Huang C, Ross P D, Fujiwara S, Davis J W, Epstein R S, Kodama K, Wasnich R D
Hawaii Osteoporosis Center, Honolulu 96814, USA.
Bone. 1996 May;18(5):437-42. doi: 10.1016/8756-3282(96)00043-9.
Age-adjusted prevalence of vertebral fracture has been reported to be higher among native Japanese women than among women of Japanese descent living in Hawaii. In this cross-sectional population-based study, we examined a variety of potential risk factors for associations with prevalent vertebral fractures and investigated whether these factors could explain the difference in vertebral fracture prevalence between native Japanese and Japanese-American women. Spine radiographs and data on spine bone mineral density (BMD) and other potential risk factors were collected among 802 Japanese women aged 50-88 years living in Hiroshima and 840 Japanese-American women aged 52-88 years living in Hawaii. In logistic regression analysis, BMD was a major predictor of prevalent vertebral fracture. In linear regression models, weight, age, and menstrual history (age at menopause or years between menarche and menopause) were significantly associated with BMD and thus might contribute to fracture risk indirectly through their effects on BMD. However, age and menstrual history provided additional and complementary information about fracture prevalence after adjusting for BMD. These variables together explained much of the difference in vertebral fracture prevalence between the two study populations. We conclude that the observed difference in age-adjusted prevalence of spine fracture between native Japanese and Japanese-American women was accounted for primarily by the differences in BMD, duration of estrogen exposure, and/or duration of estrogen deficiency. Thus, current BMD is a major but not the sole risk factor for vertebral fractures. Age-related and menopause-related mechanisms may also play an important role in spine fracture independent of BMD.
据报道，日本本土女性的年龄调整后椎体骨折患病率高于生活在夏威夷的日裔女性。在这项基于人群的横断面研究中，我们研究了与现患椎体骨折相关的各种潜在风险因素，并调查了这些因素是否可以解释日本本土女性和日裔美国女性之间椎体骨折患病率的差异。我们收集了802名年龄在50 - 88岁之间居住在广岛的日本女性以及840名年龄在52 - 88岁之间居住在夏威夷的日裔美国女性的脊柱X光片、脊柱骨密度（BMD）数据和其他潜在风险因素的数据。在逻辑回归分析中，骨密度是现患椎体骨折的主要预测因素。在线性回归模型中，体重、年龄和月经史（绝经年龄或初潮至绝经之间的年限）与骨密度显著相关，因此可能通过它们对骨密度的影响间接导致骨折风险。然而，在调整骨密度后，年龄和月经史提供了关于骨折患病率的额外补充信息。这些变量共同解释了两个研究人群之间椎体骨折患病率差异的大部分原因。我们得出结论，日本本土女性和日裔美国女性之间年龄调整后脊柱骨折患病率的差异主要是由骨密度、雌激素暴露持续时间和/或雌激素缺乏持续时间的差异造成的。因此，当前的骨密度是椎体骨折的主要但不是唯一的风险因素。与年龄和绝经相关的机制在脊柱骨折中可能也起着独立于骨密度的重要作用。
