Combined results of three physical performance tests predict incident fracture independently of aBMD in community-dwelling elderly Japanese men: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Cohort Study
Combined results of three physical performance tests predict incident fracture independently of aBMD in community-dwelling elderly Japanese men: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Cohort Study
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DOI：
10.1016/j.bone.2021.116240
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发表时间：
2021-10-29
期刊：
影响因子：
4.1
通讯作者：
Kurumatani，Norio
中科院分区：
文献类型：
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作者：
Fujita，Yuki;Iki，Masayuki;Kurumatani，Norio
背景几项研究探讨了女性身体机能与骨折之间的关系，但很少有此类研究针对老年男性。本研究旨在确定在调整混杂因素后，多种身体机能测试的综合结果是否可以预测老年男性随后的骨折发生率。方法对参与本研究的2174名老年男性，2012年完成基线研究访视，包括身体机能测试（步行速度、手握力和单腿站立）和双能X射线骨密度测定法测量骨密度。五年和十年后进行了后续研究访问，在此期间通过详细访谈确定了骨折事件。我们排除了 140 名患有疾病或服用已知会影响基线骨代谢的药物的男性，185 名预测因子和潜在混杂因素缺失值的男性，以及 1 名未参加任何后续研究访视的男性。对其余 1686 名男性进行了分析。每项身体表现测试均按四分位数进行分析。表现不佳被定义为表现最差的四分之一。使用 Cox 比例风险模型评估身体表现与骨折之间的关联。结果在平均 8.4 年的随访期内，我们在 1686 名男性中发现了 175 例临床骨折（骨质疏松性骨折：77 例，严重骨质疏松性骨折：48 例）。在调整了包括骨矿物质密度在内的潜在混杂因素后，与在任何一项测试中表现不佳的男性相比，在所有三项身体机能测试中表现不佳的男性发生骨质疏松性骨折的风险高出 3.7 倍，发生严重骨质疏松性骨折的风险高出 6.6 倍。 结论 在所有三项身体机能测试中表现不佳的日本老年男性发生骨质疏松症的风险显着更高 骨折与骨矿物质密度无关。多项身体机能测试的综合结果可能有助于预测老年男性骨折事件。
BackgroundSeveral studies have examined the association between physical performance and fracture in women, but few such studies have targeted elderly men. This study aimed to determine whether the combined results of several physical performance tests can predict the subsequent incidence of fractures in elderly men after adjusting for confounding factors.MethodsOf the 2174 elderly men who participated in this study, 2012 completed the baseline study visit, including physical performance tests (walking speed, hand grip strength, and one-leg standing) and measurement of bone mineral density by dual-energy X-ray absorptiometry. Follow-up study visits were conducted five and ten years later, during which incident fractures were identified by detailed interviews. We excluded 140 men with diseases or who took medications known to affect bone metabolism at baseline, 185 with missing values for predictors and potential confounding factors, and one who did not participate in any of the follow-up study visits. The remaining 1686 men were analyzed. Each physical performance test was analyzed by quartiles. Poor performance was defined as belonging to the worst quartile of performance. The association between physical performance and fracture was assessed using Cox proportional hazards models.ResultsWe identified 175 clinical fractures (osteoporotic fracture: 77, major osteoporotic fracture: 48) in 1686 men during a mean follow-up period of 8.4 years. After adjusting for potential confounding factors including bone mineral density, men who performed poorly on all three physical performance tests had a 3.7-fold higher risk of osteoporotic fracture and a 6.6-fold higher risk of major osteoporotic fracture than men who did not perform poorly on any of the tests.ConclusionsJapanese elderly men who performed poorly on all three physical performance tests had a significantly higher risk of incident osteoporotic fracture independently of bone mineral density. The combined results of several physical performance tests may be useful for predicting incident fractures in elderly men.