Cardiovascular diseases and future risk of hip fracture in women
Cardiovascular diseases and future risk of hip fracture in women
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DOI：
10.1007/s00198-007-0386-0
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发表时间：
2007-10-01
影响因子：
4
通讯作者：
Michaelsson, K.
中科院分区：
文献类型：
--
作者：
Sennerby, U.;Farahmand, B.;Michaelsson, K.
我们使用了一项以人群为基础的女性病例对照研究，并与瑞典住院登记相关联，以检查心血管疾病后髋部骨折的风险是否增加。最近的数据表明，心血管疾病(CVD)可能与骨质疏松症有关，这可能解释了髋部骨折后死亡风险的增加。然而，目前还不确定在任何心血管疾病和心血管疾病亚组中是否存在骨折风险的增加。这项研究的目的是确定心血管疾病与未来髋部骨折风险之间是否存在关联。了解风险模式将有助于更好地了解骨质疏松和心血管疾病的常见病理途径。方法我们在瑞典50-81岁的女性中进行了一项基于人群的病例对照研究，研究对象为1327例髋部骨折病例和3170名随机选择的人群对照。骨折前的心血管和其他疾病的信息是通过链接到瑞典国家住院登记获得的。通过非条件Logistic回归计算优势比(OR)和95%可信区间(CI)。结果在研究进入研究之前，骨折组(25%)被诊断为心血管疾病的比例是对照组(12%)的两倍多。此外，在调整了包括几种慢性病在内的变量后，我们发现发生心血管事件后髋部骨折的风险增加了一倍(OR 2.38；95%CI 1.92-2.94)。髋部骨折的风险随着因心血管疾病住院的次数的增加而逐渐增加，并且骨折风险最高出现在心血管事件发生后的第一年。高血压、心力衰竭和脑血管病变仍然是独立的危险因素，即使在对其他心血管疾病进行相互调整后，优势比也增加了2到3倍。结论女性在诊断出心血管疾病后髋部骨折的风险显著增加，这一发现与骨质疏松性骨折和心血管疾病的常见病理途径的概念一致。
We used a population-based case-control study in women and linkage to the Swedish in-patient register to examine if there is an increased risk of hip fracture after a cardiovascular disease. There was a substantially increased risk of hip fracture after a diagnosis of a cardiovascular disease.Introduction Recent data have indicated that cardiovascular diseases (CVDs) might have a relationship to osteoporosis, which may explain the increased risk of mortality after hip fracture. It is uncertain, however, whether there is an increased risk of fracture after any cardiovascular disease and in subgroups of CVDs. The objective of this study was to determine whether there are associations between CVD and future hip fracture risk. Knowledge of the risk pattern would lead to better understanding of common pathologic pathways of osteoporosis and CVD.Methods We conducted a population-based case-control study of 1,327 incident hip fracture cases and 3,170 randomly selected population controls among women 50-81 years old in Sweden. Information on cardiovascular and other diseases before the fracture was obtained by linkage to the Swedish National Inpatient Register. Odds ratios (OR) and 95% confidence intervals (CI) where calculated by unconditional logistic regression.Results Before study entry, CVDs were diagnosed more than twice as commonly among fracture cases (25%) as among controls (12%). Also, after adjustment for variables including several chronic diseases, we found a doubled risk of hip fracture after a CVD event (OR 2.38; 95% CI 1.92-2.94). There was a gradient increase in risk of hip fracture with increasing number of hospitalizations for CVD and highest fracture risk occurred the first year after the CVD event. Hypertension, heart failure, and cerebrovascular lesions remained independent risk factors, with 2- to 3-fold increases in odds ratios, even after mutual adjustments for other CVDs.Conclusion There was a substantially increased risk of hip fracture in women after a diagnosis of a CVD, a finding compatible with the concept of common pathologic pathways for osteoporotic fractures and CVD.