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Risk factors for fractures among Japanese-American men: The Honolulu Heart Program and Honolulu–Asia Aging Study

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Abstract

Summary

Baseline risk factors were associated with fractures that developed after 29–31 years among Japanese-American men. Hip fracture risk increased with increasing BMI (28% increase for 1 U increase), physical activity (7% increase for 1 U increase), and was decreased with increasing arm girth (27% decrease for 1 U increase).

Purpose

The objective of this study was to identify risk factors among Japanese-American men aged 45–68 years at baseline that were associated with prevalence and incidence of fractures at advanced age.

Methods

We used baseline information from Honolulu Heart Program (HHP) and Honolulu–Asia Aging Study (HAAS). The HHP was a prospective study with primary focus on risk factors for cardiovascular disease. A cohort of 8,006 men of Japanese ancestry aged 45–68 years residing on Oahu was recruited in 1965 and followed for 31 years. The HAAS started in 1991 in conjunction with the HHP with a focus on age-related health conditions. Self-reported hip, spine, and forearm fracture prevalence was ascertained in 1991–1993 among 3,845 men aged 71–93 years. Incidence was obtained during the period (1994–1999) among 2,737 men aged 74–98 years. Poisson regression models were used to determine multi-variable adjusted prevalence and incidence ratios for fracture.

Results

Incident hip fracture was directly associated with baseline body mass index (BMI) and physical activity, and inversely associated with left upper arm girth. Incident spine fracture was directly associated with baseline age. Prevalent hip fracture was directly associated with baseline pack-years of smoking. Prevalent spine fracture was inversely associated with baseline education, and directly associated with standing height and use of medication for diabetes. Prevalent forearm fracture was inversely associated with baseline age, and directly associated with education.

Conclusions

Results indicated that multiple baseline demographic lifestyle and anthropometric characteristics predict fracture risk at advanced age. In addition, associations varied by fracture location.

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Acknowledgments

This study has been supported by the Intramural Research Program of the National Institutes of Health, National Institute on Aging (grants U01 AG019349 and R01 AG0-17155 S1), and National Heart, Lung, and Blood Institute (grant N01 HC05102).

The authors gratefully acknowledge the contributions of Ka-On Fong (data deriving) and Mr. Ja Kook Gu and Ms. Anna Mnatsakanova (statistical programming). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health or any other government agencies, and no official endorsement should be inferred.

Conflicts of interest

None.

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Authors and Affiliations

  1. Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS: L-4050, 1095 Willowdale Rd, Morgantown, WV, 26505-2888, USA

    Claudia C. Ma, Cecil M. Burchfiel, Desta Fekedulegn & Michael E. Andrew

  2. Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, 1960 East–West Rd., Honolulu, HI, 96822, USA

    John Grove & Yuanan Lu

  3. Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala, Suite 406, Honolulu, HI, 96813, USA

    John Grove

  4. Honolulu Heart Program, Kuakini Medical Center, 347 North Kuakini Street, HPM-9, Honolulu, HI, 96817, USA

    Bradley Willcox, Kamal H. Masaki, J. David Curb & Beatriz L. Rodriguez

  5. Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, 347 N. Kuakini Street, HPM9, Honolulu, HI, 96817, USA

    Bradley Willcox, Kamal H. Masaki, J. David Curb & Beatriz L. Rodriguez

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  1. Claudia C. Ma
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  2. Cecil M. Burchfiel
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  3. John Grove
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  6. Michael E. Andrew
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  7. Bradley Willcox
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  10. Beatriz L. Rodriguez
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Correspondence to Claudia C. Ma.

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Ma, C.C., Burchfiel, C.M., Grove, J. et al. Risk factors for fractures among Japanese-American men: The Honolulu Heart Program and Honolulu–Asia Aging Study. Arch Osteoporos 6, 197–207 (2011). https://doi.org/10.1007/s11657-011-0068-6

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  • DOI: https://doi.org/10.1007/s11657-011-0068-6

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