Lo J C, Zheng P, Grimsrud C D, Chandra M, Ettinger B, Budayr A, Lau G, Baur M M, Hui R L, Neugebauer R
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA,
Osteoporos Int. 2014 Sep;25(9):2313-8. doi: 10.1007/s00198-014-2750-1. Epub 2014 Jun 26.
Contemporary femur fracture rates were examined in northern California women and compared by race/ethnicity. During 2006-2012, hip fracture rates declined, but diaphyseal fracture rates increased, especially in Asians. Women with diaphyseal fracture were younger and more likely to be bisphosphonate-treated. These disparities in femur fracture should be further examined.
The epidemiology of diaphyseal femur fracture differs from proximal femur (hip) fracture, although few studies have examined demographic variations in the current era. This study examines contemporary differences in low-energy femur fracture by race/ethnicity in a large, diverse integrated health-care delivery system.
The incidence of hip and diaphyseal fracture in northern California women aged ≥50 years old during 2006-2012 was examined. Hip (femoral neck and pertrochanteric) fractures were classified by hospital diagnosis codes, while diaphyseal (subtrochanteric and femoral shaft) fractures were further adjudicated based on radiologic findings. Demographic and clinical data were obtained from health plan databases. Fracture incidence was examined over time and by race/ethnicity.
There were 10,648 (97.3 %) hip and 300 (2.7 %) diaphyseal fractures among 10,493 women. The age-adjusted incidence of hip fracture fell from 281 to 240 per 100,000 women and was highest for white women. However, diaphyseal fracture rates increased over time, with a significant upward trend in Asians (9 to 27 per 100,000) who also had the highest rate of diaphyseal fracture. Women with diaphyseal fracture were younger than women with hip fracture, more likely to be of Asian race and to have received bisphosphonate drugs. Women with longer bisphosphonate treatment duration were also more likely to have a diaphyseal fracture, especially younger Asian women.
During 2006 to 2012, hip fracture rates declined, but diaphyseal fracture rates increased, particularly among Asian women. The association of diaphyseal fracture and bisphosphonate therapy should be further investigated with examination of fracture pattern.
对北加利福尼亚州女性的当代股骨骨折发生率进行了研究，并按种族/族裔进行了比较。在2006 - 2012年期间，髋部骨折发生率下降，但骨干骨折发生率上升，尤其是在亚洲女性中。发生骨干骨折的女性更年轻，且更有可能接受双膦酸盐治疗。股骨骨折的这些差异应进一步研究。
虽然很少有研究考察当代股骨骨干骨折与近端股骨（髋部）骨折在人口统计学上的差异，但股骨骨干骨折的流行病学与近端股骨骨折不同。本研究在一个大型、多样化的综合医疗保健服务系统中，考察了按种族/族裔划分的当代低能量股骨骨折差异。
对2006 - 2012年期间北加利福尼亚州年龄≥50岁女性的髋部和骨干骨折发生率进行了研究。髋部（股骨颈和转子周围）骨折通过医院诊断编码进行分类，而骨干（转子下和股骨干）骨折则根据放射学检查结果进行进一步判定。人口统计学和临床数据从健康计划数据库中获取。对骨折发生率随时间以及按种族/族裔进行了研究。
10493名女性中，有10648例（97.3%）髋部骨折和300例（2.7%）骨干骨折。年龄调整后的髋部骨折发生率从每10万名女性281例降至240例，白人女性的发生率最高。然而，骨干骨折发生率随时间上升，亚洲女性（每10万名从9例增至27例）有显著上升趋势，且骨干骨折发生率也是最高的。发生骨干骨折的女性比髋部骨折女性更年轻，更可能是亚洲种族且接受过双膦酸盐药物治疗。双膦酸盐治疗持续时间较长的女性也更有可能发生骨干骨折，尤其是年轻的亚洲女性。
在2006年至2012年期间，髋部骨折发生率下降，但骨干骨折发生率上升，尤其是在亚洲女性中。骨干骨折与双膦酸盐治疗之间的关联应通过对骨折类型的检查进一步研究。
