WATER FLUORIDATION AND FRACTURES IN OLDER WOMEN

在过去的45年里，关于 围绕公共供水加氟的健康问题。 最近的生态学研究表明， 氟化症和髋部骨折重新引发了争论(Jacobsen等人， Danielson等人)。然而，这两项研究都是在 总体水平，并受到生态谬误的影响。为了 准确评估社区水氟化之间的关联 和骨质疏松性骨折，必须对个人进行研究 激素替代疗法等混杂因素和实际情况 氟化物暴露可以测量。这项研究的目的是 评价氟化作用与骨质疏松性骨折的关系 同时控制所有已知的混杂变量。这项研究 人口将由参加国家卫生研究院资助的妇女组成 骨质疏松性骨折(SOF)中心研究。在1986-88年间，略微 超过9700名妇女(大于或等于65岁)参加了登记 在四个地点的SOF研究中：俄勒冈州波特兰；宾夕法尼亚州莫诺加赫拉山谷； 马里兰州巴尔的摩和明尼阿波利斯大约有7500名女性服用了 在五年的时间里参加四次广泛的考试。特种部队 数据库包含关于所有已知混杂变量的信息，骨 多个地点的矿物质密度和断裂率。的数据库 Monogahela山谷还包含关于氟暴露的信息，途径是 从1950年到1990年，为每位参与者提供了水系统。在.期间 在这项研究过程中，来自水系统的氟化物暴露数据将 从参加波特兰特种部队的妇女中聚集起来， 巴尔的摩和明尼阿波利斯的研究地点。巴尔的摩和明尼阿波利斯 分别从1952年和1957年开始含氟，而波特兰和 莫农加赫拉河谷的大部分都没有加氟。首要目标 这项研究的目的是确定氟化物暴露状态是否 与骨折发生率、骨密度和/或 个体水平上的骨丢失率曾经是混淆变量 是被控制的。鉴于USPHS促进了水的氟化 在1.0ppm预防龋齿，饮用这种水的效果 关于骨质疏松症的变化需要澄清。

For the past 45 years, there has been a great deal of debate regarding the health issues surrounding the fluoridation of public water supplies. Recent ecological studies demonstrating a positive association between fluoridation and hip fracture have rekindled the debate (Jacobsen et al., Danielson et al.). Both of these studies, however, were conducted at the aggregate level and are subject to the ecologic fallacy. In order to accurately evaluate the association between community water fluoridation and osteoporotic fractures, research must be conducted on the individual level where confounders such as hormone replacement therapy and actual fluoride exposure can be measured. The purpose of this study is to evaluate the association between fluoridation and osteoporotic fractures while controlling for all known confounding variables. The study population will consist of women enrolled in the NIH supported multi- center Study of Osteoporotic Fractures (SOF). During 1986-88, slightly more than 9,700 women (greater than or equal to 65 years) were enrolled in the SOF study at four sites; Portland, OR; the Monogahela Valley, PA; Baltimore, MD; and Minneapolis, MN. Approximately 7,500 women have taken part in four extensive examinations over a five-year period. The SOF database contains information on all known confounding variables, bone mineral density at multiple sites, and fracture rates. The database for the Monogahela Valley also contains information on fluoride exposure via water systems for each of the participants from 1950-1990. During the course of this study, data on fluoride exposure from water systems will be gathered from the women participating in SOF at the Portland, Baltimore, and Minneapolis study sites. Baltimore and Minneapolis have been fluoridated since 1952 and 1957 respectively, while Portland and the majority of the Monongahela Valley are not fluoridated. The primary goal of the study will be to determine if fluoride exposure status is associated with fracture incidence rates, bone mineral density, and/or the rate of bone loss on the individual level once confounding variables are controlled for. Given that the USPHS promotes fluoridation of water at 1.0 ppm to prevent dental caries, the effect of consuming such water on osteoporotic changes needs to be clarified.