Wang Suyuan, Zhang Fengyin, Guo Yanhong, Zhang Chenghui, Zhong Yang, Hao Doudou, Zhu Suyin, Wu Yunhong
Xizang Autonomous Region Clinical Research Center for High-altitude Stress, Endocrinology and Metabolism Disease, Hospital of Chengdu Office of People's Government of Xizang Autonomous Region (Hospital.C.X.), Chengdu, 610041, China.
Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Xizang Autonomous Region (Hospital.C.X.), Chengdu, 610041, China.
BMC Geriatr. 2025 Nov 10;25(1):884. doi: 10.1186/s12877-025-06492-6.
Previous investigations have suggested that high-altitude residency may increase the risk of bone loss; however, evidence on the impact of high-altitude exposure on the risk of hip fracture is lacking. Notably, hip fractures are the most serious complication of osteoporosis.
We designed and conducted a retrospective cohort analysis using the China Health and Longitudinal Study data from 2011 to 2018. Participants were divided into two groups based on the altitude of their residence, with a threshold of 1500 m. Propensity score matching was used to balance covariates, including socioeconomic indicators and medical histories. Univariate Cox regression analysis was performed to evaluate the effect size of high-altitude exposure on the risk of hip fractures. To perform subgroup analysis, the participants were stratified based on sex, body mass index, smoking, and drinking.
After matching, 399 participants in the high-altitude group and 3192 in the low-altitude group were enrolled. Cox regression showed that exposure to high altitude increased the risk of hip fracture (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.06–2.57, = 0.03). Subgroup analysis showed that women (HR: 1.996, 95% CI: 1.142–3.491, = 0.025) and participants with overweight (HR: 2.703, 95% CI: 1.186–6.165, = 0.034) were vulnerable to the impact of high-altitude exposure compared with men and participants with normal weight.
Exposure to high altitudes increases the risk of hip fractures, and prevention interventions should receive greater attention in these districts.
The online version contains supplementary material available at 10.1186/s12877-025-06492-6.
先前的调查表明，高海拔居住可能会增加骨质流失的风险；然而，关于高海拔暴露对髋部骨折风险影响的证据却很缺乏。值得注意的是，髋部骨折是骨质疏松症最严重的并发症。
我们利用2011年至2018年中国健康与养老追踪调查数据设计并进行了一项回顾性队列分析。参与者根据其居住海拔分为两组，以1500米为界值。倾向得分匹配用于平衡协变量，包括社会经济指标和病史。进行单因素Cox回归分析以评估高海拔暴露对髋部骨折风险的效应大小。为进行亚组分析，参与者按性别、体重指数、吸烟和饮酒情况进行分层。
匹配后，高海拔组纳入399名参与者，低海拔组纳入3192名参与者。Cox回归显示，高海拔暴露会增加髋部骨折风险（风险比[HR]：1.65，95%置信区间[CI]：1.06–2.57，P = 0.03）。亚组分析表明，与男性和体重正常的参与者相比，女性（HR：1.996，95% CI：1.142–3.491，P = 0.025）和超重参与者（HR：2.703，95% CI：1.186–6.165，P = 0.034）更容易受到高海拔暴露的影响。
高海拔暴露会增加髋部骨折风险，在这些地区预防干预措施应得到更多关注。
在线版本包含可在10.1186/s12877-025-06492-6获取的补充材料。
