Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool
Authors' conclusion
A family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk.
Study context
- Population
- Men and women from 42 international prospective cohorts in 29 countries
- Participants
- 350,542 men42 cohorts
- Comparison
- Family history of fracture vs no family history of fracture
- Outcome
- Incident fracture (any clinical, any osteoporotic, major osteoporotic fracture (MOF), hip fracture)
Methodological detailsextended Poisson model in each cohort, adjusted for current age, sex, BMD and follow-up time
- Extended Poisson model in each cohort
- Adjusted for current age, sex, BMD and follow-up time
Pooled result
As reported in the abstract
Fracture risk with parental history of hip fracture
Each group vs no family historyEstimate (95% CI)
Parental history of hip fracture
HR (hip fracture) 1.37(1.23–1.52)
Parental history of hip fracture
HR (MOF) 1.19(1.12–1.27)
Further pooled results
Additional BMD adjustment and effect modifiers
- Associations slightly reduced but remained significant with additional BMD adjustment; did not vary by baseline offspring age, follow-up time or parent affected
Parental history of any fracture; sibling history of hip or any fracture
- Similar associations to parental history of hip fracture (more limited analysis)
Original publication
Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool. Osteoporos Int. Published 23 August 2025. doi:10. 1007/ s00198-025-07607-w
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