Poór G, Atkinson E J, O'Fallon W M, Melton L J
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
J Bone Miner Res. 1995 Dec;10(12):1900-7. doi: 10.1002/jbmr.5650101209.
To assess the influence on the risk of hip fractures in men of medical conditions associated with secondary osteoporosis or with an increased likelihood of falling, we conducted a population-based nested case-control study among the 232 Rochester, Minnesota, men with an initial hip fracture due to moderate trauma in 1965-1989 and an equal number of age-matched control men from the general population. Information on selected medical and surgical conditions and certain behavioral risk factors prior to fracture (or comparable index date for controls) was obtained from inpatient and outpatient medical records in the community that averaged over 36 years in duration. After adjusting for age, obesity, and inactivity, disorders linked with secondary osteoporosis were associated with a 2-fold increase in the risk of hip fracture in men (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.3-4.3), while conditions linked with an increased risk of falling were associated with almost a 7-fold increase in risk (OR 6.9; 95% CI 3.3-14.8). These factors together appeared to account for about 72% of the hip fractures in men. Increased attention must be paid to these conditions which, in aggregate, are very common in elderly men and lead to a substantial increase in the risk of hip fracture with its devastating sequelae of death, disability and cost.
为评估与继发性骨质疏松症相关或跌倒可能性增加的疾病对男性髋部骨折风险的影响，我们在明尼苏达州罗切斯特市进行了一项基于人群的巢式病例对照研究。研究对象为1965年至1989年间因中度创伤首次发生髋部骨折的232名男性，以及从普通人群中选取的同等数量、年龄匹配的对照男性。关于骨折前（或对照的可比索引日期）选定的内科和外科疾病以及某些行为危险因素的信息，来自社区平均时长超过36年的住院和门诊医疗记录。在对年龄、肥胖和缺乏运动进行校正后，与继发性骨质疏松症相关的疾病使男性髋部骨折风险增加了2倍（比值比[OR] 2.3；95%置信区间[CI] 1.3 - 4.3），而与跌倒风险增加相关的疾病使风险增加了近7倍（OR 6.9；95% CI 3.3 - 14.8）。这些因素共同似乎占男性髋部骨折的约72%。必须更加关注这些疾病，总体而言，它们在老年男性中非常常见，并导致髋部骨折风险大幅增加，随之而来的是死亡、残疾和成本等灾难性后果。
