Naves M, Díaz-López J B, Gómez C, Rodríguez-Rebollar A, Cannata-Andía Jorge B
Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain.
Osteoporos Int. 2005 Dec;16(12):2013-7. doi: 10.1007/s00198-005-1983-4. Epub 2005 Aug 10.
It is well known that the adoption of preventive measures for osteoporosis may contribute to minimizing its impact as a result of bone fractures. However, there are well-recognized risk factors involved in the onset of osteoporosis that are not possible to modify. Better knowledge of these non-modifiable factors could aid prevention in subjects at high risk of fractures. The aim of this study was to evaluate the likely association between gynecological, reproductive and family history of hip fracture with the incidence of vertebral and nonvertebral osteoporotic fractures in women older than 50. We studied 255 women aged 50 and over, randomly selected from a Spanish population that had participated in a study of prevalence of vertebral fractures (EVOS study). This cohort was prospectively followed for 8 years by means of four postal questionnaires, in order to find out the incidence of nonvertebral fractures. Concerning the incidence of vertebral fractures, participants were invited to repeat the lumbar spine X-rays 4 years after the initial study. A total of 31 women had incident osteoporotic fractures. The analysis of gynecological variables showed that an increase in the age at menarche was a risk factor for all incident osteoporotic fractures [OR=1.57 (1.04-2.37)]. The presence of amenorrhea at any age during the fertile period was associated with higher incidence of all osteoporotic fractures [OR=6.30 (1.61-24.70)]. Among all the reproductive variables analyzed (pregnancy, number of live births and breast-feeding) only pregnancy was an important protective factor in preventing incident Colles fracture [OR=0.15 (0.03-0.62)]. A family history of hip fracture was associated with a higher incidence of all osteoporotic fractures [OR=3.59 (1.01-12.79)]. In summary, a late age at menarche, the presence of amenorrhea and having close relatives with hip fracture were all risk factors which, independently of bone mineral density (BMD) and age, were associated with higher incidence of all osteoporotic fractures. Pregnancy was an important protective factor for the incidence of Colles fractures.
众所周知，采取骨质疏松症预防措施可能有助于将其因骨折造成的影响降至最低。然而，骨质疏松症发病存在一些公认的风险因素，这些因素无法改变。更深入了解这些不可改变的因素有助于对骨折高危人群进行预防。本研究的目的是评估50岁以上女性的妇科、生殖和髋部骨折家族史与椎体和非椎体骨质疏松性骨折发生率之间可能存在的关联。我们研究了从参与椎体骨折患病率研究（EVOS研究）的西班牙人群中随机选取的255名50岁及以上的女性。通过四份邮寄问卷对该队列进行了为期8年的前瞻性随访，以了解非椎体骨折的发生率。关于椎体骨折的发生率，邀请参与者在初始研究4年后重复进行腰椎X光检查。共有31名女性发生了骨质疏松性骨折。对妇科变量的分析表明，初潮年龄增加是所有骨质疏松性骨折事件的一个风险因素[比值比（OR）=1.57（1.04 - 2.37）]。生育期任何年龄出现闭经都与所有骨质疏松性骨折的较高发生率相关[OR = 6.30（1.61 - 24.70）]。在所有分析的生殖变量（怀孕、活产数和母乳喂养）中，只有怀孕是预防Colles骨折事件的重要保护因素[OR = 0.15（0.03 - 0.62）]。髋部骨折家族史与所有骨质疏松性骨折的较高发生率相关[OR = 3.59（1.01 - 12.79）]。总之，初潮年龄晚、闭经以及有髋部骨折的近亲都是风险因素，这些因素独立于骨密度（BMD）和年龄，与所有骨质疏松性骨折的较高发生率相关。怀孕是Colles骨折发生率的重要保护因素。
