| Title: | Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool |
| Journal: | Osteoporosis International |
| Published: | 23 Aug 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40848065/ |
| DOI: | https://doi.org/10.1007/s00198-025-07607-w |
Publication 19681
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Abstract
In the largest meta-analysis of international cohorts to date, a family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. Parental and sibling histories of fracture carry the same significance for future fracture, including the impact of family hip fracture on future hip fracture risk.PurposeWe have undertaken a meta-analysis of international prospective cohorts to quantify the relationship between a family history of fracture and future fracture incidence.MethodsThe analysis dataset comprised 350,542 men and women from 42 cohorts in 29 countries followed for 2.8 million person-years. We investigated the relationship between family history of hip fracture or any fracture and the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture alone using an extended Poisson model in each cohort. Models were adjusted for current age, sex, BMD, and follow-up time.ResultsAs no difference in influence of family history of fracture was seen between genders, results are presented for men and women combined. A parental history of hip fracture was associated with a higher risk of incident fracture across all fracture outcome categories, with a stronger relationship with future hip fracture (hazard ratios (HR, 95% CI) for hip and MOF 1.37, 1.23-1.52 and 1.19, 1.12-1.27, respectively). Associations were slightly reduced but remained significant when additionally adjusted for BMD and did not vary by baseline offspring age, follow-up time, or parent affected. In a more limited analysis, parental history of any fracture or a sibling history of hip or any fracture showed similar associations to those observed with parental history of hip fracture.ConclusionsA family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. While parental hip fracture appears the strongest factor for future hip fracture, a family history of other fractures might be appropriate for inclusion in future iterations of the FRAX tool.</p>
10 Keywords
- Aged
- Bone Density
- Female
- Hip Fractures
- Humans
- Incidence
- Male
- Middle Aged
- Osteoporotic Fractures
- Risk Assessment
88 Authors
- Eugene V. McCloskey
- Helena Johansson
- Enwu Liu
- Kristina E. Åkesson
- Fred A. Anderson
- Rafael Azagra-Ledesma
- Cecilie L. Bager
- Charlotte Beaudart
- Heike A. Bischoff-Ferrari
- Emmanuel Biver
- Olivier Bruyère
- Jane A. Cauley
- Jacqueline R. Center
- Roland Chapurlat
- Claus Christiansen
- Cyrus Cooper
- Carolyn J. Crandall
- Steven R. Cummings
- José A. P. da Silva
- Bess Dawson-Hughes
- Adolfo Diez-Perez
- Alyssa B. Dufour
- John A. Eisman
- Petra J. M. Elders
- Serge Ferrari
- Yuki Fujita
- Saeko Fujiwara
- Claus-Christian Glüer
- Inbal Goldshtein
- David Goltzman
- Vilmundur Gudnason
- Jill Hall
- Didier Hans
- Mari Hoff
- Rosemary J. Hollick
- Martijn Huisman
- Masayuki Iki
- Sophia Ish-Shalom
- Graeme Jones
- Magnus K. Karlsson
- Sundeep Khosla
- Douglas P. Kiel
- Woon-Puay Koh
- Fjorda Koromani
- Mark A. Kotowicz
- Heikki Kröger
- Timothy Kwok
- Olivier Lamy
- Arnulf Langhammer
- Bagher Larijani
- Kurt Lippuner
- Dan Mellström
- Fiona E. A. McGuigan
- Thomas Merlijn
- Tuan V. Nguyen
- Anna Nordström
- Peter Nordström
- Terence W. O´Neill
- Barbara Obermayer-Pietsch
- Claes Ohlsson
- Eric S. Orwoll
- Julie A. Pasco
- Fernando Rivadeneira
- Berit Schei
- Anne-Marie Schott
- Eric J. Shiroma
- Kristin Siggeirsdottir
- Eleanor M. Simonsick
- Elisabeth Sornay-Rendu
- Reijo Sund
- Karin M. A. Swart
- Pawel Szulc
- Junko Tamaki
- David J. Torgerson
- Natasja M. van Schoor
- Tjeerd P. van Staa
- Joan Vila
- Nicholas J. Wareham
- Nicole C. Wright
- Noriko Yoshimura
- M. Carola Zillikens
- Marta Zwart
- Marian Schini
- Liesbeth Vandenput
- Nicholas C. Harvey
- Mattias Lorentzon
- William D. Leslie
- John A. Kanis
1 Application
| Application ID | Title |
|---|---|
| 3593 | Osteoporosis, fractures and cardiovascular risk |
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