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出生时的体型及儿童期生长与老年髋部骨折的关联:赫尔辛基出生队列研究的探索性随访

Association of Body Size at Birth and Childhood Growth With Hip Fractures in Older Age: An Exploratory Follow-Up of the Helsinki Birth Cohort Study.

作者信息

Mikkola Tuija M, von Bonsdorff Mikaela B, Osmond Clive, Salonen Minna K, Kajantie Eero, Eriksson Johan G

机构信息

Folkhälsan Research Center, Helsinki, Finland.

Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

出版信息

J Bone Miner Res. 2017 Jun;32(6):1194-1200. doi: 10.1002/jbmr.3100. Epub 2017 Mar 2.

Abstract

Childhood growth has been linked with bone properties in adulthood, whereas less is known about the contribution of early growth to bone fracture risk. We investigated the association of body size at birth and childhood growth with hip fractures and pharmacotherapy for osteoporosis in older age. Men and women, born full term, from the Helsinki Birth Cohort Study (n = 8345) were followed until the age of 68 to 80 years. Height and weight from birth to 11 years were obtained from health care records and diagnoses of hip fractures and osteoporosis drug purchases from national registers. Independent associations of each age period were analyzed using Cox models adjusted for age, childhood and adulthood socioeconomic status, and drugs affecting bone metabolism. In men, the risk of hip fractures was nonlinearly associated with childhood growth. Compared to intermediate increase, low and high increase in height between 2 and 7 years (p < 0.001) were associated with all hip fractures and hip fractures sustained after the age of 50 years. Further, compared to intermediate gain, low and high gain in BMI between 7 and 11 years (p = 0.001) were associated with greater risk of hip fractures in men. In women, growth was not associated with the risk of hip fractures but greater weight (hazard ratio [HR] = 0.85; 95% CI, 0.77 to 0.94; p = 0.001) and BMI (HR 0.86; 95% CI, 0.78 to 0.95; p = 0.003) gain between ages 2 and 7 years were associated with a decreased risk of pharmacotherapy for osteoporosis. In men, growth was not associated with the risk of pharmacotherapy for osteoporosis. In conclusion, growth during childhood may contribute to the risk of hip fractures in later life among men. © 2017 American Society for Bone and Mineral Research.

摘要

儿童期生长与成年期的骨骼特性相关,而早期生长对骨折风险的影响则鲜为人知。我们调查了出生时的体型和儿童期生长与老年髋部骨折及骨质疏松症药物治疗之间的关联。来自赫尔辛基出生队列研究(n = 8345)的足月出生的男性和女性被随访至68至80岁。从医疗保健记录中获取出生至11岁的身高和体重,并从国家登记处获取髋部骨折诊断和骨质疏松症药物购买信息。使用调整了年龄、儿童期和成年期社会经济地位以及影响骨代谢药物的Cox模型分析每个年龄阶段的独立关联。在男性中,髋部骨折风险与儿童期生长呈非线性相关。与中等增长相比,2至7岁间身高的低增长和高增长(p < 0.001)与所有髋部骨折以及50岁后发生的髋部骨折相关。此外,与中等增长相比,7至11岁间BMI的低增长和高增长(p = 0.001)与男性髋部骨折风险增加相关。在女性中,生长与髋部骨折风险无关,但2至7岁间体重增加更多(风险比[HR] = 0.85;95%置信区间,0.77至0.94;p = 0.001)和BMI增加(HR 0.86;95%置信区间,0.78至0.95;p = 0.003)与骨质疏松症药物治疗风险降低相关。在男性中,生长与骨质疏松症药物治疗风险无关。总之,儿童期生长可能会增加男性晚年髋部骨折的风险。© 2017美国骨与矿物质研究学会

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