Hyperkyphosis, kyphosis progression, and risk of non-spine fractures in older community dwelling women: the study of osteoporotic fractures (SOF).
Hyperkyphosis, kyphosis progression, and risk of non-spine fractures in older community dwelling women: the study of osteoporotic fractures (SOF).
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DOI：
10.1002/jbmr.2251
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发表时间：
2014-10
影响因子：
6.2
通讯作者：
Ensrud, Kristine E.
中科院分区：
文献类型：
--
作者：
Kado, Deborah M.;Miller-Martinez, Dana;Lui, Li-Yung;Cawthon, Peggy;Katzman, Wendy B.;Hillier, Teresa A.;Fink, Howard A.;Ensrud, Kristine E.
虽然加重的后凸与骨质疏松症有关，但目前尚不清楚它是否会增加未来骨折的风险，与骨密度（BMD）和椎体骨折无关。我们使用来自骨质疏松性骨折研究的数据，研究了基线Cobb角后凸和15年后凸变化与非脊柱骨折的关系。从9704名原始参与者中随机抽取994名65岁或以上的白人女性，在基线和平均15年后通过侧位脊柱x线片重复测量后凸的Cobb角。非脊柱骨折，经x线报告证实，每四个月评估一次，长达21.3年。与后凸较低四分位数的女性相比，后凸大于53度的女性（前四分位数）发生非脊柱骨折的风险增加了50% (95% CI, 1.10 -2.06)，校正了骨密度、常见椎体骨折、既往骨折史和其他骨折危险因素。Cobb角后凸在15年内平均进展7度（SD = 6.8）。后凸变化每增加1 SD，多变量调整后骨折风险增加28% (95% CI, 1.06 - 1.55)，通过进一步调整基线骨密度（后凸变化每增加1 SD的HR， 1.19; 95% CI 0.99 - 1.44），骨折风险降低。在老年妇女中，较大的后凸与非脊柱骨折风险升高相关，与传统的骨折危险因素无关。此外，脊柱后凸的恶化也与骨折风险增加有关，这部分是由低基线骨密度介导的，而低基线骨密度本身就是脊柱后凸进展的危险因素。这些结果表明，随机对照骨折干预试验应考虑实施后凸措施，以：1)进一步研究后凸和后凸改变作为额外的骨折危险因素；2)测试治疗是否可以改善或延缓其进展。
While accentuated kyphosis is associated with osteoporosis, it is unknown whether it increases risk of future fractures, independent of bone mineral density (BMD) and vertebral fractures. We examined the associations of baseline Cobb angle kyphosis and 15 year change in kyphosis with incident non-spine fractures using data from the Study of Osteoporotic Fractures. A total of 994 predominantly white women, aged 65 or older, were randomly sampled from 9,704 original participants to have repeated Cobb angle measurements of kyphosis measured from lateral spine radiographs at baseline and an average of 15 years later. Non-spine fractures, confirmed by radiographic report, were assessed every four months for up to 21.3 years. Compared with women in the lower three quartiles of kyphosis, women with kyphosis greater than 53 degrees (top quartile) had a 50% increased risk of non-spine fracture (95% CI, 1.10 –2.06 after adjusting for BMD, prevalent vertebral fractures, prior history of fractures, and other fracture risk factors. Cobb angle kyphosis progressed an average of 7 degrees (SD = 6.8) over 15 years. Per 1 SD increase in kyphosis change, there was a multivariable adjusted 28% increased risk of fracture (95% CI, 1.06 – 1.55) that was attenuated by further adjustment for baseline BMD (HR per SD increase in kyphosis change, 1.19; 95% CI 0.99 –1.44). Greater kyphosis is associated with an elevated non-spine fracture risk independent of traditional fracture risk factors in older women. Furthermore, worsening kyphosis is also associated with increased fracture risk that is partially mediated by low baseline BMD that itself is a risk factor for kyphosis progression. These results suggest that randomized controlled fracture intervention trials should consider implementing kyphosis measures to: 1) further study kyphosis and kyphosis change as an additional fracture risk factor; and 2) test whether therapies may improve or delay its progression.
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影响因子：
39.2
作者：
Kado DM;Lui LY;Ensrud KE;Fink HA;Karlamangla AS;Cummings SR;Study of Osteoporotic Fractures
通讯作者：
Study of Osteoporotic Fractures
影响因子：
37.8
作者：
Cook, Nancy R.
通讯作者：
Cook, Nancy R.
影响因子：
6.2
作者：
Hillier, Teresa A.;Lui, Li-Yung;Kado, Deborah M.;LeBlanc, E. S.;Vesco, Kimberly K.;Bauer, Douglas C.;Cauley, Jane A.;Ensrud, Kristine E.;Black, Dennis M.;Hochberg, Marc C.;Cummings, Steven R.
通讯作者：
Cummings, Steven R.
DOI：
10.1111/j.1532-5415.1997.tb01470.x
发表时间：
1997-06-01
影响因子：
6.3
作者：
Ensrud, KE;Black, DM;Cummings, SR
通讯作者：
Cummings, SR
影响因子：
6.2
作者：
Schousboe, John T.;Fink, Howard A.;Ensrud, Kristine E.
通讯作者：
Ensrud, Kristine E.