Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Health Screening Center, Seoul, Korea.
J Bone Miner Res. 2019 Jun;34(6):1049-1057. doi: 10.1002/jbmr.3675. Epub 2019 Feb 27.
Anemia is a common health problem in older adults and is associated with risk factors for fracture such as low physical function and low bone mass. The aim of this study was to examine the relationship between anemia and fracture risk in older adults. We conducted a retrospective cohort study from 2003 to 2013. The participants were community-dwelling Korean adults aged 65 years and older who participated in the National Health Screening Program (n = 72,131) between 2003 and 2008. Anemia (<12 g/dL for women and <13 g/dL for men) and severity of anemia (mild: 11 g/dL ≤ Hb < 12 g/dL; moderate to severe: Hb < 11 g/dL) were defined by World Health Organization (WHO) criteria. The incidence of any fractures, vertebral fractures, and femur fractures was identified using ICD-10 codes. Cox proportional hazard regression models were used to assess risk of fracture according to anemia. Anemia was associated with increased risk of fracture in men (any: adjusted hazard ratio [aHR] = 1.29, 95% confidence interval [CI] 1.18-1.41; vertebral: aHR = 1.20, 95% CI 1.03-1.40; femur: aHR = 1.71, 95% CI 1.44-2.04), and less strongly but still significantly in women (any: aHR = 1.10, 95% CI 1.11-1.41; vertebral: aHR = 1.11, 95% CI 1.03-1.20; femur: aHR = 1.37, 95% CI 1.25-1.52). Higher risk was observed in subjects with moderate-to-severe anemia in both sexes. Considering the high prevalence of anemia in older adults, it is important that health professionals recognize increased fracture risk in older adults with anemia. © 2019 American Society for Bone and Mineral Research.
贫血是老年人常见的健康问题，与骨折的危险因素有关，如身体功能低下和骨量低。本研究旨在探讨老年人贫血与骨折风险的关系。我们进行了一项回顾性队列研究，时间范围为 2003 年至 2013 年。参与者为参加 2003 年至 2008 年全国健康筛查计划的年龄在 65 岁及以上的社区居住的韩国成年人（n=72131）。贫血（女性<12g/dL，男性<13g/dL）和贫血严重程度（轻度：11g/dL≤Hb<12g/dL；中度至重度：Hb<11g/dL）根据世界卫生组织（WHO）标准定义。使用国际疾病分类第 10 版（ICD-10）代码确定任何骨折、椎体骨折和股骨骨折的发生率。使用 Cox 比例风险回归模型根据贫血评估骨折风险。贫血与男性骨折风险增加相关（任何：校正后的危险比[aHR]=1.29，95%置信区间[CI]为 1.18-1.41；椎体：aHR=1.20，95%CI 为 1.03-1.40；股骨：aHR=1.71，95%CI 为 1.44-2.04），在女性中虽然相关性较弱但仍具有统计学意义（任何：aHR=1.10，95%CI 为 1.11-1.41；椎体：aHR=1.11，95%CI 为 1.03-1.20；股骨：aHR=1.37，95%CI 为 1.25-1.52）。在两性中，中度至重度贫血患者的风险更高。考虑到老年人中贫血的高患病率，健康专业人员认识到贫血老年人骨折风险增加非常重要。 © 2019 美国骨与矿物质研究协会。
