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Risk factors for 5-year prospective height loss among postmenopausal women

Mai, Xiaodan, PhD1; Marshall, Britt, MD2; Hovey, Kathleen M., MS1; Sperrazza, Jill, MD3; Wactawski-Wende, Jean, PhD1

doi: 10.1097/GME.0000000000001108
Original Articles

Objective: Height loss is common in older women and has been associated with increased morbidity and mortality. In this study, we identified factors that could predict prospective height loss in postmenopausal women.

Methods: Height was measured in 1,024 postmenopausal women, enrolled in the Buffalo Osteoporosis and Periodontal Disease Study, at baseline and 5 years later using a fixed stadiometer. Demographics, lifestyle, medical history, and medication use were assessed at baseline. Stepwise logistic regression was used to identify factors that are associated with marked height loss of ≥1 inch. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for each predictor. Receiver-operating characteristic (ROC) curve was performed to determine the discriminatory ability of the prediction model.

Results: The mean loss of height was 0.4 (SD 0.7) inches. Age (OR 1.11, 95% CI 1.06-1.16), weight (OR 1.05, 95% CI 1.03-1.07), use of oral corticosteroids (OR 4.96, 95% CI 1.25-19.72), and strenuous exercise at age 18 ≥ three times per week (OR 0.55, 95% CI 0.31-0.98) were significantly associated with marked height loss in the multivariable-adjusted model. The area under the ROC curve is 72.1%. Addition of bone mineral density measures did not improve the discriminatory ability of the prediction model.

Conclusions: This set of available variables may be useful in predicting the 5-year risk of height loss of 1 inch or more in postmenopausal women. These findings may help to target older women at risk of height loss who may benefit most from prevention strategies for fracture and mortality.

1Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY

2Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA

3Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.

Address correspondence to: Jean Wactawski-Wende, University at Buffalo, 410 Kimball Tower, Buffalo, NY 14214. E-mail: jww@buffalo.edu

Received 21 December, 2017

Revised 26 February, 2018

Accepted 26 February, 2018

Funding/support: This study was supported by grant R01DE013505 from the National Institute of Dental and Craniofacial Research, National Institutes of Health (NIH), Bethesda, MD, to Dr Wactawski-Wende, US Army, Medical Research and Materiel Command, Fort Detrick, MD, Grant OS950077, and National Heart, Lung, and Blood Institute (NIH) contracts N01WH32122, HHSN268201100001C, and HHSN268201600001C (Women's Health Initiative) to Dr Wactawski-Wende. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through contracts, HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.

Financial disclosure/conflicts of interest: None reported.

© 2018 by The North American Menopause Society.