PURPOSE Low bone mineral density (BMD) is associated with increased risk of fractures and mortality. We investigated if rate of BMD loss in the distal forearm over seven years predicted mortality. METHODS 1725 postmenopausal women and 1879 men aged 50-74 who participated in the longitudinal Tromsø Study waves 4 (1994-95) and 5 (2001-2002) were included. Cox regression models adjusted for lifestyle- and health related variables were used to assess associations between BMD change over seven years and subsequent mortality during up to 17 years of follow-up in participants with normal and low BMD at baseline. RESULTS Baseline BMD decreased and seven-year bone loss increased with increasing age. Overall, mortality rates were higher among those with low versus normal BMD (38 vs 19 per 1000 py in women, 56 vs 34 in men) and at higher bone loss rates (rate ratio high:low = 1.2 in women, 1.7 in men). BMD change was associated with increased mortality only in men with normal baseline BMD. In this group, men with a BMD loss of >4% had significantly higher mortality (HR 1.50, 95% CI 1.21, 1.87) than men with increased or unchanged BMD. BMD change was not significantly associated with increased mortality in women or in men with low BMD at baseline. CONCLUSIONS BMD loss in the distal forearm was associated with increased mortality in men with normal BMD at baseline, but not in women. We found no clear association between BMD loss and mortality in those with low BMD at baseline.

中文翻译：

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非负重前臂远端的骨矿物质密度损失可以预测死亡率吗？

目的 低骨密度 (BMD) 与骨折和死亡风险增加有关。我们调查了 7 年内前臂远端 BMD 损失率是否能预测死亡率。方法 1725 名年龄在 50-74 岁之间的绝经后妇女和 1879 名男性参与了纵向特罗姆瑟研究第 4 波（1994-95）和第 5 波（2001-2002）。针对生活方式和健康相关变量调整的 Cox 回归模型用于评估基线 BMD 正常和低的参与者在长达 17 年的随访期间，7 年的 BMD 变化与随后的死亡率之间的关联。结果随着年龄的增长，基线 BMD 下降，7 年骨质流失增加。总体而言，低 BMD 与正常 BMD 的死亡率更高（女性每 1000 py 38 vs 19，56 vs 34 男性）和更高的骨质流失率（比率高：低 = 女性 1.2，男性 1.7）。仅在基线 BMD 正常的男性中，BMD 变化与死亡率增加有关。在该组中，BMD 损失 >4% 的男性的死亡率（HR 1.50，95% CI 1.21，1.87）明显高于 BMD 增加或不变的男性。BMD 变化与女性或基线 BMD 低的男性死亡率增加没有显着相关性。结论 前臂远端 BMD 损失与基线 BMD 正常男性的死亡率增加有关，但与女性无关。我们发现基线 BMD 低的患者的 BMD 损失与死亡率之间没有明确的关联。4% 的死亡率显着高于 BMD 增加或不变的男性 (HR 1.50, 95% CI 1.21, 1.87)。BMD 变化与女性或基线 BMD 低的男性死亡率增加没有显着相关性。结论 前臂远端 BMD 损失与基线 BMD 正常男性的死亡率增加有关，但与女性无关。我们发现基线 BMD 低的患者的 BMD 损失与死亡率之间没有明确的关联。4% 的死亡率显着高于 BMD 增加或不变的男性 (HR 1.50, 95% CI 1.21, 1.87)。BMD 变化与女性或基线 BMD 低的男性死亡率增加没有显着相关性。结论 前臂远端 BMD 损失与基线 BMD 正常男性的死亡率增加有关，但与女性无关。我们发现基线 BMD 低的患者的 BMD 损失与死亡率之间没有明确的关联。