Kanis J A, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B
WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, UK.
Osteoporos Int. 2000;11(8):669-74. doi: 10.1007/s001980070064.
The objectives of the present study were to estimate long-term risks of osteoporotic fractures. The incidence of hip, distal forearm, proximal humerus and vertebral fracture were obtained from patient records in Malmö, Sweden. Vertebral fractures were confined to those coming to clinical attention, either as an inpatient or an outpatient case. Patient records were examined to exclude individuals with prior fractures at the same site. Future mortality rates were computed for each year of age from Poisson models using the Swedish Patient Register and the Statistical Year Book. The incidence and lifetime risk of any fracture were determined from the proportion of individuals fracture-free from the age of 45 years. Lifetime risk of shoulder, forearm, hip and spine fracture were 13.3%, 21.5%, 23.3% and 15.4% respectively in women at the age of 45 years. Corresponding values for men at the age of 45 years were 4.4%, 5.2%, 11.2% and 8.6%. The risk of any of these fractures was 47.3% and 23.8% in women and men respectively. Remaining lifetime risk was stable with age for hip fracture, but decreased by 20-30% by the age of 70 years in the case of other fractures. Ten and 15 year risks for all types of fractures increased with age until the age of 80 years, when they approached lifetime risks because of the competing probabilities of fracture and death. We conclude that fractures of the hip and spine carry higher risks than fractures at other sites, and that lifetime risks of fracture of the hip in particular have been underestimated.
本研究的目的是评估骨质疏松性骨折的长期风险。髋部、前臂远端、肱骨近端和椎体骨折的发病率来自瑞典马尔默的患者记录。椎体骨折仅限于那些作为住院患者或门诊患者引起临床关注的病例。对患者记录进行检查，以排除在同一部位有既往骨折的个体。使用瑞典患者登记册和统计年鉴，通过泊松模型计算每个年龄的未来死亡率。从45岁时无骨折个体的比例确定任何骨折的发病率和终生风险。45岁女性肩部、前臂、髋部和脊柱骨折的终生风险分别为13.3%、21.5%、23.3%和15.4%。45岁男性的相应值分别为4.4%、5.2%、11.2%和8.6%。这些骨折中任何一种的风险在女性和男性中分别为47.3%和23.8%。髋部骨折的剩余终生风险随年龄稳定，但其他骨折在70岁时降低20 - 30%。所有类型骨折的10年和15年风险随年龄增加，直到80岁，此时由于骨折和死亡的竞争概率，它们接近终生风险。我们得出结论，髋部和脊柱骨折比其他部位的骨折风险更高，尤其是髋部骨折的终生风险被低估了。
