Predictors of osteoporotic fracture in postmenopausal women: a meta-analysis
J Orthop Surg Res. 2023 Aug 5;18(1):574. doi: 10.1186/s13018-023-04051-6
Guanghua Long 1, Chong Liu 1, Tuo Liang 1, Zide Zhang 1, Zhaojie Qin 1, Xinli Zhan 2
Osteoporosis affects more than 200 million women worldwide, with postmenopausal women being particularly susceptible to this condition and its severe sequelae disproportionately, such as osteoporotic fractures. To date, the current focus has been more on symptomatic treatment, rather than preventive measures. To address this, we performed a meta-analysis aiming to identify potential predictors of osteoporotic fractures in postmenopausal women, with the ultimate goal of identifying high-risk patients and exploring potential therapeutic approaches. We searched Embase, MEDLINE and Cochrane with search terms (postmenopausal AND fracture) AND ("risk factor" OR "predictive factor") in May 2022 for cohort and case-control studies on the predictors of osteoporotic fracture in postmenopausal women.
Ten studies with 1,287,021 postmenopausal women were found eligible for analyses, in which the sample size ranged from 311 to 1,272,115. The surveyed date spanned from 1993 to 2021.
Our results suggested that
| Factor | VitaminDWiki observation |
| age | associated with low Vitamin D |
| BMI | associated with low Vitamin D |
| senior high school and above | |
| parity ≥ 3 | associated with low Vitamin D |
| history of hypertension | associated with low Vitamin D |
| history of diabetes mellitus | associated with low Vitamin D |
| history of alcohol intake | associated with low Vitamin D |
| age at menarche ≥ 15 | |
| age at menopause < 40 | |
| age at menopause > 50 | |
| estrogen use and | |
| vitamin D supplements | People rarely supplement with enough |
were significantly associated with osteoporotic fracture in postmenopausal women.
Our findings facilitate the early prediction of osteoporotic fracture in postmenopausal women and may contribute to potential therapeutic approaches. By focusing on preventive strategies and identifying high-risk individuals, we can work toward reducing the burden of osteoporosis-related fractures in this vulnerable population.
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Vitamin D use may indicate a prevention strategy, which was associated with an increased risk of any nonvertebral fracture [38]. It is likely that more individuals may take vitamin D if they have a deficiency, leading to the association between vitamin D use and increased fracture risk. Our analysis also showed that vitamin D use is a risk factor of osteoporotic fracture in postmenopausal women. Two important UK studies have not shown positive effect of vitamin D and calcium supplementation on the free-living elderly women’s fracture prevention [74, 75]. This discrepancy in findings highlights the complexity of the relationship between vitamin D use and fracture risk, and further research is needed to better understand this association.
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Reduce fracture if: Mg, Vitamin K1, Sunshine, Vitamin D, and improve Receptor
- Hip fractures greatly reduced by sunshine, vitamin D, and vitamin K – meta-analysis Sept 2012
- Hip fractures reduced 2X to 6X with just 10 minutes of sunlight daily – RCT 2003-2010
- Fractures 1.5 X more-likely if low serum Magnesium – meta-analysis March 2023
- Hip fractures requiring hospitalization cut in half by Vitamin K1 (100 mcg per day) – Sept 2022
- Osteoporosis Risk varies with Vitamin D Receptor – three meta-analyses in 2020
- Osteoporosis 2.8 X more likely if Vitamin D receptor (VDR) genes altered – Aug 2013