{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:56:05Z","timestamp":1782219365618,"version":"3.54.5"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The purposes of this study were to examine fracture risk profiles at specific bone sites, and to understand why model discrimination using clinical risk factors is generally better in hip fracture models than in models that combine hip with other bones. Using 3-year data from the GLOW study (54,229 women with more than 4400 total fractures), we present Cox regression model results for 10 individual fracture sites, for both any and first-time fracture, among women aged \u226555 years. Advanced age is the strongest risk factor in hip (hazard ratio [HR]\u2009=\u20092.3 per 10-year increase), pelvis (HR\u2009=\u20091.8), upper leg (HR\u2009=\u20091.8), and clavicle (HR\u2009=\u20091.7) models. Age has a weaker association with wrist (HR\u2009=\u20091.1), rib (HR\u2009=\u20091.2), lower leg (not statistically significant), and ankle (HR\u2009=\u20090.81) fractures. Greater weight is associated with reduced risk for hip, pelvis, spine, and wrist, but higher risk for first lower leg and ankle fractures. Prior fracture of the same bone, although significant in nine of 10 models, is most strongly associated with spine (HR\u2009=\u20096.6) and rib (HR\u2009=\u20094.8) fractures. Past falls are important in all but spine models. Model c indices are \u22650.71 for hip, pelvis, upper leg, spine, clavicle, and rib, but \u22640.66 for upper arm\/shoulder, lower leg, wrist, and ankle fractures. The c index for combining hip, spine, upper arm, and wrist (major fracture) is 0.67. First-time fracture models have c indices ranging from 0.59 for wrist to 0.78 for hip and pelvis. The c index for first-time major fracture is 0.63. In conclusion, substantial differences in risk profiles exist among the 10 bones considered. \u00a9 2012 American Society for Bone and Mineral Research.<\/jats:p>","DOI":"10.1002\/jbmr.1652","type":"journal-article","created":{"date-parts":[[2012,5,2]],"date-time":"2012-05-02T04:53:27Z","timestamp":1335934407000},"page":"1907-1915","source":"Crossref","is-referenced-by-count":43,"title":["Differing risk profiles for individual fracture sites: Evidence from the global longitudinal study of osteoporosis in women (GLOW)"],"prefix":"10.1093","volume":"27","author":[{"given":"Gordon","family":"FitzGerald","sequence":"first","affiliation":[{"name":"Center for Outcomes Research, University of Massachusetts (UMASS) Medical School, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Boonen","sequence":"additional","affiliation":[{"name":"Leuven University Center for Metabolic Bone Diseases, Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet E","family":"Compston","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Pfeilschifter","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Z","family":"LaCroix","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"David W","family":"Hosmer","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research, University of Massachusetts (UMASS) Medical School, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick H","family":"Hooven","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research, University of Massachusetts (UMASS) Medical School, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen H","family":"Gehlbach","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research, University of Massachusetts (UMASS) Medical School, Worcester, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the GLOW Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2012,5,1]]},"reference":[{"key":"2024020318285089600_bib1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s001980170072","article-title":"An assessment tool for predicting fracture risk in postmenopausal 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