Kherad M, Mellström D, Rosengren B E, Hasserius R, Nilsson J-Å, Redlund-Johnell I, Ohlsson C, Lorentzon M, Karlsson M K
Skåne University Hospital, SE-20502, Malmo, Sweden.
Sahlgrenska Hospital, SE- 431 80, Mölndal, Sweden.
Bone Joint J. 2015 Aug;97-B(8):1106-10. doi: 10.1302/0301-620X.97B8.35032.
We sought to determine whether specific characteristics of vertebral fractures in elderly men are associated with low bone mineral density (BMD) and osteoporosis. Mister Osteoporosis Sweden is a population based cohort study involving 3014 men aged 69 to 81 years. Of these, 1427 had readable lateral radiographs of the thoracic and lumbar spine. Total body (TB) BMD (g/cm²) and total right hip (TH) BMD were measured by dual energy x-ray absorptiometry. The proportion of men with osteoporosis was calculated from TH BMD. There were 215 men (15.1%) with a vertebral fracture. Those with a fracture had lower TB BMD than those without (p < 0.001). Among men with a fracture, TB BMD was lower in those with more than three fractures (p = 0.02), those with biconcave fractures (p = 0.02) and those with vertebral body compression of > 42% (worst quartile) (p = 0.03). The mean odds ratio (OR) for having osteoporosis when having any type of vertebral fracture was 6.1 (95% confidence interval (CI) 3.9 to 9.5) compared with those without a fracture. A combination of more than three fractures and compression in the worst quartile had a mean OR of 114.2 (95% CI 6.7 to 1938.3) of having osteoporosis compared with those without a fracture. We recommend BMD studies to be undertaken in these subcohorts of elderly men with a vertebral fracture.
我们试图确定老年男性椎体骨折的特定特征是否与低骨密度（BMD）和骨质疏松症相关。瑞典骨质疏松症先生研究是一项基于人群的队列研究，涉及3014名年龄在69至81岁之间的男性。其中，1427人有可读的胸腰椎侧位X线片。通过双能X线吸收法测量全身（TB）骨密度（g/cm²）和右侧全髋（TH）骨密度。根据TH骨密度计算骨质疏松症男性的比例。有215名男性（15.1%）发生椎体骨折。骨折患者的TB骨密度低于未骨折患者（p < 0.001）。在骨折男性中，骨折超过三处的患者、出现双凹形骨折的患者以及椎体压缩超过42%（最差四分位数）的患者，其TB骨密度较低（p = 0.02、p = 0.02和p = 0.03）。与未骨折者相比，发生任何类型椎体骨折时患骨质疏松症的平均优势比（OR）为6.1（95%置信区间（CI）3.9至9.5）。与未骨折者相比，骨折超过三处且处于最差四分位数压缩状态的患者患骨质疏松症的平均OR为114.2（95%CI 6.7至1938.3）。我们建议对这些患有椎体骨折的老年男性亚组进行骨密度研究。
