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Osteoporosis: HELP
Articles by Marcia L. Stefanick
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, Marcia L. Stefanick wrote the following 7 articles about Osteoporosis.
 
+ Citations + Abstracts
1 Clinical Trial Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS). 2016

Cauley, Jane A / Cawthon, Peggy M / Peters, Katherine E / Cummings, Steven R / Ensrud, Kristine E / Bauer, Douglas C / Taylor, Brent C / Shikany, James M / Hoffman, Andrew R / Lane, Nancy E / Kado, Deborah M / Stefanick, Marcia L / Orwoll, Eric S / Anonymous8090861. ·University of Pittsburgh, Pittsburgh, PA, USA. jcauley@edc.pitt.edu. · California Pacific Medical Center Research Institute, San Francisco, CA, USA. · University of California, San Francisco, San Francisco, CA, USA. · Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. · Department of Medicine, University of Minnesota, Minneapolis, MN, USA. · Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA. · University of Alabama at Birmingham, Birmingham, AL, USA. · Stanford University, Stanford, CA, USA. · University of California, Davis, Davis, CA, USA. · University of California, San Diego, San Diego, CA, USA. · Oregon Health & Science University, Portland, OR, USA. ·J Bone Miner Res · Pubmed #26988112.

ABSTRACT: Almost 30% of hip fractures occur in men; the mortality, morbidity, and loss of independence after hip fractures are greater in men than in women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5994 men, primarily white, age 65+ years recruited at six US clinical centers. During a mean of 8.6 years of 97% complete follow-up, 178 men experienced incident hip fractures. Information on risk factors including femoral neck bone mineral density (FNBMD) was obtained at the baseline visit. Cox proportional hazards models were used to calculate the hazard ratio (HR) with 95% confidence intervals; Fine and Gray models adjusted for competing mortality risk. Older age (≥75 years), low FNBMD, currently smoking, greater height and height loss since age 25 years, history of fracture, use of tricyclic antidepressants, history of myocardial infarction or angina, hyperthyroidism or Parkinson's disease, lower protein intake, and lower executive function were all associated with an increased hip fracture risk. Further adjustment for competing mortality attenuated HR for smoking, hyperthyroidism, and Parkinson's disease. The incidence rate of hip fracture per 1000 person-years (PY) was greatest in men with FNBMD T-scores <-2.5 (white women reference database) who also had 4+ risk factors, 33.4. Men age ≥80 years with 3+ major comorbidities experienced hip fracture at rates of 14.52 versus 0.88 per 1000 PY in men age <70 years with zero comorbidities. Older men with low FNBMD, multiple risk factors, and multimorbidity have a high risk of hip fracture. Many of these assessments can easily be incorporated into routine clinical practice and may lead to improved risk stratification. © 2016 American Society for Bone and Mineral Research.

2 Article Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative. 2020

Ochs-Balcom, Heather M / Hovey, Kathleen M / Andrews, Christopher / Cauley, Jane A / Hale, Lauren / Li, Wenjun / Bea, Jennifer W / Sarto, Gloria E / Stefanick, Marcia L / Stone, Katie L / Watts, Nelson B / Zaslavsky, Oleg / Wactawski-Wende, Jean. ·Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA. · Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA. · Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. · Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA. · Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA. · Department of Medicine, University of Arizona Cancer Center, Tucson, AZ, USA. · Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. · Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA. · Research Institute, California Pacific Medical Center, San Francisco, CA, USA. · Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. · Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA. · Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA. ·J Bone Miner Res · Pubmed #31692127.

ABSTRACT: Short sleep duration, recognized as a public health epidemic, is associated with adverse health conditions, yet little is known about the association between sleep and bone health. We tested the associations of usual sleep behavior and bone mineral density (BMD) and osteoporosis. In a sample of 11,084 postmenopausal women from the Women's Health Initiative (WHI; mean age 63.3 years, SD = 7.4), we performed a cross-sectional study of the association of self-reported usual hours of sleep and sleep quality (WHI Insomnia Rating Score) with whole body, total hip, femoral neck, and spine BMD using linear regression models. We also studied the association of sleep duration and quality with dual-energy X-ray absorptiometry (DXA)-defined low bone mass (T-score < -2.5 to <-1) and osteoporosis (T-score ≤ -2.5) using multinomial regression models. We adjusted for age, DXA machine, race, menopausal symptoms, education, smoking, physical activity, body mass index, alcohol use, physical function, and sleep medication use. In adjusted linear regression models, women who reported sleeping 5 hours or less per night had on average 0.012 to 0.018 g/cm

3 Article Associations of Parity, Breastfeeding, and Fractures in the Women's Health Observational Study. 2017

Crandall, Carolyn J / Liu, Jingmin / Cauley, Jane / Newcomb, Polly A / Manson, JoAnn E / Vitolins, Mara Z / Jacobson, Lisette T / Rykman, Kelli K / Stefanick, Marcia L. ·Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; the Women's Health Initiative Clinical Coordinating Center and the Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington; the Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; the Department of Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; the Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina; the Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas; the Departments of Epidemiology and Pediatrics, University of Iowa, Iowa City, Iowa; and the Departments of Medicine and Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California. ·Obstet Gynecol · Pubmed #28594759.

