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Published in: Osteoporosis International 5/2015

01-05-2015 | Original Article

Fracture incidence in a large cohort of men age 30 years and older with osteoporosis

Authors: A. D. Manthripragada, C. D. O’Malley, U. Gruntmanis, J. W. Hall, R. B. Wagman, P. D. Miller

Published in: Osteoporosis International | Issue 5/2015

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Abstract

Summary

In this large retrospective study of men with presumed osteoporosis, we estimate the rate of osteoporosis-related fractures in men age ≥30 years. Our results suggest that spine and hip fractures continue to be a considerable disease burden for osteoporotic men of all ages.

Introduction

The purposes of this study were to describe a cohort of men with presumed osteoporosis and estimate the incidence rates of fractures by age.

Methods

Using US administrative claims data, we identified 43,813 men ≥30 years old with an osteoporosis diagnosis or use of an osteoporosis medication. Men were followed for a minimum of 12 months after diagnosis or treatment of osteoporosis (index date), until the earliest of fracture (hip, spine, pelvis, distal femur, humerus, wrist, forearm), disenrollment, or study end date.

Results

During the study period, there were 3834 first fractures following the index date and 3303 fractures in the 6-month period prior to the diagnosis/treatment of osteoporosis. Incidence rates of osteoporosis-related fracture, estimated from the index date onward, increased with age, although did not significantly differ from one another in younger age groups (30–49 and 50–64 years). Spine fractures had the highest incidence rate in men across all age groups, increasing from 10.8 per 100,000 person-years (p-yrs) (95 % confidence interval (CI) 9.1, 12.7), 12.2 per 100,000 p-yrs (95 % CI 11.2, 13.3), and 15.3 per 100,000 p-yrs (95 % CI 13.8, 16.9) in men 30–49, 50–64, and 65–74 years to 33.4 per 100,000 p-yrs (95 % CI 31.5, 35.4) in men ≥75 years. Hip fractures were the second most common, with the incidence rate reaching 16.2 per 100,000 (95 % CI 14.9, 17.6) in the ≥75-year group.

