Författare: Mellström Dan
Titel: Riskfaktorer för fraktur och osteoporos [summary] (serie: Tema osteoporos) 2006 nr 40 sid 2983-5
Ämnesord:
Benbrott
Frakturer, spontana
Benskörhet
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Summary:
Age, previous fractures, family history, smoking and low BMI are of bone mineral density (BMD) independent risk factors for new fractures.
An international meta-analysis of fracture risk from 11 cohorts (n=60.000) led by John Kanis and Olof Johnell has shown that not only bone mineral density, BMD, should be included in a risk-score for prediction of fractures. The meta-analysis showed that previous fracture increases the risk for any new fracture with a relative risk (RR) of 1.86. Family history of fractures and smoking increased the RR for hip fracture with 2.5 and 1.8, respectively. All these increased risks were in large independent of bone mineral density. Only low BMI (20) showed an increased RR 1.95 for hip fracture. However, most of this increased risk was related to change in BMD. Prior corticosteroid use increased the RR of hip fracture with 4.4 at age 50 and 2.5 at age 85 independent of BMD. Age has been shown to be a major independent risk factor for both osteoporosis and fracture. A 80-year old woman with the same hip BMD as a 50-year old woman has a 6 times greater risk for future hip fracture. All these independent risk factors will be included in a fracture multiple risk-score together with BMD for calculating the absolute risk for fractures similar to risk-scores used for calculating cardiovascular disease.
Dan Mellstrom
Correspondence: Dan Mellstrom, Center for Bone Research at the Sahlgrenska Academy
Osteoporosmottagningen, Geriatriska kliniken Östra, Sahlgrenska Universitetssjukhuset
Gibraltargatan 1 C, 411 32 Göteborg, Telefon 031 - 343 90 35, dan.mellstrom@vgregion.se
