体重指数和随后的骨折风险:更新FRAX®的元分析
Nicholas C Harvey1,2, Helena Johansson3, Eugene V McCloskey3,4
1MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom.
概括
体重不足的人面临更高的骨折风险,无论骨矿物质密度 (BMD). 超重和肥胖最初看起来是保护性的,但当考虑 BMD 时,它们成为风险因素,特别是在最高的体重指数 (BMI) 类别中.
科学领域:
- 整形外科 整形外科 整形外科
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 体重指数 (BMI) 是用于体重分类的广泛使用的指标.
- 体重指数和骨折风险之间的关系很复杂,可能会受到骨矿物质密度 (BMD) 的影响.
- 了解这些关联对于骨折预防策略至关重要.
研究的目的:
- 为了量化BMI对事故骨折的预测值.
- 检查年龄,性别,随访时间和骨质量如何改变BMI与骨折风险关系.
- 为了告知骨折风险评估工具的更新,如FRAX.
主要方法:
- 63个队列的国际元分析,包括1,667,922个个体.
- 利用扩展的Poisson模型来评估BMI类别 (体重不足,正常,超重,肥胖I,肥胖II) 和骨折风险.
- 根据年龄,性别,随访时间和股骨部 BMD T-score 的调整分析.
主要成果:
- 体重不足始终与两性中部骨折 (HF) 和其他骨质疏松性骨折的风险显著增加有关.
- 最初,超重和肥胖症与正常体重相比,显示HF风险降低.
- 在调整到部部骨质量后,超重/肥胖的保护作用减少,最高的BMI类别 (肥胖II) 与骨折风险增加有关,特别是在男性中.
结论:
- 体重不足是骨折的一个重要风险因素,独立于BMD.
- 超重和肥胖对骨折的明显保护作用在很大程度上是由骨损伤解释的,这些类别可以与增加的风险有关,特别是在更高的BMI水平.
- 这些发现突显了BMI在骨折风险评估中的细微作用,并对临床指导方针和风险预测模型产生影响.
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