Naves M, Díaz-López J B, Gómez C, Rodríguez-Rebollar A, Rodríguez-García M, Cannata-Andía J B
Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación, Hospital Universitario Central de Asturias, Universidad de Oviedo, 33006 Oviedo, Spain.
Osteoporos Int. 2003 Jul;14(6):520-4. doi: 10.1007/s00198-003-1405-4. Epub 2003 Apr 25.
There is little data concerning the morbidity, mortality, and epidemiology of vertebral fracture. The aim of this study was to evaluate the effect of prevalent and incident vertebral fractures as risk factors for further osteoporotic fractures and mortality. The study was performed on a cohort of 316 women and 308 men older than 50 belonging to the EVOS study, randomly selected from our city register. At the beginning of the study and 4 years later, lateral dorsal and lumbar X-rays were performed. In addition, evaluation of the incidence of osteoporotic nonvertebral fractures was performed throughout 8 years. The incidence of all osteoporotic fractures was higher in women than in men (two-fold increase in vertebral fracture incidence and five-fold increase in Colles' and femur incidence). Vertebral fracture was a strong risk factor for a new vertebral fracture [RR=4.7 (1.8-11.9)], hip fracture [RR=6.7 (2.0-22.7)] and Colles' fracture [RR=3.0 (1.1-7.8)]. Prevalent and incident vertebral fractures were associated with a higher risk of having a hip fracture [RR=10.0 (2.0-50.2)] and Colles' fracture [RR=5.5 (1.3-23.4)]. In addition, in women, the vertebral fracture was associated with a higher mortality. By contrast, no association was found in men. These results demonstrate the association between a previous vertebral fracture with increments in the incidence of osteoporotic fractures of any type. In addition, we found a significantly higher mortality rate in women having vertebral fractures. These findings support the necessity of preventing the occurrence of vertebral fractures to limit their strong negative impact on mortality.
关于椎体骨折的发病率、死亡率及流行病学的数据很少。本研究的目的是评估现患和新发椎体骨折作为进一步骨质疏松性骨折及死亡风险因素的作用。该研究对属于EVOS研究的316名50岁以上女性和308名50岁以上男性组成的队列进行，这些人是从我市登记册中随机选取的。在研究开始时及4年后，拍摄了胸背部和腰椎侧位X线片。此外，在8年期间对骨质疏松性非椎体骨折的发生率进行了评估。所有骨质疏松性骨折的发生率女性高于男性（椎体骨折发生率增加两倍，Colles骨折和股骨骨折发生率增加五倍）。椎体骨折是新发椎体骨折[相对危险度（RR）=4.7（1.8 - 11.9）]、髋部骨折[RR = 6.7（2.0 - 22.7）]和Colles骨折[RR = 3.0（1.1 - 7.8）]的强风险因素。现患和新发椎体骨折与发生髋部骨折[RR = 10.0（2.0 - 50.2）]和Colles骨折[RR = 5.5（1.3 - 23.4）]的较高风险相关。此外，在女性中，椎体骨折与较高的死亡率相关。相比之下，在男性中未发现相关性。这些结果表明既往椎体骨折与任何类型骨质疏松性骨折发生率的增加之间存在关联。此外，我们发现有椎体骨折的女性死亡率显著更高。这些发现支持预防椎体骨折发生以限制其对死亡率产生严重负面影响的必要性。
