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Fatores de risco de fraturas de bacia na população de meia idade

13/04/2006

Fatores de risco de fraturas de bacia na população de meia idade: um estudo de 33.000 homens e mulheres

 

Pesquisadores afirmam que: "O fator de risco mais significativo para fratura de bacia tanto para homens como mulheres foi o diabetes." Muitos fatores de risco foram similares para homens e mulheres, porém com variação na razão de risco. O padrão de razão de risco para fraturas cervicais em comparação com fraturas trocantéricas diferiu tanto em homens quanto em mulheres. Estes achados indicam que aqueles que sofrem uma fratura de bacia antes dos 75 anos de idade têm uma menor expectativa de vida, sugerindo que fraturas de bacia afetam o segmento populacional menos saudável.

 

 

Osteoporosis International

Publisher: Springer London

ISSN: 0937-941X (Paper) 1433-2965 (Online)

DOI: 10.1007/s00198-005-2006-1

Issue:  Volume 16, Number 12

Date:  December 2005

Pages: 2185 - 2194

Case Report

Risk factors for hip fractures in a middle-aged population: a study of 33,000 men and women

Anna H. Holmberg , Olof Johnell1, Peter M. Nilsson2, Jan-Åke Nilsson2, 2, Göran Berglund2 and Kristina Åkesson1

(1) 

Department of Orthopaedics, Lund University, Malmö University Hospital, 20502 Malmö, Sweden

 

(2) 

Department of Medicine, Lund University, Malmö University Hospital, 20502  Malmö, Sweden

Received: 28 February 2005  Accepted: 4 August 2005  Published online: 22 September 2005

Abstract  Knowledge about subjects who sustain hip fractures in middle age is poor. This study prospectively investigated risk factors for hip fracture in middle age and compared risk factors for cervical and trochanteric hip fractures. The Malmö Preventive Project consists of 22,444 men, mean age 44 years, and 10,902 women, mean age 50 years at inclusion. Baseline assessment included multiple examinations and lifestyle information. Follow-up was up to 16 years with regard to occurrence of fracture. One hundred thirty-five women had one low-energy hip fracture each, 93 of which were cervical and 42 trochanteric. One hundred sixty-three men had 166 hip fractures, of which 81 were cervical and 85 trochanteric. In the final Cox regression model for women, the risk factors with the strongest associations with hip fracture were diabetes (risk ratio (RR) 3.89, 95% confidence interval (CI) 1.69–8.93, p =0.001) and poor self-rated health (RR 1.74, 95%CI 1.22–2.48, p =0.002). A history of previous fracture (RR 4.76, 95%CI 2.74–8.26, p =0.0001) was also a significant risk factor. In men, diabetes had the strongest association with hip fracture (RR 6.13, 95%CI 3.19–11.8, p =0.001). Smoking (RR 2.20, 95%CI 1.54–3.15, p =0.001), high serum -glutamyl transferase (RR 1.84, 95%CI 1.50–2.26, p =0.001), poor self-rated health (RR 1.49, 95%CI 1.06–2.10, p =0.02) and reported sleep disturbances (RR 1.52, 95%CI 1.03–2.27, p =0.04) were other significant risk factors. The strongest risk factor for hip fracture for both women and men in middle age was diabetes. Many risk factors were similar for men and women, although the risk ratio differed. The risk factor pattern for cervical versus trochanteric fractures differed in both men and women. The findings indicate that those suffering a hip fracture before the age of 75 have a shorter life expectancy, suggesting that hip fractures affect the less healthy segment of the population.

Keywords  Hip fracture - Men - Middle age - Risk factor – Women

Anna H. Holmberg
Email:
Anna.Holmberg@skane.se
Phone: +46-40-336123
Fax: +46-40-336200

 


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