Cummings S R, Black D M, Nevitt M C, Browner W, Cauley J, Ensrud K, Genant H K, Palermo L, Scott J, Vogt T M
Division of General Internal Medicine, University of California, San Francisco.
Lancet. 1993 Jan 9;341(8837):72-5. doi: 10.1016/0140-6736(93)92555-8.
Women with low bone density in the radius or calcaneus are at increased risk of hip fracture. To see whether bone density of the hip measured by dual X-ray absorptiometry is a better predictor of hip fracture than measurements of other bones, we assessed bone density at several sites in 8134 women aged 65 years or more. 65 women had hip fractures during a mean follow-up of 1.8 years. Each SD decrease in femoral neck bone density increased the age-adjusted risk of hip fracture 2.6 times (95% CL 1.9, 3.6). Women with bone density in the lowest quartile had an 8.5-fold greater risk of hip fracture than those in the highest quartile. Bone density of the femoral neck was a better predictor than measurements of the spine (p < 0.0001), radius (p < 0.002), and moderately better than the calcaneus (p = 0.10). Low hip bone density is a stronger predictor of hip fracture than bone density at other sites. Efforts to prevent hip fractures should focus on women with low hip bone density.
桡骨或跟骨骨密度低的女性髋部骨折风险增加。为了确定双能X线吸收法测量的髋部骨密度是否比其他部位骨骼测量更能预测髋部骨折，我们评估了8134名65岁及以上女性多个部位的骨密度。在平均1.8年的随访期间，65名女性发生了髋部骨折。股骨颈骨密度每降低1个标准差，年龄调整后的髋部骨折风险增加2.6倍（95%可信区间1.9, 3.6）。骨密度处于最低四分位数的女性髋部骨折风险比最高四分位数的女性高8.5倍。股骨颈骨密度比脊柱测量（p < 0.0001）、桡骨测量（p < 0.002）更能预测髋部骨折，比跟骨测量稍好（p = 0.10）。髋部骨密度低比其他部位骨密度更能预测髋部骨折。预防髋部骨折的努力应集中在髋部骨密度低的女性身上。
