Pye Stephen R, Tobias Jon, Silman Alan J, Reeve Jonathan, O'Neill Terence W
ARC Epidemiology Unit, The University of Manchester, Manchester, United Kingdom.
J Bone Miner Res. 2009 Jul;24(7):1314-8. doi: 10.1359/jbmr.090220.
Childhood fractures are common. Their clinical relevance to osteoporosis and fractures in later life is unclear. The aim of this study was to determine the predictive risk of childhood fracture on the risk of fracture in later life. Men and women >or=50 yr of age were recruited from population registers for participation in the European Prospective Osteoporosis Study (EPOS). Subjects completed an interviewer administered questionnaire that included questions about previous fractures and the age at which the first of these fractures occurred. Lateral spine radiographs were performed to ascertain prevalent vertebral deformities. Subjects were followed prospectively by postal questionnaire to determine the occurrence of clinical fractures. A subsample of subjects had BMD measurements performed. Cox proportional hazards model was used to determine the predictive risk of childhood fracture between the ages of 8 and 18 yr on the risk of future limb fracture and logistic regression was used to determine the association between reported childhood fractures and prevalent vertebral deformity. A total of 6451 men (mean age, 63.8 yr) and 6936 women (mean age, 63.1 yr) were included in the analysis. Mean follow-up time was 3 yr. Of these, 574 (8.9%) men and 313 (4.5%) women reported a first fracture (any site) between the ages of 8 and 18 yr. A recalled history of any childhood fracture or forearm fracture was not associated with an increased risk of future limb fracture or prevalent vertebral deformity in either men or women. Among the 4807 subjects who had DXA measurements, there was no difference in bone mass among those subjects who had reported a childhood fracture and those who did not. Our data suggest that self-reported previous childhood fracture is not associated with an increased risk of future fracture in men or women.
儿童骨折很常见。它们与骨质疏松症及晚年骨折的临床相关性尚不清楚。本研究的目的是确定儿童骨折对晚年骨折风险的预测性风险。从人口登记册中招募年龄≥50岁的男性和女性参与欧洲前瞻性骨质疏松症研究（EPOS）。受试者完成了一份由访谈员管理的问卷，其中包括有关既往骨折及首次骨折发生年龄的问题。进行了脊柱侧位X线片检查以确定现患椎体畸形情况。通过邮寄问卷对受试者进行前瞻性随访，以确定临床骨折的发生情况。对一部分受试者进行了骨密度测量。采用Cox比例风险模型确定8至18岁儿童骨折对未来肢体骨折风险的预测性风险，并采用逻辑回归分析确定报告的儿童骨折与现患椎体畸形之间的关联。分析共纳入6451名男性（平均年龄63.8岁）和6936名女性（平均年龄63.1岁）。平均随访时间为3年。其中，574名（8.9%）男性和313名（4.5%）女性报告在8至18岁之间有首次骨折（任何部位）。回忆起有任何儿童期骨折或前臂骨折病史，在男性或女性中均与未来肢体骨折风险增加或现患椎体畸形无关。在4807名进行了双能X线吸收法（DXA）测量的受试者中，报告有儿童期骨折的受试者与未报告的受试者之间骨量无差异。我们的数据表明，自我报告的既往儿童期骨折与男性或女性未来骨折风险增加无关。
