Obesity is Not Protective Against Fracture in Postmenopausal Women: GLOW
Identifieur interne : 001C84 ( Pmc/Corpus ); précédent : 001C83; suivant : 001C85Obesity is Not Protective Against Fracture in Postmenopausal Women: GLOW
Auteurs : Juliet E. Compston ; Nelson B. Watts ; Roland Chapurlat ; Cyrus Cooper ; Steven Boonen ; Susan Greenspan ; Johannes Pfeilschifter ; Stuart Silverman ; Adolfo Díez-Pérez ; Robert Lindsay ; Kenneth G. Saag ; J. Coen Netelenbos ; Stephen Gehlbach ; Frederick H. Hooven ; Julie Flahive ; Jonathan D. Adachi ; Maurizio Rossini ; Andrea Z. Lacroix ; Christian Roux ; Philip N. Sambrook ; Ethel S. SirisSource :
- The American journal of medicine [ 0002-9343 ] ; 2011.
Abstract
To investigate the prevalence and incidence of clinical fractures in obese, postmenopausal women enrolled in the Global Longitudinal study of Osteoporosis in Women (GLOW).
This was a multinational, prospective, observational, population-based study carried out by 723 physician practices at 17 sites in 10 countries. A total of 60,393 women aged ≥55 years were included. Data were collected using self-administered questionnaires that covered domains that included patient characteristics, fracture history, risk factors for fracture, and anti-osteoporosis medications.
Body mass index (BMI) and fracture history were available at baseline, 1 and 2 years in 44,534 women, 23.4% of whom were obese (BMI ≥30 kg/m2). Fracture prevalence in obese women at baseline was 222 per 1,000 and incidence at 2 years was 61.7 per 1,000, similar to rates in non-obese women (227 and 66.0 per 1,000, respectively). Fractures in obese women accounted for 23% and 22% of all previous and incident fractures, respectively. The risk of incident ankle and upper leg fractures was significantly higher in obese than in non-obese women whilst the risk of wrist fracture was significantly lower. Obese women with fracture were more likely to have experienced early menopause and to report two or more falls in the past year. Self-reported asthma, emphysema, and type 1 diabetes were all significantly more common in obese than non-obese women with incident fracture. At 2 years, 27% of obese women with incident fracture were receiving bone-protective therapy, compared with 41% of non-obese and 57% of underweight women.
Our results demonstrate that obesity is not protective against fracture in postmenopausal women and is associated with increased risk of ankle and upper leg fractures. These findings have major public health implications in view of the rapidly rising incidence of obesity. Further studies are required to establish the pathogenesis of fractures in the obese population and to develop effective preventive strategies.
Url:
DOI: 10.1016/j.amjmed.2011.06.013
PubMed: 22017783
PubMed Central: 4897773
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Obesity is Not Protective Against Fracture in Postmenopausal Women: GLOW</title><author><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E." last="Compston">Juliet E. Compston</name><affiliation><nlm:aff id="A1">Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK</nlm:aff></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><nlm:aff id="A2">Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff></affiliation></author><author><name sortKey="Chapurlat, Roland" sort="Chapurlat, Roland" uniqKey="Chapurlat R" first="Roland" last="Chapurlat">Roland Chapurlat</name><affiliation><nlm:aff id="A3">INSERM Research Unit 831, Université de Lyon, Department of Orthopedics and Rheumatology, Hôpital E Herriot, Lyon, France</nlm:aff></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation><nlm:aff id="A4">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, and Norman Collisson Chair of Musculoskeletal Sciences, University of Oxford, Oxford, UK</nlm:aff></affiliation></author><author><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name><affiliation><nlm:aff id="A5">Leuven University Center for Metabolic Bone Diseases and Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Greenspan, Susan" sort="Greenspan, Susan" uniqKey="Greenspan S" first="Susan" last="Greenspan">Susan Greenspan</name><affiliation><nlm:aff id="A6">University of Pittsburgh, Pittsburgh, Pennsylvania, USA</nlm:aff></affiliation></author><author><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name><affiliation><nlm:aff id="A7">Alfried Krupp Krankenhaus, Department of Internal Medicine III, Essen, Germany</nlm:aff></affiliation></author><author><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name><affiliation><nlm:aff id="A8">Cedars-Sinai Medical Center, Los Angeles, California, USA</nlm:aff></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><nlm:aff