Browner W S, Seeley D G, Vogt T M, Cummings S R
Department of Medicine, Veterans Affairs Medical Center, San Francisco, California.
Lancet. 1991 Aug 10;338(8763):355-8. doi: 10.1016/0140-6736(91)90489-c.
9704 ambulatory women aged 65 years or older were prospectively studied to determine whether low bone mineral density (osteopenia) was associated with mortality. Bone mineral density was measured at entry to the study by single-photon absorptiometry. 299 women died during a mean of 2.8 years' follow-up. Osteopenia was associated with increased non-trauma mortality, probably because it is a marker for several other adverse factors. Each standard deviation decrease in proximal radius bone mineral density (0.104 g/cm2) was associated with a 1.19-fold increase in mortality (95% confidence interval 1.04-1.36), adjusted for age and duration of follow-up. Diminished bone mineral density at the proximal radius was strongly associated with deaths from stroke (relative risk = 1.74; 95% CI 1.12-2.70), an association that was not confounded by history of previous stroke, hypertension, postmenopausal use of oestrogen, thiazide diuretic treatment, diabetes mellitus, and smoking. Most deaths in women with low bone mineral density are unrelated to the occurrence of fractures-an observation that should be taken into account when estimating the need for and cost-effectiveness of bone-density screening and fracture prevention programmes.
对9704名65岁及以上的非卧床女性进行了前瞻性研究，以确定低骨密度（骨质减少）是否与死亡率相关。在研究开始时通过单光子吸收法测量骨密度。在平均2.8年的随访期间，有299名女性死亡。骨质减少与非创伤性死亡率增加相关，可能是因为它是其他几个不利因素的一个标志。桡骨近端骨密度每降低一个标准差（0.104克/平方厘米），死亡率就会增加1.19倍（95%置信区间为1.04 - 1.36），该结果已根据年龄和随访时间进行调整。桡骨近端骨密度降低与中风死亡密切相关（相对风险 = 1.74；95%置信区间为1.12 - 2.70），这种关联不受既往中风史、高血压、绝经后使用雌激素、噻嗪类利尿剂治疗、糖尿病和吸烟的影响。骨密度低的女性中，大多数死亡与骨折的发生无关——在评估骨密度筛查和骨折预防计划的必要性及成本效益时，应考虑到这一观察结果。