ABSTRACT: OBJECTIVE: To examine associations of several aspects of parity and history of lactation with incident hip fractures and clinical fractures and, in a subset of women, with bone mineral density. METHODS: In this observational study, we analyzed data from 93,676 postmenopausal women participating in the Women's Health Initiative Observational Study and all bone density data from the subset of participants who underwent bone density testing at three clinical centers. At baseline, participants were aged 50-79 years. Using Cox proportional hazards regression analysis, we examined associations of fracture incidence and bone density with several aspects of parity (number of pregnancies, age at first pregnancy lasting 6 months or greater, and number of pregnancies lasting 6 months or greater) and breastfeeding (number of episodes of breastfeeding for at least 1 month, number of children breastfed, age when first breastfed, age when last breastfed, total number of months breastfed). RESULTS: The mean baseline age (standard deviation) of participants was 64 (±7.4) years (mean follow-up 7.9 years). During follow-up, the incident rate of hip fracture was 1.27%. Ten percent of participants were nulligravid. In fully adjusted models, number of pregnancies, parity, age at first birth, number of children breastfed, age at first breastfeeding, age at last breastfeeding, and total duration of breastfeeding were not statistically significantly associated with hip fracture incidence. There were no consistent associations of parity or lactation characteristics with overall clinical fracture risk or bone density. However, compared with never breastfeeding, a history of breastfeeding for at least 1 month was associated with a decreased risk of hip fracture (yes compared with no, hazard ratio 0.84, 95% confidence interval 0.73-0.98). CONCLUSION: Patterns of parity and history of lactation were largely unrelated to fracture risk or bone density.

4 Article No Increase in Fractures After Stopping Hormone Therapy: Results From the Women's Health Initiative. 2017

Watts, Nelson B / Cauley, Jane A / Jackson, Rebecca D / LaCroix, Andrea Z / Lewis, Cora E / Manson, JoAnn E / Neuner, Joan M / Phillips, Lawrence S / Stefanick, Marcia L / Wactawski-Wende, Jean / Crandall, Carolyn / Anonymous8520886. ·Mercy Health Osteoporosis and Bone Health Services, Cincinnati, Ohio 45236. · Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261. · Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, Ohio 43210. · Women's Health Center of Excellence, Family Medicine and Public Health, University of California, San Diego, La Jolla, California 92093. · Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115. · Medical College of Wisconsin Cancer Center Population Science, Division of General Internal Medicine and Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, Wisconsin 53226. · Atlanta VA Medical Center, Decatur, Georgia 30033. · Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30322. · Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California 94305. · Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, New York 14214; and. · Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095. ·J Clin Endocrinol Metab · Pubmed #27820659.

ABSTRACT: Context: The Women's Health Initiative (WHI) hormone therapy (HT) trials showed protection against hip and total fractures, but a later observational report suggested loss of benefit and a rebound increased risk after cessation of HT. Objective: The purpose of this study was to examine fractures after discontinuation of HT. Design and Setting: Two placebo-controlled randomized trials served as the study setting. Patients: Study patients included WHI participants (N = 15,187) who continued active HT or placebo through the intervention period and who did not take HT in the postintervention period. Interventions: Trial interventions included conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) in naturally menopausal women and CEE alone in women with prior hysterectomy. Main Outcome Measures: Total fractures and hip fractures through 5 years after discontinuation of HT were recorded. Results: Hip fractures were infrequent (∼2.5 per 1000 person-years); this finding was similar between trials and in former HT and placebo groups. There was no difference in total fractures in the CEE + MPA trial for former HT vs former placebo users (28.9 per 1000 person-years and 29.9 per 1000 person-years, respectively; hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.87 to 1.09; P = 0.63); however, in the CEE-alone trial, total fractures were higher in former placebo users (36.9 per 1000 person-years) compared with the former active group (31.1 per 1000 person-years), a finding that was suggestive of a residual benefit of CEE against total fractures (HR, 0.85; 95% CI, 0.73 to 0.98; P = 0.03). Conclusions: We found no evidence for increased fracture risk, either sustained or transient, for former HT users compared with former placebo users after stopping HT. There was residual benefit for total fractures in former HT users from the CEE-alone study.

