When, Where and How Osteoporosis-Associated Fractures Occur: An Analysis from the Global Longitudinal Study of Osteoporosis in Women (GLOW)
Identifieur interne : 004403 ( Main/Exploration ); précédent : 004402; suivant : 004404When, Where and How Osteoporosis-Associated Fractures Occur: An Analysis from the Global Longitudinal Study of Osteoporosis in Women (GLOW)
Auteurs : Aline G. Costa [États-Unis, Brésil] ; Allison Wyman [États-Unis] ; Ethel S. Siris [États-Unis] ; Nelson B. Watts [États-Unis] ; Stuart Silverman [États-Unis] ; Kenneth G. Saag [États-Unis] ; Christian Roux [France] ; Maurizio Rossini [Italie] ; Johannes Pfeilschifter [Allemagne] ; Jeri W. Nieves [États-Unis] ; J. Coen Netelenbos [Pays-Bas] ; Lyn March [Australie] ; Andrea Z. Lacroix [États-Unis] ; Frederick H. Hooven [États-Unis] ; Susan L. Greenspan [États-Unis] ; Stephen H. Gehlbach [États-Unis] ; Adolfo Díez-Pérez [Espagne] ; Cyrus Cooper [Royaume-Uni] ; Juliet E. Compston [Royaume-Uni] ; Roland D. Chapurlat [France] ; Steven Boonen [Belgique] ; Frederick A. Anderson [États-Unis] ; Jonathan D. Adachi [Canada] ; Silvano Adami [Italie]Source :
- PLoS ONE [ 1932-6203 ] ; 2013.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- epidemiology : Hip Fractures, Osteoporosis, Postmenopausal.
- prevention & control : Hip Fractures, Osteoporosis, Postmenopausal.
- Accidental Falls, Age Factors, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Retrospective Studies, Seasons.
Abstract
To examine when, where and how fractures occur in postmenopausal women.
We analyzed data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), including women aged ≥55 years from the United States of America, Canada, Australia and seven European countries. Women completed questionnaires including fracture data at baseline and years 1, 2 and 3.
Among 60,393 postmenopausal women, 4122 incident fractures were reported (86% non-hip, non-vertebral [NHNV], 8% presumably clinical vertebral and 6% hip). Hip fractures were more likely to occur in spring, with little seasonal variation for NHNV or spine fractures. Hip fractures occurred equally inside or outside the home, whereas 65% of NHNV fractures occurred outside and 61% of vertebral fractures occurred inside the home. Falls preceded 68–86% of NHNV and 68–83% of hip fractures among women aged ≤64 to ≥85 years, increasing with age. About 45% of vertebral fractures were associated with falls in all age groups except those ≥85 years, when only 24% occurred after falling.
In this multi-national cohort, fractures occurred throughout the year, with only hip fracture having a seasonal variation, with a higher proportion in spring. Hip fractures occurred equally within and outside the home, spine fractures more often in the home, and NHNV fractures outside the home. Falls were a proximate cause of most hip and NHNV fractures. Postmenopausal women at risk for fracture need counseling about reducing potentially modifiable fracture risk factors, particularly falls both inside and outside the home and during all seasons of the year.
