Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool.
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McCloskey Eugene V, Johansson Helena, Liu Enwu, Åkesson Kristina E, Anderson Fred A, Azagra-Ledesma Rafael, Bager Cecilie L, Beaudart Charlotte, Bischoff-Ferrari Heike A, Biver Emmanuel, Bruyère Olivier, Cauley Jane A, Center Jacqueline R, Chapurlat Roland, Christiansen Claus, Cooper Cyrus, Crandall Carolyn J, Cummings Steven R, da Silva José A P, Dawson-Hughes Bess, Diez-Perez Adolfo, Dufour Alyssa B, Eisman John A, Elders Petra J M, Ferrari Serge, Fujita Yuki, Fujiwara Saeko, Glüer Claus-Christian, Goldshtein Inbal, Goltzman David, Gudnason Vilmundur, Hall Jill, Hans Didier, Hoff Mari, Hollick Rosemary J, Huisman Martijn, Iki Masayuki, Ish-Shalom Sophia, Jones Graeme, Karlsson Magnus K, Khosla Sundeep, Kiel Douglas P, Koh Woon-Puay, Koromani Fjorda, Kotowicz Mark A, Kröger Heikki, Kwok Timothy, Lamy Olivier, Langhammer Arnulf, Larijani Bagher, Lippuner Kurt, Mellström Dan, McGuigan Fiona E A, Merlijn Thomas, Nguyen Tuan V, Nordström Anna, Nordström Peter, O Neill Terence W, Obermayer-Pietsch Barbara, Ohlsson Claes, Orwoll Eric S, Pasco Julie A, Rivadeneira Fernando, Schei Berit, Schott Anne-Marie, Shiroma Eric J, Siggeirsdottir Kristin, Simonsick Eleanor M, Sornay-Rendu Elisabeth, Sund Reijo, Swart Karin M A, Szulc Pawel, Tamaki Junko, Torgerson David J, van Schoor Natasja M, van Staa Tjeerd P, Vila Joan, Wareham Nicholas J, Wright Nicole C, Yoshimura Noriko, Zillikens M Carola, Zwart Marta, Schini Marian, Vandenput Liesbeth, Harvey Nicholas C, Lorentzon Mattias, Leslie William D, Kanis John A
Аннотация
PURPOSE: We have undertaken a meta-analysis of international prospective cohorts to quantify the relationship between a family history of fracture and future fracture incidence.
METHODS: The analysis dataset comprised 350,542 men and women from 42 cohorts in 29 countries followed for 2.8 million person-years. We investigated the relationship between family history of hip fracture or any fracture and the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture alone using an extended Poisson model in each cohort. Models were adjusted for current age, sex, BMD, and follow-up time.
RESULTS: As no difference in influence of family history of fracture was seen between genders, results are presented for men and women combined. A parental history of hip fracture was associated with a higher risk of incident fracture across all fracture outcome categories, with a stronger relationship with future hip fracture (hazard ratios (HR, 95% CI) for hip and MOF 1.37, 1.23-1.52 and 1.19, 1.12-1.27, respectively). Associations were slightly reduced but remained significant when additionally adjusted for BMD and did not vary by baseline offspring age, follow-up time, or parent affected. In a more limited analysis, parental history of any fracture or a sibling history of hip or any fracture showed similar associations to those observed with parental history of hip fracture.
CONCLUSIONS: A family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. While parental hip fracture appears the strongest factor for future hip fracture, a family history of other fractures might be appropriate for inclusion in future iterations of the FRAX tool.