Mussolino M E, Looker A C, Madans J H, Langlois J A, Orwoll E S
Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
J Bone Miner Res. 1998 Jun;13(6):918-24. doi: 10.1359/jbmr.1998.13.6.918.
This prospective population-based study assessed predictors of hip fracture risk in white men. Participants were members of the Epidemiologic Follow-up Study cohort of the First National Health and Nutrition Examination Survey, a nationally representative sample of noninstitutionalized civilians who were followed for a maximum of 22 years. A cohort of 2879 white men (2249 in the nutrition and weight-loss subsample, 1437 in the bone density subsample) aged 45-74 years at baseline (1971-1975) were observed through 1992. Ninety-four percent of the original cohort were successfully traced. Hospital records and death certificates were used to identify a total of 71 hip fracture cases (61 in the nutrition and weight-loss subsample, 26 in the bone-density subsample). Among the factors evaluated were age at baseline, previous fractures other than hip, body mass index, smoking status, alcohol consumption, nonrecreational physical activity, weight loss from maximum, calcium intake, number of calories, protein consumption, chronic disease prevalence, and phalangeal bone density. The risk adjusted relative risk (RR) of hip fracture was significantly associated with presence of one or more chronic conditions (RR = 1.91, 95% confidence interval [CI] = 1.19-3.06), weight loss from maximum > or = 10% (RR = 2.27, 95% CI 1.13-4.59), and 1 SD change in phalangeal bone density (RR = 1.73, 95% CI 1.11-2.68). No other variables were significantly related to hip fracture risk. Although based on a small number of cases, this is one of the first prospective studies to relate weight loss and bone density to hip fracture risk in men.
这项基于人群的前瞻性研究评估了白人男性髋部骨折风险的预测因素。参与者是第一次全国健康与营养检查调查的流行病学随访研究队列的成员，该队列是一个具有全国代表性的非机构化平民样本，随访时间最长为22年。观察了一组在基线时（1971 - 1975年）年龄为45 - 74岁的2879名白人男性（营养与体重减轻子样本中有2249人，骨密度子样本中有1437人），直至1992年。原队列中94%的人被成功追踪。通过医院记录和死亡证明共确定了71例髋部骨折病例（营养与体重减轻子样本中有61例，骨密度子样本中有26例）。评估的因素包括基线年龄、除髋部以外的既往骨折、体重指数、吸烟状况、饮酒量、非娱乐性身体活动、最大体重减轻量、钙摄入量、卡路里摄入量、蛋白质摄入量、慢性病患病率以及指骨骨密度。髋部骨折的风险调整相对风险（RR）与一种或多种慢性病的存在显著相关（RR = 1.91，95%置信区间[CI] = 1.19 - 3.06）、最大体重减轻量≥10%（RR = 2.27，95% CI 1.13 - 4.59）以及指骨骨密度变化1个标准差（RR = 1.73，95% CI 1.11 - 2.68）。没有其他变量与髋部骨折风险显著相关。尽管基于少量病例，但这是首批将体重减轻和骨密度与男性髋部骨折风险相关联的前瞻性研究之一。
