Determinants of incidence of osteoporotic fractures in the female Spanish population older than 50
Determinants of incidence of osteoporotic fractures in the female Spanish population older than 50
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DOI：
10.1007/s00198-005-1983-4
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发表时间：
2005-12-01
影响因子：
4
通讯作者：
Cannata-Andía, JB
中科院分区：
文献类型：
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作者：
Naves, M;Díaz-López, JB;Cannata-Andía, JB
众所周知，对骨质疏松症采取预防措施可能有助于尽量减少骨折造成的影响。然而，有公认的风险因素参与骨质疏松症的发病是不可能改变的。更好地了解这些不可改变的因素可以帮助预防骨折高危人群。本研究的目的是评估50岁以上女性髋部骨折的妇科、生殖和家族史与椎骨和非椎骨骨质疏松性骨折发生率之间的可能联系。我们研究了255名年龄在50岁及以上的女性，这些女性是从参加了一项椎骨骨折患病率研究（EVOS研究）的西班牙人群中随机选择的。通过4份邮寄问卷对该队列进行了8年的前瞻性随访，以了解非椎骨骨折的发生率。关于椎骨骨折的发生率，参与者被邀请在初始研究后4年重复腰椎X线检查。共有31名妇女发生了腰椎骨折。对妇科变量的分析表明，初潮年龄的增加是所有发生骨盆骨折的危险因素[OR=1.57（1.04-2.37）]。在生育期内任何年龄段出现闭经均与所有骨质疏松性骨折的发生率增高相关[OR=6.30（1.61-24.70）]。在分析的所有生殖变量（妊娠、活产数和母乳喂养）中，只有妊娠是预防Colles骨折发生的重要保护因素[OR=0.15（0.03-0.62）]。髋部骨折家族史与所有髋部骨折的发生率较高相关[OR=3.59（1.01-12.79）]。总之，初潮年龄晚、闭经和近亲髋部骨折均为危险因素，与骨密度（BMD）和年龄无关，与所有骨质疏松性骨折的发生率较高相关。妊娠是Colles骨折发生的重要保护因素。
It is well known that the adoption of preventive measures for osteoporosis may contribute to minimizing its impact as a result of bone fractures. However, there are well-recognized risk factors involved in the onset of osteoporosis that are not possible to modify. Better knowledge of these non-modifiable factors could aid prevention in subjects at high risk of fractures. The aim of this study was to evaluate the likely association between gynecological, reproductive and family history of hip fracture with the incidence of vertebral and nonvertebral osteoporotic fractures in women older than 50. We studied 255 women aged 50 and over, randomly selected from a Spanish population that had participated in a study of prevalence of vertebral fractures (EVOS study). This cohort was prospectively followed for 8 years by means of four postal questionnaires, in order to find out the incidence of nonvertebral fractures. Concerning the incidence of vertebral fractures, participants were invited to repeat the lumbar spine X-rays 4 years after the initial study. A total of 31 women had incident osteoporotic fractures. The analysis of gynecological variables showed that an increase in the age at menarche was a risk factor for all incident osteoporotic fractures [OR=1.57 (1.04-2.37)]. The presence of amenorrhea at any age during the fertile period was associated with higher incidence of all osteoporotic fractures [OR=6.30 (1.61-24.70]. Among all the reproductive variables analyzed (pregnancy, number of live births and breast-feeding) only pregnancy was an important protective factor in preventing incident Colles fracture [OR=0.15 (0.03-0.62)]. A family history of hip fracture was associated with a higher incidence of all osteoporotic fractures [OR=3.59 (1.01-12.79)]. In summary, a late age at menarche, the presence of amenorrhea and having close relatives with hip fracture were all risk factors which, independently of bone mineral density (BMD) and age, were associated with higher incidence of all osteoporotic fractures. Pregnancy was an important protective factor for the incidence of Colles fractures.