Jones Graeme, Ma Deqiong
Menzies Research Institute, Private Bag 23, Hobart, Tasmania 7000, Australia.
Bone. 2005 Feb;36(2):352-7. doi: 10.1016/j.bone.2004.11.001.
The aim of this population-based case-control study was to describe the association among skeletal age deviation (SAD), bone density, and upper limb fracture risk in male and female children aged 9-16 years. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. Skeletal age was assessed by standard atlas. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) and metacarpal index (MI). There were no significant differences in mean skeletal age or chronological age between fracture cases and controls. However, SAD was associated with total, hand, and female fracture risk (all P<0.05). The fracture associations became nonsignificant after adjustment for BMD and MI in all subgroups with the exception of hand fractures (OR, 0.67/year; 95% CI, 0.47-0.96). SAD was also positively associated with BMD at all sites (r=0.33-0.35, all P<0.05) and MI (r=0.20, P<0.05). The strength of association reduced but remained significant at most sites after adjustment for body size, maturity, age, and sex. In conclusion, SAD is positively associated with measures of bone strength and negatively associated with upper limb fracture risk (especially those of the hand) in children. SAD is simple to measure and gives additional information regarding bone health and fracture risk in children.
这项基于人群的病例对照研究旨在描述9至16岁男女儿童骨骼年龄偏差（SAD）、骨密度和上肢骨折风险之间的关联。共研究了321例骨折病例和321名随机选取的个体匹配对照。骨骼年龄通过标准图谱评估。骨矿物质密度（BMD）通过双能X线吸收法（DXA）和掌骨指数（MI）测量。骨折病例和对照之间的平均骨骼年龄或实足年龄无显著差异。然而，SAD与总体、手部和女性骨折风险相关（所有P<0.05）。除手部骨折外，在所有亚组中对BMD和MI进行调整后，骨折关联变得不显著（OR，0.67/年；95%CI，0.47 - 0.96）。SAD在所有部位也与BMD呈正相关（r = 0.33 - 0.35，所有P<0.05）以及与MI呈正相关（r = 0.20，P<0.05）。在对体型、成熟度、年龄和性别进行调整后，关联强度降低，但在大多数部位仍显著。总之，SAD与儿童骨强度指标呈正相关，与上肢骨折风险（尤其是手部骨折风险）呈负相关。SAD易于测量，并能提供有关儿童骨骼健康和骨折风险的额外信息。
