Risk factors for a first-incident radiographic vertebral fracture in women ≥65 years of age:: The study of osteoporotic fractures
Risk factors for a first-incident radiographic vertebral fracture in women ≥65 years of age:: The study of osteoporotic fractures
复制标题
DOI：
10.1359/jbmr.2005.20.1.131
复制
发表时间：
2005-01-01
影响因子：
6.2
通讯作者：
Cauley, JA
中科院分区：
文献类型：
--
作者：
Nevitt, MC;Cummings, SR;Cauley, JA
老年妇女的椎骨骨折预示着发生其他椎体骨折的风险增加。为了确定初次椎骨骨折的危险因素，我们研究了5822名年龄大于或等于65岁的妇女，她们在基线脊柱X线片上没有骨折。几个可改变的危险因素增加了老年妇女发生第一次椎骨骨折的风险，具有多种危险因素和低BMD的妇女风险最高。风险因素和低BMD应该是有用的，以帮助集中精力，以防止这些fractures.Introduction：椎骨骨折是一种常见的原因，背痛和残疾和信号的风险增加额外的骨质疏松性骨折的老年妇女。鲜为人知的是，第一次发生的风险因素的一个vertebralfracture.Materials和Methods：为了确定第一个椎骨骨折的风险因素，我们研究了5822名妇女大于或等于65岁的骨质疏松性骨折的研究谁没有骨折的基线X线片的脊柱。我们在基线时测量了潜在的危险因素和手腕和跟骨的BMD，在随访的中途测量了脊柱和髋关节的BMD。骨折通过标准方法进行评估，从基线和平均3.7年后的随访中获得的脊柱X光片。在多变量分析中，年龄较大，既往非脊柱骨折，所有部位的BMD低，体重指数（BMI）低，目前吸烟，妊娠期间牛奶摄入量低，日常体力活动水平低，跌倒，和定期使用含铝抗酸剂独立地增加了第一次椎骨骨折的风险。使用雌激素的妇女和从事娱乐性体育活动的妇女的风险降低。低BMI、吸烟、使用雌激素和抗酸剂以及既往骨折的影响部分由BMD介导。在手腕骨密度较低的三分之一的妇女有五个或更多的风险因素有12倍以上的风险比妇女在骨密度最高的三分之一，有零至三个风险因素。27%的高风险女性遭受了60%的骨折事件。总之，几个可改变的危险因素和骨密度独立增加老年妇女的风险发展的第一个椎骨骨折。危险因素和BMD的结合应该有助于集中精力预防椎骨骨折。
Vertebral fractures in older women signal an increased risk of additional osteoporotic fractures. To identify risk factors for first vertebral fractures, we studied 5822 women greater than or equal to65 years of age who had no fracture on baseline radiographs of the spine. Several modifiable risk factors increased an older woman's risk of developing a first vertebral fracture, and women with multiple risk factors and low BMD had the highest risk. Risk factors and low BMD should be useful to help focus efforts to prevent these fractures.Introduction: Vertebral fractures are a common cause of back pain and disability and signal an increased risk of additional osteoporotic fractures in older women. Little is known about the risk factors for the first occurrence of a vertebral fracture.Materials and Methods: To identify risk factors for a first vertebral fracture, we studied 5822 women greater than or equal to65 years of age from the Study of Osteoporotic Fractures who had no fracture on baseline radiographs of the spine. We measured potential risk factors and BMD of the wrist and calcaneus at baseline and BMD of the spine and hip halfway through follow-up. Fractures were assessed by standard methods from spine radiographs obtained at baseline and follow-up an average of 3.7 years later.Results and Conclusions: In multivariable analyses, older age, previous nonspine fracture, low BMD at all sites, a low body mass index (BMI), current smoking, low milk consumption during pregnancy, low levels of daily physical activity, having a fall, and regular use of aluminum-containing antacids independently increased the risk of a first vertebral fracture. Women using estrogen and those who engaged in recreational physical activity had a decreased risk. The effects of low BMI, smoking, use of estrogen and antacids, and previous fracture were partially mediated by BMD. Women in the lower third of wrist BMD with five or more risk factors had a 12-fold greater risk than women in the highest third of BMD who had zero to three risk factors. The 27% of women at highest risk suffered 60% of the incident fractures. In conclusion, several modifiable risk factors and BMD independently increase an older woman's risk of developing a first vertebral fracture. The combination of risk factors and BMD should be useful for focusing efforts to prevent vertebral fractures.