Conclusion

These incidence rates suggest that spine and hip fractures are a considerable disease burden for men of all ages diagnosed and/or treated for osteoporosis.
Literature
1.
go back to reference Consensus Development Statement (1997) Who are candidates for prevention and treatment for osteoporosis? Osteoporos Int 7(1):1–6CrossRef Consensus Development Statement (1997) Who are candidates for prevention and treatment for osteoporosis? Osteoporos Int 7(1):1–6CrossRef
2.
go back to reference Curtis JR, Adachi JD, Saag KG (2009) Bridging the osteoporosis quality chasm. J Bone Miner Res 24(1):3–7CrossRefPubMed Curtis JR, Adachi JD, Saag KG (2009) Bridging the osteoporosis quality chasm. J Bone Miner Res 24(1):3–7CrossRefPubMed
3.
4.
go back to reference Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733CrossRefPubMed Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733CrossRefPubMed
5.
go back to reference Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(2):S3–S7, ReviewCrossRefPubMed Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(2):S3–S7, ReviewCrossRefPubMed
6.
go back to reference Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521CrossRefPubMed Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521CrossRefPubMed
7.
go back to reference Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390CrossRefPubMedCentralPubMed Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390CrossRefPubMedCentralPubMed
8.
go back to reference Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579CrossRefPubMed Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579CrossRefPubMed
9.
go back to reference Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD (1997) Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma 11(3):162–165CrossRefPubMed Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD (1997) Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma 11(3):162–165CrossRefPubMed
10.
go back to reference Di Monaco M, Castiglioni C, Vallero F, Di Monaco R, Tappero R (2012) Men recover ability to function less than women do: an observational study of 1094 subjects after hip fracture. Am J Phys Med Rehabil 91(4):309–315CrossRefPubMed Di Monaco M, Castiglioni C, Vallero F, Di Monaco R, Tappero R (2012) Men recover ability to function less than women do: an observational study of 1094 subjects after hip fracture. Am J Phys Med Rehabil 91(4):309–315CrossRefPubMed
11.
go back to reference Seeman E, Bianchi G, Khosla S, Kanis JA, Orwoll E (2006) Bone fragility in men—where are we? Osteoporos Int 17(11):1577–1583CrossRefPubMed Seeman E, Bianchi G, Khosla S, Kanis JA, Orwoll E (2006) Bone fragility in men—where are we? Osteoporos Int 17(11):1577–1583CrossRefPubMed
12.
go back to reference Larijani B, Hossein-Nezhad A, Mojtahedi A, Pajouhi M, Bastanhagh MH, Soltani A, Mirfezi SZ, Dashti R (2005) Normative data of bone mineral density in healthy population of Tehran, Iran: a cross sectional study. BMC Musculoskelet Disord 2:6–38 Larijani B, Hossein-Nezhad A, Mojtahedi A, Pajouhi M, Bastanhagh MH, Soltani A, Mirfezi SZ, Dashti R (2005) Normative data of bone mineral density in healthy population of Tehran, Iran: a cross sectional study. BMC Musculoskelet Disord 2:6–38
13.
go back to reference Lynn HS, Lau EM, Au B, Leung PC (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporos Int 16(12):1663–1668CrossRefPubMed Lynn HS, Lau EM, Au B, Leung PC (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporos Int 16(12):1663–1668CrossRefPubMed
14.
go back to reference Pérez-Castrillón JL, Martín-Escudero JC, del Pino-Montes J, Blanco FS, Martín FJ, Paredes MG, Fernández FP, Arés TA (2005) Prevalence of osteoporosis using DXA bone mineral density measurements at the calcaneus: cut-off points of diagnosis and exclusion of osteoporosis. J Clin Densitom 8(4):404–408CrossRefPubMed Pérez-Castrillón JL, Martín-Escudero JC, del Pino-Montes J, Blanco FS, Martín FJ, Paredes MG, Fernández FP, Arés TA (2005) Prevalence of osteoporosis using DXA bone mineral density measurements at the calcaneus: cut-off points of diagnosis and exclusion of osteoporosis. J Clin Densitom 8(4):404–408CrossRefPubMed
15.
go back to reference Richy F, Gourlay ML, Garrett J, Hanson L, Reginster JY (2004) Osteoporosis prevalence in men varies by the normative reference. J Clin Densitom 7(2):127–133CrossRefPubMed Richy F, Gourlay ML, Garrett J, Hanson L, Reginster JY (2004) Osteoporosis prevalence in men varies by the normative reference. J Clin Densitom 7(2):127–133CrossRefPubMed
16.
go back to reference Melton LJ 3rd, Atkinson EJ, O'Connor MK, O'Fallon WM, Riggs BL (1998) Bone density and fracture risk in men. J Bone Miner Res 13(12):1915–1923CrossRefPubMed Melton LJ 3rd, Atkinson EJ, O'Connor MK, O'Fallon WM, Riggs BL (1998) Bone density and fracture risk in men. J Bone Miner Res 13(12):1915–1923CrossRefPubMed
17.
go back to reference Schneeweiss S, Avorn J (2005) A review of uses of health care utilization databases for epidemiologic research on therapeutics. J Clin Epidemiol 58:323–337CrossRefPubMed Schneeweiss S, Avorn J (2005) A review of uses of health care utilization databases for epidemiologic research on therapeutics. J Clin Epidemiol 58:323–337CrossRefPubMed
18.
