RISK-FACTORS FOR HIP FRACTURE IN EUROPEAN WOMEN - THE MEDOS STUDY

被引:414
作者
JOHNELL, O
GULLBERG, B
KANIS, JA
ALLANDER, E
ELFFORS, L
DEQUEKER, J
DILSEN, G
GENNARI, C
VAZ, AL
LYRITIS, G
MAZZUOLI, G
MIRAVET, L
PASSERI, M
CANO, RP
RAPADO, A
RIBOT, C
机构
[1] UNIV SHEFFIELD,SCH MED,WHO,COLLABORATING CTR METAB BONE DIS,SHEFFIELD S10 2RX,S YORKSHIRE,ENGLAND
[2] MALMO GEN HOSP,DEPT ORTHOPAED,S-21401 MALMO,SWEDEN
[3] MALMO GEN HOSP,DEPT COMMUNITY HLTH SCI,S-21401 MALMO,SWEDEN
[4] HUDDINGE UNIV HOSP,DEPT SOCIAL MED,S-14186 HUDDINGE,SWEDEN
[5] HUDDINGE UNIV HOSP,DEPT GERIATR MED,S-14186 HUDDINGE,SWEDEN
[6] ACAD ZIEKENHUIS,AFDELING RHEUMATOL,PELLENBERG,BELGIUM
[7] UNIV ISTANBUL,CAPA TIP FAK,ISTANBUL,TURKEY
[8] UNIV SIENA,INST MED PATHOL,I-53100 SIENA,ITALY
[9] ACCID HOSP,TH GAROFALIDIS RES CTR,KIFISIA,GREECE
[10] POLICLIN UMBERTO 1,MED CLIN 2,I-00161 ROME,ITALY
[11] HOP LARIBOISIERE,CTR VIGGO PETERSEN,F-75475 PARIS,FRANCE
[12] IST CLIN MED GEN,PARMA,ITALY
[13] UNIV SEVILLE,DEPT MED,SEVILLE,SPAIN
[14] DEPT MED INTERNA,MADRID,SPAIN
[15] CHU TOULOUSE PURPAN,SERV ENDOCRINOL,TOULOUSE,FRANCE
关键词
D O I
10.1002/jbmr.5650101125
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aims of this study were to determine common international risk factors for hip fracture in women aged 50 years or more. We studied women aged 50 years or more who sustained a hip fracture in 14 centers from Portugal, Spain, France, Italy, Greece, and Turkey over a 1-year period. Women aged 50 years or more selected from the neighborhood or population registers served as controls. Cases and controls were interviewed using a structured questionnaire on work, physical activity, exposure to sunlight, reproductive history and gynecologic status, height, weight, mental score, and consumption of tobacco, alcohol, calcium, coffee, and tea. Significant risk factors identified by univariate analysis included low body mass index (BMI), short fertile period, low physical activity, lack of sunlight exposure, low milk consumption, no consumption of tea, and a poor mental score. No significant adverse effects of coffee or smoking were observed. Moderate intake of spirits was a protective factor in young adulthood, but otherwise no significant effect of alcohol intake was observed. For some risks, a threshold effect was observed. A low BMI and milk consumption were significant risks only in the lowest 50% and 10% of the population, respectively. A late menarche, poor mental score, low BMI and physical activity, low exposure to sunlight, and a low consumption of calcium and tea remained independent risk factors after multivariate analysis, accounting for 70% of hip fractures, Excluding mental score and age at menarche (not potentially reversible), the attributable risk was 56%. Thus, about half of the hip fractures could be explained on the basis of the potentially reversible risk factors sought. In contrast, the use of risk factors to ''predict'' hip fractures had moderate sensitivity and specificity. We conclude that variations in lifestyle factors are associated with significant differences in the risk of hip fracture, account for a large component of the total risk, and may be of some value in selecting individuals at high risk.
引用
收藏
页码:1802 / 1815
页数:14
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