Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Skip to main content

Advertisement

Springer Nature Link
Log in

Are there specific clinical risk factors for the occurrence of multiple fractures? The FRISBEE study

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

This study showed additional clinical risk factors for the occurrence of multiple fractures with regards to a single fracture, with often higher hazard ratios. It would be important to include the risk of the occurrence of multiple fractures in future prediction models.

Purpose

To identify clinical risk factors (CRFs) which would specifically increase the risk of multiple fractures.

Methods

Data of the 3560 postmenopausal women of the FRISBEE study were analysed. The CRFs and the fractures are collected annually. The cohort was divided into three groups: those who had no incident fracture, those who had a single incident fracture and those who had 2 two or more incident fractures (i.e. multiple fractures). Statistical analyses were performed using Cox proportional hazards models.

Results

Among the 3560 subjects (followed for 9.1 (7.2–10.6) years), 261 subjects had two or more validated fractures during follow-up (146 were major osteoporotic fractures (MOFs)), 628 had one fracture (435 MOFs), 2671 had no fracture (2979 had no MOF); 157 subjects had two or more central fractures, 389 had only one and 3014 had none. The risk factors for those with multiple fractures at any site were age, history of fracture, history of fall, total hip bone mineral density (BMD), spine BMD and rheumatoid arthritis. For those with multiple MOFs, significant CRFs were age, history of fracture, parental hip fracture, total hip BMD and rheumatoid arthritis.

Conclusion

We found in a prospective cohort study that there were more CRFs and higher hazard ratios for the occurrence of multiple fractures than for a single fracture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16:6–10. https://doi.org/10.1007/s00198-004-1702-6

    Article  Google Scholar 

  2. Borgström F, Karlsson L, Ortsäter G et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15. https://doi.org/10.1007/s11657-020-0706-y

  3. Nazrun AS, Tzar MN, Mokhtar SA, Mohamed IN (2014) A systematic review of the outcomes of osteoporotic fracture patients after hospital discharge: morbidity, subsequent fractures, and mortality. Ther Clin Risk Manag 10:937–948. https://doi.org/10.2147/TCRM.S72456

    Article  Google Scholar 

  4. Morin S, Lix LM, Azimaee M et al (2011) Mortality rates after incident non-traumatic fractures in older men and women. Osteoporos Int 22:2439–2448. https://doi.org/10.1007/s00198-010-1480-2

    Article  CAS  Google Scholar 

  5. Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382. https://doi.org/10.1016/j.bone.2004.03.024

    Article  CAS  Google Scholar 

  6. Hansen L, Petersen KD, Eriksen SA et al (2014) Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective. Osteoporos Int 26:513–519. https://doi.org/10.1007/s00198-014-2875-2

    Article  Google Scholar 

  7. Crandall CJ, Larson JC, LaCroix AZ et al (2021) Risk of subsequent fractures in postmenopausal women after nontraumatic vs traumatic fractures. JAMA Intern Med 181:1055–1063. https://doi.org/10.1001/jamainternmed.2021.2617

    Article  Google Scholar 

  8. Iconaru L, Moreau M, Baleanu F et al (2021) Risk factors for imminent fractures: a substudy of the FRISBEE cohort. Osteoporos Int. https://doi.org/10.1007/s00198-020-05772-8

  9. Man R, Wong Y, Yan P et al (2022) The imminent risk of a fracture — existing worldwide data: a systematic review and meta - analysis. Osteoporos Int. https://doi.org/10.1007/s00198-022-06473-0

  10. Kanis JA, Johnell O, Oden A et al (2008) FRAXTM and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397. https://doi.org/10.1007/s00198-007-0543-5

    Article  CAS  Google Scholar 

  11. Nguyen ND, Frost SA, Center JR et al (2008) Development of prognostic nomograms for individualizing 5-year and 10-year fracture risks. Osteoporos Int 19:1431–1444. https://doi.org/10.1007/s00198-008-0588-0

    Article  CAS  Google Scholar 

  12. Baleanu F, Moreau M, Charles A et al (2022) Fragility fractures in postmenopausal women: development of 5-year prediction models using the FRISBEE study. J Clin Endocrinol Metab 1–11. https://doi.org/10.1530/endoabs.79.005

  13. Rubin KH, Möller S, Holmberg T et al (2018) A new fracture risk assessment tool (FREM) based on public health registries. J Bone Miner Res 33:1967–1979. https://doi.org/10.1002/jbmr.3528

