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- Title
Older Men With Anemia Have Increased Fracture Risk Independent of Bone Mineral Density.
- Authors
Valderrábano, Rodrigo J; Lee, Jennifer; Lui, Li-Yung; Hoffman, Andrew R; Cummings, Steven R; Orwoll, Eric S; Wu, Joy Y; Osteoporotic Fractures in Men (MrOS) Study Research Group
- Abstract
<bold>Context: </bold>Extremely low hemoglobin (Hgb) values have been linked to increased fracture risk at different sites. However, careful assessment of clinically defined anemia and fracture risk is lacking.<bold>Objective: </bold>To determine whether men with anemia were at increased risk of fracture after accounting for bone mineral density (BMD) and bone loss.<bold>Design: </bold>Cross-sectional analysis (at visit 3) and prospective analysis (from baseline to visit 3) in the Osteoporotic Fractures in Men (MrOS), a multisite, longitudinal cohort study.<bold>Setting: </bold>Six communities in the United States.<bold>Participants: </bold>A total of 3632 community-dwelling men (age ≥65 years) in MrOS at baseline (2000 through 2002) who were able to walk unassisted, did not have hip replacement or fracture, and had complete blood cell counts at visit 3 (2007 through 2009).<bold>Outcomes: </bold>Adjudicated spine and nonspine fractures during a median 7.2 years of follow-up.<bold>Results: </bold>Analytic baseline characteristics associated with fractures or anemia (defined as Hgb <12 g/dL) were included in multivariable models. Anemia was associated with increased risk of any fracture [hazard ratio (HR), 1.67; 95% confidence interval (CI), 1.26 to 2.21] and nonspine fracture (HR, 1.70; 95% CI, 1.25 to 2.31). A model including change in BMD slightly attenuated the association with any (HR, 1.60; 95% CI, 1.20 to 2.13) and nonspine fractures (HR, 1.57; 95% CI, 1.14 to 2.15). Including absolute BMD did not significantly alter the anemia-fracture association. Anemia was not associated with spine fracture.<bold>Conclusions: </bold>Community-dwelling older men with anemia had a 57% to 72% increase in nonspine fracture risk independent of BMD and bone loss.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2017, pN.PAG
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2017-00266