In the Journals

Parental hip fracture predicts fracture risk in adult offspring

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May 5, 2016

Adults are at higher risk for major osteoporotic fracture if one of their parents experienced a hip fracture, particularly if that fracture occurred at a younger age, according to recent study findings.

In a historical cohort study, William Leslie, MD, MSc, FRCPC, professor of medicine and radiology at the University of Manitoba in Winnipeg, Manitoba, Canada, and colleagues analyzed data from all Manitoba residents aged at least 40 years between 1997 and 2014 with continuous health care coverage and linkage to at least one parent through the publicly funded health care insurance database (261,705 offspring; 48.3% women; 478,792 parents). Researchers identified parental hip fracture and age at fracture through hospital records from 1970 to 2014; major osteoporotic fractures in offspring were identified from hospital records and physician billing claims from 1984 onward (high trauma fractures were excluded).

William Leslie

William Leslie

During more than 2.9 million person-years of follow-up, 7,323 adults experienced a major osteoporotic fracture, including 331 incident hip fractures. Of those, 4.4% had a parent who experienced an incident hip fracture. Researchers found that parental hip fracture was independently associated with increased risk for major osteoporotic fracture in offspring after multivariable adjustment (HR = 1.3; 95% CI, 1.2-1.41). Results were similar for men (adjusted HR = 1.26; 95% CI, 1.12-1.43) and women (adjusted HR = 1.32; 95% CI, 1.19-1.46).

Researchers found that the association between major osteoporotic fracture in offspring and parental hip fracture was strongest when parental hip fracture occurred before age 70 years (adjusted HR = 1.5; 95% CI, 1.3-1.73), with the association decreasing with age and becoming nonsignificant for parental hip fracture at age 80 years or older.

“An accurate family history can help to identify individuals at higher risk for osteoporotic fractures,” Leslie told Endocrine Today. “For individuals using the WHO fracture risk assessment (FRAX) tool to estimate fracture risk, age of parental hip fracture may be an important new piece of information to consider.”

Leslie said the study provides proof of concept that familial associations can be studied using administrative data, thereby avoiding the recall bias that can affect self-report.

“This opens to door to using objectively verified family information ascertained from health-record linkage for the study of other familial disorders and familial relationships,” Leslie said. by Regina Schaffer

For more information:

William Leslie, MD , MSc , FRCPC, can be reached at the University of Manitoba, 66 Chancellors Circle, Winnipeg, MB R3T 2N2, Canada; email: bleslie@sbgh.mb.ca.

Disclosure: Leslie reports receiving speakers’ fees from Amgen, Eli Lilly and Novartis, and has received research grants from Amgen and Genzyme.

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