Url:
DOI: 10.1371/journal.pone.0083306
PubMed: 24349484
PubMed Central: 3859637
Affiliations:
- Allemagne, Australie, Belgique, Brésil, Canada, Espagne, France, Italie, Pays-Bas, Royaume-Uni, États-Unis
- Alabama, Auvergne-Rhône-Alpes, Californie, Catalogne, Hollande-Septentrionale, Massachusetts, Ohio, Ontario, Pennsylvanie, Rhône-Alpes, Washington (État), État de New York, État de São Paulo, Île-de-France
- Amsterdam, Barcelone, Hamilton (Ontario), Lyon, New York, Paris, Pittsburgh, São Paulo
- Université Columbia, Université McMaster, Université de Pittsburgh
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Gehlbach</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Pérez">Adolfo Díez-Pérez</name><affiliation wicri:level="3"><nlm:aff id="aff16"><addr-line>Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona, Spain</addr-line></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation><affiliation><nlm:aff id="aff17"><addr-line>RETICEF, ISCIII Madrid; Spain</addr-line></nlm:aff><wicri:noCountry code="subfield">ISCIII Madrid; Spain</wicri:noCountry></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation wicri:level="1"><nlm:aff id="aff18"><addr-line>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation></author><author><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E." last="Compston">Juliet E. Compston</name><affiliation wicri:level="1"><nlm:aff id="aff19"><addr-line>Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cambridge University Hospitals NHS Foundation Trust, Cambridge</wicri:regionArea><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D." last="Chapurlat">Roland D. Chapurlat</name><affiliation wicri:level="3"><nlm:aff id="aff20"><addr-line>Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name><affiliation wicri:level="1"><nlm:aff id="aff21"><addr-line>Universiteit Leuven, Leuven, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Universiteit Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Frederick A" sort="Anderson, Frederick A" uniqKey="Anderson F" first="Frederick A." last="Anderson">Frederick A. 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Siris</name><affiliation wicri:level="2"><nlm:aff id="aff4"><addr-line>Department of Medicine, Columbia University Medical Center, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Columbia University Medical Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Watts, Nelson B" sort="Watts, Nelson B" uniqKey="Watts N" first="Nelson B." last="Watts">Nelson B. Watts</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Mercy Health Osteoporosis and Bone Health Services, Cincinnati, Ohio, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Mercy Health Osteoporosis and Bone Health Services, Cincinnati, Ohio</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name><affiliation wicri:level="2"><nlm:aff id="aff6"><addr-line>Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Saag, Kenneth G" sort="Saag, Kenneth G" uniqKey="Saag K" first="Kenneth G." last="Saag">Kenneth G. Saag</name><affiliation wicri:level="2"><nlm:aff id="aff7"><addr-line>Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama</wicri:regionArea><placeName><region type="state">Alabama</region></placeName></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation wicri:level="3"><nlm:aff id="aff8"><addr-line>Paris Descartes University, Cochin Hospital, Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris Descartes University, Cochin Hospital, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name><affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Rheumatology Section, Department of Medicine, University of Verona, Italy,</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Rheumatology Section, Department of Medicine, University of Verona</wicri:regionArea><wicri:noRegion>University of Verona</wicri:noRegion></affiliation></author><author><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name><affiliation wicri:level="1"><nlm:aff id="aff10"><addr-line>Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen</wicri:regionArea><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Nieves, Jeri W" sort="Nieves, Jeri W" uniqKey="Nieves J" first="Jeri W." last="Nieves">Jeri W. Nieves</name><affiliation wicri:level="2"><nlm:aff id="aff11"><addr-line>Helen Hayes Hospital and Columbia University, West Haverstraw, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Helen Hayes Hospital and Columbia University, West Haverstraw, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Netelenbos, J Coen" sort="Netelenbos, J Coen" uniqKey="Netelenbos J" first="J. Coen" last="Netelenbos">J. Coen Netelenbos</name><affiliation wicri:level="3"><nlm:aff id="aff12"><addr-line>Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</addr-line></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Endocrinology, VU University Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name><affiliation wicri:level="1"><nlm:aff id="aff13"><addr-line>University of Sydney Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>University of Sydney Institute of Bone and Joint Research and Department of Rheumatology, Royal North Shore Hospital</wicri:regionArea><wicri:noRegion>Royal North Shore Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Lacroix, Andrea Z" sort="Lacroix, Andrea Z" uniqKey="Lacroix A" first="Andrea Z." last="Lacroix">Andrea Z. Lacroix</name><affiliation wicri:level="2"><nlm:aff id="aff14"><addr-line>Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Fred