Valderrábano Rodrigo J, Lee Jennifer, Lui Li-Yung, Hoffman Andrew R, Cummings Steven R, Orwoll Eric S, Wu Joy Y
Division of Endocrinology, Stanford University School of Medicine, Stanford, California 94305.
Palo Alto Veteran Affairs Health Care System, Palo Alto, California 94304.
J Clin Endocrinol Metab. 2017 Jul 1;102(7):2199-2206. doi: 10.1210/jc.2017-00266.
Extremely low hemoglobin (Hgb) values have been linked to increased fracture risk at different sites. However, careful assessment of clinically defined anemia and fracture risk is lacking.
To determine whether men with anemia were at increased risk of fracture after accounting for bone mineral density (BMD) and bone loss.
Cross-sectional analysis (at visit 3) and prospective analysis (from baseline to visit 3) in the Osteoporotic Fractures in Men (MrOS), a multisite, longitudinal cohort study.
Six communities in the United States.
A total of 3632 community-dwelling men (age ≥65 years) in MrOS at baseline (2000 through 2002) who were able to walk unassisted, did not have hip replacement or fracture, and had complete blood cell counts at visit 3 (2007 through 2009).
Adjudicated spine and nonspine fractures during a median 7.2 years of follow-up.
Analytic baseline characteristics associated with fractures or anemia (defined as Hgb <12 g/dL) were included in multivariable models. Anemia was associated with increased risk of any fracture [hazard ratio (HR), 1.67; 95% confidence interval (CI), 1.26 to 2.21] and nonspine fracture (HR, 1.70; 95% CI, 1.25 to 2.31). A model including change in BMD slightly attenuated the association with any (HR, 1.60; 95% CI, 1.20 to 2.13) and nonspine fractures (HR, 1.57; 95% CI, 1.14 to 2.15). Including absolute BMD did not significantly alter the anemia-fracture association. Anemia was not associated with spine fracture.
Community-dwelling older men with anemia had a 57% to 72% increase in nonspine fracture risk independent of BMD and bone loss.
极低的血红蛋白（Hgb）值与不同部位骨折风险增加有关。然而，缺乏对临床定义的贫血和骨折风险的仔细评估。
确定在考虑骨密度（BMD）和骨质流失后，贫血男性的骨折风险是否增加。
在男性骨质疏松性骨折（MrOS）研究中进行横断面分析（在第3次随访时）和前瞻性分析（从基线到第3次随访），这是一项多地点纵向队列研究。
美国的六个社区。
MrOS研究中共有3632名社区居住男性（年龄≥65岁），他们在基线时（2000年至2002年）能够独立行走，没有进行髋关节置换或骨折，并且在第3次随访时（2007年至2009年）进行了全血细胞计数。
在中位7.2年的随访期间判定的脊柱和非脊柱骨折。
与骨折或贫血（定义为Hgb<12 g/dL）相关的分析基线特征被纳入多变量模型。贫血与任何骨折风险增加相关[风险比（HR），1.67；95%置信区间（CI），1.26至2.21]和非脊柱骨折（HR，1.70；95%CI，1.25至2.31）。一个包括BMD变化的模型略微减弱了与任何骨折（HR，1.60；95%CI，1.20至2.13）和非脊柱骨折（HR，1.57；95%CI，1.14至2.15）的关联。纳入绝对BMD并没有显著改变贫血与骨折的关联。贫血与脊柱骨折无关。
社区居住的老年贫血男性非脊柱骨折风险增加57%至72%，与BMD和骨质流失无关。
