Division of Comprehensive Geriatrics in Community, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachidori, Niigata, Niigata, 9518510, Japan.
Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
J Bone Miner Metab. 2019 May;37(3):484-490. doi: 10.1007/s00774-018-0937-9. Epub 2018 Jun 28.
The aim of this study was to survey the incidence of osteoporotic fragility fractures, which include vertebral, hip, distal radius, and proximal humerus fractures, in patients ≥ 50 years of age, from 2004 to 2015, in Sado City, Japan. We examined temporal changes in the incidence of these fractures from 2010 through 2015. The incidence of vertebral (p < 0.001) and radius fractures (p = 0.001) was lower in 2015 than in 2010, with only the incidence of hip fracture (p = 0.013) being lower in 2015 than in 2004. With regard to age-specific incidences, there was a sharp increase in vertebral and hip fractures among the segment of the population 70-89 years old, with no remarkable change in the incidence of radial and humeral fractures. Pre-existing vertebral fractures were identified in 69.6% of patients with a hip fracture, 35.6% of patients with a distal radius fracture, and 55% of patients with a humeral fracture. Among patients with pre-existing vertebral fractures, 42.5% had a single fracture, whereas 57.5% had 2 or more fractures. The proportion of patients on anti-osteoporotic agents before the occurrence of fractures increased to 14.5% in 2015, compared to 4% in 2004 and 7.6% in 2010. We speculate that the increase in the use of anti-osteoporotic agents is the main reason for the declining incidence of fractures. Therefore, considering the sharp increase in hip and vertebral fractures among individuals in their mid-1970s and older, judicious use of anti-osteoporotic agents among these individuals could be useful for lowering the occurrence of these fractures.
本研究旨在调查日本佐渡市 2004 年至 2015 年间≥50 岁患者的骨质疏松性脆性骨折（包括椎体、髋部、桡骨远端和肱骨近端骨折）的发生率。我们研究了 2010 年至 2015 年期间这些骨折发生率的时间变化。2015 年椎体（p<0.001）和桡骨骨折（p=0.001）的发生率低于 2010 年，只有髋部骨折（p=0.013）的发生率低于 2004 年。关于年龄特异性发病率，70-89 岁人群的椎体和髋部骨折急剧增加，而桡骨和肱骨骨折的发生率没有明显变化。在髋部骨折患者中，69.6%存在既往椎体骨折，在桡骨远端骨折患者中，35.6%存在既往椎体骨折，在肱骨骨折患者中，55%存在既往椎体骨折。在存在既往椎体骨折的患者中，42.5%有单个骨折，57.5%有 2 个或更多骨折。在发生骨折之前使用抗骨质疏松药物的患者比例从 2004 年的 4%和 2010 年的 7.6%增加到 2015 年的 14.5%。我们推测，抗骨质疏松药物使用的增加是骨折发生率下降的主要原因。因此，考虑到 70 岁中期及以上人群髋部和椎体骨折的急剧增加，在这些人群中合理使用抗骨质疏松药物可能有助于降低这些骨折的发生。
