A random sample cohort study for developing a risk assessment method for vertebral and clinical fractures

点击翻译按钮获取中文摘要

We performed in 2002 a follow-up study six years after the baseline and an addition survey for clinical fractures in 2003.The results obtained were as follows :(1)The number of eligible subjects for the follow-up study was 1588 and 1173(73.9%) completed the study.(2)Factors suggested to reduce bone loss were as follows : maintaining or gaining weight, exercise more than once a week, intake of a grass of milk per day or more, dietary calcium intake more than 750mg per day, and intake of fermented soybean, "natto", 3 times a week or more.(3)We determined incident clinical fractures during the follow-up period through the interviews at follow-up and an additional mailing survey for the subjects who did not visit the study. The total number of fracture was 121 including 56 fractures having occurred with low-energy impact, 26 forearm fractures and 3 hip fractures.(4)The risk of osteoporotic fractures significantly increased with the decrease in bone mineral density at the spine and total hi … More p but not at the distal radius. However, the risk of forearm fractures in the lowest bone density category at the distal radius was 8 times higher than that in the highest category and the corresponding risks were 4 at the spine and 10 at the total hip.(5)We determined genotypes of polymorphisms at the 3-end,5-end and promoter region of the VDR gene. The allele frequency of each polymorphism was similar to the previously reported for Japanese. However, either of the polymorphism did not show a significant effect on bone density and incidence of clinical fractures. However, some significant interactions of the genotypes and lifestyle factors on bone density were observed, that is, Fok I polymorphism and milk intake or participation in a sport club in middle school age for premenopaus al women, and Apa I polymorphism and milk intake at baseline in postmenopausal women.The risk of osteoporotic fractures was represented by bone density but not by the polymorphisms evaluated in the present study. Effects of other genetic factors should be examined in further studies to implement a tailor-made prevention against osteoporosis and osteoporotic fractures. Less