By contrast, the risk of hip fracture was reduced substantially

with increasing levels of both strenuous and any physical activity (Table 2 and Fig. 3). Likelihood ratio tests suggested that there was no significant interaction between BMI and strenuous physical activity in association with ankle, wrist or hip fracture (pinteraction = .21, .42 and .77, respectively). There was also no significant interaction between BMI and any physical activity for ankle, wrist or hip fracture (pinteraction = .82, .83 and .18, respectively) (eTable 3). A sensitivity analysis restricted to women without missing data for any of the adjustment variables showed similar risk relationships, as did Pembrolizumab purchase a sensitivity analysis which excluded the first 3 years of follow-up (eTable 4). The relationships between

BMI and wrist and hip fractures did not vary significantly according to a woman’s use of menopausal hormone therapy (pinteraction = .19 and .06, respectively; see eTable 5). The relation of BMI to ankle fracture was slightly, but significantly, stronger in current users of menopausal hormone therapy than in never users (pinteraction = .003; see eTable 5). The relation of strenuous activity to ankle, wrist, and hip fractures did not vary significantly by use of menopausal hormone therapy selleck chemicals (pinteraction = .45, .93, and .34, respectively; see eTable 5). Nor was there any significant variation by menopausal hormone therapy use for any physical

activity in relation to ankle or wrist fracture (pinteraction = .64 and .54). However, there was a smaller reduction in hip fracture risk associated with any physical activity in current users than in never users of menopausal hormone therapy (pinteraction = .007). In this prospective study of 1.2 million postmenopausal women, 6807 had a record of one or more ankle fractures, 9733 had a record of one or more wrist fractures, and 5267 had a record of one or more hip fractures during a follow-up of about 8 years per woman. The cumulative absolute risk for ages 50 Anacetrapib to 84 was 2.5% for ankle fracture, 5.0% for wrist fracture, and 6.2% for hip fracture. Age-specific rates for ankle fracture did not vary much, but rates for wrist fracture increased slightly, and rates for hip fracture increased sharply with age. We also found that the association with adiposity varied by fracture site. Increasing adiposity was associated with an increased risk of ankle fracture but a reduced risk of wrist and hip fractures. Trends in fracture risks per unit change in BMI tended to be greatest among lean women. Physical inactivity was associated with an increased risk of hip fracture, but had no material influence on risk of ankle and wrist fractures. The relationships of BMI and physical activity to fracture risk were independent of one another for ankles, wrists, and hips.