Arden N K, Griffiths G O, Hart D J, Doyle D V, Spector T D
Department of Rheumatology, St Thomas' Hospital, London.
Br J Rheumatol. 1996 Dec;35(12):1299-304. doi: 10.1093/rheumatology/35.12.1299.
Studies of the association between the presence of osteoarthritis (OA) and the risk of osteoporotic fractures have produced conflicting results. To address this question further, we have examined the association between self-reported, validated fractures and radiological OA at multiple sites in a large population of normal Caucasian women aged 45-65 yr. Despite having increased bone mineral density (BMD) of 5.3%, subjects with hip OA had a significantly increased risk of fracture [odds ratio (OR) 2.38, 95% CI 1.06-5.35] compared to controls. Subjects with lumbar spine OA, however, had a significantly reduced risk of fracture (OR 0.45, 95% CI 0.23-0.80) compared to controls. This association was not explained by differences in BMD, weight, sex hormones or physical activity. No clear association was seen with fracture for hand or knee OA. These data suggest that the increased risk of fracture in subjects with OA of the hip is most likely to be due to mechanical and locomotor factors, such as the risk of falling.
骨关节炎（OA）的存在与骨质疏松性骨折风险之间的关联研究结果相互矛盾。为了进一步探讨这个问题，我们在一大群年龄在45 - 65岁的正常白种女性中，研究了自我报告且经验证的骨折与多个部位放射学OA之间的关联。尽管髋部OA患者的骨矿物质密度（BMD）增加了5.3%，但与对照组相比，其骨折风险显著增加[比值比（OR）2.38，95%置信区间1.06 - 5.35]。然而，与对照组相比，腰椎OA患者的骨折风险显著降低（OR 0.45，95%置信区间0.23 - 0.80）。这种关联不能用BMD、体重、性激素或身体活动的差异来解释。手部或膝部OA与骨折之间未发现明显关联。这些数据表明，髋部OA患者骨折风险增加很可能是由于机械和运动因素，如跌倒风险。
