Height loss in postmenopausal women-do we need more for fracture risk assessment? Results from the GO Study

W Pluskiewicz; P Adamczyk; B Drozdzowska

doi:10.1007/s00198-021-05941-3

Height loss in postmenopausal women-do we need more for fracture risk assessment? Results from the GO Study

Osteoporos Int. 2021 Oct;32(10):2043-2049. doi: 10.1007/s00198-021-05941-3. Epub 2021 Apr 5.

Authors

W Pluskiewicz¹, P Adamczyk², B Drozdzowska³

Affiliations

¹ Department and Clinic of Internal Diseases, Diabetology, and Nephrology, Metabolic Bone Diseases Unit, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 3-Maja 13/15 Street, 41-800 Zabrze, Katowice, Poland. wpluskiewicz@sum.edu.pl.
² Department of Pediatrics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
³ Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.

Abstract

Human body height loss of 3-4 cm or more may be considered a simple indicator of increasing fracture risk, where the information is very similar to the results from fracture risk assessments by available online calculators, all of them based on a multiple variable approaches.

Introduction: The aim of the study was to assess the relationship between body height loss (HL) and fracture risk in postmenopausal women from the Gliwice Osteoporosis (GO) Study.

Methods: The study sample included 1735 postmenopausal women, aged over 55 years and recruited at the Osteoporotic Outpatient Clinic. The mean age of the study participants was 68.15 ± 8.16 years. Fracture risk was established, using the fracture risk assessment tool (FRAX) (10-year probability of major and hip fractures), the Garvan calculator (any and hip fractures, 5 and 10 years) and the Polish (POL-RISK) algorithm, available at www. fracture - risk .pl (any fractures, 5 years). Bone densitometry at the femoral neck was performed, using a Prodigy device (Lunar, GE, USA). Body heights were measured before bone densitometry, using a wall stadiometer and compared with the maximum body heights, measured in early adulthood and reported by the study participants themselves.

Results: In 199 women, the body heights, measured during the study, did not change in comparison to their corresponding values in early adulthood, while being decreased in the other 1536 women. The mean height loss (HL) in the whole study group was 3.95 ± 3.24 cm. That HL correlated significantly with the calculated fracture risk (the r range from 0.13 to 0.39, p < 0.0001). In general, regarding the patients with fracture risk close to the recommended therapeutic thresholds, HL was around 3-4 cm, except of the values from the FRAX calculator for major fractures, where the commonly used therapeutic threshold (20%) was related to HL of approximately 6.5 cm. In subjects with HL between 3.5 and 4 cm (n = 208), the FRAX value for major fractures was 6.83 ± 3.74.

Conclusions: Body height measurements, carried out to establish HL, provide an important information for clinical practice, where HL of 3-4 cm or more may be considered a simple indicator of increasing fracture risk.

Keywords: FRAX; Fracture risk; Garvan; Height loss; POL-RISK.

MeSH terms

Adult
Aged
Bone Density
Female
Hip Fractures*
Humans
Middle Aged
Osteoporosis*
Osteoporosis, Postmenopausal* / complications
Osteoporosis, Postmenopausal* / epidemiology
Osteoporotic Fractures* / epidemiology
Osteoporotic Fractures* / etiology
Postmenopause
Risk Assessment
Risk Factors