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. 2018 Apr;29(4):927-935.
doi: 10.1007/s00198-017-4363-y. Epub 2018 Jan 27.

Lower risk of hip fractures among Swedish women with large hips?

S Klingberg  1   2 , K Mehlig  3 , V Sundh  3   4 , B L Heitmann  5   6   7 , L Lissner  3
Affiliations

Lower risk of hip fractures among Swedish women with large hips?

S Klingberg et al. Osteoporos Int. 2018 Apr.

Abstract

In women, a large hip circumference (HC) related to lower hip fracture risk, independent of age and regardless if HC was measured long before or closer to the fracture. In older women, body mass index (BMI) explained the protection.

Introduction: In postmenopausal women, HC has been suggested to inversely associate with hip fracture while this has not been investigated in middle-aged women. We examined the association between HC, measured at two different time points, and hip fracture in a Swedish female population-based sample monitored for incident hip fractures over many years.

Methods: Baseline HC, measured in 1968 or 1974 (n = 1451, mean age 47.6 years), or the HC measures that were the most proximal before event or censoring (n = 1325, mean age 71.7 years), were used to assess the effects of HC on hip fracture risk in women participating in the Prospective Population Study of Women in Gothenburg. HC was parameterized as quintiles with the lowest quintile (Q1) as reference. Incident hip fractures over 45 years of follow-up (n = 257) were identified through hospital registers.

Results: Higher quintiles of HC at both baseline and proximal to event were inversely associated with hip fracture risk in age-adjusted models, but only baseline HC predicted hip fractures independently of BMI and other covariates (HR (95% CI) Q2, 0.85 (0.56-1.27); Q3, 0.59 (0.36-0.96); Q4, 0.57 (0.34-0.96); Q5, 0.58 (0.31-1.10)).

Conclusions: A large HC is protective against hip fracture in midlife and in advanced age, but the association between proximal HC and hip fracture was explained by concurrent BMI suggesting that padding was not the main mechanism for the association. The independent protection seen in middle-aged women points to other mechanisms influencing bone strength.

Keywords: Body mass index; Hip circumference; Hip fractures; Longitudinal.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Hazard ratio (HR) for proximal hip circumference in relation to risk of hip fractures at different levels of adjustment (n cases/total, 232/1326). Dark line represents HR. Dotted lines represent 95% confidence interval for the HR. Reference value for hip circumference was set at mean hip circumference (101 cm). aTest for curvature P = 0.65, test for overall significance P = 0.003, test for linearity P < 0.001. bTest for curvature P = 0.50, test for overall significance P = 0.55, test for linearity P = 0.39. cTest for curvature P = 0.31, test for overall significance P = 0.29, test for linearity P = 0.24
Fig. 2
Fig. 2
Hazard ratio (HR) for baseline hip circumference in relation to risk of hip fractures (n cases/total, 257/1452) and fractures at other sites (n cases/total, 331/1421). Models were adjusted for baseline values of age, BMI categories, height, smoking, leisure time physical activity, and hormone replacement therapy. Dark line represents HR. Dotted lines represent 95% confidence interval for the HR. Reference value for hip circumference was set at mean hip circumference (100 cm). aTest for curvature P = 0.49, test for overall significance P = 0.09, test for linearity P < 0.05. bTest for curvature P = 0.07, test for overall significance P = 0.07, test for linearity P = 0.20
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References

    1. Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C, Epidemiology IOFWGo, Quality of L A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012;23(9):2239–2256. doi: 10.1007/s00198-012-1964-3. - DOI - PMC - PubMed
    1. Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M. Complications of hip fractures: a review. World J Orthop. 2014;5(4):402–411. doi: 10.5312/wjo.v5.i4.402. - DOI - PMC - PubMed
    1. Santesso N, Carrasco-Labra A, Brignardello-Petersen R. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev. 2014;3:CD001255. - PMC - PubMed
    1. Johansson H, Kanis JA, Oden A, McCloskey E, Chapurlat RD, Christiansen C, Cummings SR, Diez-Perez A, Eisman JA, Fujiwara S, Gluer CC, Goltzman D, Hans D, Khaw KT, Krieg MA, Kroger H, LaCroix AZ, Lau E, Leslie WD, Mellstrom D, Melton LJ, 3rd, O'Neill TW, Pasco JA, Prior JC, Reid DM, Rivadeneira F, van Staa T, Yoshimura N, Zillikens MC. A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res. 2014;29(1):223–233. doi: 10.1002/jbmr.2017. - DOI - PubMed
    1. Tang X, Liu G, Kang J, Hou Y, Jiang F, Yuan W, Shi J. Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. PLoS One. 2013;8(4):e55077. doi: 10.1371/journal.pone.0055077. - DOI - PMC - PubMed

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