Schneider J L, Fink H A, Ewing S K, Ensrud K E, Cummings S R
California Pacific Medical Center Research Institute, San Francisco, CA, USA.
Osteoporos Int. 2008 Jul;19(7):1093-7. doi: 10.1007/s00198-008-0583-5. Epub 2008 Feb 27.
Among community-dwelling older women, compared to those without Parkinson's disease (PD), women with PD have 7.3% lower BMD and an increased risk for hip fracture (HR = 2.6).
Studies reporting an association of Parkinson's disease (PD) with low bone mineral density (BMD) and increased fracture risk often have been prone to selection bias, and have not accounted for potentially important explanatory variables, including recent weight loss. Further, little is known about the association between PD and non-hip fractures. Consequently, we investigated the independent association of PD with hip BMD and long-term fracture risk.
Associations of self-reported PD with hip BMD and incident hip and non-spine, non-hip fracture were analyzed using linear regression and Cox proportional hazards, respectively. This prospective cohort study analyzed 8,105 older women with known PD status (n = 73 with PD) at four US clinical centers of the Study of Osteoporotic Fractures.
Compared to women without PD, age-adjusted mean total hip BMD was 7.3% lower in women with PD. Women with PD had a 2.6-fold higher age-adjusted risk for incident hip fracture. Parkinson's disease was not significantly associated with non-spine, non-hip fractures.
In age-adjusted models, women with PD had lower hip BMD and increased hip fracture risk, associations that were no longer significant after further weight and multivariate adjustment. Older women with PD should be considered for evaluation and treatment to reduce their fracture risk.
在社区居住的老年女性中,与无帕金森病(PD)的女性相比,患PD的女性骨密度(BMD)低7.3%,髋部骨折风险增加(风险比=2.6)。
报告帕金森病(PD)与低骨矿物质密度(BMD)及骨折风险增加之间存在关联的研究往往容易出现选择偏倚,且未考虑潜在的重要解释变量,包括近期体重减轻。此外,对于PD与非髋部骨折之间的关联知之甚少。因此,我们研究了PD与髋部BMD及长期骨折风险之间的独立关联。
分别使用线性回归和Cox比例风险模型分析自我报告的PD与髋部BMD以及髋部骨折和非脊柱、非髋部骨折发生率之间的关联。这项前瞻性队列研究分析了美国骨质疏松性骨折研究的四个临床中心的8105名已知PD状态的老年女性(n = 73名患有PD)。
与无PD的女性相比,年龄调整后的患PD女性的平均全髋BMD低7.3%。患PD的女性发生髋部骨折的年龄调整风险高2.6倍。帕金森病与非脊柱、非髋部骨折无显著关联。
在年龄调整模型中,患PD的女性髋部BMD较低且髋部骨折风险增加,在进一步进行体重和多变量调整后,这些关联不再显著。应考虑对患PD的老年女性进行评估和治疗,以降低其骨折风险。