Clark P, de la Peña F, Gómez García F, Orozco J A, Tugwell P
Hospital de Especialidades Centro Médico Nacional Siglo XXI, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), México, D.F.
Arch Med Res. 1998 Autumn;29(3):253-7.
Osteoporosis (OP) and its fractures are a major problem due to their impact in morbidity and mortality in the elderly. Although this entity is well studied in other countries, OP and its fractures have not been evaluated carefully in our population. The objective was to assess risk factors for osteoporotic hip fracture in Mexicans.
A total of 295 subjects, 152 cases and 143 controls, were studied. Cases were patients with hip fracture, of both sexes and 45 years of age or older. Controls were healthy subjects who were in hospital waiting rooms accompanying patients without hip fractures. A questionnaire covering known possible risk factors for osteoporotic hip fracture was administered by the same evaluator to all subjects. Pelvic roentgenograms, anterior-posterior view, were obtained in both cases and controls to perform the Singh index and the cortical index of the femur.
Fractures were present in (72.2%) of women. Weight and any alcohol ingestion were associated with an increased risk of hip fracture. The odds ratio (OR) for low weight by the Quetelet Index was 4.03 (95% CI 1.93-8.39) p < 0.001. Any alcohol intake was associated with an OR of 1.73 (95% CI 1.04-2.90) p < or = 0.03 for the total group, and 2.78 (95% CI 1.25-6.14) p < or = 0.003 for women. Controls had a significantly higher mean daily calcium intake compared to cases (mean, SD 575.9 +/- 297.2 vs. 490.4 +/- 245.5, p < or = (0.007). Family history, smoking, physical activity, pregnancies, breastfeeding or concomitant diseases were not associated with risk of hip fracture.
This study confirmed the risk factors for osteoporotic hip fracture in Mexicans, previously shown for other ethnic groups. Further research in different factors, such as rate of bone turnover, anthropometric dimensions, and genetic studies (osteoporosis gene) are needed in order to define the differences among ethnic groups.
骨质疏松症(OP)及其骨折是一个重大问题,因为它们会影响老年人的发病率和死亡率。尽管在其他国家对这个问题已有充分研究,但在我国人群中,OP及其骨折尚未得到仔细评估。目的是评估墨西哥人骨质疏松性髋部骨折的危险因素。
共研究了295名受试者,其中152例为病例组,143例为对照组。病例组为髋部骨折患者,男女不限,年龄在45岁及以上。对照组为在医院候诊室陪伴无髋部骨折患者的健康受试者。由同一名评估人员向所有受试者发放一份涵盖已知可能导致骨质疏松性髋部骨折危险因素的问卷。对病例组和对照组均拍摄骨盆前后位X线片,以进行股骨的辛格指数和皮质指数评估。
女性骨折发生率为(72.2%)。体重和饮酒与髋部骨折风险增加相关。根据奎特莱指数,低体重的优势比(OR)为4.03(95%可信区间1.93 - 8.39),p < 0.001。总体而言,饮酒与OR为1.73(95%可信区间1.04 - 2.90)相关,p ≤ 0.03;女性饮酒与OR为2.78(95%可信区间1.25 - 6.14)相关,p ≤ 0.003。与病例组相比,对照组的平均每日钙摄入量显著更高(均值,标准差575.9 ± 297.2对490.4 ± 245.5,p ≤ 0.007)。家族史、吸烟、体育活动、怀孕、母乳喂养或伴发疾病与髋部骨折风险无关。
本研究证实了墨西哥人骨质疏松性髋部骨折的危险因素,此前其他种族群体也有相关报道。为了明确不同种族群体之间的差异,需要对不同因素进行进一步研究,如骨转换率、人体测量学维度和基因研究(骨质疏松症基因)。