在接受骨质疏松症评估的老年人中,第一次骨折的年龄和后来的骨折风险
Carrie Ye1, Suzanne N Morin2, Lisa M Lix3
1Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
JAMA network open
|December 2, 2024
概括
成年期的骨折,无论年龄如何,都会显著增加未来骨折的风险. 成年早期的骨折也与随后的骨折有关,这凸显了全面骨折风险评估的必要性.
科学领域:
- 整形外科 整形外科 整形外科
- 流行病学 流行病学
- 老年学是一门学科.
背景情况:
- 脆弱性骨折通常以年龄来定义 (例如,>40-50岁).
- 成年早期的骨折与随后的骨折风险之间的关联仍然不清楚.
- 评估骨折风险往往依赖于与年龄相关的定义,可能会忽视较早的骨折事件.
研究的目的:
- 调查先前骨折的年龄与未来骨折的风险之间的关联.
- 为了确定是否在成年早期发生的骨折预测未来的骨折风险类似于晚年成年期的骨折风险.
- 通过评估骨折时间的影响,为骨折风险评估策略提供信息.
主要方法:
- 一项基于人口的观察性队列研究,使用曼尼托巴骨矿物密度注册表.
- 包括1996年至2018年第一次测量骨矿物质密度 (BMD) 的人.
- 根据第一次骨折时的年龄分层分层,先前患有成人骨折的个体 (从20-29岁到≥80岁的10年间隔).
- 使用到2021年3月的相关行政健康数据识别发生骨折的情况.
主要成果:
- 该队列包括88,696人,其中23.8%的人在57.7岁的平均年龄之前有骨折.
- 在平均9.0年的随访期间,14.6%的人经历了事件骨折,包括骨质疏松和主要骨质疏松骨折.
- 所有事件骨折,骨质疏松性骨折和主要骨质疏松性骨折的性别和年龄调整后的危险比率在第一次骨折时在所有年龄类别中显著增加.
- 完全调整后的模型显示,未来骨折的风险估计持续上升 (HRs 1.51-2.12),无论最初骨折时的年龄如何.
结论:
- 成年后的骨折与随后的骨折的风险增加有关,无论最初的骨折发生的年龄如何.
- 在评估个人长期骨折风险时,不应忽视成年早期的骨折.
- 目前的骨折风险评估模型可能需要改进,以纳入发生在年轻成人年龄的骨折的影响.
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