The variation in BMD is determined by multiple factors, including genetic and environmental factors 4, 5. Thus, osteoporosis has been operationally defined in terms of BMD 2, 3. Therefore, BMD is one of the most important predictors of fracture each standard deviation (SD) reduction in BMD is associated with 2-fold increase in the risk of fracture 3. The variation in BMD can account for up to 60% of the variance in bone strength 2.
Bone strength is primarily reflected by bone mineral density (BMD), which is measured by the dual-energy X-ray absorptiometry (DXA) technology. The disease affects more than 30% women and 15% men aged 50 years and older 1. Osteoporosis is a common metabolic bone disorder characterized by reduced bone strength and increased fracture risk.
These data suggest that unhealthy lifestyle habits are associated with an increased risk of fracture in men, but not in women, and that the association is mediated by BMD. However, in women, the association was uncertain (HR 1.30 95% CI, 1.11 to 1.53). In men, each unit lower in LRS was associated with a 66% increase in the risk of total fracture (non-adjusted hazard ratio 1.66 95% CI, 1.26 to 2.20) and still significant after adjusting for age, weight or BMD. In either men or women, individuals with a fracture had a significantly lower age-adjusted LRS than those without a fracture. Baseline values of lifestyle factors were assessed. Each individual had a unique LRS, with higher scores being associated with a healthier lifestyle. A “lifestyle risk score” (LRS) was derived as the weighted sum of effects of dietary calcium intake, physical activity index, and cigarette smoking.
The incidence of new fractures was ascertained by X-ray reports. The study involved 1683 women and 1010 men (50+ years old, followed up for up to 20 years). In this study, we sought to define the contribution of lifestyle factors to fracture risk by using a profiling approach. Fragility fracture and bone mineral density (BMD) are influenced by common and modifiable lifestyle factors.
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