Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
J Bone Miner Res. 2022 Aug;37(8):1562-1570. doi: 10.1002/jbmr.4624. Epub 2022 Jul 6.
Maintenance of vigorous exercise habits from young to old age is considered protective against hip fractures, but data on fracture risk in lifelong vigorous exercisers are lacking. This longitudinal cohort study examined the hazard of hip fractures in 1844 male former athletes and 1216 population controls and in relation to exercise volume and intensity in later years. Incident hip fractures after age 50 years were identified from hospital discharge register from 1972 to 2015. Exercise and covariate information was obtained from questionnaires administered in 1985, 1995, 2001, and 2008. Analyses were conducted using extended proportional hazards regression model for time-dependent exposures and effects. During the mean ± SD follow-up of 21.6 ± 10.3 years, 62 (3.4%) athletes and 38 (3.1%) controls sustained a hip fracture. Adjusted hazard ratio (HR) indicated no statistically significant difference between athletes and controls (0.84; 95% confidence interval [CI], 0.55-1.29). In subgroup analyses, adjusted HRs for athletes with recent high (≥15 metabolic equivalent hours [MET-h]/week) and low (<15 MET-h/week) exercise volume were 0.83 (95% CI, 0.46-1.48) and 1.04 (95% CI, 0.57-1.87), respectively, compared with controls. The adjusted HR was not statistically significant between athletes with low-intensity exercise (<6 METs) and controls (1.08; 95% CI, 0.62-1.85). Athletes engaging in vigorous-intensity exercise (≥6 METs at least 75 minutes/week) had initially 77% lower hazard rate (adjusted HR 0.23; 95% CI, 0.06-0.86) than controls. However, the HR was time-dependent (adjusted HR 1.04; 95% CI, 1.01-1.07); by age 75 years the HRs for the athletes with vigorous-intensity exercise reached the level of the controls, but after 85 years the HRs for these athletes increased approximately 1.3-fold annually relative to the controls. In conclusion, these data suggest that continuation of vigorous-intensity exercise is associated with lower HR of hip fracture up to old age. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
从年轻时保持剧烈运动的习惯被认为可以预防髋部骨折，但缺乏终身剧烈运动者骨折风险的数据。这项纵向队列研究调查了 1844 名男性前运动员和 1216 名人群对照者在 50 岁后髋部骨折的发生率，并与后来的运动量和强度有关。1972 年至 2015 年期间，从医院出院记录中确定了 50 岁后发生的髋部骨折。运动和协变量信息是从 1985 年、1995 年、2001 年和 2008 年进行的问卷调查中获得的。使用时间依赖性暴露和效应的扩展比例风险回归模型进行分析。在平均 ± SD 随访 21.6 ± 10.3 年后，62 名运动员（3.4%）和 38 名对照者（3.1%）发生了髋部骨折。调整后的危险比（HR）表明运动员和对照组之间没有统计学上的显著差异（0.84；95%置信区间[CI]，0.55-1.29）。在亚组分析中，最近运动量高（≥15 代谢当量小时[MET-h]/周）和低（＜15 MET-h/周）的运动员的调整 HR 分别为 0.83（95%CI，0.46-1.48）和 1.04（95%CI，0.57-1.87），与对照组相比。低强度运动（＜6 METs）的运动员与对照组之间的调整 HR 无统计学意义（1.08；95%CI，0.62-1.85）。从事高强度运动（至少每周 75 分钟，≥6 METs）的运动员最初的危险率降低了 77%（调整后的 HR 为 0.23；95%CI，0.06-0.86），低于对照组。然而，HR 是时间依赖性的（调整后的 HR 为 1.04；95%CI，1.01-1.07）；到 75 岁时，高强度运动运动员的 HR 与对照组相当，但到 85 岁后，这些运动员的 HR 每年比对照组增加约 1.3 倍。总之，这些数据表明，持续进行高强度运动可降低髋部骨折的 HR，直至老年。
