Johnell O, Kanis J A
Department of Orthopaedics, Malmö University Hospital, Malmö, Sweden.
Osteoporos Int. 2006 Dec;17(12):1726-33. doi: 10.1007/s00198-006-0172-4. Epub 2006 Sep 16.
The aim of this study was to quantify the global burden of osteoporotic fracture worldwide.
The incidence of hip fractures was identified by systematic review and the incidence of osteoporotic fractures was imputed from the incidence of hip fractures in different regions of the world. Excess mortality and disability weights used age- and sex-specific data from Sweden to calculate the Disability Adjusted Life Years (DALYs) lost due to osteoporotic fracture.
In the year 2000 there were an estimated 9.0 million osteoporotic fractures of which 1.6 million were at the hip, 1.7 million at the forearm and 1.4 million were clinical vertebral fractures. The greatest number of osteoporotic fractures occurred in Europe (34.8%). The total DALYs lost was 5.8 million of which 51% were accounted for by fractures that occurred in Europe and the Americas. World-wide, osteoporotic fractures accounted for 0.83% of the global burden of non-communicable disease and was 1.75% of the global burden in Europe. In Europe, osteoporotic fractures accounted for more DALYs lost than common cancers with the exception of lung cancer. For chronic musculo-skeletal disorders the DALYs lost in Europe due to osteoporosis (2.0 million) were less than for osteoarthrosis (3.1 million) but greater than for rheumatoid arthritis (1.0 million).
We conclude that osteoporotic fractures are a significant cause of morbidity and mortality, particularly in the developed countries.
本研究旨在量化全球骨质疏松性骨折的总体负担。
通过系统综述确定髋部骨折的发病率,并根据世界不同地区髋部骨折的发病率推算骨质疏松性骨折的发病率。超额死亡率和残疾权重采用瑞典的年龄和性别特异性数据来计算因骨质疏松性骨折导致的伤残调整生命年(DALYs)损失。
2000年,估计有900万例骨质疏松性骨折,其中髋部骨折160万例,前臂骨折170万例,临床椎体骨折140万例。骨质疏松性骨折数量最多的发生在欧洲(34.8%)。总的伤残调整生命年损失为580万,其中51%由欧洲和美洲发生的骨折所致。在全球范围内,骨质疏松性骨折占全球非传染性疾病负担的0.83%,在欧洲占全球负担的1.75%。在欧洲,除肺癌外,骨质疏松性骨折导致的伤残调整生命年损失比常见癌症更多。对于慢性肌肉骨骼疾病,欧洲因骨质疏松症导致的伤残调整生命年损失(200万)低于骨关节炎(310万),但高于类风湿关节炎(100万)。
我们得出结论,骨质疏松性骨折是发病和死亡的重要原因,尤其是在发达国家。