This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: [10.1002/jbmr.2016]
Risk factors for fracture in middle- and older-age men of African descent
Copyright © 2013 American Society for Bone and Mineral Research
Disclosure: All authors state that they have no conflicts of interest.
- Accepted manuscript online: 15 JUN 2013 06:12AM EST
- Manuscript Accepted: 3 JUN 2013
- Manuscript Revised: 17 MAY 2013
- Manuscript Received: 8 MAR 2013
- Cited By
- General population study;
- fracture prevention;
Although fracture rates are lower in individuals of African descent compared to individuals of European ancestry, morbidity and mortality following a fracture may be greater in African ancestry individuals. However, fracture risk and associated clinical risk factors have not been well-defined among African ancestry populations, especially among African ancestry men. We used data collected from the Tobago Bone Health Study to examine potential clinical risk factors for incident fractures including demographic information, anthropometric measurements, medical history, lifestyle factors, bone mineral density (BMD) and hip structural geometry. Among 1,933 Afro-Caribbean men aged ≥40 years at study entry (mean age: 57.2 ± 11.0 years), 65 reported at least one new fracture during 10 years of subsequent follow-up. Younger age, mixed Afro-Caribbean ancestry, prior fracture history, BMD and hip structural geometry were statistically significant risk factors for incident fractures. One Standard deviation change in several skeletal parameters (hip BMD, cross-sectional area, outer diameter, cortical thickness and buckling ratio) were each associated with a 35% to 56% increase in incident fracture risk after adjusting for age. Men with a prior fracture history were 3 times more likely to experience a new fracture during follow-up, and the association remained strong after adjusting for age, mixed Afro-Caribbean ancestry and skeletal parameters (hazard ratios ranged 2.72–2.82). Our findings suggest that except for age, risk factors for fracture in men of African ancestry are similar to established risk factors in Caucasian populations. Prior fracture history is a powerful and independent risk factor for incident fractures among African ancestry men and could easily be incorporated into clinical risk evaluation.