Post-menopausal women who unintentionally lose weight face fracture risks much sooner than thought
• Such women need to be assessed promptly for the health of their hips and spine
April 27, 2015, Rotterdam, The Netherlands. Press Dispensary. Recent findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW) show for the first time that post-menopausal women who experience unintentional weight loss are at significant risk of suffering fractures in the next year and so should be assessed within that time – much sooner than is customary.
The findings, and a call for early assessments, were presented today by Cambridge Professor Juliet Compston at ECTS-IBMS 2015, the fourth joint meeting of the European Calcified Tissue Society (ECTS) and the International Bone and Mineral Society (IBMS) in Rotterdam, The Netherlands.
Professor Compston said: “What we’ve found from this study is that post-menopausal women who experience unintentional weight loss need prompt assessment to look at the health of their bones. And women with unintentional bone loss need appropriate management. To wait years for this is to wait too long.
“Typically, forearm and hip fractures are well documented in studies carried out six years after weight loss, whereas we’ve found significant risk of hip and spine fracture within just one year.”
Professor Compston, of Cambridge University Hospitals NHS Foundation Trust in the UK, worked with an 11-strong international GLOW team to investigate the relationship between unintentional weight loss in postmenopausal women and clinical fractures at multiple sites in the year following weight loss. Around 43,000 women were studied, using self-administered questionnaires. The data collected included demographics, medical history, fracture occurrence, medications and weight loss of 10 lb (4.5 kg) or more over the preceding year.
Professor Compston continued: “We found that unintentional weight loss of 10 lb or more was reported the following year by 8.0% of the women studied and by another 7.7% the year after that. We looked at the incidence of fractures and, once the results were adjusted for clinically relevant variables, we saw a significantly increased risk for hip spine, and some other fractures in the year following the unintentional weight loss.”
She concluded: “The speed of this increase in risk has not previously been reported and it shows how such women need to be assessed sooner.”
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Notes for editors
About The European Calcified Tissue Society
The European Calcified Tissue Society (ECTS) is the major organisation in Europe for researchers and clinicians working in the field of calcified tissues and related fields. ECTS acts as a forum for the dissemination of high quality research through its annual meeting, the European Symposium on Calcified Tissues, and through training courses and workshops.
Calcified tissues are central to a healthy skeleton and to bone disorders – such as osteoporosis, back pain and fractures – that make life a misery for countless people. Children can inherit some forms of bone diseases causing bone pain, shortness and deformed limbs.
About the International Bone and Mineral Society (IBMS)
IBMS is the international organization that facilitates the generation and dissemination of knowledge of bone and mineral metabolism through communication, community, training, and multi-disciplinary meetings throughout the world.
About ECTS-IBMS 2015
The fourth Joint Meeting of ECTS and IBMS is taking place in Rotterdam, The Netherlands, on April 25-28, 2015, at the Congress Centre De Doelen.
Recognised as the foremost annual European gathering in the field, ECTS-IBMS 2015 features a broad and stimulating scientific programme addressing the very latest advances, challenges, and developments in bone and calcified tissue. With an international delegation of scientists, clinicians, health care professionals, and researchers in attendance, the Joint Meeting is a unique opportunity to share in the vision of leading experts and discover what the future holds for this fast moving and exciting sector of medical research and practice.
GLOW (Global Longitudinal study of Osteoporosis in Women) is an international cohort study involving 723 physician practices across 10 countries in Europe, North America and Australasia, using self-administered questionnaires.
About the study
The adverse effects of weight loss on bone mineral density in postmenopausal women are well documented, and increased risk of distal forearm and hip fractures has been reported in studies with average follow-up periods of around 6 years after weight loss. The aim of this study was to investigate the effects of unintentional weight loss in postmenopausal women on the incidence of clinical fractures at multiple sites in the year following weight loss.
As part of GLOW, self-administered questionnaires were mailed. Data collected included demographics, medical history, fracture occurrence, medications and weight loss of 10 lb (4.5 kg) or more over the preceding year. Cox models treating weight loss as a time-varying covariate were used to predict fracture in the following survey year, adjusting for factors such as age, prior fracture, co-morbidities and falls previously shown to be associated with the specific fracture.*
Unintentional weight loss of ≥10 lb during the previous 12 months was reported in year 2 by 3405 (8.0%) of 42,756 and in year 3 by 3322 (7.7%) of 43,004 women. After adjustment for clinically relevant variables, a significantly increased risk was seen for hip (HR 1.83, 95% CI 1.25–2.69, p<0.01) and spine fracture (HR 1.46, 95% CI 1.02–2.09, p=0.04) in the year following the unintentional weight loss.
Professor Juliet Compston (Cambridge University Hospitals NHS Foundation Trust, UK) worked with Allison Wyman, Stephen Gehlbach and Gordon FitzGerald (Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA), Nelson Watts (Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA), Ethel Siris (Columbia University Medical Center, New York, USA), J Coen Netelenbos (VU University Medical Center, Amsterdam, Netherlands), Adolfo Díez-Perez (Hospital del Mar-IMIM-Autonomous University of Barcelona, Spain), Cyrus Cooper (University of Southampton, Southampton, UK), Roland Chapurlat (INSERM UMR 1033, Université de Lyon, Lyon, France), Silvano Adami (University of Verona, Italy) and Jonathan Adachi (McMaster University, Hamilton, ON, Canada).
* FitzGerald G. et al. (2012) J Bone Miner Res 27:1907–15.