Puisto Ville, Rissanen Harri, Heliövaara Markku, Knekt Paul, Helenius Ilkka
National Public Health Institute and the Hospital for Children and Adolescents, Helsinki, Finland.
Ann Epidemiol. 2008 Aug;18(8):595-601. doi: 10.1016/j.annepidem.2008.04.009.
Vertebral fractures and scoliosis, unlike Scheuermann's disease, have been associated with increased mortality. Total and cause-specific mortalities of these spinal deformities were studied to produce epidemiologic knowledge.
A population of 16,010 Finnish men and women 20 to 92 years of age participated in a health examination from 1973-1976. Their spinal deformities were assessed from chest radiographs by two radiologists. Logistic regression and Cox's model were used to estimate risk ratios and to control confounding. The follow-up period was 30 years.
Vertebral fracture significantly predicted total mortality, and this increase in mortality was due to an excess of cancer and respiratory deaths. The increased risk of cancer death persisted even when those subjects with a history of cancer and the first 5 years of follow-up were excluded to avoid the effect of metastatic fractures, and when confounding was controlled. In this analysis the relative risk of cancer death in subjects with a baseline vertebral fracture was 2.02 (95% confidence interval: 1.23-3.31).
Vertebral fracture significantly predicted increased mortality from cancer. To clarify the mechanism, the fractures should be studied further for their associations with defined and site-specific cancer types.
与休门氏病不同，椎体骨折和脊柱侧弯与死亡率增加有关。对这些脊柱畸形的全因死亡率和特定病因死亡率进行研究以获取流行病学知识。
1973年至1976年，16010名年龄在20至92岁之间的芬兰男女参与了一项健康检查。两名放射科医生通过胸部X光片评估他们的脊柱畸形情况。采用逻辑回归和考克斯模型来估计风险比并控制混杂因素。随访期为30年。
椎体骨折显著预测了全因死亡率，而这种死亡率的增加是由于癌症和呼吸道疾病死亡人数过多所致。即使排除有癌症病史的受试者以及随访的前5年以避免转移性骨折的影响，并控制混杂因素后，癌症死亡风险的增加仍然存在。在此分析中，基线时有椎体骨折的受试者癌症死亡的相对风险为2.02（95%置信区间：1.23 - 3.31）。
椎体骨折显著预测了癌症死亡率的增加。为阐明其机制，应进一步研究骨折与特定明确癌症类型之间的关联。
