Hormone replacement therapy and risk for foot, distal forearm, proximal humerus, and pelvis fractures.
Hormone replacement therapy and risk for foot, distal forearm, proximal humerus, and pelvis fractures.
复制标题
激素替代疗法和足部、前臂远端、肱骨近端和骨盆骨折的风险。
DOI：
10.1007/s00198-003-1379-2
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
Kelsey,JenniferL
中科院分区：
文献类型：
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作者：
Keegan,TheresaHM;Gopalakrishnan,Geetha;Sidney,Stephen;QuesenberryJr,CharlesP;Kelsey,JenniferL
本病例对照流行病学研究探讨了激素替代疗法（HRT）与45岁及以上女性四个部位骨折风险之间的关系。从1996年10月到2001年5月，从北方加州的五个Kaiser Permanente医疗中心招募了前臂远端（n=744）、足部（n=618）、肱骨近端（n=331）和骨盆（n=109）骨折的患者。对照组（n=1617）在相同时间段内从相同的5家医疗中心随机选择，分层定义为5岁年龄组、性别和白色与非白色或未知记录的人种/种族。经过培训的访谈员使用标准化问卷收集信息。与从未使用HRT的绝经后妇女相比，目前使用HRT至少3个月的绝经后妇女前臂远端骨折的风险降低（调整OR=0.55，95% CI：0.43，0.72），肱骨近端（调整后OR=0.51，95% CI：0.36，0.74）和骨盆（调整后OR=0.51，95% CI：0.27，0.95），但不包括足部（调整后OR=1.05，95% CI：0.81，1.35）。过去使用HRT超过7年也似乎与前臂远端和肱骨近端骨折风险降低相关。女性在末次月经后未接受HRT的时间越长，前臂远端、肱骨近端和骨盆骨折的风险就越大。这项研究的结果支持长期，目前使用HRT预防骨质疏松性骨折，但其他风险和利益也需要考虑。
This case-control epidemiologic study examines the relationship between hormone replacement therapy (HRT) and risk for fractures of four sites among women 45 years of age and older. From October 1996 to May 2001, incident patients with distal forearm (n=744), foot (n=618), proximal humerus (n=331), and pelvis (n=109) fractures were recruited from five Kaiser Permanente Medical Centers in northern California. Controls (n=1617) were selected at random from the same five medical centers over the same time period within strata defined by 5-year age group, gender, and white versus nonwhite or unknown recorded race/ethnicity. Trained interviewers collected information using a standardized questionnaire. Compared with postmenopausal women who never used HRT, postmenopausal women currently using HRT for at least 3 months had a decreased risk of fracture at the distal forearm (adjusted OR=0.55, 95% CI: 0.43, 0.72), proximal humerus (adjusted OR=0.51, 95% CI: 0.36, 0.74), and pelvis (adjusted OR=0.51, 95% CI: 0.27, 0.95), but not the foot (adjusted OR=1.05, 95% CI: 0.81, 1.35). Past use of HRT for more than 7 years also appeared to be associated with a reduced risk of fracture at the distal forearm and proximal humerus. The longer a woman went without HRT after her last menstrual period, the greater her risk of fracture in the distal forearm, proximal humerus, and pelvis. The findings of this study support long-term, current use of HRT for the prevention of osteoporotic fractures, but other risks and benefits also need to be considered.