Department of Public Health, Kinki University School of Medicine, 377-2 Oono-higashi, Osaka-Sayama 589-8511, Japan.
Osteoporos Int. 2010 Sep;21(9):1513-22. doi: 10.1007/s00198-009-1113-9. Epub 2009 Nov 19.
Prevalent vertebral deformity increases incident vertebral fracture risk according to studies focusing primarily on Caucasian elderly populations. We report a 3-fold increase in this risk in a population-based cohort of Japanese women after adjusting for subject propensity for having vertebral deformities. This relationship tended to be stronger in middle-aged women.
Evidence on increased risk of incident vertebral fractures associated with vertebral deformity in middle-aged women is limited. We aimed to evaluate this risk in a population-based cohort of Japanese women.
We followed 712 women aged 50-79 years at baseline randomly selected from 3 municipalities in Japan for 6 years. McCloskey-Kanis criteria identified vertebral deformities on X-ray absorptiometric images. At follow-up, vertebra with > or = 20% height reduction from baseline were considered incident fractures. Rate ratio (RR) of incident fracture for prevalent vertebral deformities was calculated using the Poisson regression equation adjusted for propensity of having vertebral deformities based on potential risk factors.
Vertebral fractures occurred in 73 women (10.3%). Crude RR of vertebral deformity-associated fracture was 4.63 [95% confidence interval (CI), 3.04-7.04] and decreased to 2.96 (95% CI, 1.77-4.94) after propensity score adjustment. Adjusted RR was generally greater in younger women at 7.19 (95% CI, 1.04-49.6), 3.19 (95% CI, 1.27-7.97), and 2.34 (95% CI, 1.33-4.11) for women aged 50-59, 60-69, and 70-79 years, respectively (p = 0.0527 for those aged 50-59 vs 70-79).
Vertebral deformity was associated with a 3-fold increase in subsequent vertebral fracture risk in Japanese women, and this association was stronger in middle-aged women.
主要针对白种老年人群体的研究表明，普遍存在的脊柱畸形会增加新发脊柱骨折的风险。我们报告了在日本女性的基于人群队列中，这种风险增加了 3 倍，并且在调整了受试者发生脊柱畸形的倾向后仍然如此。这种关系在中年女性中似乎更强。
关于中年女性脊柱畸形与新发脊柱骨折风险增加相关的证据有限。我们旨在评估日本女性基于人群的队列中的这种风险。
我们对日本 3 个市的 712 名年龄在 50-79 岁的女性进行了 6 年的随访。McCloskey-Kanis 标准通过 X 射线吸收测量图像识别脊柱畸形。在随访时，基线时椎体高度减少>或=20%的椎体被认为是新发骨折。使用泊松回归方程，根据潜在风险因素，对存在脊柱畸形的倾向进行校正后，计算出与普遍存在的脊柱畸形相关的新发骨折的发病率比（RR）。
共有 73 名女性（10.3%）发生了脊柱骨折。未校正时，脊柱畸形相关骨折的 RR 为 4.63（95%可信区间，3.04-7.04），校正倾向评分后降至 2.96（95%可信区间，1.77-4.94）。在年龄较小的女性中，调整后的 RR 普遍更大，分别为 7.19（95%可信区间，1.04-49.6）、3.19（95%可信区间，1.27-7.97）和 2.34（95%可信区间，1.33-4.11），年龄分别为 50-59 岁、60-69 岁和 70-79 岁（年龄为 50-59 岁的女性与 70-79 岁的女性相比，p=0.0527）。
在日本女性中，脊柱畸形与随后发生的脊柱骨折风险增加了 3 倍，这种关联在中年女性中更强。
