Abstract
We wanted to estimate the independent fracture risk associated with chronic diseases for men and women separately, adjusting for other known risk factors. This is a population-based study of all those who attended the fourth survey (1994–1995) in the Tromsø Study ( n =27,159) who were followed until 31 December 2000 with respect to non-vertebral fractures. At baseline the age range was 25–98 years. Chronic disease cases were defined by self-report in questionnaires. All non-vertebral fractures were registered by computerized search in radiographic archives in the sole provider of radiographic service in the area. A total of 446 and 803 non-vertebral fractures were registered among men and women, respectively. Self-reported diabetes mellitus, stroke, asthma, hypo- and hyperthyroidism and psychiatric disorders were associated with increased fracture risk. Multivariate analyses showed an independent risk of fractures associated with self-reported diabetes mellitus, hypothyroidism and psychiatric disorders among men. Among women the independent risk was associated with self-reported asthma, hypo- and hyperthyroidism and psychiatric disorders. Self-reported heart disease had a protective effect on wrist fracture, especially in women. Increased burden of chronic diseases increase the risk of all non-vertebral ( P <0.0001), wrist ( P =0.005), proximal humerus ( P =0.0004) and hip fracture ( P =0.0002) in men, and for the proximal humerus ( P =0.003) and hip fracture ( P =0.04) in women. There was an independent fracture risk associated with self-reported diabetes mellitus, asthma, hypo- and hyperthyroidism and psychiatric disorders in men and women. Increasing burden of disease increased fracture risk in both men and women.
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References
Cummings SR, et al (2000) Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 7:178–208
Huopio J, et al (2000) Risk factors for perimenopausal fractures: a prospective study. Osteoporosis Int 11:219–227
Ross PD, Osteoporosis: frequency, consequences, and risk factors. Arch Intern Med 156:1399–1411
Meyer HE, Tverdal A, Falch JA (1993) Risk factors for hip fracture in middle-aged Norwegian women and men. Am J Epidemiol 137:1203–1211
Honkanen R, et al (1998) Relationships between risk factors and fractures differ by type of fracture: A population-based study of 12,192 perimenopausal women. Osteoporos Int 8:25–31
Forsen L, et al (1999) Diabetes mellitus and the incidence of hip fracture: results from the Nord-Trondelag Health Survey. Diabetologia 42:920–925
Schwartz AV, et al (2001) Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metabol 86:32–38
Ivers RQ, et al (2001) Diabetes and risk of fracture: The Blue Mountains Eye Study. Diabetes Care 24:1198–203
Ramnemark A, et al (2000) Stroke, a major and increasing risk factor for femoral neck fracture. Stroke 31:1572–1577
Cummings SR, et al (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–773
Jaglal SB, Kreiger N, Darlington G (1993) Past and recent physical activity and risk of hip fracture. Am J Epidemiol 138:107–118
Smith BJ, Phillips PJ, Heller RF (1999) Asthma and chronic obstructive airway diseases are associated with osteoporosis and fractures: a literature review. Respirology 4:101–109
Jancar J, Jancar MP (1998) Age-related fractures in people with intellectual disability and epilepsy. J Intellect Disabil Res 42:429–433
Vestergaard P, et al (1999) Fracture risk is increased in epilepsy. Acta Neurol Scand 99:269–275
Wejda B, et al (1995) Hip fractures and the thyroid: A case-control study. J Intern Med 237:241–247
Forsen L, et al (1999) Mental distress and risk of hip fracture. Do broken hearts lead to broken bones? J Epidemiol Community Health 53:343–347
Bae JM, et al (2002) A cohort study on the association between psychotropics and hip fracture in Korean elderly women. J Korean Med Sci 17:65–70
Schwab M, et al (2000) Psychotropic drug use, falls and hip fracture in the elderly. Aging Clin Exp Res 12:234–239
Søgaard AJ, Tverdal A, et al (2004) Long-term mental distress, bone mineral density and non-vertebral fractures. The Tromsø Study. Osteoporos Int
Melchior TM, Sorensen H, Torp-Pedersen C (1994) Hip and distal arm fracture rates in peri- and postmenopausal insulin-treated diabetic females. J Intern Med 236:203–208
Hallengren B, et al (1999) No increase in fracture incidence in patients treated for thyrotoxicosis in Malmo during 1970–1974. A 20-year population-based follow-up. J Intern Med 246:139–144
Persson I, et al (1992) Reduced risk of hip fracture in women with endometrial cancer. Int J Epidemiol 21:636–642
Adami HO, et al (1990) Hip fractures in women with breast cancer. Am J Epidemiol 132:877–883
Schirmer H, Lunde P, Rasmussen K (1999) Prevalence of left ventricular hypertrophy in a general population; The Tromso Study. Eur Heart J 20:429–438
The Tromsø Study (1994) http://www.ism.uit.no/tromso5/forsteskjema-t4-eng.pdf
The Tromsø Study (1994) http://www.ism.uit.no/tromso5/skjema2-u70-t4-eng.pdf
The Tromsø Study (1994) http://www.ism.uit.no/tromso5/skjema2-o70-t4-eng.pdf
Joakimsen RM, et al (2001) The Tromso study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register? Osteoporos Int 12:1001–1005
SAS Institute (1992) SAS/STAT guide for personal computers. Version 6 edn. SAS Institute, Cary, NC
Joakimsen RM (1999) Risk factors for non-vertebral fractures in a middle-aged population (thesis). In: Institute of community medicine. University of Tromsø, Tromsø
Simpson CF, et al (2004) Agreement between self-report of disease diagnoses and medical record validation in disabled older women: factors that modify agreement. J Am Geriatr Soc 52:123–127
Haapanen N, et al (1997) Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. Am J Epidemiol 145:762–769
Kriegsman DM, et al (1996) Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. J Clin Epidemiol 49:1407–1417
Bergmann MM, et al (1998) Validity of self-reported diagnoses leading to hospitalization: a comparison of self-reports with hospital records in a prospective study of American adults. Am J Epidemiol 147:969–977
Jaglal SB, Kreiger N, Darlington G (1993) Past and recent physical activity and risk of hip fracture. Am J Epidemiol 138:107–118
Van Staa TP, et al (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15:993–1000
Toogood JH, et al (1995) Bone mineral density and the risk of fracture in patients receiving long-term inhaled steroid therapy for asthma. J Allerg Clin Immunol 96:157–166
van Staa TP, Leufkens HG, Cooper C (2001) Use of inhaled corticosteroids and risk of fractures. J Bone Miner Res 16:581–588
Varosy PD, et al (2003) Fracture and the risk of coronary events in women with heart disease. Am J Med 115:196–202
Fox KM, et al (2000) Femoral neck and intertrochanteric fractures have different risk factors: a prospective study. Osteoporosis Int 11:1018–1023
Kelsey JL et al (1992) Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group [published erratum appears in Am J Epidemiol May 15 1992; 135:1183]. Am J Epidemiol 135:477–489
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An erratum to this article can be found online at http://dx.doi.org/10.1007/s00198-009-0846-9.
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Ahmed, L.A., Schirmer, H., Berntsen, G.K. et al. Self-reported diseases and the risk of non-vertebral fractures: the Tromsø study. Osteoporos Int 17, 46–53 (2006). https://doi.org/10.1007/s00198-005-1892-6
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DOI: https://doi.org/10.1007/s00198-005-1892-6