risk factors for fractures

Understanding fracture risk is an important area of research for a rapidly aging, fracture-prone population. Published in the BMJ, Trajanoska and colleagues searched for genetic risk factors for fractures.

 

The risk of fracturing bones increases significantly in older people, but some individuals are at higher risk of fracture than others. Fractures in old age can lead to significantly decreased quality of life as individuals experience pain, difficulty moving, and difficulty recovering. Identifying risk factors for fractures will help inform preventative care strategies in a rapidly aging population.

In a new study published in the BMJ, Trajanoska and colleagues investigated the genetic risk factors for fractures. To do so, they employed a genome-wide association study (GWAS) approach. In GWAS, the entire genomes of people affected by a particular condition are compared to those of people who are not affected. Any gene variants shared by affected individuals, but not by unaffected individuals, are linked to the condition.

The researchers used a sample of 37,857 individuals who had experienced fracture and compared them to 227,116 individuals who had not, then verified the findings in another group of 147,200 individuals with fractures and 150,085 controls. All individuals were obtained from a global sample from the Genetic Factor for Osteoporosis consortium, GEFOS, and were primarily from Europe, North America, and Australia.

The researchers found15 locations on the genome that were associated with fracture risk. All were at or near genes that had previously been linked to bone mineral density. Other potential risk factors, such as grip strength and vitamin D, were not found to be significantly linked to fracture risk.

The results indicate that there is a significant genetic component to the risk factors for fractures and that other factors, such as exercise and vitamin D status, may not be as important as previously thought. This agrees with previous results showing no links between vitamin D and calcium supplementation and fracture risk. The genes identified in this study and their effects represent potential targets for future drugs.

The results also highlight the relationship between bone mineral density, osteoporosis risk, and fracture risk, and suggest a mechanism by which early menopause in women is tied to all three factors. Together, this information can help doctors devise more comprehensive approaches to diminishing fracture risk.

Written by C.I. Villamil

Reference: Trajanoska et al. 2018. Assessment of the genetic and clinical determinants of fracture risk (…) BMJ 362:k3225.

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