Summary

In this prospective study in Swedish elderly men, PAD based on an ABI < 0.9 was associated with an increased risk of hip fracture, independent of age and hip BMD. However, after further adjustments for comorbidity, medications, physical function, and socioeconomic factors, the association diminished and was no longer statistically significant.

Introduction

To examine if peripheral arterial disease (PAD) is associated with an increased risk for hip fracture in men independent of hip BMD.

Methods

Ankle-brachial index (ABI) was assessed in the Swedish MrOS (Osteoporotic Fractures in Men) study, a prospective observational study including 3014 men aged 69–81 years at baseline. PAD was defined as ABI < 0.90. Incident fractures were assessed in computerized X-ray archives. The risk for hip fractures was calculated using Cox proportional hazard models. At baseline, BMD was assessed using DXA (Lunar Prodigy and Hologic QDR 4500) and functional measurements and blood samples were collected. Standardized questionnaires were used to collect information about medical history, falls, and medication.

Results

During 10 years of follow-up, 186 men had an incident hip fracture. The hazard ratio (HR) for hip fracture in men with PAD was 1.70 (95% CI 1.14–2.54), adjusted for age and study site. Additional adjustment for total hip BMD marginally affected this association (HR 1.64; 95% CI 1.10–2.45). In a final multivariate model, the HR attenuated to a non-significant HR 1.38 (95% CI 0.91–2.11) adjusted for age, site, hip BMD, BMI, falls, smoking, eGFR, handgrip strength, walking speed, former hip fracture, antihypertensive treatment, diabetes, education, and history of cardiovascular disease.

Conclusion

This study suggests that PAD is associated with an increased risk for hip fracture independently of hip BMD in elderly Swedish men. However, the high frequency of comorbidity and lower physical performance among men with PAD might partly explain this association.

中文翻译：

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老年男性外周动脉疾病与髋部骨折风险之间的关联不能用髋部骨矿物质密度低来解释。MrOS瑞典研究的结果

概括

在这项针对瑞典老年男性的前瞻性研究中，基于 ABI < 0.9 的 PAD 与髋部骨折风险增加相关，与年龄和髋部 BMD 无关。然而，在对合并症、药物、身体机能和社会经济因素进行进一步调整后，这种关联减弱并且不再具有统计学意义。

介绍

检查外周动脉疾病 (PAD) 是否与男性髋部骨折风险增加相关，而与髋部 BMD 无关。

方法

在瑞典 MrOS（男性骨质疏松性骨折）研究中评估了踝臂指数（ABI），这是一项前瞻性观察研究，包括 3014 名基线年龄在 69-81 岁的男性。PAD 定义为 ABI < 0.90。在计算机化的 X 射线档案中评估事件骨折。使用 Cox 比例风险模型计算髋部骨折的风险。在基线时，使用 DXA（Lunar Prodigy and Hologic QDR 4500）评估 BMD，并收集功能测量和血液样本。标准化问卷用于收集有关病史、跌倒和药物治疗的信息。

结果

在 10 年的随访中，186 名男性发生髋部骨折。PAD 男性髋部骨折的风险比 (HR) 为 1.70 (95% CI 1.14–2.54)，根据年龄和研究地点进行了调整。对总髋骨 BMD 的额外调整对该关联有轻微影响（HR 1.64；95% CI 1.10–2.45）。在最终的多变量模型中，根据年龄、部位、髋部 BMD、BMI、跌倒、吸烟、eGFR、握力、步行速度、既往髋部骨折情况调整后，HR 衰减至不显着的 HR 1.38 (95% CI 0.91–2.11) 、抗高血压治疗、糖尿病、教育和心血管疾病史。

结论

这项研究表明，在瑞典老年男性中，PAD 与髋部骨折风险的增加无关，而与髋部 BMD 无关。然而，PAD 男性合并症的高频率和较低的身体机能可能部分解释了这种关联。