    Article  Google Scholar 

  14. Iconaru L, Charles A, Baleanu F et al (2021) Prediction of an imminent fracture after an index fracture – models derived from the Frisbee cohort. J Bone Miner Res. https://doi.org/10.1002/jbmr.4432

  15. Langsetmo L, Goltzman D, Kovacs CS et al (2016) Repeat low-trauma fractures occur frequently among men and women who have osteopenic BMD. J Bone Miner Res 24:1515–1522. https://doi.org/10.1359/jbmr.090319.Repeat

    Article  Google Scholar 

  16. Alarkawi D, Bliuc D, Tran T et al (2020) Impact of osteoporotic fracture type and subsequent fracture on mortality : the Tromsø Study. Osteoporos Int 31:119–130. https://doi.org/10.1007/s00198-019-05174-5

    Article  CAS  Google Scholar 

  17. Llopis-Cardona F, Armero C, Hurtado I et al (2022) Incidence of subsequent hip fracture and mortality in elderly patients: a multistate population-based cohort study in Eastern Spain. J Bone Miner Res 37:1200–1208. https://doi.org/10.1002/jbmr.4562

    Article  Google Scholar 

  18. Iconaru L, Baleanu F, Charles A et al (2021) Which treatment to prevent an imminent fracture? Bone Rep 15:101105. https://doi.org/10.1016/j.bonr.2021.101105

    Article  Google Scholar 

  19. Cappelle SI, Ramon I, Dekelver C et al (2017) Distribution of clinical risk factors for fracture in a Brussels cohort of postmenopausal women: the FRISBEE study and comparison with other major cohort studies. Maturitas 106:1–7. https://doi.org/10.1016/j.maturitas.2017.08.010

    Article  CAS  Google Scholar 

  20. Baleanu F, Moreau M, Kinnard V et al (2020) Underevaluation of fractures by self-report: an analysis from the FRISBEE cohort. Arch Osteoporos 15:5–9. https://doi.org/10.1007/s11657-020-00739-y

    Article  Google Scholar 

  21. Johansson H, Kanis JA, Odén A et al (2014) A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 29:223–233. https://doi.org/10.1002/jbmr.2017

    Article  Google Scholar 

  22. Charles A, Mugisha A, Iconaru L et al (2022) Distribution of fracture sites in postmenopausal overweight and obese women: the FRISBEE study. Calcif Tissue Int 1–6. https://doi.org/10.1007/s00223-022-00968-y

  23. Jin S, Hsieh E, Peng L et al (2018) Incidence of fractures among patients with rheumatoid arthritis: a systematic review and meta-analysis. Osteoporos Int 29:1263–1275. https://doi.org/10.1007/s00198-018-4473-1

    Article  CAS  Google Scholar 

  24. Raterman HG, Bultink IE, Lems WF (2020) Osteoporosis in patients with rheumatoid arthritis: an update in epidemiology, pathogenesis, and fracture prevention. Expert Opin Pharmacother 00:1725–1737. https://doi.org/10.1080/14656566.2020.1787381

    Article  Google Scholar 

  25. Ishizu H, Shimizu H, Shimizu T et al (2021) Rheumatoid arthritis is a risk factor for refracture in patients with fragility fractures. Mod Rheumatol roab109:1–6. https://doi.org/10.1093/mr/roab109

    Article  Google Scholar 

Download references

Funding

The FRISBEE study was supported by IRIS-Research and CHU Brugmann.

Author information

Authors and Affiliations

  1. Department of Endocrinology, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    A. Charles, L. Iconaru, F. Baleanu & J. J. Body

  2. Department of Internal Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    F. Benoit, M. Surquin & A. Mugisha

  3. Department of Nuclear Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    P. Bergmann

  4. Laboratory of Translational Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    P. Bergmann & J. J. Body

Authors
  1. A. Charles
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Iconaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Baleanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Benoit
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Surquin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Mugisha
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. J. Body
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Charles.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1.

(DOCX 19 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Charles, A., Iconaru, L., Baleanu, F. et al. Are there specific clinical risk factors for the occurrence of multiple fractures? The FRISBEE study. Osteoporos Int 34, 501–506 (2023). https://doi.org/10.1007/s00198-022-06663-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-022-06663-w

Keywords

Search

Navigation