id="A9">Hospital del Mar-IMIM-Autonomous University of Barcelona, and RETICEF, Instituto Carlos III, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Lindsay, Robert" sort="Lindsay, Robert" uniqKey="Lindsay R" first="Robert" last="Lindsay">Robert Lindsay</name><affiliation><nlm:aff id="A10">Columbia University, and Regional Bone Center, Helen Hayes Hospital, West Haverstraw, New York, USA</nlm:aff></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><nlm:aff id="A11">University of Alabama-Birmingham, Division of Clinical Immunology and Rheumatology, Birmingham, Alabama, USA</nlm:aff></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><nlm:aff id="A12">Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Gehlbach, Stephen" sort="Gehlbach, Stephen" uniqKey="Gehlbach S" first="Stephen" last="Gehlbach">Stephen Gehlbach</name><affiliation><nlm:aff id="A13">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</nlm:aff></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><nlm:aff id="A13">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</nlm:aff></affiliation></author><author><name sortKey="Flahive, Julie" sort="Flahive, Julie" uniqKey="Flahive J" first="Julie" last="Flahive">Julie Flahive</name><affiliation><nlm:aff id="A13">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</nlm:aff></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><nlm:aff id="A14">St Joseph’s Healthcare, McMaster University, Hamilton, Ontario, Canada</nlm:aff></affiliation></author><author><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name><affiliation><nlm:aff id="A15">Department of Rheumatology, University of Verona, Ospedale, Verona, Valeggio, Italy</nlm:aff></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><nlm:aff id="A16">Fred Hutchinson Cancer Research Center, Seattle, Washington, USA</nlm:aff></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation><nlm:aff id="A17">Paris Descartes University, Cochin Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Sambrook, Philip N" sort="Sambrook, Philip N" uniqKey="Sambrook P" first="Philip N." last="Sambrook">Philip N. Sambrook</name><affiliation><nlm:aff id="A18">University of Sydney-Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia</nlm:aff></affiliation></author><author><name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S." last="Siris">Ethel S. Siris</name><affiliation><nlm:aff id="A19">Columbia University Medical Center, New York, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22017783</idno><idno type="pmc">4897773</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897773</idno><idno type="RBID">PMC:4897773</idno><idno type="doi">10.1016/j.amjmed.2011.06.013</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001C84</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001C84</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Obesity is Not Protective Against Fracture in Postmenopausal Women: GLOW</title><author><name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E." last="Compston">Juliet E. Compston</name><affiliation><nlm:aff id="A1">Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK</nlm:aff></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><nlm:aff id="A2">Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff></affiliation></author><author><name sortKey="Chapurlat, Roland" sort="Chapurlat, Roland" uniqKey="Chapurlat R" first="Roland" last="Chapurlat">Roland Chapurlat</name><affiliation><nlm:aff id="A3">INSERM Research Unit 831, Université de Lyon, Department of Orthopedics and Rheumatology, Hôpital E Herriot, Lyon, France</nlm:aff></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation><nlm:aff id="A4">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, and Norman Collisson Chair of Musculoskeletal Sciences, University of Oxford, Oxford, UK</nlm:aff></affiliation></author><author><name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name><affiliation><nlm:aff id="A5">Leuven University Center for Metabolic Bone Diseases and Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Greenspan, Susan" sort="Greenspan, Susan" uniqKey="Greenspan S" first="Susan" last="Greenspan">Susan Greenspan</name><affiliation><nlm:aff id="A6">University of Pittsburgh, Pittsburgh, Pennsylvania, USA</nlm:aff></affiliation></author><author><name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name><affiliation><nlm:aff id="A7">Alfried Krupp Krankenhaus, Department of Internal Medicine III, Essen, Germany</nlm:aff></affiliation></author><author><name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name><affiliation><nlm:aff id="A8">Cedars-Sinai Medical Center, Los Angeles, California, USA</nlm:aff></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><nlm:aff