SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool.
Abstract readMeta-Analysis
In one paragraph
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive value of BMD for hip and other fractures: a meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Pooled it
- Links between bone fractures and the gut microbiota.Nature reviews. Endocrinology · 2026Review
- Midlife risk factors predict long-term hip fracture risk in women: a 35-yr follow-up.JBMR plus · 2026Article
- Fracture risk prediction, treatment thresholds, and the role of bone mineral density: a comparative analysis of FRAX and SHAFRE.Journal of bone and mineral metabolism · 2026Article
- Osteoporosis in rheumatoid arthritis: a new perspective on risk factors and clinical prediction models.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Intestinal dysbiosis can progress ineffective bone mineral density (BMD) improvement with vitamin D in post-partum 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
- Age-specific association between moderate-to-vigorous physical activity and bone health: insights from a universal pDXA screening cohort in rural China.Frontiers in endocrinology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
88 authors.
Eugene V McCloskeyCentre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. e.v.mccloskey@sheffield.ac.uk.ORCID http://orcid.org/0000-0003-0177-8140
Helena JohanssonCentre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
Enwu LiuCollege of Medicine and Public Health, Flinders University, Adelaide, Australia.
Kristina E ÅkessonClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
Fred A AndersonGLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
Rafael Azagra-LedesmaDepartment of Medicine, Autonomous University of Barcelona, Barcelona, Spain.ORCID http://orcid.org/0000-0003-0093-333X
Cecilie L BagerNordic Bioscience A/S, Herlev, Denmark.
Charlotte BeaudartPublic Health Aging Research & Epidemiology (PHARE) Group, Research Unit in Clinical Pharmacology and Toxicology (URPC), NAmur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium.
Heike A Bischoff-FerrariDepartment of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland.
Emmanuel BiverDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.ORCID http://orcid.org/0000-0001-6174-1951
Olivier BruyèreResearch Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.ORCID http://orcid.org/0000-0003-4269-9393
Jane A CauleyDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Philadelphia, USA.ORCID http://orcid.org/0000-0003-0752-4408
Jacqueline R CenterGarvan Institute of Medical Research, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0002-5278-4527
Roland ChapurlatINSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France.
Claus ChristiansenNordic Bioscience A/S, Herlev, Denmark.
Cyrus CooperMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
Carolyn J CrandallDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Steven R CummingsSan Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA.
José A P da SilvaCoimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.ORCID http://orcid.org/0000-0002-2782-6780
Bess Dawson-HughesBone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston, MA, USA.ORCID http://orcid.org/0000-0003-3136-0386
Adolfo Diez-PerezDepartment of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain.
Alyssa B DufourMarcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.
John A EismanSt Vincent's Clinical School, School of Medicine and Health, University of New South Wales Sydney, Sydney, NSW, Australia.
Petra J M EldersDepartment of General Practice, Amsterdam UMC, Location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Serge FerrariDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Yuki FujitaDepartment of Hygiene and Public Health, Faculty of Medicine, Kansai Medical University, Osaka, Japan.
Saeko FujiwaraDepartment of Pharmacy, Yasuda Women's University, Hiroshima, Japan.
Claus-Christian GlüerSection Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany.
Inbal GoldshteinMaccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
David GoltzmanDepartment of Medicine, McGill University and McGill University Health Centre, Montreal, Canada.
Vilmundur GudnasonIcelandic Heart Association, Kopavogur, Iceland.
Jill HallMRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
Didier HansCentre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland.ORCID http://orcid.org/0000-0003-1826-5958
Mari HoffDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.ORCID http://orcid.org/0000-0002-9992-8663
Rosemary J HollickAberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK.
Martijn HuismanDepartment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
Masayuki IkiDepartment of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan.ORCID http://orcid.org/0000-0003-2128-5255
Sophia Ish-ShalomEndocrine Clinic, Elisha Hospital, Haifa, Israel.
Graeme JonesMenzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Magnus K KarlssonClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
Sundeep KhoslaRobert and Arlene Kogod Center On Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA.
Douglas P KielMarcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.
Woon-Puay KohHealthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Fjorda KoromaniDepartment of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Mark A KotowiczIMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia.ORCID http://orcid.org/0000-0002-8094-1411
Heikki KrögerDepartment of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland.ORCID http://orcid.org/0000-0003-4245-8186
Timothy KwokDepartment of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Olivier LamyCentre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
Arnulf LanghammerHUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway.ORCID http://orcid.org/0000-0001-5296-6673
Bagher LarijaniEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0007-9526-9430
Kurt LippunerFaculty of Medicine, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Dan MellströmGeriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Fiona E A McGuiganClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
Thomas MerlijnDepartment of General Practice, Amsterdam UMC, Location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Tuan V NguyenSchool of Biomedical Engineering, University of Technology Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0002-3246-6281
Anna NordströmDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Peter NordströmDepartment of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden.ORCID http://orcid.org/0000-0003-2924-508X
Terence W O NeillCaring Sciences, Clinical Geriatrics, Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK.
Barbara Obermayer-PietschDiv. of Endocrinology and Diabetology, Dept. of Internal Medicine, Medical University Graz, Endocrine Lab Platform, Auenbruggerplatz 15, 8036, Graz, Austria.ORCID http://orcid.org/0000-0003-3543-1807
Claes OhlssonSahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eric S OrwollDepartment of Medicine, Oregon Health and Science University, Portland, OR, USA.ORCID http://orcid.org/0000-0002-8520-7355
Julie A PascoIMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia.ORCID http://orcid.org/0000-0002-8968-4714
Fernando RivadeneiraDepartment of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Berit ScheiDepartment of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Anne-Marie SchottUniversité Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France.ORCID http://orcid.org/0000-0003-3337-4474
Eric J ShiromaLaboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA.
