School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan.
Department of Rehabilitation, Sanin Rosai Hospital, 1-8-1 Kaikeshinden, Yonago, Tottori, 683-8605, Japan.
Osteoporos Int. 2023 Oct;34(10):1703-1709. doi: 10.1007/s00198-023-06816-5. Epub 2023 Jun 8.
A history of fracture in adulthood and urinary pentosidine levels were independently and significantly associated with fracture occurrence in this prospective observational study of community-dwelling older adults.
This prospective observational study aimed to determine the factors associated with fragility fractures in community-dwelling older adults.
Overall, 254 older adults who were participants of the Good Aging and Intervention Against Nursing Care and Activity Decline study in 2016 were included in this study. Grip strength, muscle mass, gait speed, calcaneal bone density, and the levels of parathyroid hormone, osteocalcin, 25-hydroxyvitamin D, total procollagen type I N-terminal propeptide, insulin-like growth factor-1 (IGF-1), tartrate-resistant acid phosphatase-5b, and urinary pentosidine were measured at baseline. Participants were classified as fracture ( +) or fracture (-) based on the data collected during a 5-year follow-up period.
Excluding those who were lost to follow-up during the observation period, 182 participants (64 men and 118 women, mean age: 74.2 years, range: 47-99 years) were included in the analysis. During the observation period, 23 patients experienced 24 new fractures. In univariate analysis, sex, height, weight, history of fracture in adulthood, baseline grip strength, muscle mass, bone density, and the levels of urinary pentosidine and IGF-1 at baseline were significantly different between patients who developed a fracture during follow-up and those who did not. In multivariate analysis, a history of fracture in adulthood and urinary pentosidine levels were independently and significantly associated with fracture occurrence.
High urine pentosidine levels and a history of fracture in adulthood are independent risk factors for fracture occurrence in community-dwelling older adults.
在这项对居住在社区的老年人群进行的前瞻性观察研究中，成年期骨折史和尿戊糖水平与骨折发生独立且显著相关。
本前瞻性观察研究旨在确定与居住在社区的老年人群脆性骨折相关的因素。
共有 2016 年参加良好老龄化及干预以预防护理和活动能力下降研究的 254 名老年人纳入本研究。在基线时测量握力、肌肉质量、步速、跟骨骨密度以及甲状旁腺激素、骨钙素、25-羟维生素 D、总Ⅰ型前胶原氨基端肽、胰岛素样生长因子-1（IGF-1）、抗酒石酸酸性磷酸酶-5b 和尿戊糖的水平。根据 5 年随访期间收集的数据，将参与者分为骨折（+）或骨折（-）。
在观察期间失访的参与者除外，182 名参与者（64 名男性和 118 名女性，平均年龄 74.2 岁，范围 47-99 岁）纳入分析。在观察期间，23 名患者发生 24 例新发骨折。在单变量分析中，性别、身高、体重、成年期骨折史、基线握力、肌肉质量、骨密度以及基线时尿戊糖和 IGF-1 的水平在随访期间发生骨折的患者和未发生骨折的患者之间存在显著差异。在多变量分析中，成年期骨折史和尿戊糖水平与骨折发生独立且显著相关。
高尿戊糖水平和成年期骨折史是居住在社区的老年人群骨折发生的独立危险因素。