5 Article A genome-wide association study meta-analysis of clinical fracture in 10,012 African American women. 2016

Taylor, Kira C / Evans, Daniel S / Edwards, Digna R Velez / Edwards, Todd L / Sofer, Tamar / Li, Guo / Liu, Youfang / Franceschini, Nora / Jackson, Rebecca D / Giri, Ayush / Donneyong, Macarius / Psaty, Bruce / Rotter, Jerome I / LaCroix, Andrea Z / Jordan, Joanne M / Robbins, John A / Lewis, Beth / Stefanick, Marcia L / Liu, Yongmei / Garcia, Melissa / Harris, Tamara / Cauley, Jane A / North, Kari E. ·School of Public Health and Information Sciences, University of Louisville, 485 E Gray St., Louisville, KY 40202, USA. · Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E. Franklin St., Chapel Hill, NC 27514, USA. · California Pacific Medical Center Research Institute, 550 16th Street, Box 0560, San Francisco, CA 94158-2549, USA. · Vanderbilt Epidemiology Center, Department of Obstetrics and Gynecology, Vanderbilt Genetics Institute, Vanderbilt University, 2525 West End Avenue, Nashville, TN 37203, USA. · Vanderbilt Genetics Institute, Division of Epidemiology, Department of Medicine, Vanderbilt University, 2525 West End Avenue, Nashville, TN 37203, USA. · Department of Biostatistics, University of Washington, UW Tower 15th floor, 4333 Brooklyn Ave NE, Seattle 98105, USA. · Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Metropolitan Park East Tower, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA. · Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill NC 27599-7280, NC, USA. · University of North Carolina at Chapel Hill, 137 E. Franklin St., Chapel Hill, NC 27514, USA. · The Ohio State University, 376 W 10th Avenue, Suite 260, Columbus, OH 43210, USA. · Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, 1620 Tremont St, St 3030, Boston, MA 02120, USA. · Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington; Group Health Research Institute, Group Health Cooperative, Metropolitan Park East Tower, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA. · Institute of Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, 1124 W. Carson Street, Bldg., E-5, Torrance, CA 90502, USA. · Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA. · Department of Medicine, University of California at Davis Medical Center, PSSB Building, 4150 V St., Sacramento, CA 95817, USA. · University of Alabama, Medical Towers 614, 1717 11th Avenue South, Birmingham, AL 35205, USA. · Stanford Prevention Research Center, Stanford University School of Medicine, Medical School Office Building, 1265 Welch Road, Mail Code 5411, Stanford, CA 94305, USA. · Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA. · Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Ave, Suite 3C309, Bethesda, MD 20892, USA. · Laboratory of Epidemiology and Population Science, Intramural Research Program, National Institute on Aging, National Institutes of Health, 31 Center Drive, Bethesda, MD 20892, USA. · University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, A510 Crabtree Hall, Pittsburgh, PA 15261, USA. · Carolina Center for Genome Sciences, 250 Bell Tower Dr., Chapel Hill, NC 27514, USA. ·Bone Rep · Pubmed #28580392.

ABSTRACT: BACKGROUND: Osteoporosis is a major public health problem associated with excess disability and mortality. It is estimated that 50-70% of the variation in osteoporotic fracture risk is attributable to genetic factors. The purpose of this hypothesis-generating study was to identify possible genetic determinants of fracture among African American (AA) women in a GWAS meta-analysis. METHODS: Data on clinical fractures (all fractures except fingers, toes, face, skull or sternum) were analyzed among AA female participants in the Women's Health Initiative (WHI) (N = 8155), Cardiovascular Health Study (CHS) (N = 504), BioVU (N = 704), Health ABC (N = 651), and the Johnston County Osteoarthritis Project (JoCoOA) (N = 291). Affymetrix (WHI) and Illumina (Health ABC, JoCoOA, BioVU, CHS) GWAS panels were used for genotyping, and a 1:1 ratio of YRI:CEU HapMap haplotypes was used as an imputation reference panel. We used Cox proportional hazard models or logistic regression to evaluate the association of ~ 2.5 million SNPs with fracture risk, adjusting for ancestry, age, and geographic region where applicable. We conducted a fixed-effects, inverse variance-weighted meta-analysis. Genome-wide significance was set at P < 5 × 10 RESULTS: One SNP, rs12775980 in an intron of CONCLUSION: This GWAS meta-analysis of fractures in African American women identified a potentially novel locus in the supervillin gene, which encodes a platelet-associated factor and was previously associated with platelet thrombus formation in African Americans. If validated in other populations of African descent, these findings suggest potential new mechanisms involved in fracture that may be particularly important among African Americans.

