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Arch Osteoporos. 2013;8:141. doi: 10.1007/s11657-013-0141-4. Epub 2013 May 29.
Differences in the relationship between femur neck bone mineral density (FNBMD) and fracture risk were examined by age, sex, and race/ethnicity in the third National Health and Nutrition Examination Survey (NHANES III) cohort. FNBMD had similar, significant predictive utility for fracture in the different subgroups, but it did not completely account for subgroup differences in risk.
Few previous studies of FNBMD and fracture risk examined the relationship by age, sex, and race within the same cohort. The present study examined the relationship between FNBMD and risk of incident major osteoporotic fracture (hip, spine, radius, and humerus) in older US adults from NHANES III (1988-1994).
Incident fractures were identified using linked mortality and Medicare records obtained through 2007 for 2,743 men and women ages 65 years and older. FNBMD was measured by dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazards ratio (HR) of fracture for FNBMD and femur neck T score and risk of major osteoporotic fracture.
The sample included 380 incident major osteoporotic fractures. Fracture risk approximately doubled for each SD decrease in FNBMD. HR's for FNBMD were similar within age, sex, or race/Hispanic origin subgroups, and also for T scores calculated with either white female or sex- and race/ethnic-specific reference data. Adding FNBMD to Cox models slightly attenuated HR for age, sex, or race/Hispanic origin, but all three variables remained significant predictors of fracture risk.
FNBMD had similar, significant predictive utility within age, sex, and race/Hispanic origin subgroups. However, FNBMD did not appear to completely account for fracture risk differences in these subgroups. Similarity of HR's for T scores calculated with two different reference databases support use of a uniform reference database to calculate these scores.
先前研究股骨颈骨密度（FNBMD）与骨折风险的关系时，很少在同一队列中按年龄、性别和种族/民族进行分析。本研究旨在探讨美国老年人股骨颈骨密度与非椎体、椎体、桡骨和肱骨骨折风险的关系。
通过 2007 年的死亡和医疗保险记录，对来自 NHANES III（1988-1994 年）的 2743 名年龄在 65 岁及以上的男性和女性进行了骨折的识别。FNBMD 通过双能 X 射线吸收法进行测量。使用 Cox 比例风险模型来估计 FNBMD 和股骨颈 T 评分与骨折风险的比值比（HR）。
样本中包括 380 例骨质疏松性骨折。FNBMD 每降低 1 个标准差，骨折风险增加约 2 倍。FNBMD 的 HR 在年龄、性别或种族/西班牙裔亚组内相似，也与白人女性或性别和种族/族裔特异性参考数据计算的 T 评分相似。在 Cox 模型中加入 FNBMD 略微降低了年龄、性别或种族/西班牙裔的 HR，但所有三个变量仍然是骨折风险的显著预测因子。
FNBMD 在年龄、性别和种族/西班牙裔亚组内具有相似的、显著的预测能力。然而，FNBMD 似乎并不能完全解释这些亚组中骨折风险的差异。用两种不同参考数据库计算的 T 评分的 HR 相似，支持使用统一的参考数据库来计算这些评分。
