Kurttio P, Gustavsson N, Vartiainen T, Pekkanen J
National Public Health Institute, Unit of Environmental Epidemiology, Kuopio, Finland.
Am J Epidemiol. 1999 Oct 15;150(8):817-24. doi: 10.1093/oxfordjournals.aje.a010086.
In the retrospective cohort study based on record linkage, the authors studied a cohort of persons born in 1900-1930 (n = 144,627), who had lived in the same rural location at least from 1967 to 1980. Estimates for fluoride concentrations (median, 0.1 mg/liter; maximum, 2.4 mg/liter) in well water in each member of the cohort were obtained by a weighted median smoothing method based on ground water measurements. Information on hip fractures was obtained from the Hospital Discharge Registry for 1981-1994. No association was observed between hip fractures and estimated fluoride concentration in the well water in either men or women when all age groups were analyzed together. However, the association was modified by age and sex so that among younger women, those aged 50-64 years, higher fluoride levels increased the risk of hip fractures. Among older men and women and younger men, no consistent association was seen. The adjusted rate ratio was 2.09 (95% confidence interval: 1.16, 3.76) for younger women who were the most exposed (>1.5 mg/liter) when compared with those who were the least exposed (< or =0.1 mg/liter). The results suggest that fluoride increases the risk of hip fractures only among women.
在这项基于记录链接的回顾性队列研究中，作者研究了一组出生于1900年至1930年的人群（n = 144,627），他们至少在1967年至1980年期间居住在同一个农村地区。通过基于地下水测量的加权中位数平滑方法，获得了该队列中每个成员井水中氟化物浓度的估计值（中位数为0.1毫克/升；最大值为2.4毫克/升）。髋部骨折的信息来自1981年至1994年的医院出院登记处。当对所有年龄组进行综合分析时，未观察到男性或女性的髋部骨折与井水中估计的氟化物浓度之间存在关联。然而，这种关联因年龄和性别而有所改变，以至于在年轻女性（50至64岁）中，较高的氟化物水平会增加髋部骨折的风险。在老年男性和女性以及年轻男性中，未发现一致的关联。与暴露最少（≤0.1毫克/升）的年轻女性相比，暴露最多（>1.5毫克/升）的年轻女性的调整率比为2.09（95%置信区间：1.16, 3.76）。结果表明，氟化物仅会增加女性髋部骨折的风险。
