Clinical risk factors for fractures in multi-ethnic women: The women's health initiative
Clinical risk factors for fractures in multi-ethnic women: The women's health initiative
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DOI：
10.1359/jbmr.070713
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发表时间：
2007-11-01
影响因子：
6.2
通讯作者：
Robbins, John
中科院分区：
文献类型：
--
作者：
Cauley, Jane A.;Wu, LieLing;Robbins, John
为了确定多种族妇女骨折的危险因素，我们研究了159,579名参加妇女健康倡议的妇女。一般来说，骨折的风险因素在不同种族群体中相似。然而，无论其种族如何，具有多种风险因素的妇女都有很高的骨折风险。针对这些高危妇女进行筛查和干预可以减少fractures.Introduction：骨折率往往较低的少数民族妇女，但后果可能更大。此外，由于目前的人口趋势，预计少数民族妇女的骨折数量将增加。有有限的前瞻性数据骨折的危险因素在少数民族women.Materials和方法：我们研究了159,579名妇女年龄50-79岁参加妇女健康倡议。通过问卷调查或检查获得有关危险因素的信息。研究进入后发生的非脊柱骨折，确定了平均随访8 +/- 2.6（SD）yr。结果：骨折的年化率（%）在白人，黑人，西班牙裔，亚洲人和美洲印第安人分别为2.0，0.9，1.3，1.2和2.0，分别。显著预测因素[HR按种族分组的骨折发生率（95% CI）如下：黑人：至少高中教育，1.22（1.0，1.5）;（+）骨折史，1.7（1.4，2.2）;以及超过两次福尔斯，1.7（1.9，2.0）;西班牙裔：身高（>162 cm），1.6（1.1，2.2）;（+）骨折史，1.9（1.4，2.5）;超过两次福尔斯，1.8（1.4，2.3）;关节炎，1.3（1.1，1.6）;皮质类固醇使用，3.9（1.9，8.0）;父母骨折史，1.3（1.0，1.6）;亚洲人：年龄（每5年），1.2（1.0，1.3）;（+）骨折史，1.5（1.1，2.0）;当前激素治疗（HT），0.7（0.5，0.8）;奇偶性（至少5个），1.8（1.1，3.0）;超过两次福尔斯，1.4（1.1，1.9）;美洲印第安人：（+）骨折史，2.9（1.5，5.7）;当前HT，0.5（0.3，0.9）。有8个或更多风险因素的女性骨折率是有4个或更少风险因素的女性的2倍多。两个种族x危险因素的相互作用被确定：年龄和跌倒history.Conclusions：无论他们的种族，妇女与多个危险因素有骨折的高风险。针对这些高危女性进行筛查和干预可以减少骨折。
To identify risk factors for fractures in multi-ethnic women, we studied 159,579 women enrolled in the Women's Health Initiative. In general, risk factors for fractures were similar across ethnic groups. However, irrespective of their ethnicity, women with multiple risk factors have a high risk of fracture. Targeting these high-risk women for screening and intervention could reduce fractures.Introduction: Fracture rates tend to be lower in minority women, but consequences may be greater. In addition, the number of fractures is expected to increase in minority women because of current demographic trends. There are limited prospective data on risk factors for fractures in minority women.Materials and Methods: We studied 159,579 women 50-79 yr of age enrolled in the Women's Health Initiative. Information on risk factors was obtained by questionnaire or examination. Nonspine fractures that occurred after study entry were identified over an average follow-up of 8 +/- 2.6 (SD) yr.Results: Annualized rates (%) of fracture in whites, blacks, Hispanics, Asians, and American Indians were 2.0, 0.9, 1.3, 1.2, and 2.0, respectively. Significant predictors [HR (95% CI] of fractures by ethnic group were as follows: blacks: at least a high school education, 1.22 (1.0, 1.5); (+) fracture history, 1.7 (1.4, 2.2); and more than two falls, 1.7 (1.9, 2.0); Hispanics: height (>162 cm), 1.6 (1.1, 2.2); (+) fracture history, 1.9 (1.4, 2.5); more than two falls, 1.8 (1.4, 2.3); arthritis, 1.3 (1.1, 1.6); corticosteroid use, 3.9 (1.9, 8.0); and parental history of fracture, 1.3 (1.0, 1.6); Asians: age (per 5 yr), 1.2 (1.0, 1.3); (+) fracture history, 1.5 (1.1, 2.0); current hormone therapy (HT), 0.7 (0.5, 0.8); parity (at least five), 1.8 (1.1, 3.0); more than two falls, 1.4 (1.1, 1.9); American Indian: (+) fracture history, 2.9 (1.5, 5.7); current HT, 0.5 (0.3, 0.9). Women with eight or more risk factors had more than a 2-fold higher rate of fracture compared with women with four or fewer risk factors. Two ethnicity x risk factor interactions were identified: age and fall history.Conclusions: Irrespective of their ethnicity, women with multiple risk factors have a high risk of fracture. Targeting these high-risk women for screening and intervention could reduce fractures.