对吸烟和骨折风险的元分析,以更新FRAX®工具
Marian Schini1, Helena Johansson2, Nicholas C Harvey3,4
1Mellanby Centre for Musculoskeletal Research, Division of Clinical Medicine, School of Medicine & Population Health, University of Sheffield, Sheffield, UK.
概括
目前的吸烟显著增加骨折风险,特别是在男性中,独立于骨密度. 戒烟可以降低这种风险,这表明它对骨健康有可逆的影响.
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:
- 吸烟是骨质疏松症和骨折的一个已知的危险因素.
- 以前的研究表明,吸烟与骨矿物质密度 (BMD) 降低之间存在联系.
- 吸烟对骨折风险的独立贡献,除了骨质量之外,需要进一步调查.
研究的目的:
- 对国际队列进行元分析,以检查当前和过去的吸烟与骨折风险之间的关系.
- 更新骨折风险评估工具 (FRAX) 以当前的吸烟数据.
- 为了确定吸烟对骨折风险的影响是否独立于BMD.
主要方法:
- 58项前性国际队列研究的元分析.
- 使用Poisson扩展模型来估计与吸烟相关的骨折风险.
- 根据年龄和随访后的时间进行调整的分析,使用额外的模型,包括腿部部的BMD.
主要成果:
- 目前的吸烟是增加骨折风险 (任何临床,骨质疏松症,主要骨质疏松症,关节骨折) 的重要预测因素.
- 当前吸烟与骨折风险之间的关联在男性中比女性更强.
- 过去的吸烟与与目前的吸烟相比,骨折风险显著降低,这表明潜在的可逆效应.
结论:
- 目前的吸烟被证实是骨折风险增加的重要预测因素,部分独立于BMD.
- 这些发现支持将吸烟状态纳入骨折风险预测模型,如FRAX.
- 数据表明,戒烟可能会降低骨折风险.
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