go back to reference MarketScan® Research Databases User Guide and Database Dictionary Commercial Claims and Encounters (2007) Medicare Supplemental and Coordination of Benefits. Data Year Edition MarketScan® Research Databases User Guide and Database Dictionary Commercial Claims and Encounters (2007) Medicare Supplemental and Coordination of Benefits. Data Year Edition
19.
go back to reference Adamson DM, Chang S, Hansen LG (2008) Health research data for the real world: the Marketscan databases. Thompson Healthcare, New York Adamson DM, Chang S, Hansen LG (2008) Health research data for the real world: the Marketscan databases. Thompson Healthcare, New York
20.
go back to reference Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619CrossRefPubMed Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619CrossRefPubMed
21.
go back to reference Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34(1):195–202CrossRefPubMed Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34(1):195–202CrossRefPubMed
22.
go back to reference Melton LJ 3rd, Crowson CS, O'Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int 9(1):29–37CrossRefPubMed Melton LJ 3rd, Crowson CS, O'Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int 9(1):29–37CrossRefPubMed
23.
go back to reference Freitas SS, Barrett-Connor E, Ensrud KE, Fink HA, Bauer DC, Cawthon PM, Lambert LC, Orwoll ES, Osteoporotic Fractures in Men (MrOS) Research Group (2008) Rate and circumstances of clinical vertebral fractures in older men. Osteoporos Int 19(5):615–623CrossRefPubMed Freitas SS, Barrett-Connor E, Ensrud KE, Fink HA, Bauer DC, Cawthon PM, Lambert LC, Orwoll ES, Osteoporotic Fractures in Men (MrOS) Research Group (2008) Rate and circumstances of clinical vertebral fractures in older men. Osteoporos Int 19(5):615–623CrossRefPubMed
24.
go back to reference Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10(3):240–247CrossRefPubMed Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10(3):240–247CrossRefPubMed
25.
go back to reference Singer BR, McLauchlan GJ, Robinson CM, Christie J (1998) Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Jt Surg Br 80(2):243–248CrossRef Singer BR, McLauchlan GJ, Robinson CM, Christie J (1998) Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Jt Surg Br 80(2):243–248CrossRef
26.
go back to reference Cooper C, O'Neill T, Silman A (1993) The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 14(1):S89–S97, ReviewCrossRefPubMed Cooper C, O'Neill T, Silman A (1993) The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 14(1):S89–S97, ReviewCrossRefPubMed
27.
go back to reference Mackey DC, Lui LY, Cawthon PM, Bauer DC, Nevitt MC, Cauley JA, Hillier TA, Lewis CE, Barrett-Connor E, Cummings SR, Study of Osteoporotic Fractures (SOF) and Osteoporotic Fractures in Men Study (MrOS) Research Groups (2007) High-trauma fractures and low bone mineral density in older women and men. JAMA 298(20):2381–2388CrossRefPubMed Mackey DC, Lui LY, Cawthon PM, Bauer DC, Nevitt MC, Cauley JA, Hillier TA, Lewis CE, Barrett-Connor E, Cummings SR, Study of Osteoporotic Fractures (SOF) and Osteoporotic Fractures in Men Study (MrOS) Research Groups (2007) High-trauma fractures and low bone mineral density in older women and men. JAMA 298(20):2381–2388CrossRefPubMed
28.
go back to reference Melton LJ 3rd (2008) Does high-trauma fracture increase the risk of subsequent osteoporotic fracture? Nat Clin Pract Endocrinol Metab 4(6):316–317PubMed Melton LJ 3rd (2008) Does high-trauma fracture increase the risk of subsequent osteoporotic fracture? Nat Clin Pract Endocrinol Metab 4(6):316–317PubMed
29.
go back to reference Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE (2004) Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int 15(10):767–778CrossRefPubMed Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE (2004) Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int 15(10):767–778CrossRefPubMed
30.
go back to reference Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162(19):2217–2222CrossRefPubMed Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162(19):2217–2222CrossRefPubMed
31.
go back to reference National Center for Injury Prevention and Control.Recommended Actions to Improve External-Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems. Atlanta, GA (2009). US Department of Health and Human Services, Centers for Disease Control and Prevention; December National Center for Injury Prevention and Control.Recommended Actions to Improve External-Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems. Atlanta, GA (2009). US Department of Health and Human Services, Centers for Disease Control and Prevention; December
32.
go back to reference Strategies to Improve External Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems (2008) Recommendations of the CDC Workgroup for Improvement of External Cause-of-Injury Coding. MMWR: Morbidity and Mortality Weekly Report 28, March Strategies to Improve External Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems (2008) Recommendations of the CDC Workgroup for Improvement of External Cause-of-Injury Coding. MMWR: Morbidity and Mortality Weekly Report 28, March
33.
