Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Arch Osteoporos. 2022 Jun 23;17(1):85. doi: 10.1007/s11657-022-01130-9.
This study includes 1005 men from the Gothenburg part of the Osteoporotic Fracture in Men Study (MrOS). Included are 66 men with anemia (hemoglobin < 130 g/L). The follow-up time was up to 16 years, and the main results are that anemia is associated with all fractures and non-vertebral osteoporotic fractures.
Anemia and osteoporotic fractures are conditions that are associated with increased morbidity and mortality. Clinical studies have suggested that anemia can be used as a predictor of future osteoporotic fractures.
Men from the Osteoporotic Fractures in Men Study (MrOS) Sweden, Gothenburg, with available hemoglobin (Hb) values (n = 1005, median age 75.3 years (SD 3.2)), were included in the current analyses. Of these, 66 suffered from anemia, defined as Hb < 130 g/L. Median follow-up time for fracture was 10.1 years and the longest follow-up time was 16.1 years.
Men with anemia had, at baseline, experienced more falls and had a higher prevalence of diabetes, cancer, prostate cancer, hypertension, and stroke. Anemia was not statistically significantly associated with bone mineral density (BMD). Men with anemia had higher serum levels of fibroblast growth factor 23 (iFGF23) (p < 0.001) and phosphate (p = 0.001) and lower serum levels of testosterone (p < 0.001) and estradiol (p < 0.001). Moreover, men with anemia had an increased risk of any fracture (hazard ratio (HR) 1.97, 95% CI 1.28-3.02) and non-vertebral osteoporotic fracture (HR 2.15, 95% CI 1.18-3.93), after adjustment for age and total hip BMD, in 10 years. The risk for any fracture was increased in 10 and 16 years independently of falls, comorbidities, inflammation, and sex hormones. The age-adjusted risk of hip fracture was increased in men with anemia (HR 2.32, 95% CI 1.06-5.12), in 10 years, although this was no longer statistically significant after further adjustment for total hip BMD.
Anemia is associated with an increased risk for any fracture and non-vertebral osteoporotic fracture in elderly men with a long follow-up time. The cause is probably multifactorial and our results support that anemia can be used as a predictor for future fracture.
本研究纳入了来自哥德堡骨质疏松性骨折男性研究（MrOS）的 1005 名男性。其中包括 66 名贫血男性（血红蛋白<130g/L）。随访时间最长可达 16 年，主要结果是贫血与所有骨折和非椎体骨质疏松性骨折有关。
贫血和骨质疏松性骨折与发病率和死亡率增加有关。临床研究表明，贫血可用作预测未来骨质疏松性骨折的指标。
本研究纳入了来自瑞典哥德堡骨质疏松性骨折男性研究（MrOS）的男性，这些男性有可用于分析的血红蛋白（Hb）值（n=1005，中位年龄 75.3 岁[SD 3.2]）。其中 66 名男性患有贫血，定义为血红蛋白<130g/L。骨折的中位随访时间为 10.1 年，最长随访时间为 16.1 年。
基线时，贫血男性经历了更多的跌倒，且糖尿病、癌症、前列腺癌、高血压和中风的患病率更高。贫血与骨密度（BMD）无统计学显著相关性。贫血男性的成纤维细胞生长因子 23（iFGF23）血清水平更高（p<0.001），磷酸盐水平更高（p=0.001），而睾酮（p<0.001）和雌二醇（p<0.001）血清水平更低。此外，在校正年龄和全髋关节 BMD 后，贫血男性发生任何骨折（风险比[HR]1.97，95%置信区间[CI]1.28-3.02）和非椎体骨质疏松性骨折（HR 2.15，95%CI 1.18-3.93）的风险增加，随访 10 年后。在排除跌倒、合并症、炎症和性激素的影响后，10 年和 16 年后，任何骨折的风险均增加。贫血男性髋关节骨折的校正年龄风险增加（HR 2.32，95%CI 1.06-5.12），尽管在进一步校正全髋关节 BMD 后，这不再具有统计学意义。
在随访时间较长的老年男性中，贫血与任何骨折和非椎体骨质疏松性骨折的风险增加有关。原因可能是多因素的，我们的结果支持贫血可用作未来骨折的预测指标。
