Ross P D, Huang C, Davis J W, Wasnich R D
Department of Research, Hawaii Osteoporosis Center, Honolulu 96814, USA.
Bone. 1995 Apr;16(4 Suppl):257S-262S. doi: 10.1016/8756-3282(94)00021-q.
We investigated the independent contributions of vertebral size and shape, bone density, and existing fractures for predicting the risk of new vertebral fractures among postmenopausal Japanese-American women in Hawaii. Baseline measurements of bone density at the distal and proximal radius and the calcaneus were obtained in 1981, and at the lumbar spine in 1984. Incident fractures were documented on serial radiographs during an average of 8.0 years of follow up of 840 women. A positive difference of 1 standard deviation in vertebral depth increased the risk of new vertebral fractures by approximately 1.3-fold (95% confidence interval = 1.03, 1.66) after controlling for bone density and prevalent fractures. A combination of large vertebral depth (above the 66th percentile) and low bone density (below the 33rd percentile) increased fracture risk approximately six times compared to women with high bone density (above the 66th percentile) and small vertebral depth (below the 33rd percentile). We conclude that combining information about vertebral depth, bone density, and prevalent fracture appears to be better for predicting new fractures than any single variable alone.
我们调查了椎体大小和形状、骨密度以及既往骨折对于预测夏威夷绝经后日裔美国女性发生新椎体骨折风险的独立作用。1981年获取了桡骨远端和近端以及跟骨的骨密度基线测量值，1984年获取了腰椎的骨密度基线测量值。在对840名女性平均8.0年的随访期间，通过系列X光片记录新发骨折情况。在控制骨密度和既往骨折因素后，椎体深度增加1个标准差的正向差异使新椎体骨折风险增加约1.3倍（95%置信区间 = 1.03, 1.66）。与骨密度高（高于第66百分位数）且椎体深度小（低于第33百分位数）的女性相比，椎体深度大（高于第66百分位数）且骨密度低（低于第33百分位数）的女性组合骨折风险增加约6倍。我们得出结论，相比于单独的任何一个变量，综合椎体深度、骨密度和既往骨折的信息似乎更有利于预测新发骨折。
