Paracetamol (acetaminophen) use, fracture and bone mineral density

Williams, Lana J., Pasco, Julie A., Henry, Margaret J., Sanders, Kerrie M., Nicholson, Geoffrey C., Kotowicz, Mark A. and Berk, Michael (2011) Paracetamol (acetaminophen) use, fracture and bone mineral density. Bone, 48 6: 1277-1281. doi:10.1016/j.bone.2011.03.435


Author Williams, Lana J.
Pasco, Julie A.
Henry, Margaret J.
Sanders, Kerrie M.
Nicholson, Geoffrey C.
Kotowicz, Mark A.
Berk, Michael
Title Paracetamol (acetaminophen) use, fracture and bone mineral density
Journal name Bone   Check publisher's open access policy
ISSN 8756-3282
Publication date 2011-03-09
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.bone.2011.03.435
Open Access Status Not yet assessed
Volume 48
Issue 6
Start page 1277
End page 1281
Total pages 5
Place of publication Philadelphia, PA, U.S.A.
Publisher Elsevier Inc.
Language eng
Subject 2712 Endocrinology, Diabetes and Metabolism
2722 Histology
1314 Physiology
Abstract Paracetamol is the most widely prescribed simple analgesic and antipyretic. It exerts its effects via cyclooxygenase and endocannabinoid pathways, which may affect signalling in bone cells and hence influence bone metabolism. Given the high rates of paracetamol use in the community and the evidence linking its mechanism of action to bone metabolism, we aimed to investigate the association between paracetamol use, fracture, and bone mineral density (BMD) in women participating in the Geelong Osteoporosis Study (GOS). Cases (n = 569) were women aged ≥ 50. years identified from radiological reports as having sustained a fracture between 1994 and 1996. Controls (n = 775) were women without fracture recruited from the same region during this period. BMD was measured at the spine, hip, total body and forearm using dual energy absorptiometry. Medication use, medical history and lifestyle factors were self-reported. There were 69 (12.1%) paracetamol users among the cases and 63 (8.1%) among the controls. Paracetamol use increased the odds for fracture (OR = 1.56, 95%CI 1.09-2.24, p = 0.02). Adjustment for BMD at the spine, total hip and forearm did not confound the association. However, incorporating total body BMD into the model attenuated the association (adjusted OR = 1.46, 95%CI 1.00-2.14, p = 0.051). Further adjustment for age, weight, physical activity, smoking, alcohol, calcium intake, medication use, medical conditions, falls and previous fracture did not explain the association. These data suggest that paracetamol use is a risk factor for fracture, although the mechanism of action remains unclear.
Keyword Endocrinology & Metabolism
Endocrinology & Metabolism
ENDOCRINOLOGY & METABOLISM
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 251638
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Tue, 07 Jun 2011, 21:10:21 EST by Erin Bowly on behalf of School of Medicine