Loop diuretic use and rates of hip bone loss and risk of falls and fractures in older women.
Loop diuretic use and rates of hip bone loss and risk of falls and fractures in older women.
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DOI：
10.1111/j.1532-5415.2009.02195.x
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发表时间：
2009-05
影响因子：
6.3
通讯作者：
Ensrud KE
中科院分区：
文献类型：
--
作者：
Lim LS;Fink HA;Blackwell T;Taylor BC;Ensrud KE
确定袢利尿剂的使用是否与老年女性髋骨丢失以及跌倒和骨折风险增加有关。 1992 年 8 月至 2004 年 4 月的前瞻性队列研究。来自美国四个地区的骨质疏松性骨折研究 (SOF)。参加第四次 SOF 检查的 65 岁及以上女性（N = 8127）有药物使用数据，从中衍生出 3 个研究队列。 1）第4次和第6次检查时通过双能X线骨密度仪评估全髋骨密度（BMD）（N = 2980）； 2) 第 4 次考试后的当年复发（2 次或以上）跌倒（N = 6244）； 3) 意外骨折，包括非脊柱骨折 (N = 6778) 和髋部骨折 (N = 7272)。多变量调整后，平均 4.4 年（+/- 0.6）后，袢利尿剂使用者与非使用者相比，髋部总 BMD 损失更大（平均年化％ BMD -0.87 与 -0.71，p=0.03）。与未使用者相比，袢利尿剂使用者的复发性跌倒风险（OR 0.99，95% CI 0.71 - 1.39）、非脊柱风险（RR 1.04，95% CI 0.90 - 1.21）和髋部骨折（RR 1.03，95% CI 0.81 - 1.31）风险并未增加。在这组老年女性中，平均使用袢利尿剂 4.4 年后，与不使用袢利尿剂相比，髋骨丢失率虽小，但明显较高。然而，两组之间跌倒或骨折的风险没有差异。
To determine if loop diuretic use is associated with hip bone loss, and increased risk of falls and fractures in older women. Prospective cohort study from August 1992 to April 2004. Four regions in the US from the Study of Osteoporotic Fractures (SOF). Women aged 65 and older (N = 8127) with medication use data who participated in the 4th SOF examination, from which 3 study cohorts were derived. 1) Bone mineral density (BMD) of the total hip assessed by dual-energy x-ray absorptiometry at the 4th and 6th examinations (N = 2980); 2) recurrent (2 or more) falls in the year following the 4th examination (N = 6244); and 3) incident fracture including nonspine (N = 6778) and hip fractures (N = 7272). After multivariable-adjustment, loop diuretic users had greater loss of total hip BMD compared to nonusers (mean annualized % BMD −0.87 vs. −0.71, p=0.03) after a mean of 4.4 years (+/− 0.6). The risks of recurrent falls (OR 0.99, 95% CI 0.71 to 1.39), nonspine (RR 1.04, 95% CI 0.90 to 1.21) and hip fracture (RR 1.03, 95% CI 0.81 to 1.31) were not increased among loop diuretic users compared with nonusers. In this cohort of older women, loop diuretic use was associated with a small, but significantly higher rate of hip bone loss compared to nonuse after a mean duration of 4.4 years. However the risk of falls or fracture did not differ between the two groups.
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影响因子：
5
作者：
PAFFENBARGER, RS;WING, AL;HYDE, RT
通讯作者：
HYDE, RT
影响因子：
120.7
作者：
CUMMINGS, SR;BLACK, DM;VOGT, TM
通讯作者：
VOGT, TM
影响因子：
11.1
作者：
Wiens, M.;Etminan, M.;Takkouche, B.
通讯作者：
Takkouche, B.
影响因子：
11.4
作者：
CUMMING, RG;KLINEBERG, RJ
通讯作者：
KLINEBERG, RJ
影响因子：
105.7
作者：
RASHIQ, S;LOGAN, RFA
通讯作者：
LOGAN, RFA