Holloway K L, Henry M J, Brennan-Olsen S L, Bucki-Smith G, Nicholson G C, Korn S, Sanders K M, Pasco J A, Kotowicz M A
Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Kitchener House (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
Barwon Health, Ryrie Street, Geelong, VIC, Australia.
Osteoporos Int. 2016 Mar;27(3):905-913. doi: 10.1007/s00198-015-3322-8. Epub 2015 Oct 5.
Non-hip, non-vertebral fractures (NHNVF) were compared with hip, vertebral and controls. NHNVF were younger and heavier than controls and hip/vertebral fractures in both men and women, respectively. Falls and prior fractures were less common in NHNVF than hip fractures. Glucocorticoid use was lower in NHNVF compared to vertebral fracture (VF) in men.
Although hip fracture (HF) and vertebral fractures (VF) receive the most attention in the literature and are the targeted sites for fracture prevention, non-hip, non-vertebral fracture (NHNVF) sites account for a greater proportion of fractures than the hip or vertebrae. This study aimed to assess risk factors for NHNVF and compare them with those for HF, VF and controls.
Incident fractures during 2005-2007 for men and 1994-1996 for women were identified using computerised keyword searches of radiological reports, and controls were selected at random from electoral rolls for participation in the Geelong Osteoporosis Study. Participants aged 60+ years were included in this study.
Compared to controls, men and women with NHNVF were younger (ORs, 0.90, 95% CI 0.86-0.94; and 0.96, 0.93-0.98, respectively) and had a lower femoral neck bone mineral density (BMD) T-score (age-adjusted; difference [men] 0.383, P = 0.002; [women] 0.287, P = 0.001). Compared to HF, men and women with NHNVF were heavier (difference [men] 9.0 kg, P = 0.01; [women] 7.6 kg, P < 0.001). Heavier weight was also a risk factor for women with NHNVF compared to VF (1.03, 1.01-1.06). In men with NHNVF, falls (0.37, 0.14-0.97) and prior fractures (0.38, 0.15-0.98) were less common compared to HF; and glucocorticoid use was less common for NHNVF (0.30, 0.11-0.85) compared to VF.
Given the high numbers of NHNVF sustained by men and women in this study, fracture prevention strategies should focus on individuals with high risk of sustaining these types of fractures, as well as on individuals who are more likely to sustain a HF or VF.
对非髋部、非椎体骨折（NHNVF）与髋部骨折、椎体骨折及对照组进行了比较。在男性和女性中，NHNVF患者分别比对照组以及髋部/椎体骨折患者更年轻、体重更重。与髋部骨折相比，NHNVF患者中跌倒和既往骨折的情况较少见。男性中，NHNVF患者使用糖皮质激素的情况低于椎体骨折（VF）患者。
尽管髋部骨折（HF）和椎体骨折（VF）在文献中受到最多关注，且是骨折预防的目标部位，但非髋部、非椎体骨折（NHNVF）部位的骨折占比高于髋部或椎体骨折。本研究旨在评估NHNVF的危险因素，并将其与HF、VF及对照组进行比较。
通过对放射学报告进行计算机关键词搜索，确定2005 - 2007年男性和1994 - 1996年女性的新发骨折情况，并从选民名单中随机选取对照组参与吉朗骨质疏松症研究。本研究纳入年龄在60岁及以上的参与者。
与对照组相比，NHNVF的男性和女性患者更年轻（比值比分别为0.90，95%可信区间0.86 - 0.94；以及0.96，0.93 - 0.98），且股骨颈骨密度（BMD）T值更低（年龄校正后；差异[男性]0.383，P = 0.002；[女性]0.287，P = 0.001）。与HF相比，NHNVF的男性和女性患者体重更重（差异[男性]9.0千克，P = 0.01；[女性]7.6千克，P < 0.001）。与VF相比，体重较重也是NHNVF女性患者的一个危险因素（1.03，1.01 - 1.06）。在NHNVF男性患者中，与HF相比，跌倒（0.37，0.14 - 0.97）和既往骨折（0.38，0.15 - 0.98）的情况较少见；与VF相比，NHNVF患者使用糖皮质激素的情况也较少见（0.30，0.11 - 0.85）。
鉴于本研究中男性和女性发生NHNVF的数量较多，骨折预防策略应关注发生这类骨折风险高的个体，以及更易发生HF或VF的个体。
