The association between alcohol consumption and risk of hip fracture differs by age and gender in Cohort of Norway: a NOREPOS study
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The association between alcohol consumption and hip fracture differed by gender: Men aged 30–59 years drinking frequently or 14+ gl/week had higher risk than moderate drinkers. No significant association was seen in older men. Women not drinking alcohol had higher risk than those drinking moderately both regarding frequency and amount.
We aimed to examine alcohol consumption and risk of hip fracture according to age and gender in the population-based Cohort of Norway (1994–2003).
Socio-demographics, lifestyle, and health were self-reported and weight and height were measured in 70,568 men and 71,357 women ≥ 30 years. Information on subsequent hip fractures was retrieved from hospitals’ electronic patient registries during 1994–2013. Frequency of alcohol consumption was categorized: never/seldom, moderate (≤ 2–3 times/week), or frequent (≥ 4 times/week), and amount as number of glasses per week: 0, 1–6, 7–13, 14–27, and 28+. Type of alcohol (wine vs. beer/hard liquor) was also examined. Cox’s proportional hazards regression was used to estimate hazard ratios (HRs) stratified on gender and baseline age < 60 and ≥ 60 years.
During median 15-year follow-up, 1558 men and 2511 women suffered a hip fracture. Using moderate drinkers as reference, men < 60 years drinking frequently had multivariable adjusted HR = 1.73 (CI 1.02–2.96) for hip fracture and more than 2.5 times higher risk if they consumed 14+ glasses compared to 1–6 glasses per week. In other groups of age and gender, no statistically significant increased risk was found in those consuming the highest levels of alcohol. Compared to women with moderate or frequent alcohol use, never/seldom-drinking women had the highest fracture risk. In women, use of wine was associated with lower fracture risk than other types of alcohol.
Risk of hip fracture was highest in men < 60 years with the highest frequency and amount of alcohol consumption and in non-drinking women.
KeywordsAge Alcohol consumption Amount Frequency Gender Hip fracture
The authors wish to acknowledge the services of CONOR and the contributing research centers delivering data to CONOR. The authors are deeply grateful to Tomislav Dimoski (Norwegian Institute of Public Health (NIPH), the Statistics Norway, the Norwegian Patient Register, and the staff at the Department of Pharmacoepidemiology (Norwegian Institute of Public Health—NIPH) contributing to the collection and encryption of the hip fracture data. Professor Aage Tverdal (NIPH) has generously managed the original project. Sincere thanks also to senior scientist Ståle Østhus (NIPH) for valuable guiding into the practical methods of calculating amount of alcohol consumption. We also want to acknowledge the other members of NOREPOS Research Group: Professor Nina Emaus, Consultant and Associate professor Guri Grimnes, Professor Berit Schei, Professor Siri Forsmo, Consultant Ellen Apalset, and Post doc Cecilie Dahl.
Compliance with ethical standards
Cohort of Norway and linkages between the data sources were approved by the Regional Committee for Medical and Health Research Ethics (region South-East) and the Norwegian Data Protection Authority. All participants in the CONOR study gave their written informed consent. The CONOR steering committee approved the project. The study has been conducted in full accordance with the Declaration of Helsinki of the World Medical Association
Conflicts of interest
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