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Simon Timpka

Research team manager

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Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age : A Cohort Study Linked to the Swedish National Patient Registry

Author

  • Daniel Prieto-Alhambra
  • Aleksandra Turkiewicz
  • Carlen Reyes
  • Simon Timpka
  • Björn Rosengren
  • Martin Englund

Summary, in English

We aimed to determine the relationship between handgrip strength, smoking, and alcohol consumption in young men and fracture risk at middle age. Thus, we carried out a cohort study including young men undergoing conscription examination in Sweden from September 1969 to May 1970 at a typical age of 18 years. Data on muscle strength, height, weight, and lifestyle factors were linked to the National Patient Register 1987–2010. Handgrip strength was considered the main exposure and smoking and alcohol consumption as secondary exposures. Outcomes were all fractures (except face, skull, digits), major osteoporotic fractures (thoracic/lumbar spine, proximal humerus, distal forearm or hip), and major traumatic fractures (shaft of humerus, forearm, femur, or lower leg) based on ICD-9 and -10 codes. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) according to handgrip strength as a continuous variable (per 1 SD), after adjustment for weight, height, parental education, smoking, and alcohol consumption. A total of 40,112 men were included, contributing 892,572 person-years. Overall, 3974 men fractured in middle age with the incidence rate (95% CI) of 44.5 (43.2–45.9) per 1000 person-years. The corresponding rates were12.2 and 5.6 per 1000 person-years for major osteoporotic and traumatic fractures, respectively. Handgrip strength-adjusted HR (95% CI) was 1.01 (0.98–1.05), 0.94 (0.88–1.00), and 0.98 (0.88–1.08) per SD for all, major osteoporotic, and major traumatic fractures, respectively. Adjusted HR (95% CI) for smokers (>21 cigarettes/d) was 1.44 (1.21, 1.71) for all fractures, while the association between alcohol consumption and hazards of fracture was J-shaped. Therefore, young adult handgrip strength was not associated with fracture risk in middle-age men, although smoking and high alcohol consumption did confer an increased risk.

Department/s

  • Lund OsteoArthritis Division - Clinical Epidemiology Unit
  • Genetic and Molecular Epidemiology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Orthopedics - Clinical and Molecular Osteoporosis Research

Publishing year

2020-03

Language

English

Pages

498-504

Publication/Series

Journal of Bone and Mineral Research

Volume

35

Issue

3

Document type

Journal article

Publisher

AMBMR

Topic

  • Orthopedics
  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • Epidemiology
  • Fracture
  • General population
  • Prevention
  • Skeletal Muscle

Status

Published

Research group

  • Lund OsteoArthritis Division - Clinical Epidemiology Unit
  • Genetic and Molecular Epidemiology
  • Orthopedics - Clinical and Molecular Osteoporosis Research

ISBN/ISSN/Other

  • ISSN: 0884-0431