Department of Social Medicine, University of Bristol, Bristol, UK.
Age Ageing. 2010 Sep;39(5):565-74. doi: 10.1093/ageing/afq068. Epub 2010 Jun 17.
physical activity is promoted for older women as a means of maintaining health and avoiding falls and fractures. Findings relating physical activity of older women to risk of falls and fracture are contradictory. The association between level of physical activity and prevalent and incident hip and wrist fractures was examined in a large representative sample of postmenopausal British women.
data from the British Women's Heart and Health Study, a cohort study of 4286 postmenopausal women aged 60-79, from 23 UK towns were used. Information on physical activity, anthropometry, falls and hip and wrist fractures from baseline examination and questionnaire (1999-2001) and follow-up questionnaire (2007) were available. Cross-sectional baseline prevalence data were analysed using logistic regression and cohort incidence data using a Cox proportional hazards model examining the association of physical activity with fracture outcomes.
3003 (70%) women, with complete baseline data, were studied. 13.6% had previously fractured a wrist and 1.3% a hip. Analyses unadjusted for confounders showed moderate protective associations between activity and fracture risk. After adjustment for confounders there was a weak trend towards fewer hip fractures (adjusted OR 0.13 [0.01, 1.18]) and more wrist fractures (adjusted OR 1.35 [0.76, 2.48]), amongst most active compared with inactive women. The crude incidence rate of wrist and/or hip fracture was 7.0 [5.9, 8.2] per 1000 person-years. No evidence was found for an association between physical activity and combined incident hip and/or wrist fracture (adjusted rate ratio inactive versus most active 1.69 [0.67, 4.24]).
no clear associations between graded physical activity and hip/wrist fractures were seen but estimates were imprecise. Physical activities are heterogeneous and individual fracture types and mechanisms differ. Very large prospective observational studies are required to disentangle the precise effects of different activity patterns on different fracture types.
体力活动被提倡用于老年女性，以维持健康、预防跌倒和骨折。然而，关于体力活动与老年女性跌倒和骨折风险的研究结果存在矛盾。本研究旨在调查英国绝经后女性体力活动水平与髋部和腕部骨折现患率和发生率的关系。
本研究使用了来自英国妇女心脏与健康研究（British Women's Heart and Health Study）的数据，该研究是一项队列研究，共纳入了 23 个英国城镇的 4286 名 60-79 岁的绝经后女性。基线检查和问卷调查（1999-2001 年）及随访问卷调查（2007 年）收集了体力活动、人体测量学、跌倒和髋部及腕部骨折的相关信息。采用逻辑回归分析横断面基线患病率数据，采用 Cox 比例风险模型分析队列发生率数据，以评估体力活动与骨折结局的关系。
共纳入了 3003 名（70%）完成基线数据采集的女性，其中 13.6%的女性既往有腕部骨折史，1.3%的女性有髋部骨折史。在未校正混杂因素的情况下，分析结果显示体力活动与骨折风险之间存在中度保护关联。在校正混杂因素后，与不活动的女性相比，最活跃的女性髋部骨折（校正后的比值比为 0.13[0.01, 1.18]）和腕部骨折（校正后的比值比为 1.35[0.76, 2.48]）的风险略有降低。最活跃与不活跃女性的粗发生率分别为 7.0[5.9, 8.2]/1000 人年。未发现体力活动与髋部和/或腕部骨折的复合发生率之间存在关联（校正后的率比值为 1.69[0.67, 4.24]）。
本研究未发现体力活动与髋部/腕部骨折之间存在明确关联，但估计值的精确度不高。体力活动的类型多种多样，且个体骨折类型和机制存在差异。需要开展非常大型的前瞻性观察性研究，以厘清不同活动模式对不同骨折类型的确切影响。
