to 3.9) for rib fractures. Adjustment for total-hip bone mineral density eliminated the elevated risk. Results were similar for other body size measures. Smaller body size was not a risk factor for humerus, elbow, wrist, ankle, or foot fractures.

Conclusions: Total body weight is useful in the prediction of hip, pelvis, and rib fractures when bone mineral density has not been measured.

*For investigators in the Study of Osteoporotic Fractures Research Group, see Appendix.


fracture ; elderly





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Body Size and the Risk for Fractures in Older Women

Copyright ©2004 by the American College of Physicians


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