School of Population Health, University of Queensland.
J Epidemiol. 2013;23(6):435-42. doi: 10.2188/jea.je20120215. Epub 2013 Sep 28.
We investigated risk factors for fracture among young adults, particularly body mass index (BMI) and physical activity, which although associated with fracture in older populations have rarely been investigated in younger people.
In 2009, 4 years after initial recruitment, 58 204 Thais aged 19 to 49 years were asked to self-report fractures incident in the preceding 4 years. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs for associations of fracture incidence with baseline BMI and physical activity.
Very obese women had a 70% increase in fracture risk (OR = 1.73, 95% CI 1.21-2.46) as compared with women with a normal BMI. Fracture risk increased by 15% with every 5-kg/m(2) increase in BMI. The effects were strongest for fractures of the lower limbs. Frequent purposeful physical activity was also associated with increased fracture risk among women (OR = 1.52, 95% CI 1.12-2.06 for 15 episodes/week vs none). Neither BMI nor physical activity was associated with fracture among men, although fracture risk decreased by 4% with every additional 2 hours of average sitting time per day (OR = 0.96, 95% CI 0.93-0.99).
The increase in obesity prevalence will likely increase fracture burden among young women but not young men. While active lifestyles have health benefits, our results highlight the importance of promoting injury prevention practices in conjunction with physical activity recommendations, particularly among women.
我们研究了年轻人骨折的危险因素，尤其是体重指数（BMI）和体力活动，尽管这些因素与老年人群的骨折有关，但在年轻人中很少有研究。
2009 年，在最初招募后的 4 年，58204 名年龄在 19 至 49 岁的泰国人被要求报告过去 4 年内发生的骨折。使用条件逻辑回归计算骨折发生率与基线 BMI 和体力活动之间的关联的比值比（OR）和 95%置信区间（CI）。
与 BMI 正常的女性相比，非常肥胖的女性骨折风险增加 70%（OR=1.73，95%CI 1.21-2.46）。BMI 每增加 5-kg/m2，骨折风险增加 15%。这种影响在下肢骨折中最为明显。经常有目的的体力活动也与女性骨折风险增加有关（每周 15 次活动与不活动相比，OR=1.52，95%CI 1.12-2.06）。BMI 和体力活动均与男性骨折无关，但每天平均坐 2 小时以上，骨折风险降低 4%（OR=0.96，95%CI 0.93-0.99）。
肥胖患病率的增加可能会增加年轻女性的骨折负担，但不会增加年轻男性的骨折负担。虽然积极的生活方式有益健康，但我们的研究结果强调了在推广体力活动建议的同时，促进预防受伤的实践的重要性，特别是在女性中。
