Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
J Bone Miner Res. 2017 Dec;32(12):2347-2354. doi: 10.1002/jbmr.3228. Epub 2017 Oct 3.
Although fractures in both the pediatric and, especially, the elderly populations have been extensively investigated, comparatively little attention has been given to the age group in between. Thus, we used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to determine incidence rates for all fractures among young adult (age range, 18 to 49 years) residents of Olmsted County, Minnesota, in 2009 to 2011, and compared the distribution of fracture sites and causes in this young adult cohort with those for older residents aged 50 years or older. During the 3-year study period, 2482 Olmsted County residents aged 18 to 49 years experienced 1 or more fractures. There were 1730 fractures among 1447 men compared with 1164 among 1035 women, and the age-adjusted incidence of all fractures was 66% greater among the men (1882 [95% confidence interval 1793-1971] versus 1135 [95% CI 1069-1201] per 100,000 person-years; p < 0.001). Of all fractures, 80% resulted from severe trauma (eg, motor vehicle accidents) compared with 33% in Olmsted County residents age ≥50 years who sustained a fracture in 2009 to 2011. Younger residents (aged 18 to 49 years), when compared with older residents (aged ≥50 years), had a greater proportion of fractures of the hands and feet (40% versus 18%) with relatively few fractures observed at traditional osteoporotic fracture sites (14% versus 43%). Vertebral fractures were still more likely to be the result of moderate trauma than at other sites, especially in younger women. In conclusion, whereas pediatric and elderly populations often fracture from no more than moderate trauma, young adults, and more commonly men, suffer fractures primarily at non-osteoporotic sites due to more significant trauma. © 2017 American Society for Bone and Mineral Research.
虽然儿科和特别是老年人群的骨折已经得到了广泛的研究，但对于介于两者之间的年龄组，相对关注较少。因此，我们使用罗切斯特流行病学项目的综合（住院和门诊）数据资源，来确定 2009 年至 2011 年明尼苏达州奥姆斯特德县年轻成年人（年龄在 18 至 49 岁之间）居民的所有骨折的发病率，并将该年轻成年人队列的骨折部位和原因分布与 50 岁或以上的老年居民进行比较。在 3 年的研究期间，2482 名年龄在 18 至 49 岁的奥姆斯特德县居民经历了 1 次或多次骨折。在 1447 名男性中发生了 1730 次骨折，而在 1035 名女性中发生了 1164 次骨折，男性所有骨折的年龄调整发病率比女性高 66%（1882 [95%置信区间 1793-1971]比 1135 [95%CI 1069-1201]每 100,000 人年；p < 0.001）。所有骨折中，80%是由严重创伤（例如，机动车事故）引起的，而在 2009 年至 2011 年期间，奥姆斯特德县年龄≥50 岁发生骨折的居民中，这一比例为 33%。与年龄较大的居民（年龄≥50 岁）相比，年轻居民（年龄 18 至 49 岁）的手和脚骨折比例更高（40%比 18%），而传统骨质疏松性骨折部位的骨折相对较少（14%比 43%）。与其他部位相比，椎体骨折更可能是中度创伤的结果，尤其是在年轻女性中。总之，儿科和老年人群通常因不超过中度创伤而骨折，而年轻成年人，更常见的是男性，由于更严重的创伤，主要在非骨质疏松性部位发生骨折。
