High body mass index ( BMI ) is associated with increased risk of osteoarthritis ( OA ) and reduced risk of fragility fracture. However, the relationship between fragility fracture and osteoarthritis remained unclear.
A study has investigated the effect of bone mineral density ( BMD ) in the osteoarthritis-fracture relationship.
Data from 2412 women and 1452 men aged greater than 45 years in the Dubbo Osteoporosis Epidemiology Study ( DOES ) were analyzed. Individuals have been followed for up to 22 years ( median: 7.5 years; range: 0.1–22 years ).
Femoral neck BMD ( FNBMD ) and lumbar spine BMD ( LSBMD ) was measured by dual energy X-ray absorptiometry ( DXA ).
The presence of osteoarthritis was ascertained at baseline by self-reported diagnosis.
The incidence of low-trauma fracture was ascertained from X-ray reports.
Overall, 29% of women and 26% of men had reported a diagnosis of osteoarthritis.
Fracture risk was significantly higher in women with osteoarthritis than those without osteoarthritis ( hazard ratio, HR = 1.50 ).
However, the association was mainly observed in women with osteopenic BMD ( HR = 1.74 ) and normal-BMD ( HR = 1.50 ) and not in those with osteoporosis.
Further analysis revealed that osteopenic women with osteoarthritis had significant increase in risk of vertebral ( HR = 1.85 ) and limb fracture ( HR = 2.49 ), but not in hip fracture.
In men, no comparable relationship was found before and after adjustment for covariates.
In conclusion, women with osteoarthritis have an increased risk of fragility fracture, and the risk was mainly observed in non-osteoporotic group. ( Xagena )
Chan MY et al, Osteoarthritis and Cartilage 2014; Published ahead of print