ArticleThe Journal of clinical endocrinology and metabolism2023
Hemoglobin Levels Improve Fracture Risk Prediction in Addition to FRAX Clinical Risk Factors and Bone Mineral Density.
Article in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Association between anaemia and osteoporosis: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Hip Fragility Fractures: One Or Two Pathologies? A Systematic Review and Meta-Analysis of Demographic, Diagnostic and Therapeutic Aspects.Aging and disease · 2025Pooled it
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- Article
- The systemic inflammation response index is independently associated with incident fracture risk in older women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Fracture risk assessment in patients with ileal urinary diversion after radical cystectomy: a comprehensive evaluation integrating bone mineral density, trabecular bone score, and FRAX®.Archives of osteoporosis · 2026Article
- Construction and validation of a nomogram predictive model for safety-related influencing factors in unilateral paracentesis kyphoplasty for spinal compression fractures.European journal of medical research · 2026Article
- How prevalent is osteoporosis in a high-risk subgroup? A multicenter study of postmenopausal women hospitalized for fractures in China.BMC musculoskeletal disorders · 2026Article
- Underweight Status is Associated with Prevalent Anemia in Postmenopausal Women with Osteoporotic Vertebral Compression Fractures: A Cross-Sectional Study.Clinical interventions in aging · 2026Article
- Prediction of hip fracture by high-resolution peripheral quantitative computed tomography in older Swedish women.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Red cell distribution width: a potential marker of reduced femoral neck bone mineral density in men and postmenopausal women.Endocrine · 2025Article
- Association between serum hemoglobin level and bone mineral density in adults: Iranian multi-center osteoporosis study (IMOS).Archives of osteoporosis · 2025Article
- Sex differences in hemoglobin levels and five-year refracture risk in patients with osteoporotic fractures: a retrospective cohort analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Hemoglobin is associated with BMDs and risk of the 10-year probability of fractures in patients with type 2 diabetes mellitus.Frontiers in endocrinology · 2024Article
Corrections and comments
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Authors and funding
11 authors at 7 institutions in 3 countries.
Funding
Abstract
contextAnemia and decreasing levels of hemoglobin (Hb) have previously been linked to increased fracture risk, but the added value to FRAX, the most utilized fracture prediction tool worldwide, is unknown.
objectiveTo investigate the association between anemia, Hb levels, bone microstructure, and risk of incident fracture and to evaluate whether Hb levels improve fracture risk prediction in addition to FRAX clinical risk factors (CRFs).
methodsA total of 2778 community-dwelling women, aged 75-80 years, and part of a prospective population-based cohort study in Sweden were included. At baseline, information on anthropometrics, CRFs, and falls was gathered, blood samples were collected, and skeletal characteristics were investigated using dual-energy x-ray absorptiometry and high-resolution peripheral quantitative computed tomography. At the end of follow-up, incident fractures were retrieved from a regional x-ray archive.
resultsThe median follow-up time was 6.4 years. Low Hb was associated with worse total hip and femoral neck bone mineral density (BMD), and lower tibia cortical and total volumetric BMD, and anemia was associated with increased risk of major osteoporotic fracture (MOF; hazard ratio 2.04; 95% CI 1.58-2.64). Similar results were obtained for hip fracture and any fracture, also when adjusting for CRFs. The ratio between 10-year fracture probabilities of MOF assessed in models with Hb levels included and not included ranged from 1.2 to 0.7 at the 10th and 90th percentile of Hb, respectively.
conclusionAnemia and decreasing levels of Hb are associated with lower cortical BMD and incident fracture in older women. Considering Hb levels may improve the clinical evaluation of patients with osteoporosis and the assessment of fracture risk.
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Registered trials
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