Summary

We ascertained the incidence of non-vertebral fracture in a low-income Brazilian elderly cohort. To the best of our knowledge, this is the first population-based study to demonstrate the frequency of non-vertebral fracture in elderly Latin Americans. Age, prior fracture, and bone mineral density (BMD) at hip were predictors of fracture.

Introduction

No data on incidence of osteoporotic non-vertebral fracture have been reported in low-income countries where the population’s aging has been faster. Even in developed countries, currently available prospective data on major fracture rates beyond hip are scarce. The aim of this study is to describe the incidence and risk factors for non-vertebral fracture in a longitudinal prospective Brazilian population-based elderly cohort.

Methods

Seven hundred seven older adults (449 women, 258 men) were evaluated at baseline and after a mean follow-up of 4.3 ± 0.8 years. Clinical questionnaire, bone mineral density (BMD), and laboratory tests were performed at baseline. New non-vertebral fracture (hip, proximal humerus, rib, forearm) was determined during the follow-up. Multivariate Poisson regression models were used to identify independent predictors of fracture.

Results

The age-standardized incidence of non-vertebral fracture was 1562.3/100,000 (1085.7–2248.1/100,000) person-years (pyr) in women and 632.8/100,000 (301.7–1327.3/100,000) in men. Concerning to hip fractures, the incidence was 421.2/100,000 (210.7–842.3/100,000) pyr in women and 89.9/100,000 (12.7–638.5/100,000) in men. In a multivariate analysis, age (RR 2.07, 95% CI 1.13–3.82, p = 0.019, each 10-year increase), prior non-vertebral fracture (RR 3.08, 95% CI 1.36–6.95, p = 0.007), and total hip BMD (RR 1.68, 95% CI 1.11–2.56, p = 0.015, each 1 SD decrease) were predictors of new non-vertebral fracture. In men, fitting a model of risk factors for fracture was prevented by the limited number of events in male sample.

Conclusion

This is the first population-based study to ascertain the incidence of major non-vertebral fractures in elderly Latin Americans, confirming the high frequency of the disorder. Age, prior fracture, and hip BMD were predictors of the short-term incidence of fracture.

中文翻译：

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低收入社区居住老年人的骨质疏松性非椎体骨折的发病率和危险因素：巴西一项基于人群的前瞻性队列研究。圣保罗衰老与健康（SPAH）研究

概要

我们确定了巴西低收入老年人群中非椎骨骨折的发生率。据我们所知，这是第一个以人群为基础的研究，该研究证明了拉丁美洲老年人中非椎骨骨折的发生率。年龄，髋关节先前的骨折以及髋部的骨矿物质密度（BMD）是骨折的预测指标。

介绍

在人口老龄化较快的低收入国家，没有关于骨质疏松性非椎骨骨折发生率的报道。即使在发达国家，目前尚缺乏有关髋关节以外的主要骨折发生率的前瞻性数据。这项研究的目的是描述在纵向前瞻性巴西人口为基础的老年队列中非椎骨骨折的发生率和危险因素。

方法

在基线和平均随访时间为4.3±0.8年后评估了777名老年人（449名女性，258名男性）。在基线进行临床问卷调查，骨矿物质密度（BMD）和实验室测试。在随访期间确定了新的非椎骨骨折（髋，肱骨近端，肋骨，前臂）。使用多元Poisson回归模型确定骨折的独立预测因子。

结果

女性的年龄标准化非椎骨骨折发生率为1562.3 / 100,000（1085.7–2248.1 / 100,000）人年（pyr），男性为632.8 / 100,000（301.7–1327.3 / 100,000）。关于髋部骨折，女性发烧率为421.2 / 100,000（210.7–842.3 / 100,000），男性为89.9 / 100,000（12.7–638.5 / 100,000）。在多变量分析中，年龄（RR 2.07，95％CI 1.13–3.82，p  = 0.019，每增加10年），先前的非椎骨骨折（RR 3.08，95％CI 1.36–6.95，p  = 0.007），以及总髋部骨密度（RR 1.68，95％CI 1.11–2.56，p  = 0.015，每降低1 SD）是新的非椎骨骨折的预测指标。在男性中，由于男性样本中事件的数量有限，无法拟合骨折危险因素模型。

结论

这是第一项基于人群的研究，用于确定拉丁美洲老年人中主要的非椎骨骨折的发生率，从而证实了该疾病的高发率。年龄，先前的骨折和髋部BMD是短期骨折发生率的预测指标。