Kanterewicz E, Yañez A, Pérez-Pons A, Codony I, Del Rio L, Díez-Pérez A
Rheumatology Unit, Department of Internal Medicine, Hospital General de Vic, Barcelona, Spain.
Osteoporos Int. 2002 Oct;13(10):824-8. doi: 10.1007/s001980200114.
Colles' fracture (CF) in postmenopausal women has been linked to low bone mass at the lumbar spine and hip. However, the diverse methodological approaches of previous studies make the results difficult to compare and thus the implications of CF in osteoporosis daily clinical practice are not clear. We explored the association between CF and low bone mineral density (BMD) in an incident case-control study in 58 postmenopausal Spanish women aged 45-80 years with recent CF and in 83 population-based controls of the same age range. The BMD of ultradistal distal forearm, lumbar spine and hip was measured by dual-energy X-ray absorptiometry (DXA) and WHO criteria were used to define osteoporosis and osteopenia. BMD was significantly lower in cases for all three areas ( p<0.001). Osteoporosis was more prevalent in cases than controls in the wrist (60% vs. 35%, p<0.001), lumbar spine (47% vs. 20%, p<0.005) and hip (19% vs. 6%, p<0.005). After adjusting for age, menopausal status and body mass index, osteoporosis and osteopenia remained significantly associated with CF only in women aged 65 years or less (ultradistal forearm OR 5.7 (95% CI 1.2-27.2), lumbar spine OR 3.9 (95% CI 1.1-14.3)). We conclude that CF in postmenopausal women aged 65 or less may be used as a sentinel finding to identify patients with generalized osteoporosis. Additionally, 70% of all CF patients regardless of their age had low bone mass ( T-score<-1SD) in any studied site.
绝经后女性的科勒斯骨折（Colles' fracture，CF）与腰椎和髋部的低骨量有关。然而，以往研究的方法多样，使得结果难以比较，因此CF在骨质疏松症日常临床实践中的意义尚不清楚。我们在一项病例对照研究中，对58名年龄在45 - 80岁、近期发生CF的西班牙绝经后女性以及83名同年龄范围的基于人群的对照者，探讨了CF与低骨密度（bone mineral density，BMD）之间的关联。采用双能X线吸收法（dual-energy X-ray absorptiometry，DXA）测量超远端前臂、腰椎和髋部的BMD，并使用世界卫生组织（WHO）标准定义骨质疏松症和骨质减少。所有三个部位的病例组BMD均显著低于对照组（p<0.001）。骨质疏松症在病例组中的患病率高于对照组，在腕部（60% vs. 35%，p<0.001）、腰椎（47% vs. 20%，p<0.005）和髋部（19% vs. 6%，p<0.005）。在调整年龄、绝经状态和体重指数后，仅在65岁及以下的女性中，骨质疏松症和骨质减少与CF仍显著相关（超远端前臂比值比（odds ratio，OR）5.7（95%可信区间（confidence interval，CI）1.2 - 27.2），腰椎OR 3.9（95% CI 1.1 - 14.3））。我们得出结论，65岁及以下绝经后女性的CF可作为一个警示性发现，用于识别全身性骨质疏松症患者。此外，所有CF患者中，无论年龄大小，70%在任何研究部位都存在低骨量（T值<-1SD）。
