As the mean age of the US population increases, the public health burden of osteoporotic fractures is expected to increase. This study prospectively examined the independent association of hip circumference with hip fracture.
The prospective association of hip circumference and hip fracture was examined in a cohort of 30,652 postmenopausal women.
Compared to the lowest quintile, successive quintiles of hip circumference were associated with a reduced hazard of hip fracture over 18 years of follow-up (HRs = 1.00, 0.78, 0.74, 0.76, 0.69, p for trend = 0.0015) after adjusting for age. Controlling for waist, this association persisted (HRs = 1.00, 0.78, 0.73, 0.72, 0.54, p for trend = 0.0006). Additionally controlling for BMI, the association of hip fracture with hip circumference was attenuated to the null while the association with successive quintiles of BMI remained significant and inverse (HRs = 1.00, 0.55, 0.45, 0.40, 0.35, p for trend <0.0001).
Although hip circumference has a strong inverse association with risk of hip fracture, this association was not independent of BMI. These results suggest that in the prediction of hip fracture risk, overall body size may be more important than body composition of the femoral-gluteal region.