Danielson C, Lyon J L, Egger M, Goodenough G K
Department of Family and Preventive Medicine, University of Utah, Salt Lake City 84132.
JAMA. 1992 Aug 12;268(6):746-8.
To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly.
Ecological cohort.
The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated to 1 ppm.
All patients with hip fractures who were 65 years of age and older over a 7-year period in the three communities, excluding (1) those with revisions of hip fractures, (2) those in whom the hip fracture was anything but a first diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom the fracture was a second fracture (n = 246).
Rate of hospital discharge for hip fracture.
The relative risk for hip fracture for women in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated areas.
We found a small but significant increase in the risk of hip fracture in both men and women exposed to artificial fluoridation at 1 ppm, suggesting that low levels of fluoride may increase the risk of hip fracture in the elderly.
检测氟化至1ppm的水对老年人髋部骨折发生率的影响。
生态队列研究。
比较犹他州三个社区65岁及以上患者股骨颈骨折的发生率，其中一个社区水氟化至1ppm，另外两个社区未进行水氟化。
三个社区7年内所有65岁及以上的髋部骨折患者，排除（1）髋部骨折翻修患者；（2）非首次诊断为髋部骨折的患者；（3）存在转移性疾病的患者；（4）骨折为二次骨折的患者（n = 246）。
髋部骨折出院率。
与未氟化地区相比，氟化地区女性髋部骨折的相对风险为1.27（95%置信区间[CI]=1.08至1.46），男性为1.41（95%CI = 1.00至1.81）。
我们发现，暴露于1ppm人工氟化环境中的男性和女性髋部骨折风险均有小幅但显著的增加，这表明低水平的氟化物可能会增加老年人髋部骨折的风险。