6 Article Risk of Nonspine Fractures in Older Adults with Sarcopenia, Low Bone Mass, or Both. 2015

Chalhoub, Didier / Cawthon, Peggy M / Ensrud, Kristine E / Stefanick, Marcia L / Kado, Deborah M / Boudreau, Robert / Greenspan, Susan / Newman, Anne B / Zmuda, Joseph / Orwoll, Eric S / Cauley, Jane A / Anonymous5460840. ·Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. · California Pacific Medical Center, San Francisco, California. · Division of Epidemiology and Community Health, Department of Medicine, University of Minnesot aand Minneapolis VA Health Care System, Minneapolis, Minnesota. · School of Medicine, Stanford University, Stanford, California. · University of California at San Diego, La Jolla, California. · Oregon Health & Sciences University, Portland, Oregon. ·J Am Geriatr Soc · Pubmed #26310882.

ABSTRACT: OBJECTIVES: To test the hypothesis that men and women with low bone mineral density (BMD) and sarcopenia have a higher risk of fracture than those with only one or neither conditions. DESIGN: The Osteoporotic Fractures in Men Study and the Study of Osteoporotic Fractures in women are prospective observational studies with a mean follow up of 9 (2000-2012) and 8 years (1997-2009), respectively. SETTING: U.S. clinical centers. PARTICIPANTS: Men (n = 5,544; mean age 73.7) and women (n = 1,114; mean age 77.6) aged 65 and older, able to walk without assistance, and without bilateral hip replacement. MEASUREMENTS: Sarcopenia was defined as low appendicular lean mass plus slowness or weakness and low BMD according to the World Health Organization definition of a T-score less than -1.0. Participants were classified as having normal BMD and no sarcopenia (3,367 men, 308 women), sarcopenia only (79 men, 48 women), low BMD only (1,986 men, 626 women), and low BMD and sarcopenia (112 men, 132 women). RESULTS: Men with low BMD and sarcopenia (hazard ratio (HR)=3.79, 95% confidence interval (CI)=2.65-5.41) and men with low BMD only (HR=1.67, 95% CI=1.45-1.93) but not men with sarcopenia only (HR=1.14, 95% CI=0.62-2.09) had greater risk of fracture than men with normal BMD and no sarcopenia. Women with low BMD and sarcopenia (HR=2.27, 95% CI=1.37-3.76) and women with low BMD alone (HR=2.62, 95% CI=1.74-3.95), but not women with only sarcopenia, had greater risk of fracture than women with normal BMD and no sarcopenia. CONCLUSION: Men with low BMD and sarcopenia are at especially high risk of fracture. Sarcopenia alone did not increase fracture risk in either group.

7 Article Preference for wine is associated with lower hip fracture incidence in post-menopausal women. 2013

Kubo, Jessica T / Stefanick, Marcia L / Robbins, John / Wactawski-Wende, Jean / Cullen, Mark R / Freiberg, Matthew / Desai, Manisha. ·Quantitative Sciences Unit, Stanford University School of Medicine, 1070 Arastradero Road, Palo Alto, Stanford, CA 94304, USA. jkubo@stanford.edu. ·BMC Womens Health · Pubmed #24053784.

ABSTRACT: BACKGROUND: Past studies of relationships between alcohol and hip fracture have generally focused on total alcohol consumed and not type of alcohol. Different types of alcohol consist of varying components which may affect risk of hip fracture differentially. This study seeks to examine the relationship between alcohol consumption, with a focus on type of alcohol consumed (e.g. beer, wine, or hard liquor) and hip fracture risk in post-menopausal women. METHODS: The longitudinal cohort consisted of U.S. post-menopausal women aged 50-79 years enrolled between 1993-1998 in the Women's Health Initiative Clinical Trials and Observational Study (N=115,655). RESULTS: Women were categorized as non-drinkers, past drinkers, infrequent drinkers and drinkers by preference of alcohol type (i.e. those who preferred wine, beer, hard liquor, or who had no strong preference). Mean alcohol consumption among current drinkers was 3.3 servings per week; this was similar among those who preferred wine, beer and liquor. After adjustment for potential confounders, alcohol preference was strongly correlated with hip fracture risk (p = 0.0167); in particular, women who preferred wine were at lower risk than non-drinkers (OR=0.78; 95% CI 0.64-0.95), past drinkers (OR=0.85; 95% CI 0.72-1.00), infrequent drinkers (OR=0.73; 95% CI 0.61-0.88), hard liquor drinkers (OR=0.87; 95% CI 0.71-1.06), beer drinkers (OR=0.72; 95% CI 0.55-0.95) and those with no strong preference (OR=0.89; 95% CI 0.89; 95% CI 0.73-1.10). CONCLUSIONS: Preference of alcohol type was associated with hip fracture; women who preferentially consumed wine had a lower risk of hip fracture compared to non-drinkers, past drinkers, and those with other alcohol preferences.