Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Incidence of and Factors for Self-reported Fragility Fractures Among Middle-aged and Elderly Women in Rural Korea: An 11-Year Follow-up Study

  • Ahn, Soon-Ki (Health Consultation Center for Daejeon Regional Headquarters, National Health Insurance Service) ;
  • Kam, Sin (Department of Preventive Medicine, Kyungpook National University School of Medicine) ;
  • Chun, Byung-Yeol (Department of Preventive Medicine, Kyungpook National University School of Medicine)
  • Received : 2014.05.15
  • Accepted : 2014.09.15
  • Published : 2014.11.30
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Abstract

Objectives: This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea. Methods: The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs). Results: Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture. Conclusions: Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

Keywords

References

  1. Scottish Intercollegiate Guidelines Network. Management of osteoporosis. Edinburgh: Scottish Intercollegiate Guidelines Network; 2003, p. 5.
  2. World Health Organization. Prevention and management of osteoporosis. Geneva: World Health Organization; 2003, p. 2.
  3. Tarantino U, Cannata G, Lecce D, Celi M, Cerocchi I, Iundusi R. Incidence of fragility fractures. Aging Clin Exp Res 2007;19 (4 Suppl):7-11.
  4. World Health Organization. WHO scientific group on the assessment of osteoporosis at primary health care level. Geneva: World Health Organization; 2007, p. 5-7.
  5. Korea National Statistical Office. Population projections for Korea: 2005-2050. Seoul: Korea National Statistical Office; 2006, p. 4 (Korean).
  6. Cho NH. Osteoporosis epidemiology. J Korean Soc Osteoporos 2005;3(1):7-34 (Korean).
  7. Kado DM, Lui LY, Ensrud KE, Fink HA, Karlamangla AS, Cummings SR, et al. Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann Intern Med 2009;150(10):681-687. https://doi.org/10.7326/0003-4819-150-10-200905190-00005
  8. Nguyen TV, Eisman JA, Kelly PJ, Sambrook PN. Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 1996;144(3):255-263. https://doi.org/10.1093/oxfordjournals.aje.a008920
  9. Robbins J, Aragaki AK, Kooperberg C, Watts N, Wactawski-Wende J, Jackson RD, et al. Factors associated with 5-year risk of hip fracture in postmenopausal women. JAMA 2007; 298(20):2389-2398. https://doi.org/10.1001/jama.298.20.2389
  10. Barrett-Connor E. The economic and human costs of osteoporotic fracture. Am J Med 1995;98(2A):3S-8S. https://doi.org/10.1016/S0002-9343(05)80037-3
  11. International Osteoporosis Foundation; European Society of Musculoskeletal Radiology. Vertebral fracture initiative resource document. Nyon: International Osteoporosis Foundation; 2003, p. 3.
  12. Kang HY, Kang DR, Jang YH, Park SE, Choi WJ, Moon SH, et al. Estimating the economic burden of osteoporotic vertebral fracture among elderly Korean women. J Prev Med Public Health 2008;41(5):287-294 (Korean). https://doi.org/10.3961/jpmph.2008.41.5.287
  13. Korean Society of Bone Metabolism. Physician's guide for diagnosis and treatment of osteoporosis. Seoul: Korean Society of Bone Metabolism; 2008, p. 3-4 (Korean).
  14. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 2009;301(5):513-521. https://doi.org/10.1001/jama.2009.50
  15. World Health Organization, Western Pacific Region. The International Association for the Study of Obesity and the International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment; 2000 [cited 2014 Aug 18]. Available from: http://www.wpro.who.int/nutrition/documents/docs/Redefiningobesity.pdf.
  16. Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, et al. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int 2008;19(1):79-86. https://doi.org/10.1007/s00198-007-0426-9
