Diane Feskanich and Walter C. Willett are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Walter C. Willett is also with and Alan J. Flint is with the Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston.
Am J Public Health. 2014 Apr;104(4):e75-81. doi: 10.2105/AJPH.2013.301667. Epub 2014 Feb 13.
We assessed associations between activity and hip fracture in men.
The Health Professionals Follow-up Study reported time spent walking, sitting, and in 10 other discretionary activities every 2 years in 35 996 men aged 50 years and older from 1986 to 2010. We calculated hazard ratios (HRs) for risk of hip fracture by amount of activity and sitting in Cox proportional hazards models, adjusted for age, body mass index, smoking, medication use, disease diagnoses, and diet.
Over 24 years, participants reported 490 low-trauma hip fractures. Energy expenditure from all activities was weakly associated with lower risk of fracture. More walking time, with little other exercise, lowered risk by 43% (HR = 0.57; 95% confidence interval [CI] = 0.39, 0.83 for ≥ 4 vs < 1 hours/week), and risk decreased linearly with more frequent walking (P < .001). Brisk (vs leisurely) pace lowered risk by 47%. Sitting lowered risk (HR = 0.62; 95% CI = 0.43, 0.89 for ≥ 50 vs < 20 hours/week), primarily among those who also walked for exercise. We observed no benefit of strenuous activity.
Walking is a relatively safe and easy activity for hip fracture prevention.
我们评估了男性活动与髋部骨折之间的关联。
健康专业人员随访研究报告了 1986 年至 2010 年期间，年龄在 50 岁及以上的 35996 名男性每两年报告一次的步行、坐立和其他 10 项自由活动的时间。我们使用 Cox 比例风险模型，根据年龄、体重指数、吸烟、药物使用、疾病诊断和饮食，调整了活动量和坐立时间与髋部骨折风险的风险比（HR）。
在 24 年的时间里，参与者报告了 490 例低创伤性髋部骨折。所有活动的能量消耗与较低的骨折风险呈弱相关。更多的步行时间，几乎没有其他运动，降低了 43%的风险（HR=0.57；95%置信区间[CI]为 0.39，0.83，≥4 小时/周与<1 小时/周相比），并且风险随步行频率的增加呈线性下降（P<0.001）。快走（与悠闲散步相比）降低了 47%的风险。坐立时间与风险呈负相关（HR=0.62；95%CI 为 0.43，0.89，≥50 小时/周与<20 小时/周相比），主要发生在那些也因运动而行走的人群中。我们没有观察到剧烈活动的益处。
步行是一种相对安全且易于进行的预防髋部骨折的活动。