Kristin SiggeirsdottirIcelandic Heart Association, Kopavogur, Iceland.ORCID http://orcid.org/0000-0002-4643-8732
Eleanor M SimonsickTranslational Gerontology Branch, National Institute On Aging Intramural Research Program, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-5460-3494
Elisabeth Sornay-RenduUMR 1033, INSERM, University of Lyon, Hôpital Edouard Herriot, Lyon, France.
Reijo SundKuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0002-6268-8117
Karin M A SwartDepartment of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.
Pawel SzulcUMR 1033, INSERM, University of Lyon, Hôpital Edouard Herriot, Lyon, France.
Junko TamakiDepartment of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan.
David J TorgersonYork Trials Unit, Department of Health Sciences, University of York, York, UK.
Natasja M van SchoorDepartment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
Tjeerd P van StaaCentre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK.ORCID http://orcid.org/0000-0001-9363-742X
Joan VilaStatistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
Nicholas J WarehamMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Nicole C WrightCenter for Health Outcomes, Implementation, Community-Engaged Sciences, School of Medicine, Tulane University, New Orleans, LA, USA.
Noriko YoshimuraDepartment of Preventive Medicine for Locomotive Organ Disorders, 22Nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan.ORCID http://orcid.org/0000-0001-9206-4658
M Carola ZillikensDepartment of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0001-9186-3423
Marta ZwartHealth Center Can Gibert del Plà, Catalan Institute of Health, Girona, Spain.ORCID http://orcid.org/0000-0003-4888-0927
Marian SchiniCentre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, Division of Clinical Medicine, School of Medicine & Population Health, University of Sheffield Medical School, Sheffield, UK.
Liesbeth VandenputSahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Nicholas C HarveyMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
Mattias LorentzonSahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
William D LeslieDepartment of Medicine, University of Manitoba, Winnipeg, MB, Canada.ORCID http://orcid.org/0000-0002-1056-1691
John A KanisCentre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
Funding
Oregon Clinical and Translational Research InstituteUL1TR000128 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ELLISON, DAVID H · 2012 to 2015
$28.7MLong term fracture risk and change in peripheral bone in the oldest old men: The MrOS studyR01AG066671 · NIA · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI BOUXSEIN, MARY L, CAWTHON, PEGGY MANNEN · 2020 to 2024
$13.3MOsteoporotic Fractures in Men (MrOS) - San Francisco Coordinating CenterU01AR066160 · NIAMS · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI CUMMINGS, STEVEN RON · 2013 to 2017
$9.3MOsteoporotic Fractures in Men (MrOS) - MinneapolisU01AG042145 · NIA · UNIVERSITY OF MINNESOTA · PI ENSRUD, KRISTINE · 2013 to 2019
$5.3MOsteporotic Fractures in Men (MrOS)- Admin CenterU01AG027810 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2017
$5.1MOsteoporotic Fractures in Men (MrOS) - PortlandU01AG042124 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2013 to 2019
$3.0MOsteoporatic Fractures in Men (MrOS)U01AG042168 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI KADO, DEBORAH · 2013 to 2017
$3.0MOsteoporotic Fractures in Men (Mr. Os) Palo AltoU01AG042143 · NIA · STANFORD UNIVERSITY · PI STEFANICK, MARCIA L. · 2013 to 2017
$3.0MOsteoporotic Fractures in Men (Mr.OS)U01AG042139 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAULEY, JANE ANN · 2013 to 2017
$2.9MOsteoporotic Fractures in Men_MrOS Renewal_BirminghamU01AG042140 · NIA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SHIKANY, JAMES M · 2013 to 2019
$2.7MNCATS NIH HHS UL1 TR000128NIAMS NIH HHS U01 AR066160NIA NIH HHS R01 AG066671NIA NIH HHS U01 AG027810NIA NIH HHS U01 AG042124NIA NIH HHS U01 AG042139NIA NIH HHS U01 AG042140NIA NIH HHS U01 AG042143NIA NIH HHS U01 AG042145NIA NIH HHS U01 AG042168
Abstract
In the largest meta-analysis of international cohorts to date, a family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. Parental and sibling histories of fracture carry the same significance for future fracture, including the impact of family hip fracture on future hip fracture risk. PURPOSE: We have undertaken a meta-analysis of international prospective cohorts to quantify the relationship between a family history of fracture and future fracture incidence.
methodsThe analysis dataset comprised 350,542 men and women from 42 cohorts in 29 countries followed for 2.8 million person-years. We investigated the relationship between family history of hip fracture or any fracture and the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture alone using an extended Poisson model in each cohort. Models were adjusted for current age, sex, BMD, and follow-up time.
resultsAs no difference in influence of family history of fracture was seen between genders, results are presented for men and women combined. A parental history of hip fracture was associated with a higher risk of incident fracture across all fracture outcome categories, with a stronger relationship with future hip fracture (hazard ratios (HR, 95% CI) for hip and MOF 1.37, 1.23-1.52 and 1.19, 1.12-1.27, respectively). Associations were slightly reduced but remained significant when additionally adjusted for BMD and did not vary by baseline offspring age, follow-up time, or parent affected. In a more limited analysis, parental history of any fracture or a sibling history of hip or any fracture showed similar associations to those observed with parental history of hip fracture.
conclusionsA family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. While parental hip fracture appears the strongest factor for future hip fracture, a family history of other fractures might be appropriate for inclusion in future iterations of the FRAX tool.
Indexed as
Osteoporotic FracturesAgedBone DensityFemaleHip FracturesHumansIncidenceMaleMiddle AgedRisk AssessmentFamily historyFRAXHip fractureMeta-analysisOsteoporotic fractureFParental history
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