Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
J Bone Miner Res. 2018 Oct;33(10):1842-1850. doi: 10.1002/jbmr.3476. Epub 2018 Jun 22.
It is not known how physical exercise affects the risk of different types of fractures, especially in highly active individuals. To investigate this association, we studied a cohort of 118,204 men and 71,757 women who from 1991 to 2009 participated in Vasaloppet, a long-distance cross-country skiing race in Sweden, and 505,194 nonparticipants frequency-matched on sex, age, and county of residence from the Swedish population. Participants ranged from recreational exercisers to world-class skiers. Race participation, distance of race run, number of races participated in, and finishing time were used as proxies for physical exercise. Incident fractures from 1991 to 2010 were obtained from national Swedish registers. Over a median follow-up of 8.9 years, 53,175 fractures of any type, 2929 hip, 3107 proximal humerus, 11,875 lower leg, 11,733 forearm, and 2391 vertebral fractures occurred. In a Cox proportional hazard regression analysis using time-updated exposure and covariate information, participation in the race was associated with an increased risk of any type of fracture (hazard ratio [HR], 1.02; 95% CI, 1.00 to 1.05); forearm fractures had an HR, 1.11 with a 95% CI, 1.06 to 1.15. There was a lower risk of hip (HR, 0.75; 95% CI, 0.67 to 0.83), proximal humerus (HR, 0.90; 95% CI, 0.82 to 0.98), and lower leg fractures (HR, 0.93; 95% CI, 0.89 to 0.97), whereas the HR of vertebral fracture was 0.97 with a 95% CI, 0.88 to 1.07. Among participants, the risk of fracture was similar irrespective of race distance and number of races run. Participants close to the median finishing time had a lower risk of fracture compared with faster and slower participants. In summary, high levels of physical exercise were associated with a slightly higher risk of fractures of any type, including forearm fractures, but a lower risk of hip, proximal humerus, and lower leg fractures. © 2018 American Society for Bone and Mineral Research.
目前尚不清楚体育锻炼如何影响不同类型骨折的风险，尤其是在高度活跃的人群中。为了研究这种关联，我们研究了一个队列，其中包括 118204 名男性和 71757 名女性，他们在 1991 年至 2009 年期间参加了瑞典的瓦尔帕洛佩特（Vasaloppet）长距离越野滑雪比赛，以及与瑞典人口中性别、年龄和所在县相匹配的 505194 名非参赛者。参与者从休闲运动员到世界级滑雪运动员不等。比赛参与度、比赛跑的距离、参与的比赛次数和完赛时间都被用作身体锻炼的代表。1991 年至 2010 年期间的骨折事件都从国家瑞典登记处获得。在中位随访 8.9 年后，发生了任何类型的骨折 53175 例，髋部骨折 2929 例，肱骨近端骨折 3107 例，小腿骨折 11875 例，前臂骨折 11733 例，椎体骨折 2391 例。在使用时间更新的暴露和协变量信息的 Cox 比例风险回归分析中，参赛与任何类型骨折的风险增加相关（风险比 [HR]，1.02；95%置信区间，1.00 至 1.05）；前臂骨折的 HR 为 1.11，95%CI 为 1.06 至 1.15。髋部骨折的风险较低（HR，0.75；95%CI，0.67 至 0.83）、肱骨近端骨折（HR，0.90；95%CI，0.82 至 0.98）和小腿骨折（HR，0.93；95%CI，0.89 至 0.97），而椎体骨折的 HR 为 0.97，95%CI 为 0.88 至 1.07。在参与者中，无论比赛距离和比赛次数如何，骨折风险都相似。接近中位数完赛时间的参与者骨折风险低于速度较快和较慢的参与者。总之，高水平的体育锻炼与任何类型的骨折风险略有增加相关，包括前臂骨折，但髋部、肱骨近端和小腿骨折的风险降低。© 2018 年美国骨骼与矿物质研究协会。
