Renal function and risk of hip and vertebral fractures in older women
Renal function and risk of hip and vertebral fractures in older women
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DOI：
10.1001/archinte.167.2.133
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发表时间：
2007-01-22
影响因子：
--
通讯作者：
Cummings, Steven R.
中科院分区：
文献类型：
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作者：
Ensrud, Kristine E.;Lui, Li-Ying;Cummings, Steven R.
背景：据报道，终末期肾病患者髋部骨折的发生率有所增加，但不太严重的肾功能不全对骨折风险的影响尚不确定。方法：我们对 9704 名 65 岁或以上女性进行了一项病例队列研究，以比较 149 名随后发生髋部骨折的女性和 150 名随后发生髋部骨折的女性的基线肾功能（使用 Cockcroft-Gault 方程估计肾小球滤过率 [eGFR]）。研究人员对 396 名随机选择的女性进行了 eGRF 导致的椎骨骨折。结果：在根据年龄、体重和跟骨骨密度进行调整的模型中，eGFR 降低与髋部骨折风险增加相关。与 eGFR 60 mL/min/1.73 m(2) 或更高的女性相比，eGFR 45 至 59 mL/min/1.73 m(2) 的女性发生髋部骨折的风险比（95% CI，1.15-4.68）为 1.57（95% CI，0.89-2.76）。 eGFR 每 1.73 m(2) 小于 45 mL/min 的患者（趋势 P = .02）。特别是，eGFR 降低的女性发生转子髋部骨折的风险增加（调整后的风险比，eGFR 45-59 mL/min / 1.73 m(2) 的女性为 3.93 [95% CI, 1.37-11.30]，eGFR < 45 mL/min / min(2) 的女性为 7.17 [95% CI, 1.93-26.67]） 1.73 m(2)；趋势 P = .004)。肾功能与椎骨骨折风险并不独立相关（调整后的比值比，对于 eGFR 45-59 mL/min 每 1.73 m(2) 的女性为 1.08 [95% CI, 0.61-1.92]，对于 eGFR < 45 mL/min 每 1.73 m(2) 的女性为 1.33 [95% CI, 0.63-2.80] m(2)；趋势 P = .47)。结论：患有中度肾功能不全的老年女性髋部骨折的风险增加。
Background: An increased rate of hip fractures has been reported in patients with end-stage renal disease, but the effect of less severe renal dysfunction on fracture risk is uncertain.Methods: We conducted a case-cohort study within a cohort of 9704 women 65 years or older to compare baseline renal function (estimated glomerular filtration rate [eGFR] using the Cockcroft-Gault equation) in 149 women who subsequently had hip fractures and 150 women who subsequently had vertebral fractures with eGRF in 396 randomly selected women.Results: In models adjusted for age, weight, and calcaneal bone density, decreasing eGFR was associated with increased risk of hip fracture. Compared with women with an eGFR 60 mL/min per 1.73 m(2) or greater, the hazard ratio (95% confidence interval [CI]) for hip fracture was 1.57 (95% CI, 0.89-2.76) in those with an eGFR 45 to 59 mL/min per 1.73 m(2) and 2.32 (95% CI, 1.15-4.68) in those with an eGFR less than 45 mL/min per 1.73 m(2) (P for trend = .02). In particular, women with a reduced eGFR were at increased risk of trochanteric hip fracture (adjusted hazard ratio, 3.93 [95% CI, 1.37-11.30] in women with an eGFR 45-59 mL/min per 1.73 m(2) and 7.17 [95% CI, 1.93-26.67] in women with an eGFR < 45 mL/min per 1.73 m(2); P for trend = .004). Renal function was not independently associated with risk of vertebral fracture (adjusted odds ratio, 1.08 [95% CI, 0.61-1.92] in women with an eGFR 45-59 mL/min per 1.73 m(2) and 1.33 [95% CI, 0.63-2.80] in women with an eGFR < 45 mL/min per 1.73 m(2); P for trend = .47).Conclusion: Older women with moderate renal dysfunction are at increased risk of hip fracture.