Martínez-Ramírez M J, Palma S, Martínez-González M A, Delgado-Martínez A D, de la Fuente C, Delgado-Rodríguez M
Service of Endocrinology and Nutrition, Hospital of Jaén & Division of Medicine, University of Jaén, Navarra, Spain.
Eur J Clin Nutr. 2007 Sep;61(9):1114-20. doi: 10.1038/sj.ejcn.1602624. Epub 2007 Feb 7.
To explore the association between fat intake, serum lipids and the risk of osteoporotic fractures in the elderly.
A hospital-based case-control study.
The study was conducted at a tertiary centre and referral hospital for the province of Jaén (Spain).
Cases (n=167) were patients aged 65 years or more with a low-energy fracture selected from the population attended at the hospital. Controls (patients without antecedents of any fracture) were 1:1 matched to cases by sex and age (n=167).
Diet was assessed by a semiquantitative food frequency questionnaire. Serum total cholesterol and high-density lipoprotein (HDL) cholesterol were also measured.
Participants in the two upper quartiles of polyunsaturated fat (PUFA) intake showed an increased risk of fracture, with statistically significant differences with respect to the first quartile in the adjusted model (odds ratio (OR)=3.59; 95% confidence interval (CI)=1.06-12.1 and OR=5.88; 95% CI=1.38-25.02); P=0.01 for the trend test). A higher ratio of monounsaturated fat (MUFA) to PUFA was associated with a reduced risk of fracture (OR=0.20; 95% CI=0.07-0.60 for the fourth quartile; P=0.002 for the trend test). The intake of omega-6 fatty acids was associated with an elevated risk of fracture (OR=3.41; 95% CI=1.05-11.15 for the fourth quartile; P=0.01 for the trend test). HDL-cholesterol levels were inversely associated with the risk of fracture (test for trend P=0.03 across quartiles).
PUFA intake was associated with an increased risk of osteoporotic fractures in the elderly, whereas a high ratio of MUFA:PUFA was associated with decreased risk.
探讨老年人脂肪摄入量、血脂与骨质疏松性骨折风险之间的关联。
一项基于医院的病例对照研究。
研究在西班牙哈恩省的一家三级中心和转诊医院进行。
病例组（n = 167）为从该医院就诊人群中选取的65岁及以上发生低能量骨折的患者。对照组（无任何骨折史的患者）按性别和年龄与病例组1:1匹配（n = 167）。
通过半定量食物频率问卷评估饮食情况。同时测量血清总胆固醇和高密度脂蛋白（HDL）胆固醇水平。
多不饱和脂肪（PUFA）摄入量处于最高两个四分位数的参与者骨折风险增加，在调整模型中与第一个四分位数相比有统计学显著差异（比值比（OR）= 3.59；95%置信区间（CI）= 1.06 - 12.1，OR = 5.88；95% CI = 1.38 - 25.02）；趋势检验P = 0.01）。单不饱和脂肪（MUFA）与PUFA的比例较高与骨折风险降低相关（第四个四分位数的OR = 0.20；95% CI = 0.07 - 0.60；趋势检验P = 0.002）。ω-6脂肪酸的摄入量与骨折风险升高相关（第四个四分位数的OR = 3.41；95% CI = 1.05 - 11.15；趋势检验P = 0.01）。HDL胆固醇水平与骨折风险呈负相关（四分位数间趋势检验P = 0.03）。
老年人摄入PUFA与骨质疏松性骨折风险增加相关，而MUFA:PUFA比例高与风险降低相关。
