Robitaille Julie, Yoon Paula W, Moore Cynthia A, Liu Tiebin, Irizarry-Delacruz Margarita, Looker Anne C, Khoury Muin J
CDC, the National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia, USA.
Am J Prev Med. 2008 Jul;35(1):47-54. doi: 10.1016/j.amepre.2008.03.027.
Osteoporosis is a major public health concern and has been associated with a family history positive for the condition. However, data on the behaviors of individuals with such a family history are scarce. The objectives of this study were to assess the relationship between the prevalence of reported physician-diagnosed osteoporosis and family history in a representative sample of U.S. women, examine whether osteoporosis risk factors account for this relationship, and evaluate the likelihood that women at high risk of osteoporosis due to family history report preventive behaviors.
The prevalence of reported osteoporosis was estimated in 8073 women aged>or=20 years in the National Health and Nutrition Examination Survey, 1999-2004. Information on osteoporosis in first-degree relatives and grandparents was obtained during interviews.
The prevalence of osteoporosis in participants was 7.94%. In 19.8% of them, a positive family history was reported and was significantly and independently associated with osteoporosis (AOR 2.35, 95% CI=1.87, 2.96). This association was stronger when two or more relatives were affected (AOR 8.48, 95% CI=4.50, 15.99). After stratification by age, the association was observed only in women aged>or=35 years. Women with a family history of osteoporosis were more likely than those with none to report preventive behavior, such as taking supplements of calcium, vitamin D, or both; physical activity; and estrogen use.
These findings indicate that family history is a significant, independent risk factor for osteoporosis in U.S. women aged>or=35 years. Further studies are warranted to evaluate family history as a convenient and inexpensive tool for identifying women at risk of osteoporosis and for promoting the adoption of preventive behaviors.
骨质疏松症是一个重大的公共卫生问题,且与该病的家族史呈阳性有关。然而,关于有此类家族史个体行为的数据却很稀少。本研究的目的是评估在美国女性的代表性样本中,报告的医生诊断骨质疏松症患病率与家族史之间的关系,检验骨质疏松症风险因素是否能解释这种关系,并评估因家族史而处于骨质疏松症高风险的女性报告预防行为的可能性。
在1999 - 2004年国家健康和营养检查调查中,对8073名年龄≥20岁的女性报告的骨质疏松症患病率进行了估计。在访谈期间获取了一级亲属和祖父母中骨质疏松症的信息。
参与者中骨质疏松症的患病率为7.94%。其中19.8%报告有阳性家族史,且与骨质疏松症显著且独立相关(调整后的比值比[AOR]为2.35,95%置信区间[CI]=1.87, 2.96)。当两个或更多亲属受影响时,这种关联更强(AOR为8.48,95% CI = 4.50, 15.99)。按年龄分层后,这种关联仅在年龄≥35岁的女性中观察到。有骨质疏松症家族史的女性比没有家族史的女性更有可能报告预防行为,如服用钙、维生素D或两者的补充剂;进行体育活动;以及使用雌激素。
这些发现表明,家族史是美国年龄≥35岁女性骨质疏松症的一个重要独立风险因素。有必要进一步开展研究,以评估家族史作为一种方便且廉价的工具,用于识别有骨质疏松症风险的女性并促进预防行为的采用。