Ensrud Kristine E, Blackwell Terri L, Cawthon Peggy M, Bauer Douglas C, Fink Howard A, Schousboe John T, Black Dennis M, Orwoll Eric S, Kado Deborah M, Cauley Jane A, Mackey Dawn C
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
J Bone Miner Res. 2016 Jan;31(1):204-7. doi: 10.1002/jbmr.2589. Epub 2015 Aug 3.
To examine the degree of trauma in major osteoporotic fractures (MOF) in men versus women, we used data from 15,698 adults aged ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) study (5994 men) and the Study of Osteoporotic Fractures (SOF) (9704 women). Participants were contacted tri-annually to ascertain incident fractures, which were confirmed by radiographic reports and coded according to degree of self-reported trauma. Trauma was classified as low (fall from ≤ standing height; fall on stairs, steps, or curb; minimal trauma other than fall [coughing, turning over]); moderate (collisions with objects during normal activity without associated fall); or high (fall from > standing height; severe trauma [motor vehicle accident, assault]). MOF included hip, clinical vertebral, wrist, and humerus fractures. Mean fracture follow-up was 9.1 years in SOF and 8.7 years in MrOS. A total of 14.6% of the MOF in men versus 6.3% of the MOF in women were classified as high trauma (p < 0.001); men versus women more often experienced fractures resulting from severe trauma as well as from fall > standing height. High-trauma fractures were more significantly common in men versus women at the hip (p = 0.002) and wrist (p < 0.001) but not at the spine or humerus. Among participants with MOF, the odds ratio of a fracture related to high-trauma fracture among men versus women was 3.12 (95% confidence interval [CI] 1.70-5.71) after adjustment for traditional risk factors. Findings were similar in analyses limited to participants with hip fractures (odds ratio [OR] = 3.34, 95% CI 1.04-10.67) and those with wrist fracture (OR = 5.68, 95% CI 2.03-15.85). Among community-dwelling older adults, MOF are more likely to be related to high trauma in men than in women. These findings are not explained by sex differences in conventional risk factors and may reflect a greater propensity among men to engage in risky behavior. © 2015 American Society for Bone and Mineral Research.
为了研究男性与女性在主要骨质疏松性骨折（MOF）中的创伤程度，我们使用了参加男性骨质疏松性骨折（MrOS）研究（5994名男性）和骨质疏松性骨折研究（SOF）（9704名女性）的15698名年龄≥65岁成年人的数据。每三年联系参与者以确定新发骨折情况，这些骨折由X线报告确认，并根据自我报告的创伤程度进行编码。创伤分为轻度（从站立高度及以下跌落；在楼梯、台阶或路边跌倒；除跌倒外的轻微创伤[咳嗽、翻身]）；中度（正常活动中与物体碰撞但未伴随跌倒）；或重度（从站立高度以上跌落；严重创伤[机动车事故、袭击]）。MOF包括髋部、临床椎体、腕部和肱骨骨折。SOF中骨折的平均随访时间为9.1年，MrOS中为8.7年。男性MOF中有14.6%被归类为重度创伤，而女性MOF中这一比例为6.3%（p<0.001）；男性比女性更常经历由严重创伤以及从站立高度以上跌落导致的骨折。重度创伤性骨折在男性髋部（p = 0.002）和腕部（p<0.001）比女性更显著常见，但在脊柱或肱骨部位并非如此。在患有MOF的参与者中，调整传统风险因素后，男性与女性相比，与重度创伤性骨折相关的骨折比值比为3.12（95%置信区间[CI]1.70 - 5.71）。在仅限于髋部骨折参与者（比值比[OR]=3.34，95%CI 1.04 - 10.67）和腕部骨折参与者（OR = 5.68，95%CI 2.03 - 15.85）的分析中，结果相似。在社区居住的老年人中，男性MOF比女性更可能与重度创伤相关。这些发现不能用传统风险因素中的性别差异来解释，可能反映出男性从事危险行为的倾向更大。©2015美国骨与矿物质研究学会。