id="A9">Hospital del Mar-IMIM-Autonomous University of Barcelona, and RETICEF, Instituto Carlos III, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Lindsay, Robert" sort="Lindsay, Robert" uniqKey="Lindsay R" first="Robert" last="Lindsay">Robert Lindsay</name><affiliation><nlm:aff id="A10">Columbia University, and Regional Bone Center, Helen Hayes Hospital, West Haverstraw, New York, USA</nlm:aff></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><nlm:aff id="A11">University of Alabama-Birmingham, Division of Clinical Immunology and Rheumatology, Birmingham, Alabama, USA</nlm:aff></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><nlm:aff id="A12">Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Gehlbach, Stephen" sort="Gehlbach, Stephen" uniqKey="Gehlbach S" first="Stephen" last="Gehlbach">Stephen Gehlbach</name><affiliation><nlm:aff id="A13">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</nlm:aff></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><nlm:aff id="A13">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</nlm:aff></affiliation></author><author><name sortKey="Flahive, Julie" sort="Flahive, Julie" uniqKey="Flahive J" first="Julie" last="Flahive">Julie Flahive</name><affiliation><nlm:aff id="A13">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</nlm:aff></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><nlm:aff id="A14">St Joseph’s Healthcare, McMaster University, Hamilton, Ontario, Canada</nlm:aff></affiliation></author><author><name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name><affiliation><nlm:aff id="A15">Department of Rheumatology, University of Verona, Ospedale, Verona, Valeggio, Italy</nlm:aff></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><nlm:aff id="A16">Fred Hutchinson Cancer Research Center, Seattle, Washington, USA</nlm:aff></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation><nlm:aff id="A17">Paris Descartes University, Cochin Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Sambrook, Philip N" sort="Sambrook, Philip N" uniqKey="Sambrook P" first="Philip N." last="Sambrook">Philip N. Sambrook</name><affiliation><nlm:aff id="A18">University of Sydney-Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia</nlm:aff></affiliation></author><author><name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S." last="Siris">Ethel S. Siris</name><affiliation><nlm:aff id="A19">Columbia University Medical Center, New York, USA</nlm:aff></affiliation></author></analytic><series><title level="j">The American journal of medicine</title><idno type="ISSN">0002-9343</idno><idno type="eISSN">1555-7162</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>OBJECTIVE</title><p id="P1">To investigate the prevalence and incidence of clinical fractures in obese, postmenopausal women enrolled in the Global Longitudinal study of Osteoporosis in Women (GLOW).</p></sec><sec id="S2"><title>METHODS</title><p id="P2">This was a multinational, prospective, observational, population-based study carried out by 723 physician practices at 17 sites in 10 countries. A total of 60,393 women aged ≥55 years were included. Data were collected using self-administered questionnaires that covered domains that included patient characteristics, fracture history, risk factors for fracture, and anti-osteoporosis medications.</p></sec><sec id="S3"><title>RESULTS</title><p id="P3">Body mass index (BMI) and fracture history were available at baseline, 1 and 2 years in 44,534 women, 23.4% of whom were obese (BMI ≥30 kg/m<sup>2</sup>). Fracture prevalence in obese women at baseline was 222 per 1,000 and incidence at 2 years was 61.7 per 1,000, similar to rates in non-obese women (227 and 66.0 per 1,000, respectively). Fractures in obese women accounted for 23% and 22% of all previous and incident fractures, respectively. The risk of incident ankle and upper leg fractures was significantly higher in obese than in non-obese women whilst the risk of wrist fracture was significantly lower. Obese women with fracture were more likely to have experienced early menopause and to report two or more falls in the past year. Self-reported asthma, emphysema, and type 1 diabetes were all significantly more common in obese than non-obese women with incident fracture. At 2 years, 27% of obese women with incident fracture were receiving bone-protective therapy, compared with 41% of non-obese and 57% of underweight women.</p></sec><sec id="S4"><title>CONCLUSIONS</title><p id="P4">Our results demonstrate that obesity is not protective against fracture in postmenopausal women and is associated with increased risk of ankle and upper leg fractures. These findings have major public health implications in view of the rapidly rising incidence of obesity. Further studies are required to establish the pathogenesis of fractures in the obese population and to develop effective preventive strategies.