TORONTO — Risk factors for fractures in later life are already present in middle age, and their early identification can provide a window of opportunity for intervention, Dr. Anna H. Holmberg said at a world congress on osteoporosis.
The Malmö Preventive Project was a prospective study that followed 22,444 men and 10,902 women from 1974 through 1999, said Dr. Holmberg of the department of orthopedics, Malmö (Sweden) University Hospital.
During follow-up, which averaged 19 years for men and 15 years for women, 1,262 men (5.6%) had 1,975 low-energy fractures, while 1,257 women (11.5%) had 1,805 low-energy fractures.
Among men, the risk factor with the highest impact on later fragility fracture was diabetes, with a relative risk (RR) of 2.38. Other strong risk factors among men were prior hospitalization for mental health problems (RR 1.92), poor appetite (RR 1.72), sleep disturbances (RR 1.53), and poor self-rated health (RR 1.25), Dr. Holmberg said at the meeting, which was sponsored by the International Osteoporosis Foundation.
Diabetes also was a strong risk factor for fractures in general among women (RR 1.87), and specifically was a significant risk factor for vertebral, ankle, and hip fractures.