Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women.
Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women.
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DOI：
10.7326/0003-4819-150-10-200905190-00005
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发表时间：
2009-05-19
影响因子：
39.2
通讯作者：
Study of Osteoporotic Fractures
中科院分区：
文献类型：
--
作者：
Kado DM;Lui LY;Ensrud KE;Fink HA;Karlamangla AS;Cummings SR;Study of Osteoporotic Fractures
过度的脊柱后凸可能与早期死亡率相关，但以前的研究没有控制临床上无症状的椎骨骨折，这是一个已知的死亡风险因素。确定过度后凸是否预示着死亡率的增加，而不依赖于椎体骨折。前瞻性队列研究。马里兰州巴尔的摩县、俄勒冈州波特兰、明尼苏达州明尼阿波利斯和宾夕法尼亚州莫农加希拉谷的四个临床中心。610名妇女，年龄67-93岁，从一个队列的9704名妇女从社区为基础的上市1986年和1988年之间招募。使用弯曲曲线测量脊柱后凸。通过形态测量学确定基线时的影像学椎体骨折，并在平均13.5年的随访期间评估死亡率。在年龄调整模型中，脊柱后凸每增加一个SD，死亡风险增加1.14倍（95% CI：1.02-1.27，p = 0.02）。在调整年龄和其他死亡率预测因素（包括骨质疏松相关因素，如低骨密度、中度和重度普遍椎体骨折以及普遍椎体骨折数量）后，脊柱后凸较大的女性早期死亡风险增加（相对危险度/SD增加：1.15; 95% C.I.：1.01-1.30，p = 0.03）。根据椎体骨折的患病情况进行分层后，只有骨折患病的女性因过度后凸而死亡的风险增加，与年龄、自我报告的健康状况、吸烟、脊柱骨密度、椎体骨折数量和严重椎体骨折无关（相对危险度/SD增加：1.58; 95%CI：1.06 - 2.35，p = 0.02）。研究人群仅包括白人女性。我们的结论是，在老年女性椎体骨折，过度后凸预测死亡率的风险增加，独立于潜在的脊柱骨质疏松症和椎体骨折的范围和严重程度。
Excessive kyphosis may be associated with earlier mortality, but previous studies have not controlled for clinically silent vertebral fractures that are a known mortality risk factor. To determine whether hyperkyphosis predicts increased mortality independent of vertebral fractures. Prospective cohort study. Four clinical centers in Baltimore County, Maryland; Portland, Oregon; Minneapolis, Minnesota; and the Monongahela Valley, Pennsylvania. 610 women, aged 67-93 years, from a cohort of 9704 women recruited from community-based listings between 1986 and 1988. Kyphosis was measured using a flexicurve. Prevalent radiographic vertebral fractures at baseline were defined by morphometry, and mortality was assessed during an average follow-up of 13.5 years. In age-adjusted models, each SD increase in kyphosis carried a 1.14-fold increased risk of mortality (95% C.I.: 1.02-1.27, p = 0.02). After adjusting for age and other predictors of mortality including osteoporosis related factors such as low bone density, moderate and severe prevalent vertebral fractures, and number of prevalent vertebral fractures, women with greater kyphosis were at increased risk for earlier mortality (Relative hazard per SD increase: 1.15; 95% C.I.: 1.01-1.30, p = 0.03). Upon stratification by prevalent vertebral fracture status, only women with prevalent fractures were at increased mortality risk from hyperkyphosis, independent of age, self-reported health, smoking, spine bone mineral density, number of vertebral fractures, and severe vertebral fractures (Relative hazard per SD increase: 1.58; 95% CI: 1.06 - 2.35, p = 0.02). The study population only included Caucasian women. We conclude that in older women with vertebral fractures, hyperkyphosis predicts an increased risk of mortality, independent of underlying spinal osteoporosis and the extent and severity of vertebral fractures.
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影响因子：
4
作者：
Ismail, AA;O'Neill, TW;Silman, AJ
通讯作者：
Silman, AJ
影响因子：
120.7
作者：
CUMMINGS, SR;BLACK, DM;VOGT, TM
通讯作者：
VOGT, TM
DOI：
10.1093/gerona/60.5.633
发表时间：
2005-05-01
影响因子：
5.1
作者：
Kado, DM;Huang, MH;Greendale, GA
通讯作者：
Greendale, GA
DOI：
10.1111/j.1532-5415.2000.tb02641.x
发表时间：
2000-03-01
影响因子：
6.3
作者：
Ensrud, KE;Thompson, DE;Black, DM
通讯作者：
Black, DM
影响因子：
39.2
作者：
Tinetti, ME;Williams, CS;Gill, TM
通讯作者：
Gill, TM