Respiratory function as a marker of bone health and fracture risk in an older population.

TitleRespiratory function as a marker of bone health and fracture risk in an older population.
Publication TypeJournal Article
Year of Publication2009
AuthorsMoayyeri, A, Bingham, SA, Luben, RN, Wareham, NJ, Khaw, K-T
JournalJ Bone Miner Res
Date Published2009 May
KeywordsAdult, Aged, Aged, 80 and over, Bone and Bones, Europe, Female, Forced Expiratory Volume, Fractures, Bone, Health, Hip Fractures, Humans, Male, Middle Aged, Prognosis, Proportional Hazards Models, Regression Analysis, Risk Factors, Ultrasonography

Identification of those at high risk of osteoporosis and fractures using clinically available tests beyond BMD measures is a major clinical challenge. We examined forced expiratory volume in 1 s (FEV1), an easily obtainable measure of respiratory function, as a clinical measure for fracture prediction. In the context of the European Prospective Investigation into Cancer-Norfolk Study, 8304 women and 6496 men 42-81 yr of age underwent a health check including spirometry and heel quantitative ultrasonography between 1997 and 2000 and were followed up for incident hip fractures until 2007. The main outcome measures were broadband ultrasound attenuation (BUA) of the heel (cross-sectional analysis) and hip fracture risk (prospective analysis). In multivariate regression models, a 1-liter increase in FEV1 was associated with a statistically significant 2.2-dB/MHz increase in BUA, independent of age, smoking, height, body mass index, history of fracture, and use of corticosteroids. Mean FEV1 was significantly lower among 84 women and 36 men with hip fracture compared with other participants. In multivariate proportional-hazard regression models, the relative risk (RR) of hip fracture associated with a 1-liter increase in FEV1 was 0.5 (95% CI, 0.3-0.9; p < 0.001) for both men and women. RR of hip fracture for a 1 SD increase in FEV1 was approximately equivalent to a 0.5 SD increase in BUA among women (1 SD among men) and an 5-yr decrease in age among both men and women. Middle-aged and older people with low respiratory function are at increased risk of osteoporosis and hip fracture. FEV1, an easy, low-cost, and feasible clinical measure, may help improve the identification of high-risk groups.

Alternate JournalJ. Bone Miner. Res.
Citation Key10.1359/jbmr.081231
PubMed ID19402201
Grant ListMC_U105630924 / / Medical Research Council / United Kingdom
MC_U106179471 / / Medical Research Council / United Kingdom
/ / British Heart Foundation / United Kingdom
/ / Cancer Research UK / United Kingdom