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首页> 外文期刊>Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research >Hyperkyphosis, kyphosis progression, and risk of non-spine fractures in older community dwelling women: The Study of Osteoporotic Fractures (SOF)
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Hyperkyphosis, kyphosis progression, and risk of non-spine fractures in older community dwelling women: The Study of Osteoporotic Fractures (SOF)

机译：老年社区女性的过度驼背，驼背发展和非脊柱骨折的风险：骨质疏松性骨折（SOF）的研究

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摘要

While accentuated kyphosis is associated with osteoporosis, it is unknown whether it increases risk of future fractures, independent of bone mineral density (BMD) and vertebral fractures. We examined the associations of baseline Cobb angle kyphosis and 15 year change in kyphosis with incident non-spine fractures using data from the Study of Osteoporotic Fractures. A total of 994 predominantly white women, aged 65 or older, were randomly sampled from 9704 original participants to have repeated Cobb angle measurements of kyphosis measured from lateral spine radiographs at baseline and an average of 15 years later. Non-spine fractures, con firmed by radiographic report, were assessed every 4 months for up to 21.3 years. Compared with women in the lower three quartiles of kyphosis, women with kyphosis greater than 53° (top quartile) had a 50% increased risk of non-spine fracture (95% CI, 1.10-2.06 after adjusting for BMD, prevalent vertebral fractures, prior history of fractures, and other fracture risk factors. Cobb angle kyphosis progressed an average of 7° (SD = 6.8) over 15 years. Per 1 SD increase in kyphosis change, there was a multivariable adjusted 28% increased risk of fracture (95% CI, 1.06-1.55) that was attenuated by further adjustment for baseline BMD (HR per SD increase in kyphosis change, 1.19; 95% CI 0.99-1.44). Greater kyphosis is associated with an elevated non-spine fracture risk independent of traditional fracture risk factors in older women. Furthermore, worsening kyphosis is also associated with increased fracture risk that is partially mediated by low baseline BMD that itself is a risk factor for kyphosis progression. These results suggest that randomized controlled fracture intervention trials should consider implementing kyphosis measures to the following: (1) further study kyphosis and kyphosis change as an additional fracture risk factor; and (2) test whether therapies may improve or delay its progression.
机译：尽管严重的后凸畸形与骨质疏松症相关，但尚不清楚它是否会增加未来骨折的风险，而与骨密度（BMD）和椎骨骨折无关。我们使用骨质疏松性骨折研究的数据检查了基线Cobb角后凸与后凸15年变化与非脊柱骨折的相关性。从9704名原始参与者中随机抽取了994名年龄在65岁或以上的白人女性，以基线水平和平均15年后的横向脊柱X线照片对后凸进行了Cobb角重复测量。通过放射线检查报告证实的非脊柱骨折，每4个月进行评估，长达21.3年。与后凸后四分之三的女性相比，后凸大于53°（前四分位）的女性发生非脊柱骨折的风险增加了50％（95％CI，校正BMD，普遍椎体骨折后的1.10-2.06，骨折的既往史和其他骨折危险因素。Cobb角后凸在15年内平均进展7°（SD = 6.8）。每1 SD后凸变化增加，经多变量调整后的骨折风险增加28％（95 CI的百分比（1.06-1.55），可通过进一步调整基线BMD来降低（后凸畸变的每SD HR增加，1.19; 95％CI 0.99-1.44），更大的后凸与非传统骨折的非脊柱骨折风险升高相关老年女性骨折的危险因素。此外，后凸畸形的恶化还与骨折风险的增加有关，这部分是由基线BMD低引起的，而BMD本身是后凸发展的危险因素。预防性试验应考虑对以下方面实施后凸畸形措施：（1）进一步研究后凸畸形和后凸畸变是另外的骨折危险因素; （2）测试疗法是否可以改善或延迟其进展。

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