Hutchinson Cancer Research Center, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Hooven, Frederick H" sort="Hooven, Frederick H" uniqKey="Hooven F" first="Frederick H." last="Hooven">Frederick H. Hooven</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Greenspan, Susan L" sort="Greenspan, Susan L" uniqKey="Greenspan S" first="Susan L." last="Greenspan">Susan L. Greenspan</name><affiliation wicri:level="4"><nlm:aff id="aff15"><addr-line>University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Pittsburgh, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Gehlbach, Stephen H" sort="Gehlbach, Stephen H" uniqKey="Gehlbach S" first="Stephen H." last="Gehlbach">Stephen H. Gehlbach</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Pérez">Adolfo Díez-Pérez</name><affiliation wicri:level="3"><nlm:aff id="aff16"><addr-line>Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona, Spain</addr-line></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation><affiliation><nlm:aff id="aff17"><addr-line>RETICEF, ISCIII Madrid; Spain</addr-line></nlm:aff><wicri:noCountry code="subfield">ISCIII Madrid; Spain</wicri:noCountry></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation wicri:level="1"><nlm:aff id="aff18"><addr-line>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation></author><author><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E." last="Compston">Juliet E. Compston</name><affiliation wicri:level="1"><nlm:aff id="aff19"><addr-line>Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cambridge University Hospitals NHS Foundation Trust, Cambridge</wicri:regionArea><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D." last="Chapurlat">Roland D. Chapurlat</name><affiliation wicri:level="3"><nlm:aff id="aff20"><addr-line>Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name><affiliation wicri:level="1"><nlm:aff id="aff21"><addr-line>Universiteit Leuven, Leuven, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Universiteit Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Frederick A" sort="Anderson, Frederick A" uniqKey="Anderson F" first="Frederick A." last="Anderson">Frederick A. Anderson</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D." last="Adachi">Jonathan D. Adachi</name><affiliation wicri:level="4"><nlm:aff id="aff22"><addr-line>St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>St Joseph's Healthcare, McMaster University, Hamilton, Ontario</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Adami, Silvano" sort="Adami, Silvano" uniqKey="Adami S" first="Silvano" last="Adami">Silvano Adami</name><affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Rheumatology Section, Department of Medicine, University of Verona, Italy,</addr-line></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Rheumatology Section, Department of Medicine, University of Verona</wicri:regionArea><wicri:noRegion>University of Verona</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls</term><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Hip Fractures (epidemiology)</term><term>Hip Fractures (prevention & control)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Osteoporosis, Postmenopausal (epidemiology)</term><term>Osteoporosis, Postmenopausal (prevention & control)</term><term>Retrospective Studies</term><term>Seasons</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Chutes accidentelles</term><term>Facteurs de l'âge</term><term>Fractures de la hanche ()</term><term>Fractures de la hanche (épidémiologie)</term><term>Humains</term><term>Mâle</term><term>Ostéoporose post-ménopausique ()</term><term>Ostéoporose post-ménopausique (épidémiologie)</term><term>Saisons</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Hip Fractures</term><term>Osteoporosis, Postmenopausal</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Hip Fractures</term><term>Osteoporosis, Postmenopausal</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Fractures de la hanche</term><term>Ostéoporose post-ménopausique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Accidental Falls</term><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Seasons</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Chutes accidentelles</term><term>Facteurs de l'âge</term><term>Fractures de la hanche</term><term>Humains</term><term>Mâle</term><term>Ostéoporose post-ménopausique</term><term>Saisons</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>To examine when, where and how fractures occur in postmenopausal women.</p></sec><sec><title>Methods</title><p>We analyzed data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), including women aged ≥55 years from the United States of America, Canada, Australia and seven European countries. Women completed questionnaires including fracture data at baseline and years 1, 2 and 3.</p></sec><sec><title>Results</title><p>Among 60,393 postmenopausal women, 4122 incident fractures were reported (86% non-hip, non-vertebral [NHNV], 8% presumably clinical vertebral and 6% hip). Hip fractures were more likely to occur in spring, with little seasonal variation for NHNV or spine fractures. Hip fractures occurred equally inside or outside the home, whereas 65% of NHNV fractures occurred outside and 61% of vertebral fractures occurred inside the home. Falls preceded 68–86% of NHNV and 68–83% of hip fractures among women aged ≤64 to ≥85 years, increasing with age. About 45% of vertebral fractures were associated with falls in all age groups except those ≥85 years, when only 24% occurred after falling.