The relationship between anthropometric measurements and fractures in women

In a population-based, retrospective study involving postmenopausal women, we investigated the relation between fracture prevalence (risk) and present as well as previous body height and weight. A questionnaire was mailed to 46,353 postmenopausal women aged 50-80 years and there were 29,802 (64.3%) responses. Questions were asked about body height and weight and fractures after the age of 25 and at what year they had occurred. The fractures were grouped according to whether they had occurred within 5 years or 10 years prior to responding to the questionnaire. Main outcome was relative risk (RR) of having sustained a fracture of the hip, radius, or spine within 5 years or within 10 years prior to responding to the questionnaire. RRs for hip and spine fractures were negatively associated with current body mass index, current weight, and weight gain since the age of 25 years. Moreover, the RRs of these fractures were positively associated with current height, height at the age of 25, and height loss since the age of 25 years, with the exception of fracture of the spine and current height. RRs for radius fracture were negatively associated with current body mass index and height loss since the age of 25. Moreover, the RRs for radius fracture were positively associated with current weight and height, weight gain since the age of 25, and weight and height at the age of 25. Height at the age of 25 was a consistent risk factor for all fracture types. The RR of the highest quartile (greatest height) vs. the lowest was 2.5 for having a hip fracture during the past 5 years and 2.3 during the past 10 years, which corresponds to a RR of 1.4 for an increase in 1 SD (5.4 cm) in height at age 25. The RR for spine fracture increased about fivefold in women having sustained > or = 3 cm height reduction compared with those who had maintained height. We conclude that tall women have a greater relative risk of experiencing fragility fractures. By using height, women at risk of a later fracture can be selected already at the age of 25 years for later follow-up. Height loss, being strongly associated with fragility fractures, indicates the presence of an already existing osteoporotic condition that should receive evaluation and treatment.