Baseline measurement of bone mass predicts fracture in white women

Article Abstract:

Studies have shown an increased risk for fracture as bone mass decreases. To see if the measurement of the mass of the radius, one of the bones of the forearm, could be used to predict the occurrence of fractures, 521 Caucasian women were studied, of whom 135 were living in a nursing home. Eighty-nine of the women sustained 138 fractures (not including spinal fractures) within 15 years of the initial bone measurement. A subject's risk of fracture was significantly related to bone mass. There was an 80 percent probability that for subjects with bone mass less than 0.6 grams per centimeter, a fracture would occur within eight years, and a 10 percent probability for subjects with bone mass greater than 0.8 grams per centimeter. For every 0.1 gram per centimeter decrease in bone mass, the increase in relative risk of fracture was 2.2 for those subjects living outside of a nursing home and 1.5 for subjects who lived in a nursing home. Therefore, where a person lived was a factor in determining risk for fractures, suggesting that the reasons for which individuals go into nursing homes include those that contribute to being prone to fractures. Age was not a factor in predicting the occurrence of a fracture. For patients who were in a retirement home and who had bone mass below 0.6 grams per centimeter, the six-year probability for a hip fracture was 43 percent. The probability of hip fracture in those with a greater bone mass was 17 percent. A single measurement of the bone mass of the radius can be used to predict the occurrence of fracture at all sites, including the forearm and hip. The estimates of prediction did not change at different sites in the body. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Injuries, Women, Arm, Fractures (Injuries), Fractures, Radius (Anatomy)

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Predictors of bone mass in perimenopausal women: a prospective study of clinical data using photon absorptiometry

Article Abstract:

The ability of the risk factors for osteoporosis, a bone disorder involving loss of bone mass, to predict low or high bone mass was assessed in 124 women at menopause. Risk factors selected for osteoporosis included age, height, weight, calcium and caffeine intake, alcohol and tobacco use, and urinary indicators of bone turnover, the cycle of formation and dissolution of bone tissue. These risk factors were not useful in identifying more than 70 percent of women with low bone mass. Certain risk factors could be used to estimate bone mass in the radius, the forearm bone, within 0.1 grams per centimeter. Seven percent of subjects, who were characterized by short stature, low body weight, low calcium intake, and a heavy cigarette habit, had low bone mass in the radius. Thirty percent of subjects could be assessed on the basis of risk factors without directly measuring bone mass. Risk factors for osteoporosis were less useful in estimating bone mass in the spine and femur, and direct bone measurements were required to determine appropriate therapy for bone loss. The findings show that risk factors for osteoporosis are of limited use in identifying women with low bone mass at menopause. In any case, bone measurements are necessary to determine whether estrogen replacement therapy, which would reduce bone loss, is required at menopause. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Physiological aspects, Menopause, Absorption of light, Light absorption

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Risk factors for low bone mass: clinical implications

Article Abstract:

Direct measurement of bone mass is the best means of assessing the risk of bone fracture among elderly women. Knowledge of risk factors for low bone mass may, however, be useful in determining treatment and allaying patients' fears. A recent study of women over 65 found that low body weight, poor muscle strength and a history of stomach surgery were associated with lower bone mass while diabetes and use of thiazide drugs were associated with higher bone mass. Knowledge of these risk factors is still less informative than bone mass measurements, which are 98% to 99% accurate and are good predictors of risk of fracture. However, knowledge that Northern European ancestry or modest alcohol consumption are not associated with an increased risk may keep patients from worrying unnecessarily. It may also help physicians in deciding which patients might benefit most from preventative intervention such as estrogen therapy.

Editorial, Bone density

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