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父母的心肺状况与子女骨折:基于人群的家族连锁研究。

Parental cardiorespiratory conditions and offspring fracture: A population-based familial linkage study.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.

Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

Bone. 2020 Oct;139:115557. doi: 10.1016/j.bone.2020.115557. Epub 2020 Jul 27.

Abstract

BACKGROUND

The role of parental cardiorespiratory conditions on fracture risk is unclear. We examined the associations between parental cardiorespiratory conditions and offspring fracture risk.

METHODS

In this population-based retrospective cohort study, we identified 279,085 offspring aged≥40 years between April 1, 1997 and December 31, 2015 with successful linkage to 273,852 mothers and 254,622 fathers. Parental cardiorespiratory conditions, including cerebral vascular disease, congestive heart failure, hypertension, ischemic heart disease, myocardial infarction, chronic obstructive pulmonary disease (COPD) and peripheral vascular disease, were ascertained using physician and hospital records dating back to 1979. The outcome was offspring incident major osteoporotic fracture (MOF).

RESULTS

During an average of 11.8 years of offspring follow-up, we identified 8762 (3.1%) incident MOF. Either parent congestive heart failure (adjusted hazard ratio [HR]: 1.13; 95% confidence interval [CI] 1.07-1.19) and COPD (adjusted HR: 1.12; 95% CI 1.07-1.17) were independently associated with increased offspring MOF risk; all their false discovery rates were <0.001. Similar risk estimates were observed when analyses were performed for fathers only, mothers only or both parents, in multivariable models with and without adjustment for offspring cardiorespiratory conditions, and stratified by offspring sex and offspring incident fracture site. Parental cerebrovascular disease, hypertension, ischemic heart disease and myocardial infarction were not associated with offspring MOF.

CONCLUSIONS

Parental congestive heart failure and parental COPD are independent risk factors for offspring MOF.

摘要

背景

父母的心肺状况对骨折风险的影响尚不清楚。我们研究了父母心肺状况与子女骨折风险之间的关系。

方法

在这项基于人群的回顾性队列研究中,我们确定了 1997 年 4 月 1 日至 2015 年 12 月 31 日之间年龄≥40 岁的 279085 名子女,这些子女与 273852 名母亲和 254622 名父亲成功关联。父母的心肺状况,包括脑血管疾病、充血性心力衰竭、高血压、缺血性心脏病、心肌梗死、慢性阻塞性肺疾病(COPD)和外周血管疾病,通过追溯到 1979 年的医生和医院记录确定。结局是子女发生主要骨质疏松性骨折(MOF)。

结果

在子女平均 11.8 年的随访期间,我们发现 8762 例(3.1%)发生 MOF。父母任何一方充血性心力衰竭(调整后的危险比[HR]:1.13;95%置信区间[CI]:1.07-1.19)和 COPD(调整后的 HR:1.12;95% CI:1.07-1.17)与子女 MOF 风险增加独立相关;所有的错误发现率都<0.001。当仅对父亲、仅对母亲或父母双方进行分析,在包含和不包含子女心肺状况的多变量模型中进行分析,以及按子女性别和子女骨折部位分层时,都观察到了类似的风险估计。父母脑血管疾病、高血压、缺血性心脏病和心肌梗死与子女 MOF 无关。

结论

父母充血性心力衰竭和父母 COPD 是子女 MOF 的独立危险因素。

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