</p></sec><sec><title>Conclusion</title><p>In this multi-national cohort, fractures occurred throughout the year, with only hip fracture having a seasonal variation, with a higher proportion in spring. Hip fractures occurred equally within and outside the home, spine fractures more often in the home, and NHNV fractures outside the home. Falls were a proximate cause of most hip and NHNV fractures. Postmenopausal women at risk for fracture need counseling about reducing potentially modifiable fracture risk factors, particularly falls both inside and outside the home and during all seasons of the year.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Burge, R" uniqKey="Burge R">R Burge</name></author><author><name sortKey="Dawson Hughes, B" uniqKey="Dawson Hughes B">B Dawson-Hughes</name></author><author><name sortKey="Solomon, Dh" uniqKey="Solomon D">DH Solomon</name></author><author><name sortKey="Wong, Jb" uniqKey="Wong J">JB Wong</name></author><author><name sortKey="King, A" uniqKey="King A">A King</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnell, O" uniqKey="Johnell O">O Johnell</name></author><author><name sortKey="Kanis, Ja" uniqKey="Kanis J">JA Kanis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hooven, Fh" uniqKey="Hooven F">FH 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sortKey="Atkinson, Ej" uniqKey="Atkinson E">EJ Atkinson</name></author><author><name sortKey="O Allon, Wm" uniqKey="O Allon W">WM O′Fallon</name></author><author><name sortKey="Melton, Lj" uniqKey="Melton L">LJ Melton</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kanis, Ja" uniqKey="Kanis J">JA Kanis</name></author><author><name sortKey="Mccloskey, Ev" uniqKey="Mccloskey E">EV McCloskey</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Brésil</li><li>Canada</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Alabama</li><li>Auvergne-Rhône-Alpes</li><li>Californie</li><li>Catalogne</li><li>Hollande-Septentrionale</li><li>Massachusetts</li><li>Ohio</li><li>Ontario</li><li>Pennsylvanie</li><li>Rhône-Alpes</li><li>Washington (État)</li><li>État de New York</li><li>État de São Paulo</li><li>Île-de-France</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Hamilton (Ontario)</li><li>Lyon</li><li>New York</li><li>Paris</li><li>Pittsburgh</li><li>São Paulo</li></settlement><orgName><li>Université Columbia</li><li>Université McMaster</li><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Costa, Aline G" sort="Costa, Aline G" uniqKey="Costa A" first="Aline G." last="Costa">Aline G. Costa</name></region><name sortKey="Anderson, Frederick A" sort="Anderson, Frederick A" uniqKey="Anderson F" first="Frederick A." last="Anderson">Frederick A. Anderson</name><name sortKey="Gehlbach, Stephen H" sort="Gehlbach, Stephen H" uniqKey="Gehlbach S" first="Stephen H." last="Gehlbach">Stephen H. Gehlbach</name><name sortKey="Greenspan, Susan L" sort="Greenspan, Susan L" uniqKey="Greenspan S" first="Susan L." last="Greenspan">Susan L. Greenspan</name><name sortKey="Hooven, Frederick H" sort="Hooven, Frederick H" uniqKey="Hooven F" first="Frederick H." last="Hooven">Frederick H. Hooven</name><name sortKey="Lacroix, Andrea Z" sort="Lacroix, Andrea Z" uniqKey="Lacroix A" first="Andrea Z." last="Lacroix">Andrea Z. Lacroix</name><name sortKey="Nieves, Jeri W" sort="Nieves, Jeri W" uniqKey="Nieves J" first="Jeri W." last="Nieves">Jeri W. Nieves</name><name sortKey="Saag, Kenneth G" sort="Saag, Kenneth G" uniqKey="Saag K" first="Kenneth G." last="Saag">Kenneth G. Saag</name><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name><name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S." last="Siris">Ethel S. Siris</name><name sortKey="Watts, Nelson B" sort="Watts, Nelson B" uniqKey="Watts N" first="Nelson B." last="Watts">Nelson B. Watts</name><name sortKey="Wyman, Allison" sort="Wyman, Allison" uniqKey="Wyman A" first="Allison" last="Wyman">Allison Wyman</name></country><country name="Brésil"><region name="État de São Paulo"><name sortKey="Costa, Aline G" sort="Costa, Aline G" uniqKey="Costa A" first="Aline G." last="Costa">Aline G. Costa</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name></region><name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D." last="Chapurlat">Roland D. Chapurlat</name></country><country name="Italie"><noRegion><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name></noRegion><name sortKey="Adami, Silvano" sort="Adami, Silvano" uniqKey="Adami S" first="Silvano" last="Adami">Silvano Adami</name></country><country name="Allemagne"><noRegion><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Netelenbos, J Coen" sort="Netelenbos, J Coen" uniqKey="Netelenbos J" first="J. Coen" last="Netelenbos">J. Coen Netelenbos</name></region></country><country name="Australie"><noRegion><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name></noRegion></country><country name="Espagne"><region name="Catalogne"><name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Pérez">Adolfo Díez-Pérez</name></region></country><country name="Royaume-Uni"><noRegion><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name></noRegion><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E." last="Compston">Juliet E. Compston</name></country><country name="Belgique"><noRegion><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D." last="Adachi">Jonathan D. Adachi</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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