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0267200</journal-id><journal-id journal-id-type="pubmed-jr-id">431</journal-id><journal-id journal-id-type="nlm-ta">Am J Med</journal-id><journal-id journal-id-type="iso-abbrev">Am. J. Med.</journal-id><journal-title-group><journal-title>The American journal of medicine</journal-title></journal-title-group><issn pub-type="ppub">0002-9343</issn><issn pub-type="epub">1555-7162</issn></journal-meta><article-meta><article-id pub-id-type="pmid">22017783</article-id><article-id pub-id-type="pmc">4897773</article-id><article-id pub-id-type="doi">10.1016/j.amjmed.2011.06.013</article-id><article-id pub-id-type="manuscript">NIHMS786578</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Obesity is Not Protective Against Fracture in Postmenopausal Women: GLOW</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Compston</surname><given-names>Juliet E.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Watts</surname><given-names>Nelson B.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Chapurlat</surname><given-names>Roland</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Cooper</surname><given-names>Cyrus</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Boonen</surname><given-names>Steven</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Greenspan</surname><given-names>Susan</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>Pfeilschifter</surname><given-names>Johannes</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">g</xref></contrib><contrib contrib-type="author"><name><surname>Silverman</surname><given-names>Stuart</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A8">h</xref></contrib><contrib contrib-type="author"><name><surname>Díez-Pérez</surname><given-names>Adolfo</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A9">i</xref></contrib><contrib contrib-type="author"><name><surname>Lindsay</surname><given-names>Robert</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A10">j</xref></contrib><contrib contrib-type="author"><name><surname>Saag</surname><given-names>Kenneth G.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A11">k</xref></contrib><contrib contrib-type="author"><name><surname>Netelenbos</surname><given-names>J. Coen</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A12">l</xref></contrib><contrib contrib-type="author"><name><surname>Gehlbach</surname><given-names>Stephen</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A13">m</xref></contrib><contrib contrib-type="author"><name><surname>Hooven</surname><given-names>Frederick H.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A13">m</xref></contrib><contrib contrib-type="author"><name><surname>Flahive</surname><given-names>Julie</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A13">m</xref></contrib><contrib contrib-type="author"><name><surname>Adachi</surname><given-names>Jonathan D.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A14">n</xref></contrib><contrib contrib-type="author"><name><surname>Rossini</surname><given-names>Maurizio</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A15">o</xref></contrib><contrib contrib-type="author"><name><surname>LaCroix</surname><given-names>Andrea Z.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A16">p</xref></contrib><contrib contrib-type="author"><name><surname>Roux</surname><given-names>Christian</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A17">q</xref></contrib><contrib contrib-type="author"><name><surname>Sambrook</surname><given-names>Philip N.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A18">r</xref></contrib><contrib contrib-type="author"><name><surname>Siris</surname><given-names>Ethel S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A19">s</xref></contrib><on-behalf-of>for the GLOW Investigators</on-behalf-of></contrib-group><aff id="A1"><label>a</label>Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK</aff><aff id="A2"><label>b</label>Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA</aff><aff id="A3"><label>c</label>INSERM Research Unit 831, Université de Lyon, Department of Orthopedics and Rheumatology, Hôpital E Herriot, Lyon, France</aff><aff id="A4"><label>d</label>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, and Norman Collisson Chair of Musculoskeletal Sciences, University of Oxford, Oxford, UK</aff><aff id="A5"><label>e</label>Leuven University Center for Metabolic Bone Diseases and Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium</aff><aff