Black D M, Cummings S R, Melton L J
Department of Epidemiology and Biostatistics, University of California, San Francisco.
J Bone Miner Res. 1992 Jun;7(6):639-46. doi: 10.1002/jbmr.5650070608.
Appendicular bone mass is inversely related to the risk of hip fracture in short-term prospective studies, but hip fractures typically occur about 30 years after menopause. We developed a model that estimates a woman's lifetime risk of hip fracture based on measurement of radial bone mass at age 50 using short-term prospective data relating bone mass to hip fracture, the correlation between bone mass at age 50 and later years, the age-specific incidence of hip fracture and mortality, and prospective data about bone mass and mortality. We estimate that a 50-year-old white woman has a 19% lifetime risk of hip fracture if her radial bone mass is at the 10th percentile for her age and an 11% lifetime risk if her bone mass is at the 90th percentile. Improved measurement techniques that have a higher predictive value for hip fracture in short-term studies could substantially increase this gradient of lifetime risk and therefore be more clinically useful.
在短期前瞻性研究中,附属骨骼质量与髋部骨折风险呈负相关,但髋部骨折通常在绝经后约30年发生。我们开发了一种模型,该模型基于50岁时桡骨质量的测量结果,利用短期前瞻性数据(将骨质量与髋部骨折相关联的数据、50岁及以后各年龄段的骨质量之间的相关性、特定年龄的髋部骨折发病率和死亡率以及有关骨质量和死亡率的前瞻性数据)来估计女性一生中髋部骨折的风险。我们估计,一名50岁的白人女性,如果其桡骨质量处于同龄人第10百分位,那么她一生中髋部骨折的风险为19%;如果其骨质量处于第90百分位,那么风险为11%。在短期研究中对髋部骨折具有更高预测价值的改进测量技术,可能会大幅增加这种终生风险梯度,从而在临床上更有用。