非承重的远端前臂的骨矿物质密度丢失能否预测死亡率？

Can bone mineral density loss in the non-weight bearing distal forearm predict mortality?

机构信息

Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Postboks 4 St. Olavs plass, 0130 Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473 Oslo, Norway.

Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Postboks 4 St. Olavs plass, 0130 Oslo, Norway.

出版信息

Bone. 2020 Jul;136:115347. doi: 10.1016/j.bone.2020.115347. Epub 2020 Mar 30.

DOI:10.1016/j.bone.2020.115347

PMID:32240848

Abstract

PURPOSE

Low bone mineral density (BMD) is associated with increased risk of fractures and mortality. We investigated if rate of BMD loss in the distal forearm over seven years predicted mortality.

METHODS

1725 postmenopausal women and 1879 men aged 50-74 who participated in the longitudinal Tromsø Study waves 4 (1994-95) and 5 (2001-2002) were included. Cox regression models adjusted for lifestyle- and health related variables were used to assess associations between BMD change over seven years and subsequent mortality during up to 17 years of follow-up in participants with normal and low BMD at baseline.

RESULTS

Baseline BMD decreased and seven-year bone loss increased with increasing age. Overall, mortality rates were higher among those with low versus normal BMD (38 vs 19 per 1000 py in women, 56 vs 34 in men) and at higher bone loss rates (rate ratio high:low = 1.2 in women, 1.7 in men). BMD change was associated with increased mortality only in men with normal baseline BMD. In this group, men with a BMD loss of >4% had significantly higher mortality (HR 1.50, 95% CI 1.21, 1.87) than men with increased or unchanged BMD. BMD change was not significantly associated with increased mortality in women or in men with low BMD at baseline.

CONCLUSIONS

BMD loss in the distal forearm was associated with increased mortality in men with normal BMD at baseline, but not in women. We found no clear association between BMD loss and mortality in those with low BMD at baseline.

摘要

目的

骨密度（BMD）低与骨折和死亡风险增加有关。我们研究了前臂远端 BMD 在七年中的损失速度是否可以预测死亡率。

方法

共有 1725 名绝经后女性和 1879 名 50-74 岁的男性参加了纵向特罗姆瑟研究的第 4 波（1994-1995 年）和第 5 波（2001-2002 年）。使用 Cox 回归模型，调整了生活方式和健康相关变量，评估了基线时 BMD 正常和低值的参与者在七年中 BMD 变化与随后 17 年随访期间死亡率之间的关系。

结果

基线 BMD 降低，七年骨丢失随年龄增长而增加。总体而言，低 BMD 组的死亡率高于正常 BMD 组（女性 38/1000 人年 vs 19/1000 人年，男性 56/1000 人年 vs 34/1000 人年），且骨丢失率更高（高 vs 低比值女性为 1.2，男性为 1.7）。BMD 变化仅与基线 BMD 正常的男性死亡率增加有关。在这组男性中，BMD 损失>4%的男性死亡率显著升高（HR 1.50，95%CI 1.21-1.87），高于 BMD 增加或不变的男性。在女性或基线时 BMD 低值的男性中，BMD 变化与死亡率增加无显著关联。