老年男性中 prevalent 椎体骨折的特征可预测新发骨折。注：这里“prevalent”在医学语境中可能有“普遍存在的、流行的”等意思，具体准确含义需结合上下文进一步确定。

Characteristics of Prevalent Vertebral Fractures Predict New Fractures in Elderly Men.

作者信息

Karlsson Magnus K, Kherad Mehrsa, Hasserius Ralph, Nilsson Jan-Åke, Redlund-Johnell Inga, Ohlsson Claes, Lorentzon Mattias, Mellström Dan, Rosengren Björn E

机构信息

Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.

Center for Bone and Arthritis Research, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

J Bone Joint Surg Am. 2016 Mar 2;98(5):379-85. doi: 10.2106/JBJS.15.00328.

DOI:10.2106/JBJS.15.00328

PMID:26935460

Abstract

BACKGROUND

Studies have shown that specific characteristics of prevalent vertebral fractures are associated with a markedly low bone mineral density. This study evaluates if these characteristics also predict subsequent fractures.

METHODS

MrOS (Mister Osteoporosis) Sweden is a population-based, prospective observational study that includes 3014 community-living men who are sixty-nine to eighty-one years of age. At baseline, 1453 men underwent lateral thoracic and lumbar spine radiography; radiographs of 1427 men were readable. A radiologist identified and characterized prevalent vertebral fractures. Incident fractures during the next five and ten years were objectively registered with use of radiographs. The annual fracture incidence and relative risk of sustaining new fractures were assessed for men with and without baseline prevalent vertebral fracture. Data are presented as the mean and the 95% confidence interval.

RESULTS

There were 215 men (15.1%) with at least one prevalent vertebral fracture. During the five-year follow-up, these men had a relative risk of 3.3 (95% confidence interval, 2.6 to 4.3) of sustaining new fractures. The relative risk of sustaining any fracture was especially high in men with two or more prevalent vertebral fractures at 5.5 (95% confidence interval, 3.7 to 7.8), in men with different types of prevalent vertebral fractures at 5.7 (95% confidence interval, 3.6 to 8.5), in men with prevalent fractures in both the thoracic and lumbar regions at 6.4 (95% confidence interval, 4.5 to 8.8), and in men with prevalent fractures with a degree of vertebral body compression in the three worst quartiles, with the relative risk for the worst quartile at 4.0 (95% confidence interval, 2.6 to 5.9).

CONCLUSIONS

Older men with a prevalent vertebral fracture have three times increased risk of sustaining new fractures compared with men without a vertebral fracture. Older men with two or more prevalent vertebral fractures, different types of fractures (wedge, biconcave, and/or crush), fractures in both the thoracic and lumbar regions, and a degree of vertebral body compression in the three worst quartiles are at an especially high risk of sustaining new fractures. Older men with prevalent vertebral fractures should be considered for fracture-prevention efforts.

摘要

背景

研究表明，现患椎体骨折的特定特征与明显较低的骨矿物质密度相关。本研究评估这些特征是否也能预测后续骨折。

方法

瑞典MrOS（男性骨质疏松症）研究是一项基于人群的前瞻性观察性研究，纳入了3014名年龄在69至81岁之间的社区居住男性。在基线时，1453名男性接受了胸腰椎侧位X线摄影；1427名男性的X线片可读。一名放射科医生识别并描述了现患椎体骨折。在接下来的五年和十年中，通过X线片客观记录新发骨折情况。对有和无基线现患椎体骨折的男性评估了年骨折发生率和发生新骨折的相对风险。数据以均值和95%置信区间表示。

结果

有215名男性（15.1%）至少有一处现患椎体骨折。在五年随访期间，这些男性发生新骨折的相对风险为3.3（95%置信区间，2.6至4.3）。在有两处或更多处现患椎体骨折的男性中，发生任何骨折的相对风险特别高，为5.5（95%置信区间，3.7至7.8）；在有不同类型现患椎体骨折的男性中为5.7（95%置信区间，3.6至8.5）；在胸腰椎均有现患骨折的男性中为6.4（95%置信区间，4.5至8.8）；在椎体压缩程度处于三个最差四分位数的现患骨折男性中，最差四分位数的相对风险为4.0（95%置信区间，2.6至5.9）。