A family history of fracture and fracture risk: a meta-analysis
A family history of fracture and fracture risk: a meta-analysis
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DOI：
10.1016/j.bone.2004.06.017
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发表时间：
2004-11-01
期刊：
影响因子：
4.1
通讯作者：
Tenenhouse, A
中科院分区：
文献类型：
--
作者：
Kanis, JA;Johansson, H;Tenenhouse, A
本研究的目的是在国际环境中确定父母的骨折史或髋部骨折史是否是未来骨折的重要危险因素，并探讨年龄、性别和骨密度（BMD）对这一风险的影响。我们研究了来自7个前瞻性研究队列的34,928名男性和女性，随访时间为134,374人年。这些队列包括EPOS/EVOS研究、CaMos、鹿特丹研究、DOES以及谢菲尔德、罗切斯特和哥德堡的队列。采用泊松回归分析各队列、各性别的骨质疏松性骨折或一级亲属髋部骨折家族史、骨密度和年龄对所有临床骨折、骨质疏松性骨折和髋部骨折风险的影响。不同研究的结果从加权系数中合并。父母有骨折史与任何骨折、骨质疏松性骨折和髋部骨折的风险轻微但显著增加有关。任何骨折的风险比为1.17 (95% CI = 1.07-1.28)，任何骨质疏松性骨折的风险比为1.18 (95% CI = 1.06-1.31)，髋部骨折的风险比为1.49 （95% CI = 1.17-1.89）。年龄越小，风险比越高，但差异不显著。父母有任何骨折史（RR分别为1.17和1.17）或骨质疏松性骨折史（RR分别为1.17和1.18）的男性和女性的风险无显著差异。对于髋部骨折，男性的风险比略高，但没有明显高于女性（RR分别为2.02和1.38）。父母有髋部骨折家族史与所有骨质疏松性骨折（RR = 1.54; 95 CI = 1.25-1.88）和髋部骨折（RR = 2.27; 95% CI = 1.47-3.49）的显著风险相关。当BMD添加到模型中时，风险没有显着改变。我们的结论是，父母有骨折史（尤其是髋部骨折家族史）会增加骨折的风险，而这与骨密度无关。在国际基础上对其进行识别，支持在病例发现战略中使用这一风险因素。(C) 2004爱思唯尔公司版权所有。
The aims of the present study were to determine whether a parental history of any fracture or hip fracture specifically are significant risk factors for future fracture in an international setting, and to explore the effects of age, sex and bone mineral density (BMD) on this risk. We studied 34,928 men and women from seven prospectively studied cohorts followed for 134,374 person-years. The cohorts comprised the EPOS/EVOS study, CaMos, the Rotterdam Study, DOES and cohorts at Sheffield, Rochester and Gothenburg. The effect of family history of osteoporotic fracture or of hip fracture in first-degree relatives, BMD and age on all clinical fracture, osteoporotic fracture and hip fracture risk alone was examined using Poisson regression in each cohort and for each sex. The results of the different studies were merged from the weighted beta coefficients.A parental history of fracture was associated with a modest but significantly increased risk of any fracture, osteoporotic fracture and hip fracture in men and women combined. The risk ratio (RR) for any fracture was 1.17 (95% CI = 1.07-1.28), for any osteoporotic fracture was 1.18 (95% CI = 1.06-1.31), and for hip fracture was 1.49 (95% CI = 1.17-1.89). The risk ratio was higher at younger ages but not significantly so. No significant difference in risk was seen between men and women with a parental history for any fracture (RR = 1.17 and 1.17, respectively) or for an osteoporotic fracture (RR = 1.17 and 1.18, respectively). For hip fracture, the risk ratios were somewhat higher, but not significantly higher, in men than in women (RR = 2.02 and 1.38, respectively). A family history of hip fracture in parents was associated with a significant risk both of all osteoporotic fracture (RR 1.54; 95 CI = 1.25-1.88) and of hip fracture (RR = 2.27; 95% CI 1.47-3.49). The risk was not significantly changed when BMD was added to the model.We conclude that a parental history of fracture (particularly a family history of hip fracture) confers an increased risk of fracture that is independent of BMD. Its identification on an international basis supports the use of this risk factor in case-finding strategies. (C) 2004 Elsevier Inc. All rights reserved.