Cummings S R, Black D M, Nevitt M C, Browner W S, Cauley J A, Genant H K, Mascioli S R, Scott J C, Seeley D G, Steiger P
Division of General Internal Medicine, University of California, San Francisco.
JAMA. 1990 Feb 2;263(5):665-8.
To determine whether measurement of bone density predicts hip fracture in women, we prospectively studied 9703 nonblack women aged 65 years and older who had measurements of bone mineral density using single-photon absorptiometry in the calcaneus, distal radius, and proximal radius. During an average of 1.6 years of follow-up, 53 hip fractures occurred. The risk of hip fracture was inversely related to bone density at all three measurement sites. After adjusting for age, the relative risk of hip fracture was 1.66 for a decrease of 1 SD in the bone density at the calcaneus (95% confidence interval, 1.22 to 2.26), 1.55 (95% confidence interval, 1.13 to 2.11) at the distal radius, and 1.41 (95% confidence interval, 1.06 to 1.88) at the proximal radius. None of the three measurements was a significantly better predictor of hip fracture than the others. After adjusting for bone mineral density, the risk of hip fracture doubled for each 10-year increase in age (relative risk, 2.09; 95% confidence interval, 1.31 to 3.33). We conclude that decreased bone density in the appendicular skeleton is associated with an increased risk of hip fracture, but this accounts for only part of the age-related increase in risk of hip fracture among older women.
为了确定骨密度测量能否预测女性髋部骨折，我们对9703名65岁及以上的非黑人女性进行了前瞻性研究，这些女性使用单光子吸收法测量了跟骨、桡骨远端和桡骨近端的骨矿物质密度。在平均1.6年的随访期间，发生了53例髋部骨折。在所有三个测量部位，髋部骨折风险均与骨密度呈负相关。校正年龄后，跟骨骨密度每降低1个标准差，髋部骨折的相对风险为1.66（95%置信区间为1.22至2.26），桡骨远端为1.55（95%置信区间为1.13至2.11），桡骨近端为1.41（95%置信区间为1.06至1.88）。这三项测量中没有一项比其他测量更能显著预测髋部骨折。校正骨矿物质密度后，年龄每增加10岁，髋部骨折风险增加一倍（相对风险为2.09；95%置信区间为1.31至3.33）。我们得出结论，四肢骨骼骨密度降低与髋部骨折风险增加有关，但这仅占老年女性髋部骨折风险随年龄增加的一部分。