id="A6"><label>f</label>University of Pittsburgh, Pittsburgh, Pennsylvania, USA</aff><aff id="A7"><label>g</label>Alfried Krupp Krankenhaus, Department of Internal Medicine III, Essen, Germany</aff><aff id="A8"><label>h</label>Cedars-Sinai Medical Center, Los Angeles, California, USA</aff><aff id="A9"><label>i</label>Hospital del Mar-IMIM-Autonomous University of Barcelona, and RETICEF, Instituto Carlos III, Barcelona, Spain</aff><aff id="A10"><label>j</label>Columbia University, and Regional Bone Center, Helen Hayes Hospital, West Haverstraw, New York, USA</aff><aff id="A11"><label>k</label>University of Alabama-Birmingham, Division of Clinical Immunology and Rheumatology, Birmingham, Alabama, USA</aff><aff id="A12"><label>l</label>Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands</aff><aff id="A13"><label>m</label>Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA</aff><aff id="A14"><label>n</label>St Joseph’s Healthcare, McMaster University, Hamilton, Ontario, Canada</aff><aff id="A15"><label>o</label>Department of Rheumatology, University of Verona, Ospedale, Verona, Valeggio, Italy</aff><aff id="A16"><label>p</label>Fred Hutchinson Cancer Research Center, Seattle, Washington, USA</aff><aff id="A17"><label>q</label>Paris Descartes University, Cochin Hospital, Paris, France</aff><aff id="A18"><label>r</label>University of Sydney-Royal North Shore Hospital, St. Leonards, Sydney, New South Wales, Australia</aff><aff id="A19"><label>s</label>Columbia University Medical Center, New York, USA</aff><author-notes><corresp id="FN1">Correspondence should be addressed to Professor Juliet E. Compston, Professor of Bone Medicine and Honorary Consultant Physician, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 157, Cambridge, CB2 2QQ, UK., Tel: +44 122 333 6867; Fax: +44 1223 336846, <email>jec1001@cam.ac.uk</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>14</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>11</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>08</day><month>6</month><year>2016</year></pub-date><volume>124</volume><issue>11</issue><fpage>1043</fpage><lpage>1050</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.amjmed.2011.06.013</pmc-comment>
<abstract><sec id="S1"><title>OBJECTIVE</title><p id="P1">To investigate the prevalence and incidence of clinical fractures in obese, postmenopausal women enrolled in the Global Longitudinal study of Osteoporosis in Women (GLOW).</p></sec><sec id="S2"><title>METHODS</title><p id="P2">This was a multinational, prospective, observational, population-based study carried out by 723 physician practices at 17 sites in 10 countries. A total of 60,393 women aged ≥55 years were included. Data were collected using self-administered questionnaires that covered domains that included patient characteristics, fracture history, risk factors for fracture, and anti-osteoporosis medications.</p></sec><sec id="S3"><title>RESULTS</title><p id="P3">Body mass index (BMI) and fracture history were available at baseline, 1 and 2 years in 44,534 women, 23.4% of whom were obese (BMI ≥30 kg/m<sup>2</sup>). Fracture prevalence in obese women at baseline was 222 per 1,000 and incidence at 2 years was 61.7 per 1,000, similar to rates in non-obese women (227 and 66.0 per 1,000, respectively). Fractures in obese women accounted for 23% and 22% of all previous and incident fractures, respectively. The risk of incident ankle and upper leg fractures was significantly higher in obese than in non-obese women whilst the risk of wrist fracture was significantly lower. Obese women with fracture were more likely to have experienced early menopause and to report two or more falls in the past year. Self-reported asthma, emphysema, and type 1 diabetes were all significantly more common in obese than non-obese women with incident fracture. At 2 years, 27% of obese women with incident fracture were receiving bone-protective therapy, compared with 41% of non-obese and 57% of underweight women.</p></sec><sec id="S4"><title>CONCLUSIONS</title><p id="P4">Our results demonstrate that obesity is not protective against fracture in postmenopausal women and is associated with increased risk of ankle and upper leg fractures. These findings have major public health implications in view of the rapidly rising incidence of obesity. Further studies are required to establish the pathogenesis of fractures in the obese population and to develop effective preventive strategies.</p></sec></abstract><kwd-group><kwd>Fractures</kwd><kwd>Obesity</kwd><kwd>Postmenopausal</kwd><kwd>Osteoporosis</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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