Department of Orthopedic Surgery, Bnai Zion Medical Center, Sderot Eliyahu Golomb 47, 31048, Haifa, Israel.
KI Research Institute, Kfar Malal, Israel.
Osteoporos Int. 2024 Oct;35(10):1839-1847. doi: 10.1007/s00198-024-07169-3. Epub 2024 Jul 13.
We studied the association between non-osteoporotic fractures and future major osteoporotic fractures, using UK health records. Non-osteoporotic fractures were found to increase the risk of major osteoporotic fractures, although to a lesser extent than osteoporotic fractures. This highlights the importance of considering all previous fractures in assessing future fracture risk.
Previous studies demonstrated that osteoporotic fractures-minor and major-increase the risk for future major osteoporotic fractures; we test whether non-osteoporotic fractures are also associated with such increased risk.
The study is a retrospective cohort study using UK primary care electronic health records. Exposure groups were defined according to fracture location prior to the year 2011 (index date): major, minor, and non-osteoporotic. The outcome of incident major osteoporotic fractures following the index date was compared between the exposure groups and the general population.
The general study population included 1,951,388 patients. The exposure groups included 39,931 patients with a prior major osteoporotic fracture, 19,397 with a prior minor osteoporotic fracture, and 50,115 patients with a prior non-osteoporotic fracture. The standardized Incidence Rate Ratio for future major osteoporotic fractures was 2.73 (95% confidence interval: 2.64-2.82), 2.43 (2.32-2.54), and 1.83 (1.74-1.92), respectively.
Non-osteoporotic fractures are significantly associated with increased risk for future major osteoporotic fractures relative to the general population, yet to a lesser extent compared to major and minor osteoporotic fractures.
先前的研究表明，骨质疏松性骨折——轻微和主要——会增加未来发生主要骨质疏松性骨折的风险；我们测试非骨质疏松性骨折是否也与这种风险增加有关。
该研究是一项使用英国初级保健电子健康记录的回顾性队列研究。暴露组根据 2011 年之前（索引日期）的骨折部位定义：主要、次要和非骨质疏松性。在索引日期后，比较暴露组和普通人群中发生的主要骨质疏松性骨折的情况。
一般研究人群包括 1951388 名患者。暴露组包括 39931 名先前有主要骨质疏松性骨折的患者、19397 名先前有轻微骨质疏松性骨折的患者和 50115 名先前有非骨质疏松性骨折的患者。未来主要骨质疏松性骨折的标准化发病率比值分别为 2.73（95%置信区间：2.64-2.82）、2.43（2.32-2.54）和 1.83（1.74-1.92）。
非骨质疏松性骨折与未来主要骨质疏松性骨折的风险增加显著相关，但与主要和次要骨质疏松性骨折相比，其相关性较小。
