Mortality associated with vertebral deformity in men and women: Results from the European Prospective Osteoporosis Study (EPOS)
Mortality associated with vertebral deformity in men and women: Results from the European Prospective Osteoporosis Study (EPOS)
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DOI：
10.1007/s001980050067
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发表时间：
1998-01-01
影响因子：
4
通讯作者：
Silman, AJ
中科院分区：
文献类型：
--
作者：
Ismail, AA;O'Neill, TW;Silman, AJ
临床上明显的脊椎畸形与存活率降低有关。然而，大多数患有放射学脊椎畸形的受试者并没有得到医学上的重视。这项研究的目的是确定放射学椎体畸形与随后的死亡率之间的关系。参与分析的受试者被招募参加欧洲一项基于人群的多中心脊椎骨质疏松调查。年龄在50岁及以上的男性和女性被邀请参加面试者管理的问卷和脊柱侧位X光片。对X线片进行形态计量学评估，并根据已建立的标准定义椎体畸形。在参与者之后进行了年度邮寄问卷--欧洲预期骨质疏松研究(EPOS)，从14个参与中心的6480名50-79岁的受试者那里获得了关于参与者生命状况的信息。在总共14380人年(中位数为2.3年)的跟踪期间，发生了189例死亡(56名女性和133名男性)。在女性中，在年龄调整后，与没有脊椎畸形的人相比，有脊椎畸形的人的死亡率略高：比率比(RR)=1.9(95%可信区间(CI)1.0，3.4)。在男性中，超额风险较小，无统计学意义，RR=1.3(95%CI为0.9，2.0)。在进一步调整吸烟、饮酒、髋部骨折病史、一般健康状况、体重指数和使用类固醇后，超额风险在男女中均降低，且无统计学意义：女性RR=1.6(95%CI 0.9，3.0)；男性RR=1.2(95%CI 0.7，1.8)。放射学上的椎体畸形与适度的超额死亡率有关，尤其是在女性。这种过度可以通过与其他与死亡率有关的不利健康和生活方式因素的关联来解释。
Clinically apparent vertebral deformities are associated with reduced survival. The majority of subjects with radiographic vertebral deformity do not, however, come to medical attention. The aim of this study was to determine the association between radiographic vertebral deformity and subsequent mortality. The subjects who took part in the analysis were recruited for participation in a multicentre population-based survey of vertebral osteoporosis in Europe. Men and women aged 50 years and over were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Radiographs were evaluated morphometrically and vertebral deformity defined according to established criteria. The participants have been followed by annual postal questionnaire - the European Prospective Osteoporosis Study (EPOS), Information concerning the vital status of participants was available from 6480 subjects, aged 50-79 years, from 14 of the participating centres. One hundred and eighty-nine deaths (56 women and 133 men) occurred during a total of 14380 person-years of follow-up (median 2.3 years). In women, after age adjustment, there was a modest excess mortality in those with, compared with those without, vertebral deformity: rate ratio (RR) = 1.9 (95% confidence interval (CI) 1.0,3.4). In men, the excess risk was smaller and non-significant RR = 1.3 (95% CI 0.9,2.0). After further adjusting for smoking, alcohol consumption, previous hip fracture, general health, body mass index and steroid use, the excess risk was reduced and non-significant in both sexes: women, RR = 1.6 (95% CI 0.9,3.0); men RR = 1.2 (95% CI 0.7,1.8). Radiographic vertebral deformity is associated with a modest excess mortality, particularly in women. Part of this excess can be explained by an association with other adverse health and lifestyle factors linked to mortality.