Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
Osteoporos Int. 2021 Aug;32(8):1547-1555. doi: 10.1007/s00198-020-05803-4. Epub 2021 Feb 4.
The risk of a recurrent fragility fracture varies by age and sex, as by site and recency of sentinel fracture.
The recency of prior fractures affects subsequent fracture risk. Variable recency may obscure other factors that affect subsequent fracture risk. The aim of this study was to quantify the effect of a sentinel fracture by site, age, and sex where the recency was held constant.
The study used data from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture incidence was compared to that of the general population determined at fixed times after a sentinel fracture (humeral, clinical vertebral, forearm, hip, and minor fractures). Outcome fractures comprised a major osteoporotic fracture and hip fracture.
Sentinel osteoporotic fractures were identified in 9504 men and women. Of these, 3616 individuals sustained a major osteoporotic fracture as the first subsequent fracture, of whom 1799 sustained a hip fracture. Hazard ratios for prior fracture were consistently higher in men than in women and decreased progressively with age. Hazard ratios varied according to the site of sentinel fracture with higher ratios for hip and vertebral fracture than for humerus, forearm, or minor osteoporotic fracture.
The risk of a recurrent fragility fracture varies by age, sex, and site of sentinel fracture when recency is held constant.
复发性脆性骨折的风险因年龄、性别以及哨兵骨折的部位和时间而有所不同。
先前骨折的时间会影响后续骨折的风险。时间的变化可能会掩盖其他影响后续骨折风险的因素。本研究的目的是在哨兵骨折的部位、年龄和性别保持不变的情况下，量化其对后续骨折风险的影响。
本研究使用雷克雅未克研究骨折登记处的数据，该数据前瞻性地记录了冰岛大量人群中所有骨骼部位的骨折。在固定时间后，将骨折发生率与普通人群的发生率进行比较（肱骨、临床椎体、前臂、髋部和小骨折）。结果骨折包括主要骨质疏松性骨折和髋部骨折。
在 9504 名男性和女性中确定了哨兵骨质疏松性骨折。其中，3616 人首次发生后续骨折为主要骨质疏松性骨折，其中 1799 人发生髋部骨折。先前骨折的风险比在男性中始终高于女性，且随年龄逐渐降低。根据哨兵骨折的部位，风险比有所不同，髋部和椎体骨折的比值高于肱骨、前臂或小骨质疏松性骨折。
当时间保持不变时，复发性脆性骨折的风险因年龄、性别和哨兵骨折的部位而异。