  17. Kannus P, Parkkari J. Prevention of hip fracture with hip protectors. Age Ageing 2006;35 Suppl 2:ii51-ii54. https://doi.org/10.1093/ageing/afl087
  18. Lee ET, Wang JW. Statistical methods for survival data analysis. 3rd ed. Hoboken: Wiley; 2003, p. 298-338.
  19. Center JR, Bliuc D, Nguyen TV, Eisman JA. Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 2007;297(4):387-394. https://doi.org/10.1001/jama.297.4.387
  20. Jung SE, Yoon YS, Lee NW, Kim T, Kim HJ, Lee KW, et al. Estimated prevalence of osteoporosis in Ansan, Korea. J Korean Soc Osteoporos 2006;4(1):41-48 (Korean).
  21. Shin HH, Kim SY, Sohn SJ. Estimation of incidence rate of osteoporotic fracture among the elderly in a city. Korean J Bone Metab 2001;8(2):159-171 (Korean).
  22. Kato I, Toniolo P, Zeleniuch-Jacquotte A, Shore RE, Koenig KL, Akhmedkhanov A, et al. Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study. Int J Epidemiol 2000;29(1):85-92. https://doi.org/10.1093/ije/29.1.85
  23. Johnell O, Gullberg B, Kanis JA, Allander E, Elffors L, Dequeker J, et al. Risk factors for hip fracture in European women: the MEDOS Study. Mediterranean Osteoporosis Study. J Bone Miner Res 1995;10(11):1802-1815.
  24. Ensrud KE, Cauley J, Lipschutz R, Cummings SR. Weight change and fractures in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med 1997;157(8):857-863. https://doi.org/10.1001/archinte.1997.00440290041004
  25. Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ 2009;339:b4229. https://doi.org/10.1136/bmj.b4229
  26. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 2008;19(4):385-397. https://doi.org/10.1007/s00198-007-0543-5
  27. Ahlborg HG, Johnell O, Turner CH, Rannevik G, Karlsson MK. Bone loss and bone size after menopause. N Engl J Med 2003;349(4):327-334. https://doi.org/10.1056/NEJMoa022464
  28. Cauley JA, Hochberg MC, Lui LY, Palermo L, Ensrud KE, Hillier TA, et al. Long-term risk of incident vertebral fractures. JAMA 2007;298(23):2761-2767. https://doi.org/10.1001/jama.298.23.2761
  29. Lips P. Epidemiology and predictors of fractures associated with osteoporosis. Am J Med 1997;103(2A):3S-8S.
  30. Ullom-Minnich P. Prevention of osteoporosis and fractures. Am Fam Physician 1999;60(1):194-202.
  31. Silva MJ. Biomechanics of osteoporotic fractures. Injury 2007;38 Suppl 3:S69-S76. https://doi.org/10.1016/j.injury.2007.08.014
  32. Kim DY. Clinical application of bone mineral density measurement. Korean J Nucl Med 2004;38(4):275-281(Korean).
  33. Cumming RG, Nevitt MC. Calcium for prevention of osteoporotic fractures in postmenopausal women. J Bone Miner Res 1997;12(9):1321-1329. https://doi.org/10.1359/jbmr.1997.12.9.1321
  34. Jang SN, Choi YH, Choi MG, Kang SH, Jeong JY, Choi YJ, et al. Prevalence and associated factors of osteoporosis among postmenopausal women in Chuncheon: Hallym Aging Study (HAS). J Prev Med Public Health 2006;39(5):389-396 (Korean).
  35. Zhang YY, Liu PY, Deng HW. The impact of reproductive and menstrual history on bone mineral density in Chinese women. J Clin Densitom 2003;6(3):289-296. https://doi.org/10.1385/JCD:6:3:289
  36. Ivers RQ, Cumming RG, Mitchell P, Peduto AJ. The accuracy of self-reported fractures in older people. J Clin Epidemiol 2002;55(5):452-457. https://doi.org/10.1016/S0895-4356(01)00518-2
  37. Ismail AA, O'Neill TW, Cockerill W, Finn JD, Cannata JB, Hoszowski K, et al. Validity of self-report of fractures: results from a prospective study in men and women across Europe: EPOS Study Group. European Prospective Osteoporosis Study Group. Osteoporos Int 2000;11(3):248-254. https://doi.org/10.1007/s001980050288

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