APPENDICULAR BONE-DENSITY AND AGE PREDICT HIP FRACTURE IN WOMEN
APPENDICULAR BONE-DENSITY AND AGE PREDICT HIP FRACTURE IN WOMEN
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DOI：
10.1001/jama.263.5.665
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发表时间：
1990-02-02
影响因子：
120.7
通讯作者：
VOGT, TM
中科院分区：
文献类型：
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作者：
CUMMINGS, SR;BLACK, DM;VOGT, TM
为了确定骨密度测量是否能预测女性髋部骨折，我们对9703名65岁及以上的非黑人女性进行了前瞻性研究，这些女性使用单光子吸收法测量了跟骨、桡骨远端和桡骨近端的骨矿物质密度。在平均1.6年的随访期间，发生了53例髋部骨折。髋部骨折的风险与所有三个测量部位的骨密度呈负相关。在对年龄进行调整后，跟骨骨密度每降低1个标准差，髋部骨折的相对风险为1.66（95%置信区间，1.22 - 2.26）；桡骨远端为1.55（95%置信区间，1.13 - 2.11）；桡骨近端为1.41（95%置信区间，1.06 - 1.88）。这三种测量方法中没有一种对髋部骨折的预测明显优于其他方法。在对骨矿物质密度进行调整后，年龄每增加10岁，髋部骨折的风险就会翻倍（相对风险，2.09%；95%置信区间，1.31 - 3.33）。我们得出结论，四肢骨骼骨密度降低与髋部骨折风险增加有关，但这仅占老年女性髋部骨折风险随年龄增长而增加的部分原因。
To determine whether measurement of bone density predicts hip fracture in women, we prospectively studied 9703 nonblack women aged 65 and older who had measurements of bone mineral density using single-photon absorptiometry in the calcaneus, distal radius, and proximal radius. During an average of 1.6 years of follow-up, 53 hip fractures occurred. The risk of hip fracture was inversely related to bone density at all three measurement sites. After adjusting for age, the relative risk of hip fracture was 1.66 for a decrease of 1 SD in the bone density at the calcaneus (95% confidence interval, 1.22 to 2.26), 1.55 (95% confidence interval, 1.13 to 2.11) at the distal radius, and 1.41 (95% confidence interval, 1.06 to 1.88) at the proximal radius. None of the three measurements was a significantly better predictor of hip fracture than the others. After adjusting for bone mineral density, the risk of hip fracture doubled for each 10-year increase in age (relative risk, 2.09%; 95% confidence interval, 1.31 to 3.33). We conclude that decreased bone density in the appendicular skeleton is associated with an increase risk of hip fracture, but this accounts for only part of the age-related increase in risk of hip fracture among older women.