Serum retinol levels and the risk of fracture
Serum retinol levels and the risk of fracture
复制标题
DOI：
10.1056/nejmoa021171
复制
发表时间：
2003-01-23
影响因子：
158.5
通讯作者：
Melhus, H
中科院分区：
文献类型：
--
作者：
Michaëlsson, K;Lithell, H;Melhus, H
虽然在动物和流行病学研究的研究表明，高维生素A摄入量与骨脆性增加，没有生物标志物的维生素A状态迄今已被用于评估骨折的风险在humans.METHODSWe招募了2322名男子，49至51岁，在一个以人口为基础的，纵向队列研究。血清视黄醇和β-胡萝卜素进行了分析，在招募样本。在30年的随访中，记录了266名男性的骨折。考克斯回归分析根据血清视黄醇水平确定骨折风险。结论血清视黄醇水平最高的男性骨折风险最高。血清视黄醇水平最高五分位数人群骨折风险的多因素分析（>75.62微克/分升[2.64微摩尔/升]），与中间五分位数相比，（62.16至67.60微克/分升[2.17至2.36微摩尔/升]）显示速率比为1.64（95%置信区间，1.12至2.41）为任何骨折和2.47（95%置信区间，1.15至5.28）为髋部骨折。在血清视黄醇水平最高的五分位数中，骨折的风险进一步增加。视黄醇水平在第99百分位数（>103.12微克/分升[3.60微摩尔/升]）的男性，其骨折的总体风险是视黄醇水平较低男性的7倍（P
BACKGROUNDAlthough studies in animals and epidemiologic studies have indicated that a high vitamin A intake is associated with increased bone fragility, no biologic marker of vitamin A status has thus far been used to assess the risk of fractures in humans.METHODSWe enrolled 2322 men, 49 to 51 years of age, in a population-based, longitudinal cohort study. Serum retinol and beta carotene were analyzed in samples obtained at enrollment. Fractures were documented in 266 men during 30 years of follow-up. Cox regression analysis was used to determine the risk of fracture according to the serum retinol level.RESULTSThe risk of fracture was highest among men with the highest levels of serum retinol. Multivariate analysis of the risk of fracture in the highest quintile for serum retinol (>75.62 microg per deciliter [2.64 micromol per liter]) as compared with the middle quintile (62.16 to 67.60 microg per deciliter [2.17 to 2.36 micromol per liter]) showed that the rate ratio was 1.64 (95 percent confidence interval, 1.12 to 2.41) for any fracture and 2.47 (95 percent confidence interval, 1.15 to 5.28) for hip fracture. The risk of fracture was further increased within the highest quintile for serum retinol. Men with retinol levels in the 99th percentile (>103.12 microg per deciliter [3.60 micromol per liter]) had an overall risk of fracture that exceeded the risk among men with lower levels by a factor of seven (P