Tebé Cristian, del Río Luis Miguel, Casas Lidia, Estrada Maria-Dolors, Kotzeva Anna, Di Gregorio Silvana, Espallargues Mireia
Agència d'Informació, Avaluació i Qualitat en Salut (AIAQS), Barcelona, España.
Gac Sanit. 2011 Nov-Dec;25(6):507-12. doi: 10.1016/j.gaceta.2011.06.007. Epub 2011 Sep 28.
Fragility fractures are an important public health issue. The aim of this study was to analyze the association of the main osteoporotic risk factors related to fragility fracture in a cohort of women with an indication of bone densitometry (BD).
A retrospective cohort was followed-up until a fragile fracture occurred, in a population of women aged 40 to 90 years with a first visit for BD between January 1992 and February 2008. We calculated the incidence rate of fracture per 1000 women-years of follow-up, and the hazard ratio (HR) of fragile fracture using a Cox regression model.
A total of 49,735 women were studied. The average age of participants was 57.8 years (SD: 8.5). Of these, 3631 women (7.1%) reported a new fragility fracture in post-baseline visits. Risk factors with higher adjusted HR were age ≥ 75 years compared with age < 55 years (HR: 3.8; 95% CI: 3.3-4.4) and having a BC result evaluated as osteoporosis compared to normal (HR: 2.0; 95% CI: 1.8-2.2). A personal history of humerus, hip or vertebral fractures had an adjusted HR of 1.2 (95% CI: 1.1-1.3).
The main risk factors for fragility fracture were advanced age, BD result and a personal history of fracture, although 74% of fractures were detected with a bone mineral density classified as normal or osteopenia. Other relevant factors were rheumatoid arthritis or having received prolonged corticosteroid therapy.
脆性骨折是一个重要的公共卫生问题。本研究的目的是分析一组有骨密度测量(BD)指征的女性队列中与脆性骨折相关的主要骨质疏松危险因素之间的关联。
对一个回顾性队列进行随访,直至发生脆性骨折,该队列包括1992年1月至2008年2月期间首次因骨密度测量就诊的40至90岁女性。我们计算了每1000名女性随访年的骨折发生率,并使用Cox回归模型计算脆性骨折的风险比(HR)。
共研究了49735名女性。参与者的平均年龄为57.8岁(标准差:8.5)。其中,3631名女性(7.1%)在基线后随访中报告发生了新的脆性骨折。调整后HR较高 的危险因素包括:与年龄<55岁相比,年龄≥75岁(HR:3.8;95%置信区间:3.3-4.4);与骨密度正常相比,骨密度结果评估为骨质疏松(HR:2.0;95%置信区间:1.8-2.2)。肱骨、髋部或椎体骨折的个人史调整后HR为1.2(95%置信区间:1.1-1.3)。
脆性骨折的主要危险因素是高龄、骨密度结果和骨折个人史,尽管74%的骨折是在骨矿物质密度分类为正常或骨量减少时检测到的。其他相关因素是类风湿关节炎或接受过长时间的糖皮质激素治疗。