This article is about the finding that fractures tend to reoccur. A study looked at 88,696 individuals who underwent a first DXA scan between 1996 and 2018. Researchers followed these participants for 9 years. During these 9 years of observation the following was noted:
- 6% of participants had any kind of fracture
- 14% had osteoporotic fractures
- 6% had a severe osteoporotic (non-ankle) fracture
- 5% had a hip fracture
- The hazard ratios for future fractures were similar between the age group of 20 to 29 and 80 years and older. The risk for a second fracture was between 1.51-fold and 2.12-fold.
The findings of the study were summarized here:
More details regarding the study
The mean age at the first DXA study to look for bone density was 64.6 years. 90.3% were women. The mean body mass index was 27.4 kg/m2. 10.1% of the cohort were smokers. 5.5% of the cohort had a history of prolonged glucocorticoid use. 3.1% were suffering from rheumatoid arthritis. And 14.9% of patients had a secondary cause of osteoporosis.
Why are there fracture risks?
Carrie Ye, MD, presented the study at the American Society for Bone and Mineral Research (ASBMR) at their 2023 Annual Meeting. It took place on October 13-16, 2023 at the Vancouver Convention Centre in Vancouver, BC, Canada. She stated that when physicians send younger patients for a DXA study, the reason is to rule out osteoporosis. They may have underlying Crohn’s disease or had steroid therapy for rheumatological conditions. Fracture risk has an association with a decrease in body mass density (BMD). Other risks are cigarette smoking or a body mass index above 25.0. Women have a risk of 9:1 compared to men to develop low bone mass density. Dr. Ye is an assistant professor and rheumatologist at the University of Alberta, Edmonton.
What should physicians do?
- Carrie Ye advised: “Don’t ignore prior fractures, even if they occurred at an early age. I think if someone has had a fracture, they ought to have a fracture risk assessment, and that doesn’t mean necessarily a DXA scan. It means you go through their other risk factors: What medications are they on? Do they have a family history? Are they super low BMI? Look at other reasons why you should be worried about their bones, and if you should be worried about their bones, certainly [measure their] BMD and see what’s going on.”
- Vitamin D3, calcium, magnesium and vitamin K2 can lead to improved calcification of bones preventing osteoporosis. By using this vitamin/mineral combination you avoid the side effects of common osteoporosis medication.
- Regular exercise in addition to calcium supplementation can improve osteoporosis and reduce the danger of fractures in people with osteoporotic bones.
Conclusion
A recent study involved 88,696 people. They all had a baseline fracture and were followed for 9 years. Many subjects had a second fracture later in life. A second fracture occurred when they had Crohn’s disease or had steroid therapy for a rheumatological condition. A decreased body mass density (BMD), smoking, and a body mass index above 25.0 were other risk factures. Women have a risk of 9:1 compared to men to develop low bone mass density. How can you prevent low bone mass density in bones? First of all, you need to engage in a regular exercise program. Second, taking supplements of vitamin D3, calcium, magnesium and vitamin K2 prevents osteoporosis. This way you can avoid the toxic side effects of regular osteoporosis medication. Finally, check-ups of your bone density on various occasions gives you more information.