Older Men with Anemia Have Increased Fracture Risk Independent of Bone Mineral Density.

Older Men with Anemia Have Increased Fracture Risk Independent of Bone Mineral Density.

J Clin Endocrinol Metab. 2017 Mar 20;:

Authors: Valderrábano RJ, Lee J, Lui LY, Hoffman AR, Cummings SR, Orwoll ES, Wu JY, Osteoporotic Fractures in Men (MrOS) Study Research Group

Abstract
Context: Extreme low hemoglobin values have been linked to increased risk of fracture at different sites in a small number of studies. However, careful assessment of a clinically relevant cutoff for anemia and cross sectional and longitudinal bone mineral density (BMD) measures is lacking.
Objective: To determine whether men with anemia were at increased risk of fracture after accounting for bone density and bone loss.
Design: Cross-sectional analysis (at visit 3) and prospective analysis (from baseline to visit 3) in the Osteoporotic Fractures in Men (MrOS), a multi-site longitudinal cohort study.
Setting: 6 communities in the U.S.
Participants: 3632 community-dwelling men (>65 years) in MrOS at baseline (2000-2002) who were able to walk without assistance and did not have a hip replacement or fracture and had complete blood counts (CBCs) at visit 3 (2007-2009).
Outcomes: Adjudicated spine and non-spine fractures during a median 7.2 years follow up.
Results: Analytic baseline characteristics associated with fractures or anemia (Hgb < 12g/dL) were included into multivariable models. Anemia was associated with increased risk of any (HR 1.67; 95% CI 1.26-2.21) and non-spine (HR 1.70; 95% CI 1.25-2.31) fractures. A model including change in BMD slightly attenuated the association with any (HR 1.60; 95% CI 1.20-2.13) and non-spine fractures (HR 1.57; 95% CI 1.14-2.15). Including absolute BMD did not significantly alter the anemia-fracture association. Anemia was not associated with spine fracture.
Conclusions: Community-dwelling older men with anemia had a 57-72% increase in non-spine fracture risk independent of bone density and bone loss over time.

PMID: 28368469 [PubMed - as supplied by publisher]

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