Department of Community Medicine, University of Tromsø, Tromsø, Norway.
BMC Musculoskelet Disord. 2012 Aug 31;13:163. doi: 10.1186/1471-2474-13-163.
Vertebral fractures, the most common type of osteoporotic fractures, are associated with increased risk of subsequent fracture, morbidity, and mortality. The aim of this study was to examine the contribution of important risk factors to the variability in vertebral fracture risk.
Vertebral fracture was ascertained by VFA method (DXA, GE Lunar Prodigy) in 2887 men and women, aged between 38 and 87 years, in the population-based Tromsø Study 2007/2008. Bone mineral density (BMD; g/cm2) at the hip was measured by DXA. Lifestyle information was collected by questionnaires. Multivariable logistic regression model, with anthropometric and lifestyle factors included, was used to assess the association between each or combined risk factors and vertebral fracture risk. Population attributable risk was estimated for combined risk factors in the final multivariable model.
In both sexes, age (odds ratio [OR] per 5 year increase: 1.32; 95% CI 1.19-1.45 in women and 1.21; 95% CI 1.10-1.33 in men) and BMD (OR per SD decrease: 1.60; 95% CI 1.34-1.90 in women and1.40; 95% CI 1.18-1.67 in men) were independent risk factors for vertebral fracture. At BMD levels higher than 0.85 g/cm2, men had a greater risk of fracture than women (OR 1.52; 95% CI 1.14-2.04), after adjusting for age. In women and men, respectively, approximately 46% and 33% of vertebral fracture risk was attributable to advancing age (more than 70 years) and low BMD (less than 0.85 g/cm2), with the latter having a greater effect than the former.
These data confirm that age and BMD are major risk factors for vertebral fracture risk. However, in both sexes the two factors accounted for less than half of fracture risk. The identification of individuals with vertebral fracture is still a challenge.
椎体骨折是最常见的骨质疏松性骨折类型，与随后骨折、发病率和死亡率的风险增加有关。本研究旨在研究重要危险因素对椎体骨折风险变异性的贡献。
在 2007/2008 年的基于人群的特罗姆瑟研究中，使用 VFA 方法（DXA，GE Lunar Prodigy）在 2887 名年龄在 38 至 87 岁之间的男性和女性中确定椎体骨折。通过 DXA 测量髋部骨矿物质密度（BMD；g/cm2）。通过问卷调查收集生活方式信息。使用多变量逻辑回归模型，纳入人体测量和生活方式因素，评估每个或组合危险因素与椎体骨折风险之间的关联。在最终的多变量模型中，估计了联合危险因素的人群归因风险。
在男性和女性中，年龄（每增加 5 年的比值比[OR]：女性为 1.32；95%CI 1.19-1.45，男性为 1.21；95%CI 1.10-1.33）和 BMD（每降低 1 SD 的 OR：女性为 1.60；95%CI 1.34-1.90，男性为 1.40；95%CI 1.18-1.67）是椎体骨折的独立危险因素。在 BMD 水平高于 0.85 g/cm2 时，男性的骨折风险高于女性（OR 1.52；95%CI 1.14-2.04），调整年龄后。在女性和男性中，分别有大约 46%和 33%的椎体骨折风险归因于年龄增长（超过 70 岁）和低 BMD（低于 0.85 g/cm2），后者的影响大于前者。
这些数据证实年龄和 BMD 是椎体骨折风险的主要危险因素。然而，在男性和女性中，这两个因素仅占骨折风险的不到一半。确定有椎体骨折的个体仍然是一个挑战。
