Smoking has been linked to a higher risk of bone fracture, but researchers have now identified certain lung-related factors -- such as smoking or passive smoke -- may help to predict an individual smoker's fracture risks.

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"Hip fractures are associated with significant morbidity and mortality in smokers with lung disease, but whether lungaspecific factors are associated with fracture risk is unknown," said study authors from the University of Pittsburgh in the US. According to the researchers, the goal was to determine whether lungaspecific factors are associated with incidents of hip fracture and if they improve risk discrimination of traditional fracture risk models in smokers.

The findings were published in the Journal of Bone and Mineral Research. In the study of 9,187 adults who currently or formerly smoked, there were 361 new hip fractures reported over a median follow-up of 7.4 years. Known risk factors associated with experiencing a hip fracture included older age, female sex, osteoporosis, previous spine and hip fracture, rheumatoid arthritis and diabetes. The study suggested that the incorporation of lungaspecific risk factors into fracture risk assessment tools may more accurately predict fracture risk in smokers.

"We need to look beyond traditional risk factors when making osteoporosis screening and management decisions in our patients with chronic obstructive pulmonary disease (COPD)," said study lead author Jessica Bon from the University of Pittsburgh. "A former smoker with frequent COPD exacerbations or significant emphysema on chest CT scan may be at greater risk of fracture than would be expected based on age or sex or other underlying comorbidities alone," Bon noted.