학술논문
Effect of co-morbidities on fracture risk: Findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)
Document Type
article
Author
Dennison, Elaine M; Compston, Juliet E; Flahive, Julie; Siris, Ethel S; Gehlbach, Stephen H; Adachi, Jonathan D; Boonen, Steven; Chapurlat, Roland; Díez-Pérez, Adolfo; Anderson, Frederick A; Hooven, Frederick H; LaCroix, Andrea Z; Lindsay, Robert; Netelenbos, J Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Saag, Kenneth G; Sambrook, Philip; Silverman, Stuart; Watts, Nelson B; Greenspan, Susan L; Premaor, Melissa; Cooper, Cyrus; Investigators, for the GLOW
Source
Bone. 50(6)
Subject
Language
Abstract
IntroductionGreater awareness of the relationship between co-morbidities and fracture risk may improve fracture-prediction algorithms such as FRAX.Materials and methodsWe used a large, multinational cohort study (GLOW) to investigate the effect of co-morbidities on fracture risk. Women completed a baseline questionnaire detailing past medical history, including co-morbidity history and fracture. They were re-contacted annually to determine incident clinical fractures. A co-morbidity index, defined as number of baseline co-morbidities, was derived. The effect of adding the co-morbidity index to FRAX risk factors on fracture prevention was examined using chi-squared tests, the May-Hosmer test, c index and comparison of predicted versus observed fracture rates.ResultsOf 52,960 women with follow-up data, enrolled between October 2006 and February 2008, 3224 (6.1%) sustained an incident fracture over 2 years. All recorded co-morbidities were significantly associated with fracture, except for high cholesterol, hypertension, celiac disease, and cancer. The strongest association was seen with Parkinson's disease (age-adjusted hazard ratio [HR]: 2.2; 95% CI: 1.6-3.1; P