Larsson K, Ljunghall S, Krusemo U B, Naessén T, Lindh E, Persson I
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
J Intern Med. 1993 Dec;234(6):585-93. doi: 10.1111/j.1365-2796.1993.tb01017.x.
To evaluate primary hyperparathyroidism (HPT) as a risk factor for hip fractures.
A population-based, record-linked, prospective study with a mean observation time of 17 years (women) and 16.5 years (men).
A cohort obtained from a register of hospital admissions in the Uppsala Health Care Region, Sweden, 1965-1983.
All patients (1373 women and 551 men) who were admitted to hospital with the diagnosis of HPT during the period. Comparisons were made with the entire background population.
Cohort subjects were followed with regard to a first instance of hip fracture prior to or after the diagnosis of HPT. The observed number of cases was compared with that expected on the basis of person-years of observation and incidence rates in the background population. Analyses were made for cervical and trochanteric fractures, and for patients operated and not operated for HPT.
(i) Women. During 23,341 person-years of observation, 67 cases of first hip fractures occurred, yielding a relative risk (RR) of 0.93 (95% confidence interval [CI] 0.72-1.19). The RR for cervical fractures was 0.77 (CI 0.54-1.06), and for trochanteric fractures 1.33 (CI 0.88-1.93). Operation for HPT did not influence the risk of hip fracture. (ii) Men. The total person-years was 9091. Eleven fractures were observed--compared with the expected 7.90 (RR 1.39; CI 0.69-2.50). Men operated for HPT had an increased risk for cervical hip fractures (RR 2.73; CI 1.18-5.39). Owing to the few fractures in this group (n = 8) the relevance of this is uncertain.
This study indicates that HPT is not a risk factor for hip fractures in women.
评估原发性甲状旁腺功能亢进症（HPT）作为髋部骨折的危险因素。
一项基于人群、记录关联的前瞻性研究，女性平均观察时间为17年，男性为16.5年。
从瑞典乌普萨拉医疗保健地区1965 - 1983年的医院入院登记册中获取的队列。
在此期间因诊断为HPT而入院的所有患者（1373名女性和551名男性）。与整个背景人群进行比较。
对队列受试者在诊断HPT之前或之后首次发生髋部骨折的情况进行随访。将观察到的病例数与根据观察人年数和背景人群发病率预期的病例数进行比较。对颈椎和转子骨折以及接受和未接受HPT手术的患者进行分析。
（i）女性。在23341人年的观察期间，发生了67例首次髋部骨折，相对风险（RR）为0.93（95%置信区间[CI]0.72 - 1.19）。颈椎骨折的RR为0.77（CI 0.54 - 1.06），转子骨折的RR为1.33（CI 0.88 - 1.93）。HPT手术不影响髋部骨折风险。（ii）男性。总人年数为9091。观察到11例骨折，而预期为7.90例（RR 1.39；CI 0.69 - 2.50）。接受HPT手术的男性发生颈椎髋部骨折的风险增加（RR 2.73；CI 1.18 - 5.39）。由于该组骨折病例数较少（n = 8），其相关性尚不确定。
本研究表明，HPT不是女性髋部骨折的危险因素。
