Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Peltolantie 3, 20720, Turku, Finland,
Osteoporos Int. 2013 Oct;24(10):2611-8. doi: 10.1007/s00198-013-2355-0. Epub 2013 Apr 18.
Adjusted for age, gender, height and weight, calcaneal quantitative ultrasound (QUS) and serum 25-hydroxyvitamin D (S-25(OH)D) proved to be significant predictors of hip fracture among subjects aged ≥50 years. Even if their contribution to the predictive power was modest, they may be useful in the assessment of hip fracture risk in the elderly.
This study assessed calcaneal QUS measurements, S-25(OH)D and several other factors for the prediction of hip fracture risk in a nationally representative population sample.
The study population consisted of 3,305 subjects (1,872 women), aged 50 years or over, who had participated in a comprehensive health survey. QUS measurements were made by means of the Hologic Sahara device. S-25(OH)D was measured by radioimmunoassay. Emerging cases of hip fracture were identified from the National Hospital Discharge Register.
During a mean follow-up of 8.4 years, 95 subjects sustained a hip fracture. After adjusting for age, gender, height, weight and each other, a 1 standard deviation increment in the quantitative ultrasound index (QUI) (21.7) and in S-25(OH)D (17.5 nmol/L) reduced the risk of hip fracture by 40 % (hazard ratio [HR] = 0.60, 95 % confidence interval [CI] = 0.42-0.86) and by 31 % (HR = 0.69, 95 % CI = 0.55-0.87), respectively. The predictive power of a model including age, gender, height and weight was improved by about 8 % after the addition of QUI and S-25(OH)D. Among subjects aged 75 years or over, the corresponding improvement was about 130 %.
QUI and S-25(OH)D were significant and independent predictors of hip fracture. However, their ability to increase the predictive power of a statistical model including readily available simple variables such as age, gender, height and weight was rather modest. Still, our findings suggest that QUI and S-25(OH)D may be of clinical use in the assessment of hip fracture risk particularly in the elderly.
在调整年龄、性别、身高和体重后，跟骨定量超声（QUS）和血清 25-羟维生素 D（S-25（OH）D）被证明是 50 岁及以上人群髋部骨折的重要预测因子。即使它们对预测能力的贡献不大，但它们可能有助于评估老年人的髋部骨折风险。
本研究评估了跟骨 QUS 测量、S-25（OH）D 和其他几个因素在全国代表性人群样本中对髋部骨折风险的预测作用。
研究人群由 3305 名年龄在 50 岁及以上、参加了一项综合健康调查的受试者组成。使用 Hologic Sahara 设备进行 QUS 测量。S-25（OH）D 通过放射免疫法测量。从国家住院患者登记处确定新发髋部骨折病例。
在平均 8.4 年的随访期间，95 名受试者发生髋部骨折。在校正年龄、性别、身高、体重和其他因素后，定量超声指数（QUI）（21.7）和 S-25（OH）D（17.5 nmol/L）每增加 1 个标准差，髋部骨折的风险分别降低 40%（危险比 [HR] = 0.60，95%置信区间 [CI] = 0.42-0.86）和 31%（HR = 0.69，95% CI = 0.55-0.87）。在包含年龄、性别、身高和体重的模型中加入 QUI 和 S-25（OH）D 后，预测能力提高了约 8%。在 75 岁及以上的受试者中，相应的提高约为 130%。
QUI 和 S-25（OH）D 是髋部骨折的重要且独立的预测因子。然而，它们增加包含年龄、性别、身高和体重等易于获得的简单变量的统计模型的预测能力的能力相当有限。尽管如此，我们的研究结果表明，QUI 和 S-25（OH）D 可能在评估髋部骨折风险方面具有临床应用价值，特别是在老年人中。
