Roy D K, O'Neill T W, Finn J D, Lunt M, Silman A J, Felsenberg D, Armbrecht G, Banzer D, Benevolenskaya L I, Bhalla A, Bruges Armas J, Cannata J B, Cooper C, Dequeker J, Diaz M N, Eastell R, Yershova O B, Felsch B, Gowin W, Havelka S, Hoszowski K, Ismail A A, Jajic I, Janott I, Johnell O, Kanis J A, Kragl G, Lopez Vaz A, Lorenc R, Lyritis G, Masaryk P, Matthis C, Miazgowski T, Gennari C, Pols H A P, Poor G, Raspe H H, Reid D M, Reisinger W, Scheidt-Nave C, Stepan J J, Todd C J, Weber K, Woolf A D, Reeve J
ARC Epidemiology Unit, University of Manchester, Manchester, UK.
Osteoporos Int. 2003 Jan;14(1):19-26. doi: 10.1007/s00198-002-1317-8.
The aim of this analysis was to determine the influence of lifestyle, anthropometric and reproductive factors on the subsequent risk of incident vertebral fracture in men and women aged 50-79 years. Subjects were recruited from population registers from 28 centers across Europe. At baseline, they completed an interviewer-administered questionnaire and had lateral thoraco-lumbar spine radiographs performed. Repeat spinal radiographs were performed a mean of 3.8 years later. Incident vertebral fractures were defined morphometrically and also qualitatively by an experienced radiologist. Poisson regression was used to determine the influence of the baseline risk factor variables on the occurrence of incident vertebral fracture. A total of 3173 men (mean age 63.1 years) and 3402 women (mean age 62.2 years) contributed data to the analysis. In total there were 193 incident morphometric and 224 qualitative fractures. In women, an age at menarche 16 years or older was associated with an increased risk of vertebral fracture (RR = 1.80; 95%CI 1.24, 2.63), whilst use of hormonal replacement was protective (RR = 0.58; 95%CI 0.34, 0.99). None of the lifestyle factors studied including smoking, alcohol intake, physical activity or milk consumption showed any consistent associations with incident vertebral fracture. In men and women, increasing body weight and body mass index were associated with a reduced risk of vertebral fracture though, apart from body mass index in men, the confidence intervals embraced unity. For most variables the strengths of the associations observed were similar using the qualitative and morphometric approaches to fracture definition. In conclusion our data suggest that modification of other lifestyle risk factors is unlikely to have a major impact on the population occurrence of vertebral fractures. The important biological mechanisms underlying vertebral fracture risk need to be explored using new investigational strategies.
本分析的目的是确定生活方式、人体测量和生殖因素对50至79岁男性和女性随后发生椎体骨折风险的影响。研究对象从欧洲28个中心的人口登记册中招募。在基线时，他们完成了一份由访谈员管理的问卷，并进行了胸腰段脊柱侧位X光检查。平均3.8年后进行了重复脊柱X光检查。新发椎体骨折通过形态计量学定义，并由经验丰富的放射科医生进行定性判断。采用泊松回归分析来确定基线风险因素变量对新发椎体骨折发生情况的影响。共有3173名男性（平均年龄63.1岁）和3402名女性（平均年龄62.2岁）为该分析提供了数据。总共发生了193例形态计量学新发骨折和224例定性骨折。在女性中，初潮年龄在16岁及以上与椎体骨折风险增加相关（相对风险=1.80；95%置信区间1.24，2.63），而使用激素替代疗法具有保护作用（相对风险=0.58；95%置信区间0.34，0.99）。所研究的生活方式因素，包括吸烟、饮酒、身体活动或牛奶摄入量，均未显示与新发椎体骨折有任何一致的关联。在男性和女性中，体重和体重指数增加与椎体骨折风险降低相关，不过，除男性的体重指数外，置信区间包含1。对于大多数变量，使用定性和形态计量学方法定义骨折时观察到的关联强度相似。总之，我们的数据表明，改变其他生活方式风险因素不太可能对人群中椎体骨折的发生率产生重大影响。需要采用新的研究策略来探索椎体骨折风险背后重要的生物学机制。
