Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA.
Osteoporos Int. 2018 Apr;29(4):859-870. doi: 10.1007/s00198-017-4349-9. Epub 2018 Jan 17.
There is limited wrist fracture information on men. Our goal was to calculate frequency and identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. We confirmed that fracture history and certain medications are predictors, and identified novel predictors including markers of kidney function and physical performance.
To calculate the incidence of wrist fractures and their risk factors in older community-dwelling men from the US Osteoporotic Fractures in Men (MrOS) study.
Using triannual postcards, we identified incident wrist fractures (centrally confirmed by radiology) in men aged ≥ 65. Potential risk factors included the following: demographics, lifestyle, bone mineral density (BMD), selected medications, biomarkers, and physical function and performance measures. Both baseline and time-varying models were adjusted for age, race/ethnicity, MrOS geographic location, and competing mortality risks.
We observed 97 incident wrist fractures among 5875 men followed for an average of 10.8 years. The incidence of wrist fracture was 1.6 per 1000 person-years overall and ranged from 1.0 among men aged 65-69 to 2.4 among men age ≥ 80. Significant predictors included the following: fracture history after age 50 [hazard ratio (95% CI): 2.48 (1.65, 3.73)], high serum phosphate [1.25 (1.02, 1.53)], use of selective serotonin receptor inhibitor (SSRI) [3.60 (1.96, 6.63), decreased right arm BMD [0.49 (0.37, 0.65) per SD increase], and inability to perform the grip strength test [3.38 (1.24, 9.25)]. We did not find associations with factors commonly associated with wrist and other osteoporosis fractures like falls, diabetes, calcium and vitamin D intake, and alcohol intake.
Among these older, community-dwelling men, we confirmed that fracture history is a strong predictor of wrist fractures in men. Medications such as SSRIs and corticosteroids also play a role in wrist fracture risk. We identified novel risk factors including kidney function and the inability to perform the grip strength test.
计算美国男性骨质疏松性骨折研究（MrOS）中年龄较大的社区男性腕部骨折的发生率及其危险因素。
我们使用三年一次的明信片，确定了年龄≥65 岁的男性腕部骨折（经放射学中心确认）的新发病例。潜在的危险因素包括以下内容：人口统计学、生活方式、骨密度（BMD）、选定的药物、生物标志物以及身体功能和表现的测量。基线和时变模型均根据年龄、种族/民族、MrOS 地理位置和竞争死亡率风险进行了调整。
在随访平均 10.8 年的 5875 名男性中，我们观察到 97 例腕部骨折。腕部骨折的发生率为每年每 1000 人 1.6 例，范围从 65-69 岁男性的 1.0 例到≥80 岁男性的 2.4 例。有意义的预测因素包括：50 岁以后的骨折史[危险比（95%CI）：2.48（1.65，3.73）]、血清磷酸盐高[1.25（1.02，1.53）]、使用选择性 5-羟色胺再摄取抑制剂（SSRIs）[3.60（1.96，6.63）]、右臂 BMD 降低[每标准差增加 0.49（0.37，0.65）]和握力测试无法完成[3.38（1.24，9.25）]。我们没有发现与腕部和其他骨质疏松性骨折常见相关因素（如跌倒、糖尿病、钙和维生素 D 摄入以及饮酒）相关的因素。
在这些年龄较大的社区男性中，我们证实骨折史是男性腕部骨折的强烈预测因素。SSRIs 和皮质类固醇等药物也在腕部骨折风险中发挥作用。我们确定了一些新的危险因素，包括肾功能和握力测试无法完成。
