Fractures between the ages of 20 and 50 years increase women's risk of subsequent fractures
Fractures between the ages of 20 and 50 years increase women's risk of subsequent fractures
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DOI：
10.1001/archinte.162.1.33
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发表时间：
2002-01-14
影响因子：
--
通讯作者：
Reid, IR
中科院分区：
文献类型：
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作者：
Wu, F;Mason, B;Reid, IR
背景：围绝经期和绝经后骨折是公认的、强有力的、独立的后续骨折预测因子。然而，绝经前骨折是否是绝经后骨折的预测因素尚不清楚。目的：确定自我报告的50岁以前的骨折是否与50岁以后的骨折相关。对1284名妇女的横断面研究（平均值+/-SD年龄，73+/-4岁），绝经10年或以上，从新西兰奥克兰的选民名册中招募。使用标准化的问卷调查获得了关于她们骨折、医疗、月经、酒精和吸烟史的详细信息。结果：9%的女性在20岁之前报告骨折; 7%的女性在20岁至50岁之间; 29%的女性在50岁之后报告骨折。年龄在20岁至50岁之间的骨折与50岁后骨折风险增加74%相关（比值比，1.74; 95%置信区间，1.12-2.70），而20岁之前发生的骨折与此无关（比值比，1.01;置信区间，0.66-1.56）。多变量分析显示，在调整骨密度、年龄、母亲髋部骨折史、绝经年龄、体重、激素替代治疗史、吸烟和饮酒史后，20 - 50岁的骨折史仍然是50岁后骨折风险的重要独立预测因素结论：20 - 50岁之间的任何骨折（与机动车事故无关）与50岁以后骨折的风险增加有关。因此，这是一个重要的临床风险因素，指出需要骨密度测量，考虑改变生活方式，并在这些妇女的抗骨质疏松症治疗。
Background: Perimenopausal and postmenopausal fractures are well-recognized, strong, independent predictors of subsequent fractures. However, it is unknown whether premenopausal fractures are predictive of postmenopausal fractures.Objective: To determine whether self-reported fractures sustained before the age of 50 years are associated with fractures after this age.Subjects and Methods: Cross-sectional study of 1284 women (mean+/-SD age, 73+/-4 years) who were 10 or more years' postmenopausal and who were recruited from electoral rolls in Auckland, New Zealand. Detailed information on their fracture, medical, menstrual, alcohol, and smoking histories was obtained using a standardized questionnaire.Results: Nine percent of the women reported fractures before the age of 20 years; 7%, between the ages of 20 and 50 years; and 29%, after the age of 50 years. Fractures sustained between the ages of 20 and 50 years were associated with a 74% increase in the risk of fractures after the age of 50 years (odds ratio, 1.74; 95% confidence interval, 1.12-2.70), while fractures occurring before the age of 20 years were not (odds ratio, 1.01; confidence interval, 0.66-1.56). Multivariate analysis showed that after bone density, age, maternal history of hip fractures, age at menopause, weight, history of hormone replacement therapy, and smoking and alcohol histories were adjusted for, a history of fractures between the ages of 20 and 50 years remained a significant independent predictor of risk of fractures after the age of 50 years (risk ratio, 1.83; confidence interval, 1.12-2.76).Conclusions: Any fracture (unrelated to Motor vehicle accidents) sustained between the ages of 20 and 50 years is associated with increased risk of fractures after the age of 50 years. Therefore, this is an important clinical risk factor that points to the need for bone density measurement, consideration of lifestyle modification, and antiosteoporosis therapies in these women.