Institute of community medicine, University of Tromsø, 9037 Tromsø, Norway.
Osteoporos Int. 2010 Sep;21(9):1503-11. doi: 10.1007/s00198-009-1102-z. Epub 2009 Nov 21.
We assessed the association between the rate of forearm bone loss and non-vertebral fracture. Bone loss at the distal forearm predicted fractures, independently of baseline BMD, but not independently of follow-up BMD in women. The BMD level where an individual ends up is the significant predictor of fracture risk.
Bone loss may predict fracture risk independently of baseline BMD. The influence of follow-up BMD on this prediction is unknown. The aim of this study was to assess the association between bone loss and fracture risk in both sexes in a prospective population-based study.
We included 1,208 postmenopausal women (50 to 74 years), and 1,336 men (55 to 74 years) from the Tromsø Study, who had repeated distal and ultra-distal forearm BMD measurements. Non-vertebral fractures were registered from 2001 to 2005.
A total of 100 women and 46 men sustained fractures during the follow-up time. Independent of baseline BMD, the RR associated with distal site bone loss of 1 SD %/year was 1.23 (1.01-1.50) for low-trauma fractures (excluding hand, foot, skull & high-trauma) and 1.32 (1.07-1.62) for osteoporotic fractures (hip, wrist and shoulder). However, bone loss did not predict fracture after adjusting for follow-up BMD. The BMD level where an individual ends up became the significant predictor of fracture risk and not the rate of bone loss. Follow-up BMD at ultra-distal site was associated with low-trauma fractures in both sexes. While ultra-distal site BMD changes were not associated with fracture risk in both sexes.
Bone loss at the distal forearm predicted non-vertebral fractures, independently of baseline BMD, but not independently of follow-up BMD, in women. The BMD level where an individual ends up is the significant predictor of fracture risk and not the rate of bone loss.
我们评估了前臂骨丢失率与非椎体骨折之间的关系。前臂远端的骨丢失可以预测骨折，独立于基线骨密度，但在女性中并不独立于随访骨密度。个人最终的骨密度水平是骨折风险的重要预测指标。
骨丢失可能独立于基线骨密度预测骨折风险。随访骨密度对这种预测的影响尚不清楚。本研究的目的是在一项前瞻性人群研究中评估男女两性的骨丢失与骨折风险之间的关系。
我们纳入了来自特罗姆瑟研究的 1208 名绝经后妇女（50 至 74 岁）和 1336 名男性（55 至 74 岁），他们进行了重复的远端和超远端前臂骨密度测量。从 2001 年到 2005 年，记录了非椎体骨折。
在随访期间，共有 100 名女性和 46 名男性发生骨折。独立于基线骨密度，每年远端部位骨丢失 1 个标准差的 RR 与低创伤性骨折（不包括手部、足部、颅骨和高创伤性骨折）相关为 1.23（1.01-1.50），与骨质疏松性骨折（髋部、腕部和肩部）相关为 1.32（1.07-1.62）。然而，在调整随访骨密度后，骨丢失并不能预测骨折。个人最终的骨密度水平成为骨折风险的重要预测指标，而不是骨丢失率。在两性中，超远端部位的骨密度与低创伤性骨折相关。而在两性中，超远端部位的骨密度变化与骨折风险无关。
在女性中，前臂远端的骨丢失预测非椎体骨折，独立于基线骨密度，但不独立于随访骨密度。个人最终的骨密度水平是骨折风险的重要预测指标，而不是骨丢失率。
