Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173-beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, Republic of Korea.
Bone. 2021 Apr;145:115878. doi: 10.1016/j.bone.2021.115878. Epub 2021 Feb 8.
Bone mineral density (BMD) assessments alone might not be sufficient for assessing fracture risk in the whole population, and decreased balance is an important risk factor for fracture. The aim of this study was to evaluate the association between baseline physical performance and fracture risk.
This community-based cohort study was conducted in rural areas. The follow-up examination was performed in 4015 subjects for approximately 4 years. We used the one-leg standing time (OLST) to assess static balance and the timed up-and-go test (TUGT) to assess dynamic balance. Fractures were assessed during the medical interview.
The participants were divided into quartile groups according to their performance level, and the lowest baseline OLST performance was associated with a 2.1-fold increased risk of major osteoporotic fracture (MOF) independent of age, gender, hip BMD, fall incidence, and lifestyle factors. The participants in the low performance quartile of baseline OLST or TUGT performance had an increased incidence of osteoporosis and falling compared to that in the participants in the highest baseline performance quartile after adjusting for covariates. Among the participants with a femoral neck T-score above -2.5, the participants with an OLST below 14 s had a 1.7-fold higher risk of MOF than the participants with an OLST of 14 s or more.
The measurement of static balance by the OLST predicted the risk of fracture in Korean adults independent of BMD and fall history. Our results suggest that the OLST may have clinical utility in identifying individuals at risk of fracture, especially those who might not be adequately identified by BMD measurements alone.
骨密度（BMD）评估可能不足以评估整个人群的骨折风险，而平衡能力下降是骨折的一个重要危险因素。本研究旨在评估基线身体机能与骨折风险之间的关系。
本社区为基础的队列研究在农村地区进行。大约 4 年后对 4015 名受试者进行了随访检查。我们使用单腿站立时间（OLST）评估静态平衡，使用计时起立行走测试（TUGT）评估动态平衡。通过医疗访谈评估骨折情况。
根据表现水平将参与者分为四分位组，基线 OLST 表现最低的参与者发生主要骨质疏松性骨折（MOF）的风险增加了 2.1 倍，独立于年龄、性别、髋部 BMD、跌倒发生率和生活方式因素。与基线 OLST 或 TUGT 表现最高四分位组的参与者相比，基线 OLST 或 TUGT 表现较低四分位组的参与者发生骨质疏松症和跌倒的发生率增加。在股骨颈 T 评分高于-2.5 的参与者中，OLST 低于 14 秒的参与者发生 MOF 的风险比 OLST 为 14 秒或更长的参与者高 1.7 倍。
OLST 通过测量静态平衡来预测韩国成年人的骨折风险，独立于 BMD 和跌倒史。我们的结果表明，OLST 可能具有临床实用价值，可以识别骨折风险较高的个体，特别是那些仅通过 BMD 测量可能无法充分识别的个体。