go back to reference Cuddihy MT, Gabriel SE, Crowson CS, O'Fallon WM, Melton LJ 3rd (1999) Forearm fractures as predictors of subsequent osteoporotic fractures. Osteoporos Int 9(6):469–475CrossRefPubMed Cuddihy MT, Gabriel SE, Crowson CS, O'Fallon WM, Melton LJ 3rd (1999) Forearm fractures as predictors of subsequent osteoporotic fractures. Osteoporos Int 9(6):469–475CrossRefPubMed
34.
go back to reference Lindau TR, Aspenberg P, Arner M, Redlundh-Johnell I, Hagberg L (1999) Fractures of the distal forearm in young adults An epidemiologic description of 341 patients. Acta Orthop Scand 70(2):124–128CrossRefPubMed Lindau TR, Aspenberg P, Arner M, Redlundh-Johnell I, Hagberg L (1999) Fractures of the distal forearm in young adults An epidemiologic description of 341 patients. Acta Orthop Scand 70(2):124–128CrossRefPubMed
35.
go back to reference Melton LJ 3rd, Amadio PC, Crowson CS, O'Fallon WM (1998) Long-term trends in the incidence of distal forearm fractures. Osteoporos Int 8(4):341–348CrossRefPubMed Melton LJ 3rd, Amadio PC, Crowson CS, O'Fallon WM (1998) Long-term trends in the incidence of distal forearm fractures. Osteoporos Int 8(4):341–348CrossRefPubMed
36.
go back to reference Melton LJ 3rd, Sampson JM, Morrey BF, Ilstrup DM (1981) Epidemiologic Features of Pelvic Fractures. Clinical Orthopaedics and Related Res. Mar-Apr (155): 43–47. Melton LJ 3rd, Sampson JM, Morrey BF, Ilstrup DM (1981) Epidemiologic Features of Pelvic Fractures. Clinical Orthopaedics and Related Res. Mar-Apr (155): 43–47.
37.
go back to reference Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382CrossRefPubMed Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382CrossRefPubMed
38.
go back to reference Langsetmo L, Goltzman D, Kovacs CS, Adachi JD, Hanley DA, Kreiger N, Josse R, Papaioannou A, Olszynski WP, Jamal SA, CaMos Research Group (2009) Repeat low-trauma fractures occur frequently among men and women who have osteopenic BMD. J Bone Miner Res 24(9):1515–1522CrossRefPubMed Langsetmo L, Goltzman D, Kovacs CS, Adachi JD, Hanley DA, Kreiger N, Josse R, Papaioannou A, Olszynski WP, Jamal SA, CaMos Research Group (2009) Repeat low-trauma fractures occur frequently among men and women who have osteopenic BMD. J Bone Miner Res 24(9):1515–1522CrossRefPubMed
39.
go back to reference Center JR, Bliuc D, Nguyen TV, Eisman JA (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394CrossRefPubMed Center JR, Bliuc D, Nguyen TV, Eisman JA (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394CrossRefPubMed
40.
go back to reference Briot K, Cortet B, Trémollières F, Sutter B, Thomas T, Roux C, Audran M, ComitéScientifique du GRIO (2009) Male osteoporosis: diagnosis and fracture risk evaluation. Joint Bone Spine 76(2):129–133CrossRefPubMed Briot K, Cortet B, Trémollières F, Sutter B, Thomas T, Roux C, Audran M, ComitéScientifique du GRIO (2009) Male osteoporosis: diagnosis and fracture risk evaluation. Joint Bone Spine 76(2):129–133CrossRefPubMed
41.
go back to reference Audran M, Cortet B (2009) Prevalence of Osteoporosis in Male Patients with Risk Factors. J Bone Miner Res 24 (Suppl 1) Audran M, Cortet B (2009) Prevalence of Osteoporosis in Male Patients with Risk Factors. J Bone Miner Res 24 (Suppl 1)
42.
go back to reference Frost M, Wraae K, Gudex C, Nielsen T, Brixen K, Hagen C, Andersen M (2012) Chronic diseases in elderly men: underreporting and underdiagnosis. Age Ageing 41(2):177–183CrossRefPubMed Frost M, Wraae K, Gudex C, Nielsen T, Brixen K, Hagen C, Andersen M (2012) Chronic diseases in elderly men: underreporting and underdiagnosis. Age Ageing 41(2):177–183CrossRefPubMed
43.
go back to reference Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001) Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 86(2):724–731CrossRefPubMed Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001) Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 86(2):724–731CrossRefPubMed
44.
go back to reference Lix LM, Yogendran MS, Leslie WD, Shaw SY, Baumgartner R, Bowman C, Metge C, Gumel A, Hux J, James RC (2008) Using multiple data features improved the validity of osteoporosis case ascertainment from administrative databases. J Clin Epidemiol 61(12):1250–1260CrossRefPubMed Lix LM, Yogendran MS, Leslie WD, Shaw SY, Baumgartner R, Bowman C, Metge C, Gumel A, Hux J, James RC (2008) Using multiple data features improved the validity of osteoporosis case ascertainment from administrative databases. J Clin Epidemiol 61(12):1250–1260CrossRefPubMed
45.
go back to reference Abelson A, Ringe JD, Gold DT, Lange JL, Thomas T (2010) Longitudinal change in clinical fracture incidence after initiation of bisphosphonates. Osteoporos Int 21(6):1021–1029CrossRefPubMedCentralPubMed Abelson A, Ringe JD, Gold DT, Lange JL, Thomas T (2010) Longitudinal change in clinical fracture incidence after initiation of bisphosphonates. Osteoporos Int 21(6):1021–1029CrossRefPubMedCentralPubMed
Metadata
Title
Fracture incidence in a large cohort of men age 30 years and older with osteoporosis
Authors
A. D. Manthripragada
C. D. O’Malley
U. Gruntmanis
J. W. Hall
R. B. Wagman
P. D. Miller
Publication date
01-05-2015
Publisher
Springer London
Published in
Osteoporosis International / Issue 5/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3035-z

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