Mussolino Michael E, Madans Jennifer H, Gillum Richard F
Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
Ann Epidemiol. 2003 Nov;13(10):692-7. doi: 10.1016/s1047-2797(03)00062-0.
We sought to assess the long-term association of bone mineral density with total, cardiovascular, and non-cardiovascular mortality.
The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of non-institutionalized civilians. A cohort aged 45 through 74 years at baseline (1971-1975) was observed through 1992. Subjects were followed for a maximum of 22 years. Included in the analyses were 3501 white and black subjects. Death certificates were used to identify a total of 1530 deaths.
Results were evaluated to determine the relative risk for death per 1 SD lower bone mineral density, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. Bone mineral density showed a significant inverse relationship to mortality in white men and blacks, but did not reach significance in white women. Based on 1 SD lower bone mineral density, the relative risk for white men was 1.16 (95% confidence interval (CI), 1.07-1.26, p<.01), while for white women the relative risk was 1.10 (95% CI, 0.99-1.23, p=.07), and in blacks the relative risk was 1.22 (95% CI, 1.05-1.42, p<.01). Bone mineral density was also associated with non-cardiovascular mortality in all three race-gender groups. An association between bone mineral density and cardiovascular mortality was found only in white men.
Bone mineral density is a significant predictor of death from all causes (white men, blacks), cardiovascular (white men only) and other causes combined, in whites and blacks.
我们试图评估骨密度与全因死亡率、心血管疾病死亡率和非心血管疾病死亡率之间的长期关联。
首次全国健康与营养检查调查数据来自全国具有代表性的非机构化平民样本。对基线时（1971 - 1975年）年龄在45至74岁的队列进行了长达1992年的观察。受试者最长随访22年。分析纳入了3501名白人和黑人受试者。通过死亡证明确定了总共1530例死亡。
在控制了基线年龄、吸烟状况、饮酒量、糖尿病史、心脏病史、教育程度、体重指数、休闲体育活动和血压用药情况后，评估结果以确定骨密度每降低1个标准差时的相对死亡风险。骨密度在白人男性和黑人中与死亡率呈显著负相关，但在白人女性中未达到显著水平。基于骨密度降低1个标准差，白人男性的相对风险为1.16（95%置信区间（CI），1.07 - 1.26，p <.01），白人女性的相对风险为1.10（95% CI，0.99 - 1.23，p =.07），黑人的相对风险为1.22（95% CI，1.05 - 1.42，p <.01）。骨密度在所有三个种族 - 性别组中也与非心血管疾病死亡率相关。仅在白人男性中发现骨密度与心血管疾病死亡率之间存在关联。
骨密度是白人男性、黑人全因死亡（白人男性、黑人）、心血管疾病死亡（仅白人男性）以及白人、黑人其他原因导致的综合死亡的重要预测指标。
