VANCOUVER, B.C. – Measuring a patient's height during routine primary care visits may be one of the simplest and least expensive ways to predict osteoporosis risk and to guide screening, according to a study at Virginia Commonwealth University, Richmond.
Height loss of 1.5 inches (about 4 cm) or more over 3 years was associated with almost a doubling of osteoporosis risk in patients aged 50 years or older in the study of 1,039 primary care patients, reported Dr. Emmeline Gasink at the annual meeting of the North American Primary Care Research Group.
Mean height loss in the study population was 0.596 inches, said Dr. Gasink, currently a resident in the family medicine program at Riverside Healthcare System in Carrollton, Va.
Among the 16% of patients who had a height loss of at least 1.5 inches, 3% had a diagnosis of osteoporosis (odds ratio, 1.8) of developing the disease.
Some patients (13%) had significant height loss but were not diagnosed with osteoporosis. Another 8% did not have significant height loss but had osteoporosis, perhaps representing osteoporosis in a nonvertebral site, said Dr. Gasink in an interview at the meeting.
Nonetheless, a height loss of 1.5 inches or greater over 3 years provided a positive predictive value of 21% for osteoporosis, she said.
The study population was 71% female, so the risk may be slightly less for males. Also, people with low bone density tend to lose height more rapidly than do those with greater bone density.
Still, the overall conclusion of the study, together with findings from five longitudinal trials reviewed by Dr. Gasink, suggest a “strong relationship” between height loss and a new vertebral fracture, lending strength to her findings.
“Height measurement should definitely be a part of a yearly physical for patients 50 and older, as recommended by the U.S. Preventive Health Task Force,” noted Dr. Gasink after the meeting. “As a family physician who follows these people over a period of years, [I suggest that] it would be an easy piece of data to help determine early risk factors for osteoporosis.”