Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
Scand J Public Health. 2012 Feb;40(1):102-8. doi: 10.1177/1403494811425604. Epub 2011 Oct 17.
It is not known whether the recently described break in the trend in hip fracture incidence in many settings applies in both women and men, depends on changes in bone mineral density (BMD) or changes in other risk factors, or whether it is apparent in both urban and rural settings.
We evaluated changes in annual hip fracture incidence from 1987 to 2002 in Swedish men aged ≥60 years in one urban (n = 25,491) and one rural population (n = 16,432) and also secular differences in BMD, measured by single-photon absorptiometry at the distal radius and multiple other risk factors for hip fracture in a population-based sub-sample of the urban and the rural men aged 60-80 years in 1988/89 (n = 202 vs. 121) and in 1998/99 (n = 79 vs. 69).
No statistically significant changes in the annual age-adjusted hip fracture incidence per 10,000 were apparent from 1987 to 2002 in urban (0.38 per year, 95% CI -0.12 to 0.88) or rural men (-0.05 per year, 95% CI -0.63 to 0.53). BMD was similar in 1988/89 and 1998/99 when examining both urban (-19.6 mg/cm(2), 95% CI -42.6 to 3.5) and rural (-23.0 mg/cm(2), 95% CI -52.1 to 6.1) men.
Since no secular change in age-adjusted hip fracture incidence was found during the study period, a levelling off in hip fracture incidence is present also in Swedish men. Because BMD on a group level was similar in 1988/89 and 1998/99, changes in other risk factors ought to be either of minor importance or counteracted by changes in different risk factors.
最近在许多地方观察到髋部骨折发生率趋势的中断，这种情况是否同样适用于女性和男性，是否取决于骨密度（BMD）的变化或其他风险因素的变化，或者是否在城市和农村地区都明显，目前尚不清楚。
我们评估了 1987 年至 2002 年期间瑞典≥60 岁男性髋部骨折的年发生率变化，城市（n=25491）和农村（n=16432）人群各有一个，还评估了城市和农村 60-80 岁人群基于人群的亚组中，1988/89 年（n=202 对 121）和 1998/99 年（n=79 对 69）时桡骨远端单光子吸收法测量的 BMD 以及其他多个髋部骨折风险因素的随时间推移的差异。
在城市（每年每 10000 人 0.38 例，95%CI -0.12 至 0.88）或农村男性（每年每 10000 人-0.05 例，95%CI -0.63 至 0.53）中，1987 年至 2002 年期间，每年年龄调整后的髋部骨折发生率无统计学意义的变化。当检查城市（-19.6mg/cm(2)，95%CI -42.6 至 3.5）和农村（-23.0mg/cm(2)，95%CI -52.1 至 6.1）男性时，1988/89 年和 1998/99 年 BMD 相似。
在研究期间未发现年龄调整后的髋部骨折发生率的长期变化，这表明瑞典男性的髋部骨折发生率也趋于平稳。由于在 1988/89 年和 1998/99 年组水平上 BMD 相似，其他风险因素的变化要么不重要，要么被不同风险因素的变化所抵消。
