Keegan Theresa H M, Kelsey Jennifer L, Sidney Stephen, Quesenberry Charles P
Division of Epidemiology, Stanford University School of Medicine, CA 94305-5405, USA.
Am J Epidemiol. 2002 May 15;155(10):926-31. doi: 10.1093/aje/155.10.926.
This case-control study examines whether foot problems are risk factors of fractures of five sites among people aged 45 years or older at six Kaiser Permanente Medical Centers in northern California. From October 1996 to May 2001, interviewers collected information through a standardized questionnaire. Incident cases of distal forearm (n = 1,000), foot (n = 827), proximal humerus (n = 448), shaft of the tibia/fibula (n = 168), and pelvis (n = 172) fractures and 1,913 controls from the same medical centers were included. After adjustment for potential confounders and for each additional foot problem, the odds of a foot fracture increased by 8% (adjusted odds ratio = 1.08, 95% confidence interval: 1.03, 1.13). In contrast, each additional foot problem was associated with a reduction in the odds of a forearm fracture (adjusted odds ratio = 0.93, 95% confidence interval: 0.89, 0.98). In general, foot problems were not related to fractures of other sites, although diabetes, which may result in foot problems, increased the odds of a proximal humerus fracture (adjusted odds ratio = 1.65, 95% confidence interval: 1.20, 2.26). If these findings are supported by data from other studies, preventive measures to retard the development of foot problems could reduce the incidence of foot fractures.
这项病例对照研究考察了在加利福尼亚州北部的六个凯撒医疗机构中，足部问题是否是45岁及以上人群五个部位骨折的危险因素。1996年10月至2001年5月期间，访员通过标准化问卷收集信息。纳入了来自同一医疗机构的1000例桡骨远端骨折、827例足部骨折、448例肱骨近端骨折、168例胫腓骨干骨折和172例骨盆骨折的发病病例以及1913名对照。在对潜在混杂因素进行调整后，每增加一个足部问题，足部骨折的几率增加8%（调整后的优势比=1.08，95%置信区间：1.03，1.13）。相比之下，每增加一个足部问题与桡骨远端骨折几率的降低相关（调整后的优势比=0.93，95%置信区间：0.89，0.98）。总体而言，足部问题与其他部位的骨折无关，尽管可能导致足部问题的糖尿病会增加肱骨近端骨折的几率（调整后的优势比=1.65，95%置信区间：1.20，2.26）。如果这些发现得到其他研究数据的支持，延缓足部问题发展的预防措施可能会降低足部骨折的发生率。
