Older men with anaemia prone to fracture independent of BMD
Older men with anaemia have a 57- to 72-percent increased risk of nonspine fracture independent of bone mineral density (BMD) and bone loss, reports a new study performed in six communities in the United States.
Researchers conducted a prospective analysis (from baseline to visit 3) and a cross-sectional analysis (at visit 3) in the Osteoporotic Fracture in Men—a multisite, longitudinal cohort study—involving a total of 3,632 community-dwelling men (aged ≥65 years) 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).
The main outcome measures were adjudicated spine and nonspine fractures during a median follow-up of 7.2 years. Multivariable models included analytic baseline characteristics associated with fractures or anaemia (defined as haemoglobin <12 g/dL).
An association existed between anaemia and increased risk of any fracture (hazard ratio [HR], 1.67; 95 percent CI, 1.26 to 2.21) and nonspine fracture (HR, 1.70; 1.25 to 2.31). A model including change in BMD slightly weakened the association with any (HR, 1.60; 1.20 to 2.13) and nonspine fractures (HR, 1.57; 1.14 to 2.15).
On the other hand, inclusion of the absolute BMD showed no significant change in the association between anaemia and fracture. Furthermore, there was no association between anaemia and spine fracture.
“Extremely low hemoglobin values have been linked to increased fracture risk at different sites. However, careful assessment of clinically defined anemia and fracture risk is lacking,” researchers noted.