The School of Medicine, Nankai University, Tianjin, China.
Hebei Orthopaedic Research Institute, Hebei Provincial Key Laboratory of Orthopaedic Biomechanics, Shijiazhuang, China.
Orthop Surg. 2024 Nov;16(11):2834-2843. doi: 10.1111/os.14245. Epub 2024 Sep 17.
Air pollution is increasing and threatening human health. The objective of this study is to investigate the population distribution characteristics of elderly osteoporosis fractures in Hebei Province and Xinjiang Uygur Autonomous Region and to analyze the effects of air pollutants on the number of elderly osteoporosis fracture inpatients in the two regions.
A retrospective collection of elderly osteoporosis fracture cases was conducted in selected hospitals in Hebei Province and Xinjiang Uygur Autonomous Region from January 1, 2018 to December 31, 2022. The chi-square test was used to compare the distributional characteristics of the population in the two regions. Additionally, we used a distributed lag nonlinear model (DLNM) in order to assess the effect of air pollutants on the number of daily hospital admissions of elderly osteoporosis fracture patients in different regions.
A total of 19,203 elderly osteoporosis fracture patients were included in the study. The average age of these patients was 76.66 ± 7.55 years, and the majority of them were female (13,514 instances, 70.37%). The disparities in age distribution (χ = 133.9 p < 0.001), fracture site (χ = 62.0 p < 0.001), and hospitalization cost (Z = -15.635 p < 0.001) between the two regions were statistically significant. The lag effect curves of PM2.5, PM10, and NO on the number of elderly osteoporosis fracture hospitalizations in Xinjiang Uygur Autonomous Region exhibited a similar pattern resembling a "W"-shaped curve. All three pollutants reached their highest values after a lag time of 14 days (PM2.5: RR = 1.053, 95% CI: 1.031, 1.074; PM10: RR = 1.031, 95% CI: 1.018, 1.043; NO: RR = 1.125, 95% CI: 1.070, 1.182). In Hebei Province, the largest impacts of PM2.5 and PM10 were observed after a lag of 14 days (PM2.5: RR = 1.022, 95% CI: 1.013, 1.028; PM10: RR = 1.013, 95% CI: 1.008, 1.018). Similarly, the maximum effect of NO was observed after a lag of 11 days (RR = 1.020, 95% CI: 1.010, 1.028).
There were differences in the epidemiological characteristics of hospitalized patients with osteoporosis fractures between the two regions, PM2.5, PM10, and NO increased the number of hospitalizations for osteoporosis fractures. Exposure to air pollutants such as PM2.5 increases the risk of osteoporosis fractures in the elderly population.
空气污染日益严重，威胁着人类健康。本研究旨在探讨河北省和新疆维吾尔自治区老年骨质疏松性骨折的人群分布特征，并分析空气污染物对两地区老年骨质疏松性骨折住院人数的影响。
2018 年 1 月 1 日至 2022 年 12 月 31 日，选取河北省和新疆维吾尔自治区部分医院进行老年骨质疏松性骨折病例回顾性收集。采用卡方检验比较两地区人群分布特征。此外，我们还使用分布滞后非线性模型（DLNM）评估空气污染物对不同地区老年骨质疏松性骨折患者每日住院人数的影响。
本研究共纳入 19203 例老年骨质疏松性骨折患者。这些患者的平均年龄为 76.66±7.55 岁，其中大多数为女性（13514 例，70.37%）。两地区年龄分布（χ=133.9，p<0.001）、骨折部位（χ=62.0，p<0.001）和住院费用（Z=-15.635，p<0.001）差异有统计学意义。新疆维吾尔自治区 PM2.5、PM10 和 NO 对老年骨质疏松性骨折住院人数的滞后效应曲线呈类似的“W”形曲线。三种污染物在滞后 14 天后均达到最高值（PM2.5：RR=1.053，95%CI：1.031，1.074；PM10：RR=1.031，95%CI：1.018，1.043；NO：RR=1.125，95%CI：1.070，1.182）。在河北省，PM2.5 和 PM10 的最大影响出现在滞后 14 天后（PM2.5：RR=1.022，95%CI：1.013，1.028；PM10：RR=1.013，95%CI：1.008，1.018）。同样，NO 的最大效应出现在滞后 11 天后（RR=1.020，95%CI：1.010，1.028）。
两地区骨质疏松性骨折住院患者的流行病学特征存在差异，PM2.5、PM10 和 NO 增加了骨质疏松性骨折的住院人数。暴露于 PM2.5 等空气污染物会增加老年人群骨质疏松性骨折的风险。
